New England Stem Cell Institute

10/24/2025

Aging, anabolic resistance, and protein needs . . .

For decades the USRDA (U.S. Recommended Daily Allowance) for dietary protein has been 0.8g/kg body weight. However, the data is now overwhelmingly clear that this recommendation was based on flawed methodology and is woefully inadequate. Modern isotope-labeled amino acid studies have shown that the MINIMUM daily protein requirement is actually 1.2g/kg ideal body weight. The average American adult currently consumes 0.9 g/kg (and women get even less on average, 0.8 g/kg). (Vegans and vegetarians get even less!)

Another problem with the RDA is that many people get the impression that these recommendations represent the OPTIMUM amounts, when in actuality they represent the MINIMUM amounts to prevent disease!

A major problem as we age is sarcopenia-- loss of lean muscle mass. This has profound implications for metabolic health, frailty, and longevity. The major causes of sarcopenia are now recognized not so much as aging per se, but rather a combination of inactivity / sedentary lifestyle and inadequate protein intake.

Inactivity leads to anabolic resistance, the concept that muscles become increasingly less sensitive to amino acid signals to stimulate muscle protein synthesis. Internationally known protein expert Luc Van Loon PhD did an elegant study with young healthy volunteers. He casted one leg for several weeks (inactivity), while the other leg remained active (including single leg resistance training). There was a dramatic increase in anabolic resistance in the casted leg after only a few weeks!

Recent research has shown that, even in sedentary older adults, simply increasing daily protein intake to 1.2 g/kg ideal body weight virtually eliminates anabolic resistance and helps preserve lean muscle!

Of course, the best prevention for anabolic resistance is activity, esp. resistance training, ideally combined with daily protein intake of 1.6-2.0g/kg ideal body weight. (Note: there is NO human randomized controlled trial that shows that protein intake in this range or even higher is harmful!)

For a deep dive into this topic, watch the attached podcast with Peter Attia MD and Rhonda Patrick PhD.

Rhonda Patrick is a scientist & host of the FoundMyFitness podcast whose work explores the intersection of nutrition, aging, & disease prevention. In this ep...

09/25/2025

TEXT NECK: This is a growing muscular skill little problem as more and more people adopt a sedentary lifestyle, and spend increasingly more time on their small screens.

The typical adult head weighs approximately 8-11 pounds. With good posture, that weight is very easily supported without difficulty by the cervical spine.

However, due to basic physics and geometry, as the head position increasingly drops forward, the effective weight on the cervical spine can reach as high as 60 pounds! This can result in chronic neck and upper back pain, muscle tension headaches, nerve entrapment syndromes, and other long-term problems.

Also, over time, this slouched posture can cause bone remodeling (changes in the actual physical shape of the bones), resulting in permanent posture changes. Growing children are the most susceptible.

09/22/2025

FDA Alert: “Pain Flex”

The FDA recently issued a consumer alert: “PAIN FLEX may be harmful due to hidden drug ingredients.” (U.S. Food and Drug Administration)

Turns out, this product—marketed for joint pain relief—was found to contain dexamethasone (a corticosteroid) and methocarbamol (a muscle relaxant), NEITHER OF WHICH WAS LISTED ON THE LABEL!

As a physician I do believe in the value of supplements. I take them myself.

I also believe in doing as much due diligence as possible—for every supplement I recommend. That means reviewing safety data, sourcing, potential interactions, and regulatory warnings.

SUPPLEMENTS ARE NOT INHERENTLY SAFE JUST BECAUSE THEY’RE “NATURAL.” Hidden ingredients, contamination, or mislabelling can cause serious harm.

Always check for third‐party verification (USP, NSF, etc.).

Be skeptical of “miracle” or “too good to be true” claims.

If a product is marketed for pain or joint relief but labeled as a dietary supplement, ask: Has it been tested? Is there lab confirmation?

If you’re taking something and notice unexpected side effects—or using with other medications—consult with a trusted clinician.

The Food and Drug Administration is advising consumers not to purchase or use PAIN FLEX, a product promoted and sold for joint pain on various websites, including Amazon.com and possibly in some retail stores.

09/11/2025

Why are physicians increasingly dropping insurance?

Aetna and Cigna just announced that they will now be automatically downcoding for charges submitted for complex (level 4 & 5) office visits-- without reviewing individual patients' medical records.

The result is that claims for complex visits will be paid at a lower level. Physicians who disagree with this automatic downcoding will have to appeal if they want to get paid fairly for the work done. This means that doctors' offices will have to invest in a significantly greater amount of staff time & effort just to get paid -- something many practices will not have the ability to do.

These new policies from Aetna and Cigna do not put patients first. They're not about catching bad actors. They're about boosting insurer profits at the expense of patient access and timely care, while squeezing physicians. It will also mean that doctors will have even LESS time to spend with patients, further eroding the quality of care.

PLEASE don't blame the doctors! They're being squeezed like a wrung out rag, while insurers continue to realize stellar profits and CEOs make bank.

09/09/2025

Recently I had the pleasure of being interviewed by the great Alberto Panero DO for his podcast. Join us as I discuss ways to “prime” the body for optimum response to Orthobiologics treatments such as PRP and stem cells!

Can you optimize the body to improve outcomes from orthobiologic injections like PRP or BMC?In this episode, Dr. Alberto Panero sits down with Dr. Paul D. To...

09/01/2025

Almonds are a good source of protein, right?

Nope! To get the same amount of protein that’s in 3.5 ounces (99.22 g) of chicken breast, you need to eat 420 almonds (250 g)!!! On top of that, that number of almonds contains 50 g of fiber and would be rather disruptive to your GI system. Furthermore, that 250g of almonds contains 1445 calories and 125.6g saturated fat. 😳

Eat up, me ‘earties, yo ho! 🏴‍☠️

08/29/2025

Vitamin D can help slow aging.

For the last two decades I have been advocating the use of vitamin D, long before the vitamin started to gain popularity. Over the ensuing years, an increasing number of studies have shown significant benefits from taking D.

We now know that vitamin D is responsible for the expression of approximately 5% of our genes. Once metabolized, it acts more like a hormone than a vitamin. (BTW, vitamin D is synthesized from cholesterol. So if you drive your cholesterol level too low, such as with the use of statins, you will compromise D production.)

Telomeres are the “tails” of our chromosomes. More specifically, telomeres are repetitive DNA sequences located at the ends of chromosomes that protect them from degradation, and prevent the loss of important genetic information during cell division. They shorten with each cell division (i.e., aging), and when they become too short, the cell can no longer divide, which is associated with aging and certain diseases.

New research shows that vitamin D can help protect the telomeres, therefore helping protect against, or slow down, the aging process.

The problem, IMO, is that most physicians and clinicians either do not recommend vitamin D supplements at all, or if they do they recommend too low a dose. The laboratory reference range for vitamin D most commonly is 30–100. I prefer to see levels in the 60-80 range. To get there, I commonly recommend daily doses of 5000 IU, but I always follow blood serum levels and adjust accordingly.

Harvard researchers discovered that daily vitamin D supplementation reduced telomere shortening by more than half compared to placebo in a four-year trial.

08/27/2025

Is your doctor or clinic selling or injecting products derived from placenta tissue, Wharton's Jelly, amniotic fluid, or umbilical cord blood?

If yes, then you're being scammed.

NONE of these products are FDA cleared or approved for clinical use! In fact, the FDA has again dropped the hammer on another manufacturer of perinatal products, Platinum Biologics, based in Orlando. Here's the link to the FDA's warning letter: https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/warning-letters/platinum-biologics-llc-705090-08152025

From the letter:

"The United States Food and Drug Administration (FDA) reviewed your company’s website at www.platinumbiologics.com/ (last visited August 2025), through which your company sells two umbilical cord derived products, Nano PRP Jelly and Nano Flex, and two exosome products, NanoEx and Nano Xsomes, for allogeneic use (collectively, “your products”). This letter is to advise you that your products are unapproved new drugs in violation of section 505(a) of the Federal Food, Drug, and Cosmetic Act (FD&C Act), 21 U.S.C. § 355(a). Your products are also unlicensed biological products . . ."

I don't know how many times I, the FDA, and other leaders in the regenerative medicine and orthobiologics field have to emphasize that, with a very rare exception for use in certain wound healing and cosmetic applications, NO product derived from perinatal sources (cord blood, Wharton's Jelly, placenta, amnion, etc.) is FDA cleared for clinical use in orthopedic, musculoskeletal, or neurologic applications. Period.

It doesn't matter what the doctor or clinic tells you. Don't be scammed and don't waste your money on illegal treatments!

Deviations/CFR/Regulations for Human Cells, Tissues & Cellular Products (HCT/Ps)

08/24/2025

I was honored to teach and speak at the 16th annual TOBI: The Orthobiologics Institute symposium in Las Vegas this weekend. TOBI is the premier international stem cell and regenerative medicine conference. It brings together a collection of international leaders in the regenerative medicine field to share new research and new clinical tools & techniques to help persons suffering from orthopedic, musculoskeletal, and neurological conditions, such as arthritis. This was the 14th straight year that I’ve presented at TOBI.

I taught x-ray guided injection techniques in the cadaver lab on Thursday, and both lectured and participated in a friendly team debate on Friday (complete with boxer’s robes and the moderator wearing a referee’s jersey!)

It’s also always fun to reconnect with old friends, and to meet new ones, particularly from around the world. Many people with whom I’m connected on LinkedIn I met for the first time face-to-face.

08/15/2025

Collagen Peptide Supplements – What does the DATA show?

Although it’s been around for a long time, it seems as though collagen supplements are becoming the next new nutritional supplement fad, with ads popping up touting the amazing benefits of collagen supplementation. Claims include better skin, hair, joint health, and so on. But what does the actual research data show? (Remember, facts don’t care about your feelings or your agenda!)

Collagens are a connective tissue proteins found in tendons, cartilage, skin, and bone. (Hair is NOT a connective tissue and has NO collagen. So claims of collagen peptide’s benefits for hair are totally bogus.)

Collagen supplements are comprised primarily of 3 amino acids—glycine, proline, and hydroxyproline. These 3 AA’s are crucial for collagen's unique triple helix 3-D structure and contribute to its properties. (Remember that the physiologic function of a protein is due to its 3-dimensional folding shape, which in turn is determined by its amino acid composition.)

Let’s go to the RESEARCH:

Aussieker et al (2025) found no effect at all of consuming collagen on ANY marker of collagen synthesis. https://pubmed.ncbi.nlm.nih.gov/40523226/

Kirmes et al (2024) found no effect of 30g/day of hydrolyzed collagen supplementation on muscle connective tissue protein synthesis or myofibrillar protein synthesis. https://pubmed.ncbi.nlm.nih.gov/39086044/

Balshaw et al (2023) found that 15g/day of bioactive collagen peptide consumption did not augment patellar tendon adaptations to strength training over 15 weeks, including tendon size, stiffness, or strain reduction. https://pubmed.ncbi.nlm.nih.gov/37436929/

A number of older studies DID find that subjects experienced a reduction in joint pain with collagen supplementation. But all of these studies were sponsored by Gelita AG, a company with $1 billion in sales from . . . collagen supplements.

Collagen to help support joint health does make some sense, but not in people with otherwise healthy joints. Coen et al (2020), in an independent (not industry sponsored) study found no benefits of collagen supplementation compared to placebo on knee pain, performance, or inflammatory biomarkers. https://pubmed.ncbi.nlm.nih.gov/31990581/

There are some studies that show benefits of collagen for acute markers, such as collagen synthesis. However, all of those studies are confounded by co-administration of vitamin C, which is essential for stimulating collagen synthesis! In fact, collagen is produced by vitamin C + PROTEIN! But collagen supplementation is a lousy protein source. And collagen is a TERRIBLE source of protein for muscle growth. In fact, the protein score for collagen is, wait for it . . . literally ZERO.

Note that collagen does not simply enter the gut and somehow magically get incorporated into the tissue. Like all proteins, collagen gets broken down into its component amino acids which are then used to rebuild tissue. So it doesn’t matter whether those AA’s came from your collagen supplement or from a high quality full protein source! Not surprisingly, research has shown that consuming other sources of protein (such as dairy) can increase the precursor AA’s for collagen production. https://pubmed.ncbi.nlm.nih.gov/31681789/

Therefore, if you consume enough high quality protein + Vitamin C, your body will have more than enough substrate to build collagen, without having to take additional collagen supplements.

So does collagen supplementation have ANY role? In patients with symptomatic osteoarthritis, collagen supplementation may be beneficial. Lugo et al (2016), in a double-blind placebo-controlled trial, found that undenatured type II collagen supplementation improved joint symptoms in knee OA patients. https://pubmed.ncbi.nlm.nih.gov/26822714/

BOTTOM LINE: While collagen peptide supplementation may have benefit in persons suffering from osteoarthritis, its use otherwise essentially is a total waste of money. It certainly is not a replacement for complete protein, and even in persons with OA, collagen should be added to a diet that already provides adequate daily protein (i.e., 0.75 gram of protein per pound of body weight, or 1.6-1.8 g per kg).