Muscle Support

Wherever I look, I seem to be seeing protein at the moment. Protein yoghurt. Protein bars. Protein bagels. Protein cereal. Protein coffee. Probably, somewhere, someone's making a protein candle promising strength gains with notes of vanilla. And yet in clinic, I keep seeing the same thing. People are eating more protein, talking more about protein, buying more protein, and still not always using protein well. That distinction matters. This week, I saw a patient, an active cyclist, taking Mounjaro to support his weight loss goals. His weight was coming down. From the outside, you might think, "Brilliant, it's working." And in many ways it was. Then he said: “My muscles just don’t feel as strong.” Testing his amino acids revealed a possible why. Amino acids are the small building blocks your body makes when it breaks protein down. They help repair, strengthen and build muscle. His amino acids were low. So my question was not simply, “Are you eating enough protein?” The better question was: Are you breaking it down, absorbing it and using it? Let’s dive in...

Data

Where insight becomes impact

What I’ve been looking at this week…

Think of protein like a string of pearls. Your digestive system has to break that string into individual pearls before your body can use them. Stomach acid starts the process. Digestive enzymes continue it. The gut lining absorbs the amino acids. Then your body decides where to send them.

For muscle repair and growth. For skin and hair support. For immune function. For enzyme, hormone or neurotransmitter production.

This is why, “I eat protein” is only the first part of the story. The real question is: Can your body turn that protein into usable building blocks?

This is where the GLP-1 conversation gets interesting. There is a lot of noise about medications like Mounjaro and Ozempic causing muscle loss. Some concern is sensible because muscle matters. Skeletal muscle is one of your most important metabolic tissues. It acts as a glucose sink after meals, a strength reserve, a balance system, a bone-loading machine and an anti-frailty fund. Muscle is not just what helps you look toned. Muscle is what helps you climb stairs, carry bags, recover from illness, stabilise your joints and stay independent as you age.

But the panic around GLP-1s may be a little dramatic.

A new systematic review and meta-analysis in the International Journal of Obesity, [doi:10.1038/s41366-026-02088-1.] looked at GLP-1 medications and body composition. The researchers reviewed 36 studies and asked a much better question than “Did the scale go down?” They asked: when people take these medications, what actually changes inside the body?

The answer was reassuring, with a caveat.

In the early months, fat loss was the main story. Weight came down. Waist size came down. Fat mass came down by 17%. Lean body mass came down by 2%. That's nearly a 9x selection for fat which is exactly the weight you want to lose. Plus as an added advantage, visceral fat came down too. This is the deeper abdominal fat around your organs, linked with insulin resistance, fatty liver risk and inflammation. You cannot accurately measure it with a tape measure, which is why body composition data can be so helpful. At 3 months, fat mass and visceral fat fell significantly, while lean mass changes were largely preserved. At 6 months, lean mass continued to be preserved in the overall analysis. By 12 months, lean mass was dropping and the early relative fat selectivity was narrowing.

So the useful message is not: “GLP-1s melt muscle.” That is fear dressed up as a headline. The review of studies shows that most of the weight you lose with GLP1-s is fat and lean mass is preserved early on. This means the more useful message is: GLP-1s can help you lose fat. Protein can help decide what happens to your muscle.

Protein matters whether you are taking a drug to support weight loss, losing weight naturally, navigating menopause, training hard, ageing actively, or simply trying not to become the person who makes sound effects every time they get out of a chair.

Because muscle loss is already happening in the background.

This age-related loss of muscle is called sarcopenia. Men and women can start losing muscle gradually from their 30s. In women, the pace often accelerates around menopause, partly because oestrogen helps support muscle, bone, insulin sensitivity and recovery.

And this is the part people miss. Protein is not automatically useful because you religiously ate 30g per meal or followed a neat 1.2- 1.6g/kg calculation. Your body has to digest it, absorb it, circulate it and use it. If your your digestion has slowed, your gut is inflamed, your enzymes are not available, or you are not strength training enough, your muscles may not get the materials or the message they need.

That is why my patient’s amino acid result mattered. His weight was coming down. He was cycling and training. His muscles felt weaker. His amino acids were low.

Not necessarily because he wasn't eating protein, but because his gut may have been ignoring it and not breaking it down, absorbing it or using it effectively

If you're muscles are feeling weaker or you're not making the gains from strength training you think you should be, the reason may lie in your gut.

Devices

Track it to hack it.

What I’ve been monitoring this week…

Another patient asked me a very valid question this week. “How can a body composition scale know all about my fat and muscle just from my feet?” You may have wondered the same. Are these scales just hype or are they accurate? Most smart body composition scales use bioelectrical impedance analysis, BIA. The scale sends a tiny electrical current through your body and measures how easily that current travels. Muscle contains more water, so it conducts electricity more easily. Fat contains less water, so it creates more resistance. The device then combines that information with height, weight, age, sex and equations to estimate body composition. So no, the scale is not a tiny radiologist under your bathroom floor. It is estimating with reasonable accuracy. Useful? Yes, very, for monitoring trends. Perfect? No. Hydration changes the readings. So can alcohol, a salty meal, sauna, a long flight, hard exercise, poor sleep and menstrual cycle phase. That is why it is important to understand what the different parameters are actually measuring.

Here's a breakdown: Weight is everything: fat, muscle, bone, organs, water and food in the gut. Body fat percentage estimates how much of your weight is fat. Lean mass means everything that is not fat, including muscle, organs, bone, connective tissue and water. Subcutaneous fat is the fat under the skin. Visceral fat is deeper abdominal fat around organs. This is the one I watch closely. Skeletal muscle mass is the muscle attached to your skeleton, the muscle that helps you lift, climb, carry and stabilise. Bone mass is an estimate of the weight of your bones. Body water percentage helps to explain why the other numbers can move around. Bioelectrical impedence is affected by hydration, so I always want this to be reasonably consistent when comparing readings.

Body composition scales are great for regular at home tracking, and then once a year consider a DEXA scan as the gold-standard tool. DEXA stands for dual-energy X-ray absorptiometry. It is used to assess bone density, and to measure bone, fat and muscle more accurately.

Hume is the scale I use both at home and in clinic. Here's a link with a discount applied if you're looking to start tracking.

Decisions

From knowing to doing.

What this means for YOU…

This week, I want you to move from eating protein to using protein. My favourite way to think about this is the Protein Power Pathway:

Eat it. Break it. Absorb it. Use it. Train it.

Here’s how to apply it. First, check your intake. Track protein for three days. 30g of protein per meal is a useful practical range, adjusted for body size, age, appetite, kidney function, training load and medical context. For older adults, the PROT-AGE study recommends 1.0 to 1.2g protein per kg body weight per day.

Second, check your breakdown. If protein makes you feel bloated, heavy, refluxy, nauseous, or affects your bowels, the issue may be digestion.

Third, check your absorption. Gut inflammation, microbiome imbalance, constipation, low stomach acid, pancreatic enzyme issues and rapid or sluggish gut transit can all affect how well nutrients reach the bloodstream.

Fourth, check your use. Low amino acids on testing can suggest your body may not have enough available building blocks for repair or growth to match your demands.

Fifth, check your training signal. Muscle needs a reason to stay strong. Squats, hinges, rows, presses, carries and step-ups tell the body: keep this tissue, I need it. Measure body composition.

Do not just ask how much protein you eat. Ask how much protein your body can use.

💼 Case in point: My patient on Mounjaro is the perfect example. His amino acids were low, which told me his body did not have enough usable building blocks circulating. That immediately changed the conversation. This was not simply about eating more protein, although that might help. It was also about understanding whether he was digesting it, absorbing it and using it. So the next step is to assess the gut properly: digestive enzymes, inflammation, gut barrier function and the microbial ecosystem. We also need to look at body composition more clearly. Because if the amino acids are low, the question becomes very precise: Where is the protein pathway breaking down? Is it intake? Is it digestion? Is it absorption? Is it inflammation? Is it the training signal? That is why testing matters. It turns “I feel weaker” into a map. And once you have a map, you can make better decisions.

If you are losing weight, feeling weaker, struggling to build muscle, navigating menopause, or eating plenty of protein but not seeing the strength gains you expect, this is exactly the kind of testing I use in clinic. Body composition tells us what is changing. Amino acids tell us whether protein is available. Gut testing can help show whether digestion and absorption are part of the problem.

🎯 If you'd like to make decisions with precision based on your personal data and using devices that are specific for you, then book a private consultation and let's start to decode your health.

Diary

Where you’ll find me…

Last week: I was in Glasgow speaking to a brilliant room of business owners and professionals about why health belongs at the centre of business strategy. It is very rare to have a doctor in your grasp for 3 hours let alone 10 minutes! I loved all the questions that came at me. These are exactly the conversations I want more leaders to have, because the strongest businesses are built by people with the energy, clarity and resilience to lead well.

This week: I’m back in Brighton hosting an intimate longevity lunch on gut health. It feels like the perfect follow-on from this memo, because protein only becomes powerful when digestion and absorption are working well. We’ll be talking microbes, enzymes, inflammation, energy and the clues your gut may be giving you. Look forward to seeing you if you're joining me.

Next week: I’ll be at The 22 talking all things biological age. This is my favourite topic in longevity. Biological age gives us a way to look beyond birthdays and start asking better questions about inflammation, repair, resilience and the pace at which the body is ageing. If you’re coming, I’m excited to meet you.

Distinction

A thought to pause on…

“The goal is not simply to lose weight. The goal is to keep the strength that helps you carry your life."

So this week, do not just ask how much protein you eat. Ask how much protein your body can actually use. Wishing you a wonderful week ahead (that's 168 hours of your Million Hour life!! Dr Alka

Be sure to send this email to anyone who you also want to live their longest, healthiest life!

If you've been forwarded this email, sign up for future newsletters here

Book A Private Consultation Apply To Join The Million Hour Club Become 10 Years Younger in 10 Weeks

Sent to: alkapatel114@gmail.com

Longevity Lifestyle Concierge, 75 Harley Street, London, W1G 8QL, United Kingdom