- Grade Across-filed
Statin-induced risk of new-onset type 2 diabetes: magnitude, mechanism, and clinical implications
Statin therapy carries a documented ~9–12% relative risk increase for new-onset type 2 diabetes, with the effect most pronounced at higher doses (atorvastatin 80 mg shows ~34% relative risk increase). The mechanism appears lipid-independent — likely intracellular cholesterol depletion in pancreatic β-cells and skeletal muscle impairing glucose disposal — rather than a downstream consequence of LDL lowering. The risk is real but typically outweighed by cardiovascular benefit in appropriate candidates.
Last reviewed:
- Grade Bcross-filed
Per-meal protein threshold for muscle protein synthesis: the 30 g / leucine-trigger rule
Muscle protein synthesis (MPS) follows a threshold, not a linear dose-response: below roughly 2.5–3 g of leucine per meal (~30 g of high-quality protein), MPS is sub-maximally stimulated. Total daily protein is necessary but insufficient — distribution across meals determines how much of that protein actually builds and preserves lean mass.
Last reviewed:
- Grade Across-filed
Why the 0.8 g/kg protein RDA systematically underestimates true requirements
The current US protein RDA of 0.8 g/kg/day was derived from short-term nitrogen-balance studies that systematically undercount nitrogen losses and target deficiency prevention, not physiological optimization. Modern tracer methods (IAAO and stable-isotope techniques) consistently yield protein requirements 25–50% higher than nitrogen-balance estimates, placing the true minimum closer to 1.0–1.2 g/kg for sedentary adults and higher for active or aging populations.
Last reviewed:
- Grade Bcross-filed
Anabolic resistance in aging and the elevated protein requirement for older adults
Older adults require more protein per meal than younger adults to achieve the same muscle protein synthesis response — a phenomenon known as anabolic resistance. Per-meal requirements rise from roughly 0.24 g/kg in young adults to 0.40 g/kg or higher after age 60, and daily targets of 1.2–1.5 g/kg/day are needed to correct the ~1–2 %/year muscle loss otherwise observed after age 60.
Last reviewed: