#227 - AMA #40: Body composition, protein, time-restricted feeding, fasting, DEXA scans, and more

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In this "Ask Me Anything" (AMA) episode, Peter discusses the importance of understanding body composition and explains how to interpret the most important metrics revealed by a DEXA scan, such as lean muscle tissue mass, visceral adiposity tissue mass, bone mineral density, and more. He discusses common concerning trends in these metrics as well as strategies to address them. He goes through DEXA scan results of both male and female patient case studies and explains the prescribed intervention for each patient. Additionally, Peter answers numerous questions about dietary protein including how much we need, when we need it, and how intake should be divided throughout the day to optimize muscle protein synthesis. Finally, Peter provides his updated point of view on time-restricted feeding and fasting and how his personal approach and recommendations for patients has evolved.

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We discuss:

• Interpreting DEXA scans: important metrics, radiation levels, and more [2:15];
• DEXA metrics: Bone mineral density (BMD) [12:00];
• DEXA metrics: Visceral adipose tissue (VAT) [14:30];
• DEXA metrics on lean tissue: appendicular lean mass index (ALMI) and fat-free mass index (FFMI) [20:45];
• Concerning trends in BMD, VAT, & muscle mass revealed through DEXA scans [24:15];
• Muscle and lean tissue loss with age and how to overcome anabolic resistance [29:15];
• Female patient case studies: DEXA scan results and prescribed interventions [35:00];
• Male patient case studies: DEXA scan results and prescribed interventions [42:45];
• Protein consumption: recommended daily intake, Peter's personal approach, timing around workouts, and more [48:15];
• What to look for with protein supplements [53:15];
• Protein intake: optimal timing and how it should be divided throughout the day [55:30];
• Time-restricted feeding (TRF): Peter's updated perspective [57:45];
• Three strategies for reducing energy intake in over-nourished patients [1:03:15];
• Prolonged fasting: potential benefits and tradeoffs [1:07:15];
• A protein-supplemented version of time-restricted feeding (TRF) [1:09:30];
• Theories about time-restricted feeding (TRF) and its positive influence on sleep and circadian rhythm [1:12:00]; and
• More.

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