Welcome to Debate Club! Please be aware that this is a space for respectful debate, and that your ideas will be challenged here. Please remember to critique the argument, not the author.

Protein and Insulin Sensitivity

Options
2

Replies

  • crackpotbaby
    crackpotbaby Posts: 1,297 Member
    Options
    lizery wrote: »
    Would you take a medicine that had been effectively tested on 11 people?

    I doubt it.

    Would you take a medicine where the only kind of testing was giving it to people then asking them later if they feel better now?

    I'm pretty sure none of what I have written relates to this.

  • Wheelhouse15
    Wheelhouse15 Posts: 5,575 Member
    Options
    lizery wrote: »
    34 women in total puts about 11 people in each of the groups.

    This is far to small a cohort to draw any conclusions from, other than suggesting further large scale studies may be warranted.

    I wouldn't go changing your diet based on this or any other stand alone, very small study.


    I agree also, and the differences in amounts are pretty small in reality. Without really knowing much about the diets it's hard to say what's happening here as well. I've seen the abstract before but haven't seen the methodology and if the difference in diet is, let's say, from animal protein high in saturated fats that alone might explain the difference in insulin sensitivity since it has already been established that saturated fats can reduce insulin sensitivity in the muscle. Also, exercise was not indicated and that too can affect insulin sensitivity so it's really hard to say how much this study really shows.

    Of course, increased insulin sensitivity is only one marker for metabolic issues so that alone may not be the biggest issue and other health benefits from losing weight may be more important here.

    Noting that I haven't been able to find much in the way of supporting studies I would say that this is just an interesting footnote but not something I would put too much stock in.

    I was wondering about physical exercise as well.

    It looks like what they eat was controlled, just different calories and additional whey for the high protein group.
    Diet Intervention
    Subjects attended weekly sessions led by an experienced weight management dietician to ensure compliance with the diet prescription, monitor body weight, and counsel subjects throughout the dietary intervention. The energy content of the initial packed meals given to the weight loss groups was targeted to provide 30% fewer calories than each person’s estimated total daily energy expenditure, based on their resting metabolic rate (RMR) multiplied by an activity factor of 1.4 (Black et al., 1996); subsequent meals and dietary intake were adjusted weekly as needed to achieve a 0.5%–1% weight loss per week until 8%–10% was achieved. Once the targeted weight loss goal was achieved, dietary energy intake was modified to maintain a stable body weight for 3–4 weeks before the testing procedures performed at baseline were repeated. Protein intake and macronutrient distribution of the diet were kept constant in accordance with the initial diet prescription throughout the intervention period. In the WM group, each subject’s energy intake was adjusted as needed to maintain body weight within 2% of the initial body weight. Target protein intake for the WL group was 0.8 g protein/kg body weight per day and 1.2 g protein/kg body weight per day for subjects in the WL-HP group.

    All subjects were provided with a base diet of frozen entrees (eLiving meals, Morrison Healthcare; Lean Cuisine, Nestlé USA; Revel Kitchen) for lunch and dinner. For breakfast, subjects consumed two energy bars (NuGo Nutrition) per day. Subjects in the WL-HP diet group also consumed two servings of a whey protein isolate (Unjury, ProSynthesis Laboratories) per day, whereas subjects in the WL group consumed snacks that provided mostly carbohydrates and fat (in proportion to their contribution to total non-protein dietary energy content of the base diet; i.e., ∼63 and 37%, respectively) instead. Additional calories needed to meet each subject’s total energy and macronutrient requirements were consumed as fruits, vegetables, dairy products, and starches. Dietary compliance was monitored by having subjects record their dietary intake every day by using the https://www.myfitnesspal.com computer app; the study dietician reviewed diet records weekly. In addition, 24-hr urinary urea nitrogen excretion was evaluated before and during the final week of the dietary intervention.

    Oh look, they used Myfitnesspal.

    I've seen MFP show up in a few study methodologies.
  • stevencloser
    stevencloser Posts: 8,911 Member
    Options
    lizery wrote: »
    lizery wrote: »
    Would you take a medicine that had been effectively tested on 11 people?

    I doubt it.

    Would you take a medicine where the only kind of testing was giving it to people then asking them later if they feel better now?

    I'm pretty sure none of what I have written relates to this.

    It kinda does because that's what you get with studies that have thousands of participants. Give them a survey to fill out and ask them the same thing again a few months later, with nothing but their word for if they even adhered to what you told them to do.
  • crackpotbaby
    crackpotbaby Posts: 1,297 Member
    Options
    lizery wrote: »
    lizery wrote: »
    Would you take a medicine that had been effectively tested on 11 people?

    I doubt it.

    Would you take a medicine where the only kind of testing was giving it to people then asking them later if they feel better now?

    I'm pretty sure none of what I have written relates to this.

    It kinda does because that's what you get with studies that have thousands of participants. Give them a survey to fill out and ask them the same thing again a few months later, with nothing but their word for if they even adhered to what you told them to do.

    The studies I'm referring to are double blind randomised controlled trials which are the subject to peer review of methodology and conclusions.

    As self reported unsupervised trial is basically a survey. I agree with you that they are rubbish but at no time did I suggest that a poorly designed study of > number of people is and better.

    I am saying that a finding I such a small number of participants should be viewed as very low grade evidence.

    To give usable data a study needs to be sufficiently rigorous in methodology and design with tight controls, appropriate analysis and conclusions, stand up to scrutiny from experts in the field (peer reviewed) and gave replicable results.

    34 post menopausal women split into 3 groups, so only 11 receiving the intervention is NOT sufficient to draw any usable conclusions.
  • crackpotbaby
    crackpotbaby Posts: 1,297 Member
    Options
    lizery wrote: »
    34 women in total puts about 11 people in each of the groups.

    This is far to small a cohort to draw any conclusions from, other than suggesting further large scale studies may be warranted.

    I wouldn't go changing your diet based on this or any other stand alone, very small study.


    I agree also, and the differences in amounts are pretty small in reality. Without really knowing much about the diets it's hard to say what's happening here as well. I've seen the abstract before but haven't seen the methodology and if the difference in diet is, let's say, from animal protein high in saturated fats that alone might explain the difference in insulin sensitivity since it has already been established that saturated fats can reduce insulin sensitivity in the muscle. Also, exercise was not indicated and that too can affect insulin sensitivity so it's really hard to say how much this study really shows.

    Of course, increased insulin sensitivity is only one marker for metabolic issues so that alone may not be the biggest issue and other health benefits from losing weight may be more important here.

    Noting that I haven't been able to find much in the way of supporting studies I would say that this is just an interesting footnote but not something I would put too much stock in.

    I was wondering about physical exercise as well.

    It looks like what they eat was controlled, just different calories and additional whey for the high protein group.
    Diet Intervention
    Subjects attended weekly sessions led by an experienced weight management dietician to ensure compliance with the diet prescription, monitor body weight, and counsel subjects throughout the dietary intervention. The energy content of the initial packed meals given to the weight loss groups was targeted to provide 30% fewer calories than each person’s estimated total daily energy expenditure, based on their resting metabolic rate (RMR) multiplied by an activity factor of 1.4 (Black et al., 1996); subsequent meals and dietary intake were adjusted weekly as needed to achieve a 0.5%–1% weight loss per week until 8%–10% was achieved. Once the targeted weight loss goal was achieved, dietary energy intake was modified to maintain a stable body weight for 3–4 weeks before the testing procedures performed at baseline were repeated. Protein intake and macronutrient distribution of the diet were kept constant in accordance with the initial diet prescription throughout the intervention period. In the WM group, each subject’s energy intake was adjusted as needed to maintain body weight within 2% of the initial body weight. Target protein intake for the WL group was 0.8 g protein/kg body weight per day and 1.2 g protein/kg body weight per day for subjects in the WL-HP group.

    All subjects were provided with a base diet of frozen entrees (eLiving meals, Morrison Healthcare; Lean Cuisine, Nestlé USA; Revel Kitchen) for lunch and dinner. For breakfast, subjects consumed two energy bars (NuGo Nutrition) per day. Subjects in the WL-HP diet group also consumed two servings of a whey protein isolate (Unjury, ProSynthesis Laboratories) per day, whereas subjects in the WL group consumed snacks that provided mostly carbohydrates and fat (in proportion to their contribution to total non-protein dietary energy content of the base diet; i.e., ∼63 and 37%, respectively) instead. Additional calories needed to meet each subject’s total energy and macronutrient requirements were consumed as fruits, vegetables, dairy products, and starches. Dietary compliance was monitored by having subjects record their dietary intake every day by using the https://www.myfitnesspal.com computer app; the study dietician reviewed diet records weekly. In addition, 24-hr urinary urea nitrogen excretion was evaluated before and during the final week of the dietary intervention.

    Oh look, they used Myfitnesspal.

    So not only small sample size, but basically self reporting diet by use of mfp, not being served up measured meals for the duration of the experiment.

  • CorneliusPhoton
    CorneliusPhoton Posts: 965 Member
    Options
    lizery wrote: »
    lizery wrote: »
    34 women in total puts about 11 people in each of the groups.

    This is far to small a cohort to draw any conclusions from, other than suggesting further large scale studies may be warranted.

    I wouldn't go changing your diet based on this or any other stand alone, very small study.


    I agree also, and the differences in amounts are pretty small in reality. Without really knowing much about the diets it's hard to say what's happening here as well. I've seen the abstract before but haven't seen the methodology and if the difference in diet is, let's say, from animal protein high in saturated fats that alone might explain the difference in insulin sensitivity since it has already been established that saturated fats can reduce insulin sensitivity in the muscle. Also, exercise was not indicated and that too can affect insulin sensitivity so it's really hard to say how much this study really shows.

    Of course, increased insulin sensitivity is only one marker for metabolic issues so that alone may not be the biggest issue and other health benefits from losing weight may be more important here.

    Noting that I haven't been able to find much in the way of supporting studies I would say that this is just an interesting footnote but not something I would put too much stock in.

    I was wondering about physical exercise as well.

    It looks like what they eat was controlled, just different calories and additional whey for the high protein group.
    Diet Intervention
    Subjects attended weekly sessions led by an experienced weight management dietician to ensure compliance with the diet prescription, monitor body weight, and counsel subjects throughout the dietary intervention. The energy content of the initial packed meals given to the weight loss groups was targeted to provide 30% fewer calories than each person’s estimated total daily energy expenditure, based on their resting metabolic rate (RMR) multiplied by an activity factor of 1.4 (Black et al., 1996); subsequent meals and dietary intake were adjusted weekly as needed to achieve a 0.5%–1% weight loss per week until 8%–10% was achieved. Once the targeted weight loss goal was achieved, dietary energy intake was modified to maintain a stable body weight for 3–4 weeks before the testing procedures performed at baseline were repeated. Protein intake and macronutrient distribution of the diet were kept constant in accordance with the initial diet prescription throughout the intervention period. In the WM group, each subject’s energy intake was adjusted as needed to maintain body weight within 2% of the initial body weight. Target protein intake for the WL group was 0.8 g protein/kg body weight per day and 1.2 g protein/kg body weight per day for subjects in the WL-HP group.

    All subjects were provided with a base diet of frozen entrees (eLiving meals, Morrison Healthcare; Lean Cuisine, Nestlé USA; Revel Kitchen) for lunch and dinner. For breakfast, subjects consumed two energy bars (NuGo Nutrition) per day. Subjects in the WL-HP diet group also consumed two servings of a whey protein isolate (Unjury, ProSynthesis Laboratories) per day, whereas subjects in the WL group consumed snacks that provided mostly carbohydrates and fat (in proportion to their contribution to total non-protein dietary energy content of the base diet; i.e., ∼63 and 37%, respectively) instead. Additional calories needed to meet each subject’s total energy and macronutrient requirements were consumed as fruits, vegetables, dairy products, and starches. Dietary compliance was monitored by having subjects record their dietary intake every day by using the https://www.myfitnesspal.com computer app; the study dietician reviewed diet records weekly. In addition, 24-hr urinary urea nitrogen excretion was evaluated before and during the final week of the dietary intervention.

    Oh look, they used Myfitnesspal.

    So not only small sample size, but basically self reporting diet by use of mfp, not being served up measured meals for the duration of the experiment.

    If you look at the quoted section above, you will see that they were served up measured meals, but they were allowed to add fruits and vegetables to make sure they met their energy and macro requirements.
  • crackpotbaby
    crackpotbaby Posts: 1,297 Member
    Options
    Cool. Well I guess that's a little better for the 11 people. Still self reporting ... still 11 people compared to another 11 and a control.

    Personally, I still wouldn't get too excited about a study of this size an nature.
  • stevencloser
    stevencloser Posts: 8,911 Member
    Options
    lizery wrote: »
    lizery wrote: »
    lizery wrote: »
    Would you take a medicine that had been effectively tested on 11 people?

    I doubt it.

    Would you take a medicine where the only kind of testing was giving it to people then asking them later if they feel better now?

    I'm pretty sure none of what I have written relates to this.

    It kinda does because that's what you get with studies that have thousands of participants. Give them a survey to fill out and ask them the same thing again a few months later, with nothing but their word for if they even adhered to what you told them to do.

    The studies I'm referring to are double blind randomised controlled trials which are the subject to peer review of methodology and conclusions.

    As self reported unsupervised trial is basically a survey. I agree with you that they are rubbish but at no time did I suggest that a poorly designed study of > number of people is and better.

    I am saying that a finding I such a small number of participants should be viewed as very low grade evidence.

    To give usable data a study needs to be sufficiently rigorous in methodology and design with tight controls, appropriate analysis and conclusions, stand up to scrutiny from experts in the field (peer reviewed) and gave replicable results.

    34 post menopausal women split into 3 groups, so only 11 receiving the intervention is NOT sufficient to draw any usable conclusions.

    A double blind controlled study with so many people would be expensive.
    Very expensive.
    So expensive that I am not aware of anything like that having been done.
  • crackpotbaby
    crackpotbaby Posts: 1,297 Member
    Options
    They are standard in medicine and drug development.

    If good research has never been done into nutrition/diet etc then one cold theorise that a factor into why there is little actual solid evidence regarding what a *healthy* diet looks like.

    Small studies are a starting point - sure.

    It's just about recognition that not all studies are equal, not all evidence is equal.

    There are many versions of this but the generally accepted hierarchy of evidence is:

    vg0yw5hv3x2v.jpeg
  • stevencloser
    stevencloser Posts: 8,911 Member
    edited December 2016
    Options
    Something interesting I found while looking for examples of large scale studies.

    https://www.edge.org/response-detail/25497

    And the thing with nutrition is that a "proper" nutritional intervention study is way harder to do, which the article sortof mentions too. With a new drug, easy you give one group the drug the other a placebo, done. You can scale that up as you wish. There's no way the control group would somehow get the drug or that the experimental group has a high amount of people who simply don't take it. For nutritional intervention you'd have to monitor every participant 24/7 for weeks to months. That's just not feasible.
  • crackpotbaby
    crackpotbaby Posts: 1,297 Member
    Options
    Something interesting I found while looking for examples of large scale studies.

    https://www.edge.org/response-detail/25497

    And the thing with nutrition is that a "proper" nutritional intervention study is way harder to do, which the article sortof mentions too. With a new drug, easy you give one group the drug the other a placebo, done. You can scale that up as you wish. There's no way the control group would somehow get the drug or that the experimental group has a high amount of people who simply don't take it. For nutritional intervention you'd have to monitor every participant 24/7 for weeks to months. That's just not feasible.

    Good point. Although it's not that simple; many drug interventions are treating conditions that can be affected by other factors (example a blood pressure tablet trial would need to factor variables like diet, cardiac function, exercise, concurrent medications etc so a large subject group can help in looking at overall response across a population, not just a handful of participants) ... but really diverging from the actual topic here.,

    I guess I'm critiquing nutritional studies in the same way I would a medical intervention/drug trial. I'm not sure that's a bad thing but I do respect the points made about the difficulty in large studies.

    But even a study of 100 people would be more convincing. Or 200 ... 36 is kinda just, meh.

    With these small studies though, just because they may be the best model researchers can realistically produce doesn't automatically make them good evidence.

    One way to increase the strength of the conclusions would be to replicate the experiment, several times and compare the data. But then wouldn't the cost of that be as prohibitive as a large no of participants?

    I dunno. I just think a finding such as this (or anything really) should be viewed in the context of the study limitations.

    That's all :smile:

  • middlehaitch
    middlehaitch Posts: 8,487 Member
    Options
    I thought this article may be of interest. It is mainly dealing with protein intake/sarcopenia but does talk about IR a little towards the end.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760315/

    Cheers, h.
    Sorry- not a scientific bone in my body.
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    Options
    lizery wrote: »
    I dunno. I just think a finding such as this (or anything really) should be viewed in the context of the study limitations.

    But as stevencloser said, you are applying standards that aren't used in nutrition studies normally (in part because the goal is different than for the large scale drug studies -- they aren't trying to get a drug approved). If you can show that other nutrition studies follow your model and this one departed from it, sure, but I don't think you can -- virtually every nutrition study that gets discussed is small like this one or one of the large correlation studies, which is why things like the Health Care Professional studies and the information from them are given such importance despite the problems with them.

    Also NO ONE should claim that the result of one of these nutrition studies proves anything (and neither the people doing this study nor me, who linked it) said otherwise. They try out ideas and typically result in findings that look interesting to explore further, as well as more questions. That's actually one thing that sometimes drives me crazy on MFP, that people will toss up some study (mice lose more weight eating during the day and not at night, overweight women with an exercise intervention lose less weight than those without it) and insist it proves some point that it clearly does not. But to insist that it lacks value and isn't worth doing is not true either -- goes way too far in the other way. There are presumably enough people to demonstrate statistically significant differences, and then more work needs to be done.
  • GottaBurnEmAll
    GottaBurnEmAll Posts: 7,722 Member
    Options
    I thought this article may be of interest. It is mainly dealing with protein intake/sarcopenia but does talk about IR a little towards the end.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760315/

    Cheers, h.
    Sorry- not a scientific bone in my body.

    That was a good read. I'm bookmarking it.
  • kimny72
    kimny72 Posts: 16,012 Member
    Options
    This topic is over my head but fascinating. Looking forward to more responses about why these results might have turned out the way they did. Obviously this one small study doesn't prove anything (no one study does) and OP didn't suggest it did. The affect of protein on insulin comes up here a lot, so I think this study is interesting to pick apart!
  • crackpotbaby
    crackpotbaby Posts: 1,297 Member
    Options
    lemurcat12 wrote: »
    lizery wrote: »
    I dunno. I just think a finding such as this (or anything really) should be viewed in the context of the study limitations.

    But as stevencloser said, you are applying standards that aren't used in nutrition studies normally (in part because the goal is different than for the large scale drug studies -- they aren't trying to get a drug approved). If you can show that other nutrition studies follow your model and this one departed from it, sure, but I don't think you can -- virtually every nutrition study that gets discussed is small like this one or one of the large correlation studies, which is why things like the Health Care Professional studies and the information from them are given such importance despite the problems with them.

    Also NO ONE should claim that the result of one of these nutrition studies proves anything (and neither the people doing this study nor me, who linked it) said otherwise. They try out ideas and typically result in findings that look interesting to explore further, as well as more questions. That's actually one thing that sometimes drives me crazy on MFP, that people will toss up some study (mice lose more weight eating during the day and not at night, overweight women with an exercise intervention lose less weight than those without it) and insist it proves some point that it clearly does not. But to insist that it lacks value and isn't worth doing is not true either -- goes way too far in the other way. There are presumably enough people to demonstrate statistically significant differences, and then more work needs to be done.

    If you read my replies, I have acknowledged my bias but furthermore also acknowledge that small studies may trigger further research ... replicates studies ... 'further work' as you say.

    Sure, a human study is better than rats. Kinda. Rats are actually psysiologically similar to humans (and easier to control variables) and finding of animal trials are often then used to see if the same apples to people. I'm not saying animal trials are good evidence. They do have their place.

    As do small scale human trials.

    Are either 'good' evidence though? No.

    I have never at any point said this trial lacks 'value'. I have said it is not broad enough to provide evidence or draw conclusions from.

    I think you - like me - are essential expressing frustration about people (lay people, the media etc) drawing conclusions based on what is poor quality evidence or skewed interpretation of same.

    With this article - great talking point, yes.
    Clinical evidence? No.

    Further research? Sure.
  • Gallowmere1984
    Gallowmere1984 Posts: 6,626 Member
    Options
    One other really odd thing that is suggested here that's kind of annoying me: insulin is a storage hormone. Having a temporary resistance to it helps (not hinders) weight loss, assuming calories are kept constant. This is part of the reason that clenbuterol and the ephedrine/caffeine stacks work as well as they do. They temporarily reduce insulin sensitivity, making storage more difficult. Insulin resistance in the obese is a symptom, not a cause.
  • Wheelhouse15
    Wheelhouse15 Posts: 5,575 Member
    Options
    lizery wrote: »
    lemurcat12 wrote: »
    lizery wrote: »
    I dunno. I just think a finding such as this (or anything really) should be viewed in the context of the study limitations.

    But as stevencloser said, you are applying standards that aren't used in nutrition studies normally (in part because the goal is different than for the large scale drug studies -- they aren't trying to get a drug approved). If you can show that other nutrition studies follow your model and this one departed from it, sure, but I don't think you can -- virtually every nutrition study that gets discussed is small like this one or one of the large correlation studies, which is why things like the Health Care Professional studies and the information from them are given such importance despite the problems with them.

    Also NO ONE should claim that the result of one of these nutrition studies proves anything (and neither the people doing this study nor me, who linked it) said otherwise. They try out ideas and typically result in findings that look interesting to explore further, as well as more questions. That's actually one thing that sometimes drives me crazy on MFP, that people will toss up some study (mice lose more weight eating during the day and not at night, overweight women with an exercise intervention lose less weight than those without it) and insist it proves some point that it clearly does not. But to insist that it lacks value and isn't worth doing is not true either -- goes way too far in the other way. There are presumably enough people to demonstrate statistically significant differences, and then more work needs to be done.

    If you read my replies, I have acknowledged my bias but furthermore also acknowledge that small studies may trigger further research ... replicates studies ... 'further work' as you say.

    Sure, a human study is better than rats. Kinda. Rats are actually psysiologically similar to humans (and easier to control variables) and finding of animal trials are often then used to see if the same apples to people. I'm not saying animal trials are good evidence. They do have their place.

    As do small scale human trials.

    Are either 'good' evidence though? No.

    I have never at any point said this trial lacks 'value'. I have said it is not broad enough to provide evidence or draw conclusions from.

    I think you - like me - are essential expressing frustration about people (lay people, the media etc) drawing conclusions based on what is poor quality evidence or skewed interpretation of same.

    With this article - great talking point, yes.
    Clinical evidence? No.

    Further research? Sure.

    As far as I can see, we are in agreement, I'm just summarizing what I think we both agree on for the more general audience to follow in case they are missing what we are discussing since it is rather important.

    The gold standard for nutritional research is the metabolic ward study were you can pretty much get a single, independent variable manipulation. When these show up they are great but they are usually the same type of small batch, short-term studies due to cost and ability to find participants willing to be voluntarily incarcerated for a month or so.

    I would say that the big difference I see here is that nutritional studies merely provide evidence to a small piece of the puzzle, which is rather large, while drug trials are trying to access as much of the big picture as possible and the scope is considerably smaller compared to human nutrition. Bringing a drug to market costs hundreds of millions of dollars and that's just not in the purview of nutritional research unfortunately.
  • Wheelhouse15
    Wheelhouse15 Posts: 5,575 Member
    Options
    One other really odd thing that is suggested here that's kind of annoying me: insulin is a storage hormone. Having a temporary resistance to it helps (not hinders) weight loss, assuming calories are kept constant. This is part of the reason that clenbuterol and the ephedrine/caffeine stacks work as well as they do. They temporarily reduce insulin sensitivity, making storage more difficult. Insulin resistance in the obese is a symptom, not a cause.

    It is an interesting point that most people miss: when you have increased insulin sensitivity it's systemic meaning that both muscle and fat cells are more sensitive so adipose cells becomes more efficient at storing fat. This reduce ability to store fat might be one of the few mechanisms to fight excessive weight gain that we actually have developed. Of course, it never defeats CICO but it might change the energy balance slightly.
  • Wheelhouse15
    Wheelhouse15 Posts: 5,575 Member
    edited December 2016
    Options
    I thought this article may be of interest. It is mainly dealing with protein intake/sarcopenia but does talk about IR a little towards the end.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2760315/

    Cheers, h.
    Sorry- not a scientific bone in my body.

    I've seen one of the related studies to this (a mouse study) and isn't really what you might think. This is a rather controversial theory by a minority of researchers who believe that in order to trigger muscle synthesis that you require a minimum of around 20g of protein at one sitting (with maximum effect at 30g) with 5g of it being Leucien and that carbohydrates don't work to spur synthesis in adults as it does in children. However, this isn't what the balance of evidence shows, which is that timing is not very important but rather the total intake of protein per day and that carbohydrates do help to spur muscle synthesis in adults as would be expected when you look at the biochemistry of cell signaling.

    I'm not convinced about the protein timing aspect but having a higher protein diet seems to be reasonable.