RHR: How Protein Supports Your Muscle Health, with Dr. Gabrielle Lyon

In this episode, we discuss:

• What The Game Changers says about protein
• How much protein we need to thrive
• The protein leverage hypothesis
• Why we need to stop over-consuming and wasting food
• The problem with the vegan narrative
• Why protein quality matters for muscles
• The importance of protein and muscle health as we age

Show notes:

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Hey, everybody. Chris Kresser here. Welcome to another episode of Revolution Health Radio. This week, I’m really excited to welcome Dr. Gabrielle Lyon as a guest. Dr. Lyon’s a Functional Medicine physician specializing in muscle-centric medicine. The concept of this medicine focuses on the largest organ in the body, skeletal muscle, as the key to longevity. She leverages evidence-based medicine with emerging cutting-edge science to restore metabolism, balanced hormones, [and] optimized body composition, all with the goal of a lifetime of vitality.

Her practice focuses on multifaceted human optimization and weight loss. Dr. Lyon’s current patient population includes elite military operators. She works closely with current retired combat operators such as the Navy SEALs, Green Berets, Army Rangers and Canadian Assaulters. Dr. Lyon is part of the Task Force Dagger Foundation, [which has] been serving this community for 10 years. In addition, her practice serves professional athletes, executives, and anyone looking to level up their health or who struggle with a lifetime of weight challenges.

I’m particularly interested in talking to Dr. Lyon about protein and protein quality. She is an expert in this area. And this is something I discussed in my recent podcast, where I critically analyzed some of the claims surrounding protein made in The Game Changers film. And so, I want to go into more depth on that with Dr. Lyon as a protein expert and, particularly, as an expert in muscle-centric medicine. One of the roles of protein, of course, is to improve muscle protein synthesis, and just generally support our muscle tissue overall. So I’m looking forward to this conversation and I hope you enjoy it. Let’s dive in.

Chris Kresser:  Dr. Lyon, thank you so much for being here. I’ve really been looking forward to this.

Gabrielle Lyon:  Yeah, it’s great. Thank you for having me. I’m glad we could make this work.

What The Game Changers Says about Protein

Chris Kresser:  So, let’s just dive right in. Yesterday, I went to LA to record a podcast with Joe Rogan critically analyzing the claims made in the film The Game Changers, which you and I have talked about extensively and I know you’ve had the displeasure of seeing yourself. So, I know you have some interesting thoughts on the anti-animal food narrative and what’s really at the core of that. So maybe we could start by talking about that.

Gabrielle Lyon:  You know, first off, I’m so glad you called it a film and not a documentary.

Chris Kresser:  Definitely not a documentary.

Gabrielle Lyon:  Because a documentary typically shows two sides of a story.

Chris Kresser:  Yeah.

Gabrielle Lyon:  And this is a propaganda film, and at the core of it is really this anti-animal narrative. And what I mean by that is that a lot of us are perfectly content eating animal products, and we don’t have a moral issue with that. So, if an individual has this anti-animal narrative and they’re speaking to a person who doesn’t really mind eating animal products, you have to go after other things. And those other aspects are number one, your health. So, if you now eat an animal product, it’s going to affect your health. Number one, and number two, it’s going to affect the environment. And that’s really at the core of the foundation of this film.

Chris Kresser:  Well, that’s often what happens, too, when you get into, and I’ve had debates or discussions with vegans in the past. As soon as I pin them down on a particular nutritional issue, then it pivots to environmental, and as soon as I then push back on the statistics, which are often wildly inaccurate about water use of beef or greenhouse gas emissions or something [like] that, then it switches to the ethical issue.

And it’s kind of like this whack-a-mole game. That was actually a condition of my debate with Joel Kahn before I agreed to go on with Rogan, that it focus only on the nutritional aspects. Not because I wasn’t willing to talk about the environmental and ethical arguments, which I did on this last show, but because I know through experience that it can get very slippery [just] like that.

Gabrielle Lyon:  It does, and it’s so interesting, because you can say “here’s the data.” Animal protein and plant protein are very different. When you are speaking to someone who is a zealot or is deeply invested in their agenda, rather than the health and welfare of humanity, they’ll say “no, it’s not.”

Chris Kresser:  Right.

Gabrielle Lyon:  I could say “the sky is blue, animal protein supports animal tissue, and plant protein supports plant tissue. And those amino acid profiles are different.” And in response to that, I’ll hear “no, it’s not.”

Chris Kresser:  Right. Do you know Stephen Zwick?

Gabrielle Lyon:  I don’t, I don’t.

Chris Kresser:  Mark Hyman introduced you and I, and he also introduced me to Stephen, who was helpful in my preparation for the Rogan debate. And he sent me this phenomenal quote that speaks directly to what you were just saying from the author, Leon Festinger, who wrote When Prophecy Fails. The quote is:

“A man with conviction is a hard man to change. Tell him you disagree, and he turns away. Show him facts and figures, and he questions your sources. Appeal to logic, and he fails to see your point.”

Gabrielle Lyon:  Wow, that really, you really said it.

Chris Kresser:  That sums it all up, right?

Gabrielle Lyon:  It does, and it’s so dangerous. The information, when it is drastically incorrect, becomes devastating for individual’s health.

Chris Kresser:  Absolutely. And you and I have both seen that firsthand as clinicians. It also, I mean, there’s another quote that I’m always reminded of in these situations, which is from Anatole France, another author, a French poet, which is:

“If 50 million people say a foolish thing, it’s still a foolish thing.”

And I feel like that’s what we’re dealing with, with the vegan narrative because it leverages this illusory truth effect, which is the idea that if you repeat something often enough that’s false, it starts to seem true.

And politicians, of course, are masters of this, and Trump being probably the most skilled at this illusory truth effect of anybody. But it’s true in the vegan community, too. So, you hear these claims about, like, we could reduce greenhouse gas emissions by 50 percent if everybody stopped eating meat. Or a single, eating four pounds of hamburger is more destructive than doing a transatlantic flight. Like, all these kind of soundbite types of things that are completely factually objectively false and no scientists who are credible in the field would agree with them.

But yet I walk into my office at WeWork and I see this Meatless Monday thing every Monday that I’m there, and it has all these statistics printed right on the flyer in the elevator. And it’s just amazing to me that this goes on.

Gabrielle Lyon:  Yes, and it’s so dangerous for, in particular, our aging population. And that’s where it becomes very personal for me. So, I did a geriatric fellowship at WashU [Washington University] in St. Louis. And it really, it weighs on you being at the bedside of countless dying individuals over a span of two years.

Chris Kresser:  Yes.

Gabrielle Lyon:  And you see sarcopenia, which is this destruction of muscle mass. It’s, you know, you decrease muscle mass and strength and size, and all the comorbidities that ride along with it. Now, we know with sarcopenia, there are really two great ways to help protect an individual. And that is number one, resistance training. And number two, is high-quality protein, dietary protein. We have this anti-animal narrative that’s weaving its way through the community and the world. And if this begins to get in the heads of our, say, 50-year-olds, I have seen the trajectory of aging.

Chris Kresser:  Yes.

Gabrielle Lyon:  And it’s terrifying and preventable. No one argues in your 20s and 30s. Really from your 20s to 40s, fine. You guys want to argue about protein? Okay. But you’re definitely going to pay for that later on in life, and it’s our duty to protect people and be honorable and credible. It’s dangerous.

Chris Kresser:  I’m so glad you brought this up, because I feel like a lot of people don’t really know about the risk of frailty and sarcopenia in the elderly, if they’re not in the medical community. I mean, most people who are working with patients do understand it, but I think the general population doesn’t really realize the threat that sarcopenia poses and how common it is. I think the stats I’ve seen, of course, this is your field, but more than 40 percent of men and 55 percent of women over the age of 50 have sarcopenia. That’s half; that’s more than half of women and almost half of men. We’re not talking about a small issue here.

Gabrielle Lyon:  And what’s so interesting is obesity is playing a role in this. So there, while we think of it as a disease of aging, which it is, we believe that sarcopenia and sarcopenic obesity, which is essentially over-fat, and under-muscled, is starting in your 30s. We are very domesticated as humans; we’re not moving the way that we did. We’re by and large not eating enough protein, and the tissue destruction is starting just like every other disease that we’re seeing much earlier.

Chris Kresser:  Right. People are often surprised when they ask me what I consider to be one of the most important things to do to maintain your health as you’re aging. And I say preserve muscle mass. And they look at me like, what? They thought it would be a totally different answer. But we know that that’s critical to reducing morbidity and mortality in the elderly. And low protein intake is associated with frailty and worse physical function. And you know, of course, then we’re also with aging battling other conditions like increased incidence of H. pylori (Helicobacter pylori), and SIBO and things that decrease protein absorption. So, it makes it even more important to have super high-quality bioavailable protein, which is animal protein.

Gabrielle Lyon:  It is.

How does protein quality affect your muscle health, and can you support healthy muscles on a vegan diet? Check out this episode of RHR to find out. #paleo #nutrition #chriskresser

How Much Protein We Need to Thrive

Chris Kresser:  Not plant protein. So, let’s talk a little bit more about the critical. Well, before we move on from this, actually, I want to chat with you a little bit about what we mean by, let’s just focus first on the quantity of protein, and then we can go into quality. Because those are two distinct but related issues, and they’re both very important. So, I talked about this with Rogan.

The RDA [Recommended Dietary Allowance] that’s been established for the average healthy sedentary adult is 0.8 grams per kilogram per day. But we know now from more accurate, newer methods that are better than nitrogen balance studies that were used to determine the RDA that it’s actually, if you use the indicator amino acid oxidation technique, you come up with 1.2 grams per kilogram of protein per day. But that’s for an adult, younger, middle-aged person. For the elderly, the range that I’ve seen is 1.2 to 1.5 grams per kilogram per day as an RDA.

Gabrielle Lyon:  That’s right.

Chris Kresser:  So, again, we’re talking about …

Gabrielle Lyon:  The minimum.

Chris Kresser:  The amount that is required to avoid malnutrition.

Gabrielle Lyon:  Right.

Chris Kresser:  That’s the definition of the RDA. Not the best amount, not the optimal amount.

Gabrielle Lyon:  Right.

Chris Kresser:  The amount to avoid malnutrition, and that’s for healthy people. That’s presuming there is no H. pylori, [and] there is no SIBO. There’s no other [condition].

Gabrielle Lyon:  Low-grade inflammation.

Chris Kresser:  Yeah, exactly, that interfere with protein absorption. Right?

Gabrielle Lyon:  Right. And there’s a great paper, the PROT-AGE study. I don’t know if you’ve seen it or if your listeners have seen it, but it really does a very nice job of laying out quantities and strategies for aging and protein intake. So, it’s called the PROT-AGE study.

Chris Kresser:  Cool. Yeah, that’s, I mean, there’s, the thing that is just so notable about this is [that] we’re not talking about controversial stuff here. Like, there are a lot of things in medicine that are controversial.

Gabrielle Lyon:  Protein quality is not one of those things.

Chris Kresser:  No. Protein quantity and quality are not controversial. It’s pretty firmly established in the scientific literature. And you can go in and look at any number of studies and find these numbers. And we’re also not talking about fringe, novel stuff. We’re talking about stuff that’s been studied for decades.

Gabrielle Lyon:  Right. And that’s I think what is so outrageous to me, is seeing a movie like The Game Changers and seeing this plant-based push, because it’s ignoring all the randomized control trials as it relates to protein. It’s ignoring all the good evidence that we actually have.

Chris Kresser:  Yeah.

Gabrielle Lyon:  To protect and maintain health.

Chris Kresser:  And the irony of this, too, is that a lot of this research has been done in the developing world where protein deficiency is a life-threatening problem. And so, they’ve studied extensively what are the highest-quality proteins that we can give this population that will give them a chance to survive and even thrive if they get enough. And then, here we have the developed world, which is characterized by great privilege and people voluntarily ignoring this high-quality protein that [is] life-sustaining, and even lifesaving in the developing world.

Gabrielle Lyon:  Absolutely. And that’s a really great point. And especially, as we begin to care for people and take care of them, as we age, it’s our responsibility to help our elders and really just anyone who is going through any kind of health issue. This is the way to do it; this is a very foundational way to do it. And you can even go up in that number. You could go from 1.6 grams up to 2.2 grams per kilogram.

Chris Kresser:  Absolutely. And then, now you’re starting to talk about more optimal for more people, right? And, especially, if anyone’s doing any kind of physical activity.

Gabrielle Lyon:  Absolutely. And with the RDA, like, the aging population, and really the general population, the RDA, let’s just say when we talk about quality of protein, leucine. So, the RDA for leucine, which is one of the branched chain amino acids, which goes to your point of high-quality protein that’s really key, is 2 to 3 grams per day, the minimum amount to protect against disease.

Chris Kresser:  Yeah.

Gabrielle Lyon:  But we know from the data that, actually, it’s more like 8 to 9 grams per day distributed throughout the day at 2.5 grams per meal of leucine for more optimal functioning, and especially as the muscle tissue ages. So, you require higher amounts of high-quality protein distributed throughout the day to generate this anabolic response and protect your tissue.

Chris Kresser:  Right. So, we’re talking about muscle protein synthesis, this process of building muscle, but also especially important as we age, repairing tissue after it breaks down and regrowing tissue. So, I made this chart for my Rogan appearance. We showed this slide on the video and we can include it in our show notes as well, [which] compared the amino acid profile of beef sirloin with white beans, soybeans, cooked peas, and rice. Some of the common plant protein. And beef is higher in every single essential amino acid than every plant protein with the exception of soybeans, which are slightly higher in tryptophan.

But the difference in leucine is just enormous. So, leucine you’ve got, it’s 2.23 for beef. And then for beans, it’s something like 0.6. Soybeans are higher than most other plant proteins than leucine, but that’s still 1.35. [It’s] 0.3 for cooked peas, and 0.22 for rice. So [it’s] not even in the same ballpark when it comes to leucine and the amino acids that are necessary for muscle protein synthesis.

Gabrielle Lyon:  And listen, you could be vegan and vegetarian, vegan or vegetarian, and be perfectly healthy. But your caloric load of what I’m listening to you speak about would be outrageous. So, if you wanted to calculate, I mean, what is that, 500 calories from soy versus a three-ounce steak?

Chris Kresser:  Right.

Gabrielle Lyon:  180 calories?

Chris Kresser:  Yeah, there was, I mean, it’s crazy. There was a study in PNAS in 2017 that you may have seen, which really got to the heart of this issue. It was specifically addressing the claim that if everyone went plant based, we could save the world.

Gabrielle Lyon:  It’s totally ridiculous.

Chris Kresser:  Yeah, it’s definitely ridiculous, and this study actually fleshed that out in a really smart way. So, they found that if every, if we just gave up all animal agriculture and everyone in the [United States] went vegan, it would only reduce greenhouse gas emissions by 2.6 percent. Yet our intake of carbohydrates and total calories would skyrocket.

Gabrielle Lyon:  Yes.

Chris Kresser:  And the incidence of nutrient deficiencies would also skyrocket. In fact, the domestic supply of food without animal products would not even meet the basic RDA for calcium, EPA [eicosapentaenoic acid], DHA [docosahexaenoic acid], retinol, and [vitamin] B12. And if they took bioavailability into account, as they said, probably zinc, vitamin K2, vitamin A, and other nutrients might also be deficient. But to your point, here’s what they said. [The] current standard American diet with animal products already provides a surplus of calories of 145 percent, which is, of course, one reason why [the] population is so overweight. And then …

Gabrielle Lyon:  Not to mention that we’re eating 300 grams of carbohydrates a day.

Chris Kresser:  Cheez Doodles and Big Gulps. Yeah. But here’s the key. If we removed animal products entirely from our diet, this surplus would increase to 230 percent because a plants-only diet requires between 444 and 522 grams more solid food; that’s about a pound more of food a day, than diets with animal products just to meet your basic nutrient requirements.

Gabrielle Lyon:  Not even to mention the subsequent health costs of diabetes, hypertension, [and] hyperlipidemia, which would probably go along with this excess carbohydrate consumption.

The Protein Leverage Hypothesis

Chris Kresser:  Absolutely. So, this is consistent with something called the protein leverage hypothesis.

Gabrielle Lyon:  Yes.

Chris Kresser:  Which we can talk about for a short period of time. So, tell us about that and how a diet that is inadequate in either quantity or quality of protein could actually lead to overconsumption of overeating, overconsumption of calories.

Gabrielle Lyon:  The protein leverage hypothesis is this concept, and I, the guy’s name is Simpson who developed it. And it’s this concept that a human will continue to eat to meet the protein requirements. And whether it’s carbohydrates, if you’re restricting protein, they’ll continue to consume carbohydrates to meet that amino acid need, which is one of the drivers of obesity. If you then add in the correct amount of protein, you no longer have this drive to feed.

Chris Kresser:  Right. And we’ve heard this so many times, right? I mean, I experienced that myself when I was vegan. I just felt like I was never satisfied. And I could never, and I couldn’t figure out why. And I’ve heard that from patients, as well. And now, we have some scientific evidence about that [which] kind of points to why this could take place.

Gabrielle Lyon:  And it’s very valuable when you implement that in clinical practice and in your daily life. It’s very easy to do.

Chris Kresser:  Yes.

Gabrielle Lyon:  By increasing your high-quality protein, you naturally decrease your carbohydrate intake.

Chris Kresser:  So, it’s, yeah, it’s obviously problematic in a culture [and] society now where 70 percent of the population is overweight, 40 percent obese. One in three have either pre-diabetes or diabetes. If you have the vegan community arguing that the end goal is to completely remove animals from agriculture, and that would result in a dramatic increase in calories and carbohydrates and a dramatic decrease in our intake of micronutrients where you have ridiculously high numbers of people that are deficient in basic nutrients already. How can that be the direction that we want to go?

Gabrielle Lyon:  Again, it goes back to this anti-animal narrative. It has nothing to do with human health. This concept that we’re not designed to eat meat or that we shouldn’t be doing that is at the core of this. I mean, we’ve been eating meat for 2.5 million years.

Chris Kresser:  Yeah, as humans, and even before that, our hominid ancestors were eating meat. We know that chimps. I mean, that’s been one of the biggest revelations in primate study in the past few decades, is that we’ve now observed chimps hunting, killing, and eating other vertebrates like monkeys. And they’ve evolved complex, cooperative hunting behaviors and also use tools in order to do that. And what does that tell us?

If an animal has evolved a complex set of behaviors to do something, it’s because that thing is [of] very high value to their survival. So probably even longer than 2.5 million years. Although we weren’t human then. Our hominid ancestors have been eating meat. So, I won’t go into a lot of detail on that now because I talked about the failures of the comparative anatomical and anthropological arguments in the film. I found that section to be the most ridiculous of the film. I mean, I was literally laughing out loud as they were rewriting history on film.

Why We Need to Stop Overconsuming and Wasting Food

Gabrielle Lyon:  Yeah. I just can’t believe anyone thought this was well done. But back to what you were saying about agriculture, if we really wanted to affect greenhouse gas. So, let’s just take a step back and look at the [United States]. So, the U.S. agriculture accounts for what, 9 percent?

Chris Kresser:  Yes.

Gabrielle Lyon:  Of its contribution to greenhouse gas. And then of that 9 percent, the majority of it is plants, about 4.8 percent, and then the rest is cattle and dairy.

Chris Kresser:  Yeah.

Gabrielle Lyon:  But of that 9 percent, we waste 40 percent of our food, and the majority of that food is fruits and vegetables. We just throw it out.

Chris Kresser:  Yeah. Yeah.

Gabrielle Lyon:  And we overeat by another 10 percent.

Chris Kresser:  Yeah.

Gabrielle Lyon:  So, it just seems if we really wanted to make an impact when it comes to agriculture, we could do very simple things that wouldn’t deter our health or, like, make us feeble and weak. All we have to do is stop wasting food and stop overconsuming.

Chris Kresser:  Yes. And since we’re on that subject, let’s talk a little bit about these numbers. Because they’re, again, also extremely misleading. They’re repeated so often that everybody just assumes that they must be true. The number in the film, as I’m sure you recall, Gabrielle, is they said the livestock sector, I have a direct quote here:

“The livestock sector is responsible for 15 percent of global man-made emissions. To put that in perspective, that’s about the same as all the emissions from all the forms of transport in the world. All the planes, trains, cars, fans and ships all added up.”

Wow. Well, if you hear that, I could see why, [if] you take it as true, which a lot of people who aren’t educated in this stuff will, I could see why you might want to become a vegan. That’s a major thing. But here’s the problem with that, as I know, you know. They’re comparing the full lifecycle of livestock, which includes all the carbon needed for feed, for transport, for processing the cattle, distributing everything, whereas they were only looking at …

Gabrielle Lyon:  And also, and not just the meat, right? So, it’s also the leather.

Chris Kresser:  Yeah, all of the by-products of livestock.

Gabrielle Lyon:  Exactly. So, it’s not just meat.

Chris Kresser:  It’s a lot. And then, they’re only looking at what we call colloquially, “tailpipe emissions” or “direct emissions” from transportation. They’re not looking at the full lifecycle of transportation, which is so mind-boggling that no one’s even done that analysis because it’s just almost impossible to do. It’s all the carbon needed to manufacture the vehicles, the inputs required for making the fuel, including the feedstock, the distribution, the fuel production, the distribution, and the final use of the fuel.

I mean, it’s crazy. So, but when you just look at direct emissions, globally, livestock accounts for 5 percent. And in the [United States], as you noted, it’s about 3.9 percent of the greenhouse gas emissions. Not 15 percent for transportation. So, it’s hard for me, I don’t know with these filmmakers, like, do they really not do the research and not really look into those claims? Are they just parroting what they’ve heard even when they’re making a film that’s going out to you, however many people that watch it? Or did they know it and just say this anyway? I’m not sure which is worse.

Gabrielle Lyon:  And you know, it’s so dangerous because it divides us as healthcare practitioners. I posted on The Game Changers just because I was so sick of getting all these questions.

Chris Kresser:  Right.

Gabrielle Lyon:  And I got so much unprofessional heat from plant-based physicians that it was, we’re all trying to do the best for our patients and it becomes very convoluted when they’re hearing information and perhaps not doing their own research.

Chris Kresser:  Yes.

The Problem with the Vegan Narrative

Gabrielle Lyon:  It’s deeply emotional for people, and then it trickles down to, say, the people who are not studying this as a profession and it just becomes like the mouse with the microphone. Completely overblown and fairy-tale-ish.

Chris Kresser:  Yeah, it’s freaky. The American College of Lifestyle Medicine is offering, I don’t know if you heard this, they’re offering CEUs to any medical professional who watches The Game Changers and completes some quiz on it. This is ridiculous. This is not science. This is not a documentary. The science in this film has not been peer reviewed. It’s a narrative, agenda-driven film. And yet an actual organization, the American College of Lifestyle Medicine, is offering CEUs for it. Well, the American College of Lifestyle Medicine was founded by Seventh-Day Adventists [SDA].

Gabrielle Lyon:  There you go.

Chris Kresser:  At Loma Linda University. And one of the SDA founders, Ellen White, taught that meat was a toxic substance and that flesh should be avoided because it increases carnal urges.

Gabrielle Lyon:  I mean, there is a lot of arginine in high-quality protein, which does cause vasodilation and nitric oxide production.

Chris Kresser:  Absolutely, she might have been onto something there.

Gabrielle Lyon:  She definitely, she definitely was onto something.

Chris Kresser:  The point being, her objections, at least initially, were not nutritional. They were moral and religious. And then, the SDA went on to influence dietary guidelines in the [United States] for over 100 years. And early Adventist, Lenna Cooper, co-founded the American Dietetic Association, which is still one of the most prominent dietetic organizations in the world. And she wrote textbooks that were used in dietetics and nursing for not only in the U.S., but around the world for more than 30 years. So, there’s this bizarre tie of this plant-based diet to Seventh-Day Adventists and religious organizations that is rarely acknowledged in any of these discussions.

Gabrielle Lyon:  I think that that’s a really important point. And I’m hoping that the people listening will really take a step back, and hopefully, we become united and less divided with this information. I mean, food policy is outrageous. The information that we’re getting, which is actually being controlled by what we hear, is incorrect and very agenda-driven and false.

Chris Kresser:  That’s what scares me about this. Because the vegan narrative is winning. I mean, I think objectively, we could say that. That there’s, it’s growing. If you look at the statistics of the percentage of people who are vegan, if you look, even just anecdotally, people you know, around you, and you look at, like, the proliferation of these kinds of films and the recommendations of dietary organizations. Like, even I think the American Dietetic Association and some others have come out, saying that the vegan diet is safe for children. And that’s just absolutely absurd.

Gabrielle Lyon:  Right. We know that that is not safe for any child.

Chris Kresser:  Absolutely absurd. There have been deaths. I think it’s theoretically possible that it could be done without harm, but it requires an enormous level of knowledge and focus and rigor to be able to pull it off, especially for a developing kid. I mean, I made that argument for athletes. But for a developing baby in utero, for a pregnant woman, and for a young child or even an adolescent child, there are some serious risks, particularly with B12 deficiency, which can result in irreversible damage that doesn’t resolve even when they start eating animal products [again]. This has been shown in the scientific literature, and there have been editorials and peer reviewed journals published questioning that these organizations have gone ahead and given the green light to this dietary approach for kids and saying, “Wait a second, we don’t actually really have evidence to support that it is safe and there’s quite a bit of evidence suggesting that it might not be safe. And are we really ready to make this?” But it’s just, it’s lost in the noise because most people are just following those practitioners who are just going to follow the recommendations of these organizations. They’re not in there reading the original literature.

Gabrielle Lyon:  Right. And it’s dangerous because the physicians are believing this. So, I’ve spoken to many, many physicians, and I just was on a national TV show that I can’t actually say [the name of] because it hasn’t aired yet. And they were plant-based physicians. And I would say, well, “No, no, this really is the data when it comes to greenhouse gas.” And they would say, “No, it’s not.”

Chris Kresser:  Right.

Gabrielle Lyon:  It’s a confirmation bias that they believe so deeply based on observational or epidemiological science, which, by the way, you utilize that kind of science to prove a point, then do a randomized control trial. You don’t say that the randomized control trials are no good because of your epidemiological data.

Chris Kresser:  Yeah. I mean, I think the travesty here is that we agree on the problem. The problem, if feedlot beef is not great for the environment, I don’t actually think the nutritional differences between grass-fed beef and feedlot beef is as big as we may have once thought it was. But there are many other reasons that our current industrialized process for producing meat is not optimal. But where we really then diverge is what the solution is. In [the] plant-based world, the solution is moving toward more industrialization, more technology, more scaling up, more monocropping, more soy, more corn, more of this monocropping agriculture that is absolutely destroying natural habitats. It’s destroying the soil.

The FAO [Food and Agriculture Organization of the United Nations] has argued that we only have about 60 harvests left now and that 33 percent of the world’s soils are in poor or very poor condition. This is one of the biggest threats we’re facing along with climate change. And it’s, of course, directly related. And so, we have to find solutions that can feed the planet but aren’t going to make the problems that led to this even worse.

Gabrielle Lyon:  Right.

Chris Kresser:  We have this kind of worship of technology and this idea that if we just scale up these technologies even bigger, more industrial monocrops, more fake meat, more lab meat, that we can …

Gabrielle Lyon:  And, by the way, we don’t even know the impact that will have on our health later on. We have no idea.

Chris Kresser:  No, I mean the soy leghemoglobin in the Impossible Burger is not generally recognized as safe by the FDA [U.S. Food and Drug Administration]. And the FDA has some documents that are available via the Freedom of Information Act saying that adequate safety testing hasn’t been done because it’s a Frankenfood. It’s not even a real food ingredient.

Gabrielle Lyon:  And it’s also governed by the FDA, FTC [Federal Trade Commission]. So, it can really make almost any claim it wants other than it can cure disease. As opposed to the commodities, which are under the USDA [U.S. Department of Agriculture], which they are only able to say they can be part of a healthy diet.

Chris Kresser:  Yeah.

Gabrielle Lyon:  So even the messaging behind what we’re hearing, the media has totally skewed based on a very fundamental level, the governing bodies.

Chris Kresser:  Absolutely. And you know, like, that that monocropping, people don’t think it through. They think, okay plant-based diet, no animals, better for the environment, done. But then,when you see studies like that in PNAS that actually do think it through, okay, well, what would actually happen if we removed all animal foods?

Oh, okay, nutrient deficiencies are going to go up, calorie intake is going to go up. And then, you have soil and agriculture scientists looking at it, too, and saying, “Oh, wow. Okay, so if we do more plant agriculture, more monocropping, we’re going to have destruction of habitats and further destruction of topsoil.” So, what’s the alternative? Holistically managed regenerative agriculture, where, as some studies have shown, the beef production can become not only carbon neutral, but a net carbon sink. They’re actually removing carbon from the atmosphere.

And not only that, you have the animals doing what they’ve done for millennia, which is actually restoring natural habitats and restoring soil quality. It may be the only way that we will ever be able to feed the planet because if we don’t have soil, we can’t feed anybody.

Gabrielle Lyon:  Totally, I couldn’t agree with you more. And why not just do some of the basics, like stop wasting food and stop overeating? Take personal responsibility. Don’t eat avocados from Mexico.

Why Protein Quality Matters for Muscles

Chris Kresser:  So, let’s, we zoomed out. I want to zoom back in, especially because this is an area of your specialty. And we talked about protein quantity. And now, I want to talk a little about protein quality, and particularly the differences between animal and plant proteins from the protein quality perspective. So, we have amino acid profile and bioavailability as the main determinant. So, let’s talk a little bit about each of those with respect to plants and animals.

Gabrielle Lyon:  So, I would say that the most important aspect of differentiating between plant protein and animal protein [is] really the essential amino acids. And of those, the branched chain amino acids. Especially as it relates to muscle health because muscle is the organ of longevity and it is the foundation of an individual’s metabolism. Having healthy muscle tissue allows for a large site of glucose disposal, fatty acid oxidation, all very important.

So, animal products contain a high amount of leucine. And leucine is important because it stimulates this complex called mTOR. And that is, what then down the line generates muscle protein synthesis. So, when that is an adequate quality, the quality of the protein and quantity, so it needs to be at about 2.5 grams of leucine to stimulate this process. That is roughly 30 grams of protein per meal. And that is very important to understand because it’s necessary for the health and longevity of your tissue.

Chris Kresser:  So, just to put that in perspective for folks, three ounces of lean ground beef is about 24 grams of protein.

Gabrielle Lyon:  And to get that in plants, you would need about five or six cups of quinoa.

Chris Kresser:  Or, to use The Game Changers argument, a peanut butter sandwich. But I did the math. You would need five tablespoons of peanut butter in that sandwich to get to that level of protein.

Gabrielle Lyon:  So ridiculous.

Chris Kresser:  It’s a third of a cup. Good luck with that.

Gabrielle Lyon:  So, animal, high-quality animal protein is high in the branched chain amino acids, and really, you get the most bang for your buck. It’s low in calories. It’s not six cups of quinoa or a peanut butter and jelly sandwich. Plant protein is notoriously low in leucine, lysine, and methionine. So, in order to get a high-quality protein, you’d have to compensate between 35 to 45 percent more protein when you’re eating soy or wheat. And then, that translates to excess calories and, ultimately, excess carbohydrates. So, animal protein and plant protein are very different and they’re utilized very differently by the body.

Chris Kresser:  Yes, if I think of an area of plant-based nutrition that has misinformation, I can’t think of an area that has more misinformation than protein. That’s why I just, as you may know, recorded a podcast specifically on that topic. Because it’s, like, you see so many of these claims in the movie and outside of the movie. I mean, the movie just kind of reiterated all the claims that have been made elsewhere, which is, hey. I mean, here’s one and you can speak to these. So, James Wilks at one point says, or I think it was Dr. Loomis:

“One of the big myths from the meat eaters, they say that plants don’t contain all of the necessary amino acids. But actually, they do. They’ve got all of the amino acids that you need.”

So, what do you say to that?

Gabrielle Lyon:  I mean, come on. That’s so ridiculous. I mean, we know that it’s low in lysine. And if you do a vegan diet, you’re going to be low in methionine, right? I mean, it’s just, we know that the amounts are totally different and lower. And especially when it comes to aging, you get this physiological process called anabolic resistance that actually requires more protein, high-quality protein, and amino acids to overcome this decrease in protein efficiency.

Chris Kresser:  Yeah, I mean, again, it’s hard. Joe asked me this question point-blank right in the beginning of the show, and I didn’t know how to answer it. Because I generally don’t know the answer and I’m disturbed [by] whatever the answer is. Because that’s such a straw man fallacy. Dr. Loomis says, “All of the plants have all of the amino acids.” Yes, well they have some of all of them. But that’s not the point. The point is, do they have enough of each of them?

Gabrielle Lyon:  And we know that they don’t.

Chris Kresser:  They don’t. I mean, that’s just [a] fact. Like, you can’t. And in theory, again, it’s possible that you can, if you really know what you’re doing, and you’re really on it, and especially if you’re willing to use protein powders, you can assemble a blend of, like, 70 percent pea and 30 percent rice protein, that will have an amino acid profile that kind of mimics what you would find in animal products.

Gabrielle Lyon:  Totally. Or you could throw in, on top of that, you could throw in some branched chain amino acids.

Chris Kresser:  Exactly. Like Patrik Baboumian in the film [is] adding leucine. Like, he knows this, right? So, he’s adding these supplements to his shakes, the four or five shakes that he has every day. But that still doesn’t address the question of bioavailability. Now, that’s the second component of the protein quality equation. The first one is amino acid profile. But if you don’t know this, which most people don’t, because they’re buying the vegan Kool-Aid and they just listen to people like Dr. Loomis, who says you can get all the amino acids you need from plants and doesn’t acknowledge. Look, I mean, there are also, there are vegans out there that I know that are much more honest intellectually about this. They recognize that plants don’t have the same amino acid profile, and they actually make an effort to educate their patients or their followers or whatever about that so they can make the right choices. That’s all I’m asking here. Don’t be dishonest about this if you really want to help people.

Gabrielle Lyon:  Right, and I think that that’s where it becomes really dangerous, the intellectual dishonesty that happens. I mean, listen, there is bio-individuality and there are some people that can do really well being vegan. I mean, one of my best friends is an orthopedic surgeon, Carrie Diulus; she’s amazing and she is vegan. And she’s done incredible on it. But that is less than 2 percent of the individuals, and I just want to say that there’s probably a reason why this happens. And I know that there is some research in the works, that the high volume of fiber changes the gut microbiome so significantly that the bugs become efficient at taking up nitrogen. And this is only, there are studies in the works right now, and it’s just in rat models, so we’ll have to see. But I mean, it is true. Some people do well, but that is few and far between and not the majority.

Chris Kresser:  Yes. And that’s the operative question here. It’s not, like I said to Joe, if the filmmakers would have said, “Hey,” if [the] argument would’ve been, “It’s possible to do well as an athlete on a vegan diet if you really know what you’re doing and it’s well planned. And look, here are a few examples of people who’ve been able to do that.” And they then honestly showed that athletes who are vegan and not people who are not vegan, like Nate Diaz, for example.

Gabrielle Lyon:  Right, right.

Chris Kresser:  Or others that are not actually vegan who they tried to play off as vegans, I actually, I wouldn’t have had any qualms with that. I’d be like, “Okay, great. If that’s your choice, and you want to do that, and you’re able to make it work, that’s awesome.” Rich Roll is someone who comes to mind who I’ve met a few times. I really like him, [he] seems like a great guy, and I think he’s approaching this from a more, he is genuinely trying to help people and he’s an amazing athlete, and he’s done well on a vegan diet for a really long time.

So, use some examples like that and actually show people how they’re making it work. Like, what they’re doing that is helping them avoid some of the problems that you can have. I would have had no qualms with the film at all. But they didn’t stop there. They were disingenuous in their portrayal of athletes. They didn’t talk about athletes that were originally in the film that they dropped from the film because they torpedoed after switching to a vegan diet. They didn’t talk about some of these things that we’re talking about in terms of the differences in [the] quality of protein.

So, that’s what gets me fired up about it because it was, I feel like it was either made by people who are really, like, shockingly clueless given their credentials, about the most basic information about protein metabolism and the science on protein, or they were purposefully misleading, or both. And none of that is okay in my book.

Gabrielle Lyon:  No. And it’s not, I agree with you. It’s not okay, and it’s deeply dangerous.

Chris Kresser:  Because all they had to do, as you pointed out earlier, is bring in some fact checking, bring in some experts. People who actually do have expertise in these areas who don’t have the same view and say, “Hey, critique this. Let me know what’s the argument against this?” And they didn’t do that. So, I think the film loses a lot of credibility.

Gabrielle Lyon:  And I think they probably didn’t do that because that wasn’t the agenda. The agenda was, how do we perpetuate an anti-animal narrative using fear mongering and scare techniques?

Chris Kresser:  Yeah.

Gabrielle Lyon:  Well, there’s two ways to do that. I’m going to come up after your health, and I’m going to come after the planet.

Chris Kresser:  Yeah. I think, I mean, this is where, and again, I have, you and I both have friends who are vegans. I was a vegan myself many years ago. I have patients that are vegan. But I think one of the issues with the way some people approach veganism is it has taken on almost, it’s probably most akin to a religion or an ideology.

Gabrielle Lyon:  It is.

Chris Kresser:  And when it gets to that point, there’s another saying that I like. I’m not sure who said this or where it came from. But it really applies here, which is that, “You can’t fight faith with facts.” And once people buy into the ideology hook, line, and sinker, you can present any kind of evidence that you want. And you could do that until you’re blue in the face. But it’s not going to make a difference. Because in the same way that if you try to have a factual kind of fact-driven conversation with someone who’s very religious, that’s, good luck with that. It’s not going to move the needle at all.

Gabrielle Lyon:  No. And it becomes very convoluted, and you go from point A to point Z, and it’s kind of like that bad relationship that you had in high school.

Chris Kresser:  Right. Yeah.

Gabrielle Lyon:  And you’re thinking, what are you talking about?

Chris Kresser:  Yeah, it’s so frustrating. I want to finish off the plant quality or protein quality and where plants don’t measure up there discussion and at least introduce the DS scale to people, digestible indispensable amino acid score, which is the newest scale that has been developed to rank proteins according to their quality, and where it’s different than the previous score, the protein digestibility corrected amino acids score. All these acronyms. PDCAAS is that, [and] PDCAAS didn’t take bioavailability into account whereas the DS does. And the lowest animal protein is chicken at 1.03 and the highest plant protein is chickpeas [at] 0.83. So, we have a situation where even the highest plant protein is lower than the lowest animal protein.

Gabrielle Lyon:  Well, I guess you just cannot argue with some basic numbers.

Chris Kresser:  Yeah. Because, right. I mean, it’s not what we eat, it’s what we absorb. Right?

Gabrielle Lyon:  Yeah. And it’s really interesting because you can’t argue, these are biological numbers.

Chris Kresser:  Yeah.

Gabrielle Lyon:  So, with the movie or just with this narrative that’s happening, the only way to deal with it is to reject it.

Chris Kresser:  Right. Like that Leon Festinger quote.

Gabrielle Lyon:  Exactly.

Chris Kresser:  Just turn away.

Gabrielle Lyon:  Right.

Chris Kresser:  Because, as we said before, you can look at the research on red meat, and you can come to different conclusions, right? It’s possible to, if you’re someone who kind of isn’t as aware of the problems with nutritional epidemiology and data collection methods, and [the] food frequency questionnaire, and healthy-user bias, and all that, or you just don’t buy those arguments, you could come away, I mean, there’s definitely research that does correlate red meat intake with disease. And you and I both know what all the problems are with that research. And we’ve talked ad nauseum about that. But I could see in that situation, how there is a debate there, and there’s controversy. But like you said, the things we’re talking about now, like, just how to evaluate protein quality and actually measuring protein quantity, like, you can just look that up on nutritiondata.com.

Gabrielle Lyon:  Right. These are hard biological values and numbers.

Chris Kresser:  These are facts.

Gabrielle Lyon:  Right. The hard numbers.

Chris Kresser:  But in this, like, fake news environment that we’re living in, people don’t even trust facts anymore. Like, so, if you present these facts to people who are totally persuaded by the vegan argument, then they will find a way to just ignore them.

Gabrielle Lyon:  Right. Absolutely.

The Importance of Protein and Muscle Health as We Age

Chris Kresser:  You and I, as clinicians, are concerned about this, especially you with your experience in geriatrics and your understanding of how frailty and sarcopenia are really, can really be the beginning of the end for people.

Gabrielle Lyon:  It is.

Chris Kresser:  I mean, there’s a saying that in medicine, you break your hip, [then] die of pneumonia, right?

Gabrielle Lyon:  Right.

Chris Kresser:  Which is, I mean, fortunately, my dad didn’t fall into this category because he exercises religiously, he’s got a great diet, [and] he eats a Paleo type of diet. But he broke, he severed the quadriceps tendon on both of his knees in a bad fall a couple of years ago on Thanksgiving. So, he was totally immobilized and straight knee, straight leg braces with both legs in the hospital. And he developed pneumonia. And so, I got to see this firsthand, like, when you’re immobilized, that even someone like him, because he couldn’t continue to move.

Gabrielle Lyon:  Right.

Chris Kresser:  He developed pneumonia. And fortunately, with my training in herbalism, we were able to reverse that and without a lot of use of drugs. And it didn’t escalate, and he’s fine and super healthy now. But that was, like, a very first-hand experience for me seeing, like, this is how it can go with someone, and thank God he had significant muscle mass still. That probably helped him survive that episode.

Gabrielle Lyon:  Absolutely.

Chris Kresser:  I’m sure you saw that over and over again in your work.

Gabrielle Lyon:  Yes. And that’s why it’s so personal. Because I think, when I take a step back, and I look at this social media sphere, and I see all these people arguing and talking about this protein and this plant protein, and I just think to myself, you know how many of these people have actually sat at the bedside of a dying person with their family?

Chris Kresser:  Yes.

Gabrielle Lyon:  I mean, I have done this over and over again. Watching these people waste away. And you can all be fine and argue in your 20s, 30s, 40s about this diet and that athlete. But man, I am telling you, the trajectory of aging, if you go down this path, is devastating. And you don’t come back. We know Doug Paddon-Jones; if you look at his literature on frailty and falls and bed rest, the decline is very sharp with a loss of muscle mass.

Chris Kresser:  Yes.

Gabrielle Lyon:  And then, you combine the zealot saying “have more plant protein,” which the aging population isn’t typically eating a lot as it is. They’re going to have, they’re not going to have a chance. Their quality of the protein that they need to eat has to be high. It does. If you ask me, I recommend animal-based products. If they want to do whey protein, and they don’t have any issues with it, a lot of people are sensitive to it, fine, do it. But you cannot ask individuals mid-life and then as they age to now swap out and eat plant-based protein. [It]  is literally killing people, the inability to overcome cachexia, to overcome sarcopenia. This [is] devastating stuff.

Chris Kresser:  It is, and it’s, we’re all going to die at some point, at least unless you believe in the singularity and Ray Kurzweil, we’re going to upload our consciousness and beat aging. Maybe we will, maybe we won’t. But as far as we know, we’re going to die. So, this is not, we’re not talking about avoiding death, but we’re talking about not hastening it and making sure that the remaining, our later years are characterized by good health. What gets me is that this is entirely preventable by correcting ignorance.

Gabrielle Lyon:  Right, yes.

Chris Kresser:  And there are certain things that are not preventable. And that’s just part of being a human being; we have to deal with those things. So, let’s minimize the parts of aging and poor health that are preventable just by being honest with what we’ve learned with our scientific knowledge over the past two centuries of doing this kind of research.

Gabrielle Lyon:  Absolutely. That’s invaluable advice.

Chris Kresser:  Well, let’s end there. Thank you so much for being a warrior on this topic and helping to raise awareness about this. It’s so important, and [I’m] grateful for all the work you’re doing.

Gabrielle Lyon:  Thank you. Thank you so much for having me.

Chris Kresser:  Where can people learn more about you and your work, Dr. Lyon?

Gabrielle Lyon:  They can find me on Instagram; I’m very active, at Dr. Gabrielle Lyon, L-y-o-n. And Facebook, same name, and my website is DrGabrielleLyon.com, which, hopefully, soon we’ll be going through a rebrand, and I am working on a book, which is exciting.

Chris Kresser:  Oh, great, yes. A baby and a book; you’ve got a lot of balls in the air.

Gabrielle Lyon:  Yeah.

Chris Kresser:  Great. What’s the topic of the book?

Gabrielle Lyon:  Protein.

Chris Kresser:  Strangely enough.

Gabrielle Lyon:  Yeah. It’ll be more involved than that.

Chris Kresser:  Yes, of course.

Gabrielle Lyon:  But it’s certainly at the very core.

Chris Kresser:  I imagine it’s not going to be called protein, no subtitle.

Gabrielle Lyon:  No, no. My literary agent would not go for that.

Chris Kresser:  Yeah.

Gabrielle Lyon:  I tried it. So, I’m working on that, and then I do have an upcoming masterclass that I will be, it will probably be out by the time this airs, and it’s on, the first one people wanted was on muscle-centric medicine.

Chris Kresser:  Great.

Gabrielle Lyon:  So that’s really the framework under which I operate.

Chris Kresser:  Yes.

Gabrielle Lyon:  And I have a weekly newsletter that I’ve taken a break [from] since having the baby, but will likely be back in full effect.

Chris Kresser:  This is just kind of a late, late addition here, but I want to throw it in because you just mentioned the muscle-centric medicine and we talked earlier about how preserving muscle mass is critical to longevity. It’s also critical if you’re suffering from any kind of chronic illness.

Gabrielle Lyon:  Yes.

Chris Kresser:  And, of course, a lot of people who listen to my podcasts are dealing with complex chronic illnesses. And one of my, the doctors who helped me most along my journey was one who helped me to understand that connection with muscle mass and healing. And that led me to continue to explore even when I was very, very sick, strength training and other weight-bearing exercise as a means of improving my health. And to this day, I still, I’m religious about that because I know it’s so important. So, I just, I thought we’d be remiss if we ended this without mentioning the importance of muscle mass to people with chronic illness, too.

Gabrielle Lyon:  It is. Your muscle, it is your organ of longevity, truly.

Chris Kresser:  Great. Okay, well, thank you again. We’ll have to give a shout-out to Mark Hyman for introducing us. He’s such a connector.

Gabrielle Lyon:  Yeah.

Chris Kresser:  And hopefully, maybe next time I’m back on the East Coast, we can get together in person.

Gabrielle Lyon:  Sounds great.

Chris Kresser:  All right. Take care.

Gabrielle Lyon:  Thank you.