Dhru Purohit Show - Why Muscle is the Key for Longevity with Dr. Gabrielle Lyon

Episode Date: May 19, 2022

This episode is brought to you by BiOptimizers and Birch Living. Skeletal muscle is a widely overlooked part of our metabolic health.  From how well we control glucose and insulin to how well we age, skeletal muscle regulates many processes. One of the most important factors for how much muscle we create and retain is our protein intake, which has become a divisive topic in the nutrition world and one still hotly debated in some dietary camps. Today’s guest on The Dhru Purohit Podcast, Dr. Gabrielle Lyon, is the perfect person to sort through the facts on the powers of skeletal muscle and how to consume protein for optimal impact.  Dr. Lyon is a Washington University fellowship-trained physician in Nutritional Science and Geriatrics and is board certified in Family Medicine. She is the founder of the Institute for Muscle Centric-Medicine™ and has a private practice that services leaders, innovators, mavericks, and executives in a number of fields. In addition, Dr. Lyon also works closely with special-operations military personnel. Her goal is to change the paradigm of medicine from obesity-focused to muscle-centric and change the way we think about health and medicine with high scientific integrity.  In this episode, we dive into: -The importance of muscle when it comes to our health (4:16) -The connection between muscle and metabolic health (16:06) -Myths about dietary protein (18:41) -Aging, longevity, and protein consumption (31:22) -Optimal lab levels when eating a protein-centric diet (49:20) -Dr. Lyon’s diet (59:27) -Why breakfast is the most important meal of the day (1:00:38) -Women and fasting (1:04:32) -How to know if you are under-muscled (1:08:03) -Does the quality of animal protein really matter? (1:27:03) -Cancer and protein consumption (1:49:50) For more on Dr. Gabrielle Lyon, follow her on Instagram @drgabriellelyon, Facebook @doctorgabriellelyon, Twitter @drgabriellelyon, YouTube @drgabriellelyon, and through her website, drgabriellelyon.com. Check out her podcast, The Gabrielle Lyon Show, here. This episode is brought to you by BiOptimizers and Birch Living. Magnesium Breakthrough from BiOptimizers really stands out from the other magnesium supplements out there. It contains seven different forms of magnesium, all of which have different functions in the body. There isn't anything else like it on the market. BiOptimizers is offering my community 10% off, so just head over to magbreakthrough.com/dhru with code DHRU10. To get $200 off your Birch Living mattress plus two free eco-rest pillows, head over to birchliving.com/dhru. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

Muscle is the organ of longevity. Obesity, diabetes, cardiovascular disease, Alzheimer's. These are diseases of skeletal muscle first. Welcome to the Drew Prod podcast. Each week we explore the inner workings of the brain and the body with one of the brightest minds in wellness, medicine, and mindset. This week's guest is Dr. Gabrielle Lyon, and we are deep diving into the conversation of muscle. Today's guest, Dr. Lyon. believes that we are under-muscled as a society. And because we are under-muscled, we don't have enough lean muscle mass. That leads to a whole host of challenges, especially as we age.

Now, because we are under-muscled, based on Dr. Lyons' view and her muscle-centric medicine approach, it also means that we need to prioritize protein, which for a lot of people can be a very confusing topic. And I've found myself in that category too. You know, we've had many distinguished guests on this podcast previously who might advocate for what would be seen as a lower protein diet. But as people become more familiar with the literature, and this is Dr. Lyons' argument in today's podcast, they start to understand that

protein is so central for building and keeping muscle as we age especially. Now, a little bit about Dr. Lyon. She is a Washington University, fellowship trained physician in nutritional science and geriatrics and is a board certified physician in family medicine. She's the founder of the Institute of Muscle Centric Medicine and has a private practice that services leaders, innovators, mavericks, and executives in their perspective fields. In addition, Dr. Lyon also works closely with special operations military and

her goal and mission in life is to change the paradigm from medicine from obesity focused to muscle centric and fundamentally shift how we think about health and medicine with highly scientific integrity. Dr. Lyons is a friend and I am so glad that she's on the podcast because as you can see with my discussion with her, I get to ask her all the questions that I have about topics that I'm confused about. And I appreciate her openness, her honesty and her willingness to walk me down the journey because like you, the audience, I still have my own questions as I navigate my personalized approach to how I want to eat and live. And before we jump into today's podcast, I just want to share one quick note. At the end of

the day, anybody who's feeling overwhelmed with the plethora of different opinions that are out there know that we don't have to use that as the reason to distract us from the core fundamentals. The core fundamentals are sleep, the importance of movement, getting away from ultra-process foods, keeping our blood sugar balanced by not eating too much refined carbs or too much sugar in our diet, especially liquid calories, having love and deep sense of community and purpose in our life, having some connection to either spirit or faith or even just quiet around us that lets us tune into our gut instinct. If you focus on those fundamentals, I'm sure I left something out, then the rest will fall into place and you can hear a diversity of opinions without feeling like, I'm not going to take

action because everything seems so confusing. Well, it's actually not that confusing for open to leaning into just hearing the arguments that are out there and then personalizing based on what our goals are. And Dr. Lyne is really good at presenting that information and helping us ask that question. What are our goals? What are our goals in life? I hope you enjoy today's podcast and let us know what your feedback is. Dr. Lyon has a book coming out and a podcast as well.

Please follow her on Instagram, subscribe to her podcast, and stay tuned for her future book release. Dr. Gabriel Lyon, welcome. Back on the podcast. It's a pleasure to have you here. It's amazing. I get to see you in person. In person. Always in person is the greatest.

Let's dive in, right? Yeah. It's been a while since our last episode. So it's important to revisit your central core. thesis about the importance of muscle when it comes to our health. Yeah. Share that message with our audience. Okay.

So the main focus of my message and my driving mission is muscle is the organ of longevity. And right now, everybody is focused on adiposity. They're focused on being and losing weight. And that is really the core central theme that we see. What if I told you we are. are not over fat, but we are under-muscled as a society. And the reality is one of the reasons obesity is so hard to treat is because fundamentally we are looking at the wrong problem.

And issues like obesity, diabetes, cardiovascular disease, Alzheimer's, these are diseases of skeletal muscle first. Boom. This is, that's a big deal. It's a big deal. And we're going to unpack it all. Yeah. Now, let me start off with something that you shared, right?

It's that you were saying that we're not over fat, we're under muscle. Yeah. Now, can it be both and asking the context of the pandemic and everything that we saw with people that had poor metabolic health, people that were obese, being a higher risk, passing away, unfortunately. Yeah. Isn't it a little bit of both? So it is a little bit of both.

And when I think about the idea of core treatment and symptomology, obesity is a symptom. It's not at the root. If individuals have healthy skeletal muscle, their survivability across all illnesses, which is very rare to be able to say that in medicine. So I am saying, Drew, if you have healthy skeletal muscle, if you have enough, if you have enough body armor, you are not only going to be able to survive through issues that happen during the pandemic, but also you'll be metabolically healthy. And I know that that's a core theme of yours. You talk a lot about metabolic health. And in my mind, when we think about skeletal muscle, we have to think about what it does. So let's get into that. And let's talk about it for especially our audience, which is primarily female,

but shout out to the men. Which I actually think that that's amazing and love that. Yeah, I love it. I love it. Shout out to everybody who's listening, of course. Yes. But for our audience, and through the different stages of life, how, and can you give some examples of how important muscle is and what it actually helps people do, especially for women. Yes. Well, of course, this happens to be my favorite topic. When you think about muscle, we often think about it in the fitness realm. And of course, that's what we hear. You think about bodybuilders. You think about protein. And really, that's a conversation that is typically thought of in their 20s, right? And it's so interesting because muscle, and we're talking about

skeletal muscle now is so much more valuable than that. The idea of locomotion and physical fitness is one small aspect of what muscle does. Muscle is actually, and by the way, makes up 40% of your body, it is the largest organ system in the body. Skeletal muscle is an organ system. And we must, if we want to change the trajectory of how people are aging and what, what we are seeing and obesity, we must address skeletal muscle as the organ system that it is. Now, I know it sounds like a very basic question. No, no question is basic because we do have to lay the foundation of what muscle does, how do we stimulate it, how it relates to health and wellness.

Of course, of course. That's what you're here to do? Yes. So you're saying skeletal muscle. What muscle is not skeletal muscle if you can break that down? So smooth muscle, things that you don't have voluntary control over. Got it. You know, and of course is cardiac muscle.

and smooth muscle and then the skeletal muscle, which you have direct control over. And again, just mention a few of those. So like a uterus. A uterus would be a smooth muscle. Yeah, exactly. That's not what we're talking about. No, we are not talking about this. We are talking about muscles that have voluntary control that, like, for example, your bicep or your quadricep, things that you can move.

Now, we know, and we've talked about on this podcast before, that one of the leading indicators of, you know, old age is grip strength. Yep. Right. And that's one of the greatest predictors of your likelihood of death, I believe. Yeah. Is that right? Yep. And so we understand that especially as people get older, having muscle is actually what protects their bones. Yes. From fracture, from breaking. And when older people, especially break a bone, I was just talking to a friend of the day. Her mom, unfortunately, fell down while playing pickle ball. And she's a walker. My friend was saying, but she doesn't really do a lot of of muscle building activities, no resistant training. She fell in a very simple fall ended up shattering her ankle. And my heart goes out to her and her mom.

It was a very sad story. And in the hospital, like a lot of people get into the hospital, they start to rapidly decline, especially when they're bedridden. You know, it's really interesting. And I'm going to share a very scary statistic. For women over the age of 65, if they fall, 50% of them will never walk again. Wow.

Say that one more time, because that's like mind-blank. For a woman, 65 or older, if she falls, there's a 50% chance she will never walk again. So that would look like what? She is bedridden or wheelchair bound? Yeah, she, yes. I mean, you know, there's an extreme risk of death. Oftentimes people end up having to go to assisted living. There are very tragic and predictable outcomes that happen if you don't address skeletal muscle

midlife. And again, there's multiple things that skeletal muscle does, which I think we should discuss as it relates to metabolism. And also there's a natural decline in skeletal muscle as we age. It's really interesting. There's a physiological process that happens, one of which is called anabolic resistance. And it's this idea that skeletal muscle is actually a nutrient sensor. It senses protein. And the efficiency by which it does that, decreases as we age. Which is why it's harder to put on muscle as we age. And also there's a decrease in hormones.

For women, especially during perimenopause, menopause, that is the time in which they have the most rapid decline in muscle mass. And we're more likely, I've heard you on many interviews talk about, we're more likely to become insulin resistant. Yes. Isn't that interesting. Just explain how that works because we've done so many episodes on metabolic health. I love this.

And we always talk about glucose monitors and the benefit and looking at your fasting insulin. But make the connection between. muscle. Okay. I would love to. I believe that obesity is a disease of skeletal muscle. And here is why. Insulin resistance, which you've talked about probably in many podcasts, insulin is the peptide hormone that is necessary to move glucose out of the bloodstream into cells. And glucose is very interesting because it's a double-edged sword. We need it, yet it is toxic. So, skeletal, muscle is the site for 80 plus percent of glucose disposal, 80 to maybe 90 percent of glucose disposal is skeletal muscle.

It's used by those muscles. Yes. Which is why, just to connect the dots from people listening, if you eat like a big meal and then you go on a fast-paced walk or you're doing like some girls or some squats or whatever, that actually helps lower your blood sugar. Yes. Well, initially you might see a little spike, but your blood sugar on average comes down afterwards. Skeletal muscle is really at the focal point of metabolic regulation. And most importantly,

insulin resistance starts in skeletal muscle first. So let's think about that. So it's 40% of our body weight. It's the site for glucose disposal and it's the site where insulin resistance starts first. Think about muscle as a suitcase. If you fill it up, right, if you're eating and you fill it up and you don't unpack it by training, then what happens? You can only stuff so much in, and then the rest, fatty acids, their increase in glucose, it goes back into the bloodstream. That is why I believe the diseases of insulin resistance, obesity, and these issues that go alongside of them begin in skeletal muscle. And it's actually in the literature. Yet we, for whatever reason, have not focused on skeletal muscle as the focal point, as the pinnacle.

It is always a periphery. And really, in fitness, there's this huge gap between exercise and fitness and muscle as this metabolic organ. Very superficially, we kind of divide the two. But ultimately, if you care about these diseases of aging, then you must optimize skeletal muscle and you must transition the way in which you eat, the way in which you train as you age. Wow. It's fantastic to get a chance to go through all that because for a lot of people, I think you

would say, which is why you are so focused on your message. You've launched a podcast. Yeah. By the way. What's the name of the podcast? The Dr. Gabrielle Lyon Show. We'll link to the show notes. You have a book coming out in October.

It's an important message because it feels like it makes sense when you're listening to it. Now, people are trying to understand all the behind-the-exam. the scenes. And they're also trying to compare it to some of the other content that they're hearing out there. One of the ones that people hear, which would be a great opportunity to just bring up early, is that actually too much protein in the diet, which how does muscle get made? Protein is a key element of it. Not the only element, but a key element of it has been linked to a lot of different chronic diseases. Let's just touch on that. We'll dive deeper into it later on. Let's just touch

on that for a second. Well, I'm a trained geriatrician from Washu, which is a very excellent institution. And one of the things and one of the most important aspects of health, longevity, aging has been protein. And there was a lot of myths about dietary protein, none of which, by the way, have been validated. Observational data, epidemiology data does one thing. And typically, when we think about the hierarchy of evidence, we take epidemiology and then we do randomized control human trials. And what we know is that based on the randomized control human trials, that now the RDA is 0.8 grams per kilogram, which is the bare minimum of protein per day.

So that is the bare minimum set to prevent deficiencies. It is not the maximum. And I would just like to bring up this example of vitamin C. Vitamin C, do you know the RDA of vitamin C? I don't know. 60 milligrams, very, very low. Now, if you were getting sick or you needed an extra boost, would you hesitate to take more vitamin C? Not at all.

In fact, you would be like, mah, I'm not feeling great. Maybe I'll take some vitamin C, right? Well, the RDA there is clearly that it's 60 milligrams to prevent deficiencies, but most people, nearly everybody, would be willing to say that is not a maximum. Yet when we look at dietary protein that's set at 0.8 grams per kilogram per day, people say, no, no, no, that's the maximum. I am using this example to highlight the huge dichotomy that we have between nutrients and then this macronutrient protein, which is arguably the elephant in the room, right?

It is the black sheep of the macronutrient family. The data would support that nearly double that is what is more important. optimal. In human randomized control trials, we know that optimizing for protein, those people always do better. They have better body composition. They have healthier lean muscle mass. They have better insulin and glucose control. These are very important measurable outcomes that we know. We also know that it improves satiation and it protects tissue. And in fact, the body there's protein turnover that happens about 300 grams a day. We have to account for that. And not only that, but protein is essential. And there's never any evidence there has not been, to my knowledge,

nor in the literature to support higher levels of dietary protein having any kind of negative effect. Ever. Ever. But epidemiology, it's really interesting. So if you look at the relative risk. So the relative risk is what we consider in medicine when it is two or above two, we consider it clinically significant. So we'll say smoking and lung cancer. The relative risk would be 12. Okay. And this is just based in the data.

So they have looked at protein and the relative risk of protein intake and any kind of illness is 1.2. so according to the evidence, it's not clinically significant. And I'm really glad you bring up this point because the evidence doesn't support the narrative. And I will say that if you look at the history, people have been arguing about nutrition and nutrition science forever since the 1800s. And when I think of the word food, what do you think of when you think of food? You might have a different perspective because you are very involved in the world of food. But when you think of food, what do you think?

First thing. Food, I see like abundance, like a farmer's market type of feel. Yeah, okay. A lot of like bright, colorful things that sort of draw you in. Do you think about emotion and family and community, which I know is big, and even comfort, right? A lot of women. But you don't necessarily think of off the top of your head,

the biochemical nutrient processes of the hard science of food. So we have food, which is emotional. It's my grandmother's cookies. It's the holidays. It's I'm feeling stressed. I'm going to eat. Food is so much more.

And then you have the science aspect. So the science is hypotheses that can be tested, a body of literature that can be learned upon, it can be tested and tested over again. So we have food science is the ultimate oxymoron. I'm bringing this up to set the stage for the confusion around food. Nobody argues about calculus. Nobody even argues about biochemistry. Yet here we have a hard science, which is a food science, and we are all arguing about it. That is unusual for any avenue of, a hard science.

Is it because also just like nutritional studies that especially have anything to do with longevity are like tough to do in a like a human level and following people over that period of time? Is that part of this? I don't think so. I think it's from biases. I think that food, even of a scientist's perspective, I think it can be very clouded. I think that evidence is evidence. There's half a century of data to support higher protein diets for humans, yet there's still more epidemiology. There's still bad press about protein. And I don't believe that it's based on confusion because, again, there are many human randomized

controlled trials that support dietary protein. And I wasn't even aware. So I've been mentored by one of the world leading protein scientists. His name is Dr. Donald Lehman. And he's mentored me for two decades. I worked when I was in my undergrad in some of the early human studies. And at that time, it wasn't such a hot topic in terms of argument. But, you know, it's really interesting as I'm writing my book.

I'm looking back at the literature. And World War II during the rationing times, there were recommendations. And the recommendations for protein, are you ready for what those were? The soldiers were given. at least one pound of meat a day. An injured soldier, and this is from literature in the 1940, I think 1945, an injured soldier was given 250 grams of protein. And what the records are showing and what was reported was that they had a 50% increase

in their healing capacity. And this is before all the kind of narrative and fighting. This is just what they were doing. And back on home soil, people were encouraged to grow victory gardens. All the high-quality protein was sent overseas. They had to feed a million people. They were encouraged to eat grains. They were given and rationed one egg a day.

They were eating processed foods, more processed foods, more grains. And there was an acknowledgement that this protein was so valuable that we were going to send it all overseas. Fast forward, 80 years later to now what we're seeing, we're seeing the same kind of narrative wrapped up differently. We are hearing protein is bad for longevity, protein is bad for the planet, or it's bad for your health. We should eat more grains. We should be more vegetarian.

And what I think is really interesting is that the same recommendations, we should be more are happening with a new narrative. And what I feel is most important is that we all want a healthy world, all of us, you, me, all the work that you do. And in order to have a healthy world, we must have transparent conversations. And that is what is missing. You know, last time we chatted, I had a big aha moment from something that you shared. And I just want to add this into the mix.

Because you're not out here, like, first of all, like you just want people to be healthy. You're not trying to tell people what to do. Absolutely not. And you're trying to show them that, hey, look, if something isn't working and you don't feel like your best, or if you care about this topic of longevity, here's a crucial conversation that you might be missing out. Right.

One of the things you mentioned last time is I was telling you that I come from, you know, growing up, I was vegetarian. Yep. And on my, both my mom and dad's side of the family, there's a long history of, you know, vegetarianism or vegetarians. And especially for my moms, it's probably. probably one of the longest, and everybody in my podcast knows, I'm not vegetarian now. And by the way, I used to be vegetarian.

Yeah, we'd love to talk to you about that. Yeah. Talk to you about that. I have a few questions about that. My mom's side, the Jane tradition, J-A-I-N, one of the longest. Yes, yes. Continuously running a group of vegetarians that are there. And I was sharing with you that, you know, when I go to India and I'll spend time, you know,

these pockets, because India is struggling with major outbreaks of metabolic health issues. news. It's like something crazy. Like it's, uh, India's only 18% of the population of the world, but they have almost like 40% of all the heart attacks in the world. It's like nuts. Right. The metabolic health is going nuts. But when I see, um, people who are older in these pockets and I go and visit or I go to the rural areas. Right. And I see older individuals that are there, uh, you know, and often people who are maybe still farmers or things like that, they're, they're very lean okay but they're shredded right like they're lean like they don't have bellies and other things like that and they're not eating protein like on animal protein at all right and I was

asking you about that and you were like look one thing that's important for you and let's see if I got it right and then correct me if I got it okay and build on it she's like one thing to important to understand is that the more you work out yes the less protein you need right so if there's people that all day are out in the sun, working all the time, they're moving their muscle. Moving their muscle. Yeah. They're going to have shredded muscle, right? And they're constantly moving their body. And maybe their protein requirement is different. Now, if you have other people that are not in that space. Which most people are not. Most people are not. And then the other next question I would say is, what then becomes optimal? Right. So. But that was just interesting for me to hear because it was putting

into context that I was like, okay, wait, why is it working for this one group? Even though this is anecdotal evidence, I haven't put a whole population set together. These could be just outliers that are part of it. It's like what is going on with them? And again, like you said, most people are not in that situation where they're working their body out, you know, eight to 16 hours a day. Right. You know, and I would say I probably would mention that number one, calories matter and then also the repair and recovery of their bodies. So do they need less protein? They certainly could get away with less because they're moving and they're keeping their muscle healthy and supple. And again, the question would be, would it be optimal? And this is a beautiful segue to say,

one of the things that happens with aging muscle is, again, muscle as an organ, is a nutrient sensor. And when we think about a practical, from a practical standpoint, you know, if you are going to eat for longevity. And that's also something we should define in terms of what actually is longevity. Sure. Is it six weeks, six months, six hours? I think it's a very nebulous term. I would even argue that it's not about the length of time you live. You know, I worked in a nursing home for two years. That is not a pretty picture. We have become very capable and able to keep people alive for periods of time that there's quite a bit of suffering that happens. I would argue it's the quality of life and the strength.

Exactly. And if we reduce dietary protein during the time in which you have the most capacity to build it in your 30s, 40s, this is the time where you build tissue. If those individuals decide that they are going to go on a lower protein diet and not really train, it doesn't get easier to build muscle. In your 50s and 60s, it's more difficult. And we really have to think, what are the health outcomes that we're looking at? And I would argue, while there's nebulous outcomes, there are very clear outcomes.

Like you mentioned grip strength. Like you mentioned physical strength. Like you mentioned, you know, being able to be. metabolically healthy. And the other thing that we know is the more healthy muscle you have, that is your amino acid reserve. If a person were to get injured, the thing that is going to save them is their muscle. Individuals that get cancer, 50 to 80 percent are going to get catexia. That is a muscle wasting. The survivability of those individuals is going to be based on their skeletal muscle.

Interesting thing about that that I'd love to just talk out. So, you know, we recently had, I mentioned to you, we were chit-chatting a little bit. We had Dr. Walter Longo and his work and he's done a lot of great stuff in the space of fasting, fasting, mimicking diet. And he has his longevity diet that he talks about. Right. And from what I can gather, you know, the primary thing that they reference when they're talking about the evidence of lowering protein is they talk about IGF1.

And so talk about what that is and what your perspective is on the idea that that is a typically with higher protein diets. So insulin-like growth factor is exactly what it sounds like, insulin-like growth factor. And when we think about where it plays a role is we think about IGF-1 being very high in young individuals. So IGF-1 being very high in young individuals and what does that look like? It's a growth factor. the idea that IGF1 is a negative influence as it relates to protein intake is not supported. So this is isolating IGF1 saying this is bad.

Now, if IGF1 is bad when IGF1 is highest in your 20s, so it doesn't necessarily would make sense that IGF1 is bad, right? That means everybody in their 20s would have cancer. The other thing is when we think about IGF1, you have to think about insulin and carbohydrates, and obesity is driving those numbers up. It is not a primary protein intake issue. So this is, in my opinion, very myopic. It is a very myopic way of looking at it as it relates to health outcomes.

So growth hormone, IGF1, these are all very valuable components to the body for the support, of healthy metabolism, muscle protein synthesis. These are not negative. And I think what would be more important to look at is, and also keep in mind there are no randomized control trials that I know of linking, and I know Longo's work very well. And one of the studies that you are referencing, there was, and I'm going to try to think of a way to put this,

of a way to put this, when this study came out linking IGF1 to protein intake, there were a group of individuals, some of the most world-renowned, well-respected protein experts, that wrote a response to this paper. And the analysis, it's still publicly available. It's still publicly available. You can link to it, link to both? Yes. And it breaks down the flaws to the way in which the data was analyzed.

And I think it's very important for people to look at because it really highlights some of the issues with making these broad... Connections? Statements and connections. Okay, got it. Yeah, I would love to read that. It's very important work. So, no, IGF1 related to protein intake and longevity, I do not believe is an issue.

I think that it is, I think a better marker to address and discuss is MTOR. So the mechanistic target of rapamycin, which is also something that Volter Longo's group discusses a lot about. And I think they were involved in finding one of the pathways or something like that? So that's Sabatini. Okay. And I would say that the work by my mentor discovered the meal threshold of leucine and mTOR. Okay.

So I have a pretty good understanding and I'm well versed in the clinical application of what this looks like beyond epidemiology data, but actually within humans. And so just explain to people because you just did IGF1. Yeah, an IDF1 from liver. MTOR pathway, like just a little context. So mechanistic target of rapamycin is mTOR and mTOR 1, mTOR C1, and that is in all tissues. It is in the brain. It is in the pancreas.

It is in muscle tissue. MTOR is a growth promoting pathway, right? It is not an initiator. It is a growth promoting pathway, which is stimulated in a multitude of ways. mTOR is stimulated in muscle by branch chain amino acids, in particular, lucine. And I'm going to lay the foundation and I'm going to come back to it because it's very important that people understand this. So mTOR in skeletal muscle, mTOR in the liver, the pancreas in the brain.

And the reason this is important is because it is a growth-promoting pathway. In the media and in some of these groups that are arguing to go more vegetarian, they will say m-tore is a bad. that stimulating this pathway is negative. And we're going to really unpack it because it's very important. M-Tor stimulation in skeletal muscle, which, by the way, it is exquisitely sensitive to. Mechanistic target of rapamycin, this protein kinase complex, is exquisitely sensitive to an amino acid called leucine. This is necessary for muscle protein synthesis. If you do that, you do not trigger this pathway, you do not stimulate muscle. We know that skeletal muscle is always important. We know that your survivability improves the healthier your muscle is. And we can agree

upon that, right? Longo would agree upon that. Now, it requires a very specific dose of protein to actually stimulate that tissue. And that is two and a half grams of leucine. And for the listener, that is a minimum of 30 grams of protein per meal to stimulate this tissue. If you are below that number and 30 grams of protein, that would be four ounces, maybe five. If you are below that, you do not stimulate mTOR pathway. Can you imagine what that does over time? Tell us. If you do not stimulate that pathway over time, you will not have the

of muscle that you need. If you have breakfast and you're having one egg and you're having a small turkey sandwich and so that your first breakfast, you're getting 15 grams of protein, and you're going, oh, I have my protein intake. You're not stimulating mTOR. And by the way, that first meal of the day is most important, which we'll come back to. I don't care what time it is. If you go on a low protein diet, you will not stimulate your tissue. You will not provide it with the amino acids it needs for survivability. Right? So now let's talk about mTOR in other parts of the body.

MTOR in the pancreas in the liver are exquisitely and more sensitive to carbohydrates and insulin. If you believe that mTOR is bad, mechanistic target of rapamycin is a bad growth promoter, then you have to believe that excess carbohydrates are bad. And you feel like that's the part that's not being talked about by people. It's like we're putting all the focus on protein. Right. But what about this other aspect? Not only that, that's like saying when you exercise, because exercise stimulates mTOR, exercise is bad for you.

So if you believe that protein is the culprit, then you would also say, well, I shouldn't be exercising either. And I think that there are people that even if they come from the world of like more plant-based eating that I've been starting to see that are talking about how protein is important, we need to put more focus on it. But it's also an essential nutrient. There are 20 amino acids, nine of which we must eat. Not only must we eat them, we must eat them in a certain amount to get the stimulus that we need. This is the most overlooked aspect of all of nutritional sciences. And it's interesting because even the RDA doesn't recognize the meal requirement of certain amino acids.

And listen, if you look at the back of a label, you'll see fat and you'll see the fat and you'll see the fat breakdown, right? Is it saturated fat? Is it mono-unsaturated fat? When you see carbohydrates, you'll see sugar. You'll see fiber. And then you get down to protein. And all you see is protein. But there are 20 amino acids and they are not created equal. The protein in quinoa and the protein in broccoli has a different amino acid than the protein in beef or the protein in chicken. Yet, we cannot make these blanket statements that if you just get your protein, you're going to be okay. I do want to acknowledge, you know, there's a gentleman, even though he has maybe completely different views on where to get that protein and other stuff.

He's been on the podcast before, but I've seen some clips. He's pretty vocal in the plant world. His name is Simon Hill. And again, you know, he has very, his own specific views. You have your views. But I do want to acknowledge that I've been seeing more and more people like him say like, look, this is important and we need to make sure we hit all these amino acids. Again, they may have different arguments of how to get there.

But I'm starting to see that conversation where previously that conversation was just like, protein's bad. Right. You don't need all this stuff. But you do need all of it. And it's amazing. And I really appreciate that he's saying that because we all want the same thing. This is not a conversation of division.

It needs to be a conversation of inclusion. And when you have people say we should eat less than the RDA, so 0.8 grams per kilogram, which is based on crude nitrogen balance studies, the idea that we would then go and say, you should eat less than that, the average woman eats 75 grams of protein a day. The average male eats 100 grams of protein a day. The advice to say, based on epidemiology or blue zones, that we should eat less than that is going to be catastrophic. I think the other thing with blue zones that sometimes is a little confusing because here you are talking.

And there's all multiple different blue zones and they do multiple different things. Totally. And they eat multiple different diets. Yeah. And definitely the spin on blue zones is that they all have these things and beans are central and they don't eat a lot of animal protein, even the ones that do. But here's one thing that could be an interesting link. I'd love to hear your thoughts on it.

Is that because a lot of your muscle development, your skeletal muscle, as I'm hearing from you, is sort of like that, you know, 18 to 40 space. Yeah, like, yeah, let's go. That's your 18 to 40 space, 18 to 40 years old. You're really establishing the foundation. Right. Then, okay, great. When you're older, could you get away with, with less?

No. Essentially, like I'm talking about like when you're in your 90s and that sort of thing. You need more because, again, muscle is a nutrient sensor and there is something called anabolic resistance that happens. What this means is your muscle doesn't sense the amino acids the same way it did as robustly that it did in your youth. In order to have healthy muscle respond in a robust way like you did it in your youth, you must get a more bolest amount of protein.

for older individuals like my dad, he eats 50 grams of protein twice a day. And people are like, oh, that's so much. But no, it's actually not. And ultimately, we must understand our perspective about where we have come to understand our nutritional needs. Nutrition science is relatively new. I mean, they were just discovering amino acids in the 1940s. That's not that long ago.

And the recommendations have yet to catch up. There is a consensus paper. There's the prodage paper. It's a prodage consensus, and this is the European working group for sarcopenia. Because ultimately, we have to bring it back to what are the health outcomes that we want. We want strength. We want glucose regulation. We want metabolic control.

The way in which we do this, the vehicle by which we can manage and mitigate these issues is skeletal muscle. Do you feel like there's any population sets that are out there or micro communities or groups that do a good job at this? That's a really good question. Is it that industrialization has become so rampant, prolific that we really don't have any groups that we can kind of look at, even if it was, you know. I wish to say that we did,

but we don't now because we are so industrialized. And then the other thing is that physical activity and movement is optional. It was never that way. We had to do it. There was no you go and work out. You just have to work out to survive because you can live. So can you imagine now we have teaching.

we have taken away a stimulus that is necessary for the body. You know, we have taken away a stimulus which is required. And these conversations are so important, these longevity conversations, and also these protein conversations, because, again, you are not going to maintain healthy muscle if you do not optimize it in your youth. It is very, very difficult. And every person will tell you. And let's even take sarcopenia off the plate, you know, like we take it out of there. What about osteoporosis? Osteoporosis, bone is made up of 40% protein.

It is very vital to get high quality nutrients and for us to understand that, you know, also when we think about the blue zones, they're not overeating, right? These issues that people want to pin onto protein, it couldn't be further from the truth because we do have evidence that we know that individuals need higher protein as a they age. And not only that, we also know that any study will show you that 0.8 grams per kilogram to 1 gram per kilogram, the people with the higher protein do better. So it's very curious as to how there is still arguments in this space. So one of the things that ends up coming up in part of the conversation, right, as we unpack all that, you know, thank you for being here again and, you know,

walking us through all this is people often say, well, it's not really the protein that we're talking about. It's often the things that get associated with in their instance where they're talking about it where they have like, let's say beef with animal protein, right? It's dietary cholesterol, which we know, right? Which, by the way, in 2015, that was taken out of the guidelines. Totally. 100%. It took 20 years to do it. It took 20 years to do it. Right. So perhaps what we're beginning to hear now is maybe not true. So, yeah, let's say that. Let's say also elevated levels of like LDL, lipoprotein B, like these things often get attributed

to animal sources of either fat or protein. Which there's no mechanism. First of all, yes, it does get attributed. There is no evidence to support that animal protein in particular is the culprit. If you have excess saturated fat, that can be a problem. If you have excess calories, that can be a problem. And when we think about beef, beef is, you know, the fat and beef is mostly mono-unsaturated. Upwards beyond 40% of the fat in beef is mono-unsaturated.

I heard that for the first time on another podcast with Rob Wolf and Joe Rogan, we're talking. It is mono-unsaturated fats, yet we demonize beef. Also, saturated fat within context, our body makes palmitate. It makes a saturated fat. If that was so bad, why would our body make it? It's confusing. So perhaps it is the context, and it really is about the total caloric load, rather than, and the data would support that, that when calories are controlled, beef, fat are not an issue.

If you have excess saturated fat, excess calories, now you have an issue. So let's run through because, you know, we've been doing. a lot of newsletters for my community on sort of optimal lab levels, right, through some of the major categories of things that are there. And I think that the most beautiful aspect, and I actually had an idea for a nonprofit. I'm going to tell you a little later on. You give me your thoughts on. Okay. But one of the things that's happening now that people can get access to more frequent testing, the cost of testing is in some places, if you know how to navigate, it's kind of coming down. There's a lot of startups and other things that are trying to make it easier, not just to track your glucose,

but also to get more regular testing for yourself. And so the idea would be that you could see firsthand, again, sometimes people disagree what are the lab levels to track, what is optimal versus not. But I'd love to see it from your standpoint. So if somebody was incorporating more protein into their diet to really have this muscle-centric medicine. I love this. Okay. I'm going to highlight, yes.

Yeah. If you run down through the top ones, including fasting insulin down to like some of the top, you know, triglycerol or. Well, I'm going to point out the ones that I think are really important. Okay, go ahead. Go ahead. Well, let's, this is really important. So when individuals eat protein, so for every 100 grams of protein, your body generates 60 grams of glucose.

For every 100 grams of protein, your body generates 60 grams of glucose. That's fascinating. So what you will see in blood work is you may see higher, and I see this is I see this all the time, you will see higher levels of blood glucose. And the reason is, is if your carbohydrates are controlled, your body becomes very good at gluconeogenesis, at generating its own blood glucose. And it could be upwards of 100,

which is really interesting. People say, oh, you want to keep it lower, you want to keep in your 80s? And I would argue, I would say, listen, your body is becoming very efficient and relying on your own blood glucose rather than external sources. Exactly. Exactly.

brilliant. So that is something you will see specific to a higher protein diet. Now, let's talk about insulin. Now, while their blood sugar remains higher, their hemoglobin A1c may also be higher. We are not talking about six. I'm talking about 5.6, 5.7, which I am absolutely fine with. Insulin now will actually be lower. It'll be less than five. Yeah, mine was like 2.3 recently. There you go. So are you eating a lower? carbohydrate diet. I do eat a lower carbonic diet. So those are some of the big influences that you'll see. And just for everybody who's listening and if you're not familiar with the past episodes, a ton of plant food, just not a lot of refined carbohydrates inside of my diet. And you have to understand

your body can also manage that. So that works great for you. Right, for me, for me. Exactly. So when I was working on some of the earlier studies at University of Illinois, one of the things is, that triglycerides and Don was very sharp in when some, he was able to look at what a optimal triglyceride would be, right? So we want it less than 100. And he would say if an individual is eating greater than 140 grams of carbohydrates, that he will see triglysterides elevated. But if they went to 140 grams of carbohydrates or less, they will see a 20% reduction in

fasting triglycerides. And this is just something very interesting to see when you are looking at blood work to see if triglycerides are elevated, perhaps this individual is eating too much glucose. Yeah. Too much carbohydrates. Yeah. And that's generally most functional medicine doctors and there's plenty of them that are also vegan as well that'll tell you as soon as they see these elevated triglycerides, there's

too much carbohydrate intake inside of the diet. Yeah. One of the other things that I also see is those that are eating a higher protein diet. and I don't know the mechanism of action as to why this is, but cortisol seems to run a little bit higher. And I don't actually think that that's a negative. I think it's the body regulating glucose. It's just contributing to glucose regulation. So those are really the big things that I see.

I also will see. And again, I don't want to just, those are the ones for sure that I see as an interface with protein. Whether it's saturated fat and if someone is a hyper responder, I really believe in terms of LDL and cholesterol that there is a huge genetic set point. And, you know, anything above 250 is likely genetic, right? I've been above 250 before. I know I do have some genetic stuff that's my family. I've run an NMR profile test. I'm due for one. I did one like a year ago. So you look at your APOB and they say, okay, it should be less enough. My APOB was elevated. So that was a little bit, you know. So it was below 100 now or below depending on what it is? I'll have to run my new

NMR report. I'm going to share with the community and everything because I've been way more targeted in the last, you know, since that last report that I had where I did my, I used a company, I think it's called True Diagnostics or something like that. And they have a nice report, no affiliation with them. I'm overdue for that. And I want to see, right? I want to see what, like, my particle size is and everything like that because my LDL has been more elevated in the past. Okay. And everybody would say run the particle size. My particle size in some instances was high, but I wasn't as strict with my carbohydrate intake. So carbohydrates, right.

But now I'm way more. Because we know that carbohydrates will help activate HMGCO8 reductase. And one of the other things that we see, gosh, what was I going to tell you? Oh, LDL cholesterol is individuals that are hypothyroid. Sometimes you'll see higher levels of cholesterol because the receptor is, you know, the receptor works with the thyroid receptor. So if someone is hypothyroid, oftentimes you see a higher LDL. What are other things that people often feel?

You're a gase. We should mention your gaseid is another thing. We've had Dr. Richard Johnson on the podcast as well as David Permanor. So let's talk about your gas. So that's just something else that I look at. Typically, the lower, the better. Oftentimes if people are above six, men seem to run higher. It's just another marker that I tend to take a peek at as it relates to metabolic health.

course there's a whole slew, but what are the ones that we could specifically say this is protein related to diet? Those are some of the things. And I'm actually starting to do some very interesting blood work experiments. I am very interested in seeing what people's blood work are post-training to see as we get to this conversation of myokines and CRP and white blood cells, these are impacted upon exercise. So part of the work that I'm doing, I'm not ready to release the data, but I'm looking at training and is this efficient and effective exercise prescription by increasing in some of these myokines. Got it.

Anything else that's out there, like sometimes you hear things like people saying that, you know, too much animal protein is inflammatory. If they actually wanted to look, right? Yeah. Forget about the studies, everything else like that that's out there. Is there anything that they want to look? Blood work in their diet to actually see if their levels of inflammation are actually, you know, exceeding.

Well, you know, I think what you're getting at is maybe TMAO. Is it a, is it's a, it's a marker. And I will say that it's actually much higher in fish and higher in vegetables. So there are markers that people attribute to, say, animal-based products, which are just not, like the interface is not there. The data isn't there. I think that when we are talking about inflammation, we have to think about total calorie load. And that's what's actually most valuable. And part of your argument, as I understand, and correct me again, is that also because you're getting a bigger bang for buck with higher quality fats and proteins, you're just going to need to eat less, like total calories comparatively. Is that part of the argument?

In general, we're overfeeding. We are an overfed society and we are not eating, the majority of us are not eating super high quality food. Weight management is really important. Body composition management is really important. And, you know, it's interesting you had mentioned kind of the rodent studies. And the rodent studies are arguably obese models and they're ad libidum fed. They're 40 percent. You know, they're overfed 40 percent. So when you see changes in IGF1 or something like that, you're looking at an obese rat, not necessarily looking at a healthy individual. So there's a lot of, and the reason I bring that up is because you were saying, okay, well, are there certain ways in which we can kind of pin certain behaviors on certain things and I would say I haven't seen that in terms of protein intake. You know, because protein is not, it's so valuable that it's not wasted. It's utilized. Again, we go through 300 grams of protein turnover a day. You know, it's not, it's required amino acids. Let's talk about your dad for a second.

You mentioned him earlier. I think you've met him. Have you met him? I feel like you have it one event. or another. I can't picture his face. So maybe if you show me a photo, I'll remember. You know, you were talking about his protein intake. Yeah. And how kind of his day looks? And you said, how old is he? 75. Oh, he's going to correct me. Sorry, dad. 74, a young 74. A young 74. So what does his diet look like? It's about 150 grams of protein.

Uh-huh. Divided in a compressed feeding window. So he's eating in an eight to nine hour window. He's hitting 50 grams of protein per meal. High fats, low-cal. What would that food look like for him? Beef, he eats a lot of eggs, a lot of beef. He lives in Ecuador, a lot of chicken. Beef is very expensive down there. And is his, you know, not to put your dad on the spot, but is also he keeps his carbohydrate. He does.

He does. And then how about for yourself? You know, let's talk about your day and what that looks like. Before we jump back to longevity and a few of the things. So I am a higher protein individual. My first meal of the day, I haven't even eaten yet. I will typically eat maybe 11 or noon, and that meal will be 50 grams of protein, whether it's a beef or chicken meal, something like that, and maybe I'll have a little bit of greens, nothing crazy, a little bit of fat. And then I'll have another small meal and then a bigger meal before dinner.

Now, I thought I heard you say earlier in the interview that breakfast is kind of like one of those things. The most important meal. Right. The first meal. We should say the first meal the day is the most important. The first meal of day. And I've had a lot of women come on the podcast and talk about how, you know, women's needs are a little bit different than men and they're on the infradian rhythm and other stuff. And again, there's variation in individuals, even within genders that are there.

Yeah. And how often there can be pros and cons, especially if a woman is in her prime fertility years, right? For fasting, you mean? For fasting or eating like a later window of like lunch is the first meal. Any hot takes on that? Yeah, sure. So let's talk about the first meal the day and why that's so important because this really services everybody. First meal the day is most important whenever you have that because it is the meal that you are primed for.

You have not eaten. You're in a catabolic state. You are fasted essentially. So the definition of fasting is anything greater than eight hours without eating, right? So if we say, hey, Drew, got to go get your fasting blood work. That would mean eight hours or more of not eating. that first meal of the day is priming your body to get your muscle, right, and your blood sugar regulation, right? The way in which you do that, this is a 100% mostly fail-proof way.

If you get high protein, and I would argue between 40 and 50 grams, that first meal, you are going to set yourself up for metabolic regulation for the rest of the day. And here's why. Number one, you are going to stimulate regardless of your age muscle protein synthesis. Whether you are 20 or you are 65 or you are my dad at 74, you will stimulate muscle protein synthesis. You must hit that first opportunity. The other part is protein is very satiating and there's work by Heather Lydie and they looked at brain fMRIs. It's almost as if protein augments willpower. It releases certain gut hormones that really help with satiation. Also, it has a high thermic effect of food, meaning it takes energy to utilize it. So if people are concerned about weight management, optimizing for muscle, this is the way

to do it. It takes 20% of the calories. So, for example, if you have 100 calories of protein, and I'm making this very black and white, nobody just eats protein, right, unless you're maybe just eating egg whites. But for every hundred, so if you eat 100 grams of protein, then 20% of those calories, so 100 calories, sorry, a protein, 20% of those calories will be utilized to metabolize that protein. So your net chloric is 80 calories. So by leveraging the dietary choices, number one, you're stimulating muscle. You must hit that opportunity.

You are being able to balance blood sugar, again, if you train. the body to be accustomed to eating protein, your body will not require external carbohydrate sources in that way. You become very efficient. Your blood sugar will remain stable. So that first meal of the day is most important. Again, and also carbohydrates, I think about carbohydrates in a meal threshold amount. And I recommend people do not exceed between 40 and 50 grams.

And this is just a great take-home point for your listener. between 40 and 50 grams of carbohydrates per meal. And the reason is because we cannot at rest unless you're out exercising dispose of more. And when you think about glucose disposal, you think about muscle, you think about what's required for liver and gut and all of these processes, brain. So, and again, the definition of diabetes is a two-hour blood, you know, blood sugar seeing over greater than 120. So in order to manage blood sugar, we are living.

looking at a 40 to 50 grams or less of carbohydrates per meal. Got it. So that was a very long-winded answer to your question, but I wanted to make sure that there's some great takeaways for your listener, especially the woman, 50, 40 to 50 grams of protein per meal. Knock that out. Get that right. And any thoughts on, you know, how soon that happens?

Because I know it's a unique day for you. You were on one podcast. You're on another podcast. So I know a lot of times when I'm not eating, I feel a little bit more focused and stuff. But do you think that there is some importance or truth and it's okay if you don't for, you know, making sure that women, again, in their prime fertile years, fertility years, whether they're interested in having kids or not, you know, typically like you hear a lot of conversation in the space of fasting of like, I'm going to skip breakfast and I'm going to go,

my first meal is typically like a lunch meal. Right. Right. Is that more detrimental to women? Do you have a hot take on that? Yeah. Let's think about what the body has in store to manage elevated levels of blood sugar. So the body has one way to deal with glucose. That's insulin. One way. The body has multiple ways to deal with low blood sugar, whether it's glucagon, whether it is cortisol, whether it is growth hormone. So if an individual's blood sugar is getting too low, you do see increases in cortisol. You do see increases in counter-regulatory stress hormones. That being said, if someone is trying to get pregnant, I personally do not recommend fasting. It is an added stress.

Just, you know, from an anecdotal perspective, I had two babies in two years or whatever, two and a half years. I don't necessarily recommend that. But I was not fasting during that time. I wanted to eliminate that kind of external stress on my body. And also for my patients, I don't recommend them fasting if they're trying to get pregnant. I mean, it's a stressor. There's one other thing that has seems to be some poll.

Again, these are observational studies. So we have to weigh them out. Which means they're low quality data. Okay, got it. Is there one takeaway, because it's good to talk about this, is that some of them seem to show that people who eat breakfast, right? Again, not getting into the quality. We're not talking about cereal and other things like that.

We're talking about higher quality, what would be considered maybe more like a European-style breakfast. right, chakoury board or some cheeses or things like that and maybe some, you know, a little bit, of food in the morning do better. And would you say that we just don't have the data because observational is too low quality? We can't come to that conclusion. I think that it depends on what health outcome we're looking at. Is it that they do better because their blood sugar is maintained? Do we have an idea of what the macronutrients are at that meal? I think that if, if, you're a meal is high quality protein, I think that's amazing. But in terms of, again, we always have to think,

well, what is the health outcome we're looking at in that way? But I also am not against fasting, and I'm certainly not against breakfast. Again, I believe that we do have to think about, you know, protein is very important in a 24-hour period, what you are getting. And then the second layer to that is protein in a discrete meal threshold, which is really important to understand, which, again, the science is there, but the recommendations have not yet caught up. That is going to be what I believe to be the future when they start understanding that meals are, there's an amino acid requirement per meal. So 24-hour period of dietary protein, understanding that meal distribution is really important, whether someone is eating breakfast or not eating breakfast or wanting to get pregnant or not wanting to get pregnant,

we have to account for the essential need for protein. So we were talking about blood work and some of the markers about how could you make sure that if you were eating a more protein-centric diet, where do you want to see like the labs and things like that? What is the best way for the person who's listening today? What is the best way to know for them, like definitively, that they are under-muscled, right? Yes. What a great question.

And I think that's going to be very difficult to identify just with blood work. And this is a very sharp question. And it doesn't have any blood work. Yeah. It could be Dexa scans, whatever it might be. Also, very important conversation. Yeah. Right now, the way in which society is is we are very fat focused.

We have body mass index and we're very good at measuring body fat percentages. In fact, Adxa would do that. In terms of measuring skeletal muscle mass, we're not great at that. We have the appendicular lean mass index, which was typically developed. One of the reasons that we look at that would be for sarcopenia or diseases of muscle. But this is not a common marker that individuals look at. People are not looking for it. They're not looking for it.

Not only that, I'm actually writing up where I'm co-writing a paper right now with an amazing PhD from someone named Rubinowitz. Or Rabinowitz's lab, Alexis Cowen. And we are looking at what would be an eye. optimal skeletal muscle mass for, say, someone like you. We don't actually know what that number is yet. And I know that your question was, how do we know if someone is in an ideal muscle range? We don't actually. We can defer it. We can do that by, again, looking at blood sugar regulation because we know muscles and metabolic organ. We can look at that by, you know, assuming that their

triglycerides are good, that their insulin is good, that their hemoglobin A1C is good. Muscles is a site for fatty acid oxidation. However, when we are looking at the health of your tissue, number one, the best way to do that would be a CT or MRI. Completely unrealistic or ultrasound, but that would again be looking at individual components of the tissue also somewhat unrealistic to, you know, when an individual goes to their primary care physician to say, hey, you know, what are my body metrics, very unrealistic. We do not at this moment have a great way. I am convinced of looking at the quality of skeletal muscle mass. And I want to separate this from the quantity. Does a Dexa do it? A Dexa does it indirectly. A dukeza does it indirectly. It extrapolates from looking at lean tissue,

which includes liver and bone. Skeletal muscle, identifying skeletal muscle on its own is not done well in clinical sciences right now, as it translates to a medical practice. So the answer is it would be really hard for me to tell you your optimal muscle mass. However, we do know that your strength is the best indicator. The stronger you are, you know, and someone will be like, well, how many push-ups should I do? I think that that's a really difficult question to ask. That has to be, it is very individual, it is very based on a training age, how long you've been training.

And that's just an example, whether it's squat or bench press or deadlift. We must understand that part of this is the perception and perspective focused on fat has really overshadowed everything. So we just haven't had a lot of resources and smart people thinking about the exact way to answer that. question. Yes, in a realistic way. Also, it hasn't been primary. Right now, when we look at skeletal muscle, it's typically in young male athletes. And, you know, now it's getting more balanced, but it's either looking at an athletic population or it's looking at a very sick population. We're not, you know, and there are papers out there that look at the skeletal muscle mass, but it's very difficult to say what an optimal level.

We can say this is a number that would indicate disease. You have lost 5% of your body weight in six months. We know this is disease. We know that if your appendicular lean mass is above 10, you have very high amounts of muscle. But those are still nebulous terms to determine what is your optimal amount. We don't know those answers. If we were trying to get close, you know.

I don't think we know. I'm asking for me. We're working on it. Okay, so let's take my situation, right? My diet hasn't, besides eating less carbohydrates over like since the, you know, pandemic and being a lot more like optimal with my glucose and measuring my fasting insulin, one of the biggest detriments to my own personal muscle mass is, and I probably lost about maybe 10 pounds of muscle mass.

In how long? In over the course of, as long as the gyms have been closed here. Interesting, right? Because I used to go to the gym and I'm one of those individuals that has the opposite. the problem as everybody else. If I do not lift heavy things, I start to notice that my muscle mass will go down. How long do you? This is really interesting. How long does that take you? What? So you start to notice it would be in three weeks? I would notice it over the course of, let's say, no, not that fast. Okay. You would not. Not three weeks fast. Okay. But maybe like a couple months, like two to three months.

All right. Like I'll start to notice that decline that's there. And when all the gyms closed and they went very aggressive in California, unfortunately, my heart goes out to all the gym owners. I was still working out. I do this thing called TB12. It's at home. It's like, you know, I have a virtual coach and I use bands. There's only so much resistance I was being able to get on the bands. I'm not lifting like dead lifts and other stuff.

I saw a big loss in muscle mass. And I was, I'm probably not hitting the recommended levels of protein that you're mentioning. Just acknowledging that. and calculating based on what the numbers are that you're mentioning. But I'm thinking that even though my strength overall is pretty strong, right, I have seen a decline in muscle mess that's there. Right. And I'm wondering, you know, where do I need to be and where do I need to get back to be in my sort of ideal zone for myself personally? I think that number one, we know that you've lost about 10 pounds of skeletal muscle mass. That is a significant loss. Okay. So let me just clarify

that. So I've lost about 10 pounds. I don't know if all that is muscle, but my muscle has gone down. So I'm sure there's some other things that are part of that too. Also, because I'm not having as much carbohydrate, there's probably some fat that's also in that mix as well. First thing that we have to do is we should get you on a bioimpedant scale. Bioimpedant scale. Okay, where do I go to get one of those? You can go, well, I mean, here I don't really know, but. But I could look it up online and find a clinic. Is it a clinic or a gym or something? You could even order. As long as you're using the same scale, you can order an at home bioimpedant scale. Okay, good. So something I can buy online. Yeah. And as long as you're measuring at the same time, every time you do it. First thing in the morning? Yeah. Whenever you want to do it. Yes. First thing in the morning. You know, ideally you would want the same kind of fluid intake, all that stuff. That would be a great place to start because right now we're shooting blind. We don't know.

So establish a little bit of a baseline. So let's see what your baseline is. Okay. And so that gives you a percentage of body fat. It's going to give you a percentage of body fat. Again, it's probably going to, it will estimate your skeletal muscle mass. And then we're going to see. Got it. And, you know, for an untrained person, which you're not actually considered untrained, they could probably put on 20 pounds of muscle in a year. If they are totally untrained, which that's a lot.

It would require a lot of effort and excellence and execution for you because you've been trained. Number one, your muscle should come back quickly, we hope. And number two, it would be great to see you get to where you were before. And then we could really push it. Right. And then we could really see you get with a great trainer, you're lifting three to four days a week. When we think about muscle hypertrophy, you think about there has to be mechanical tension, there has to be metabolic stress, there has to be ribosomal biogenesis, which is the creation of new protein.

And then you need calories. You need protein, you need calories. We add in all those things, and it would be amazing to see with a well-defined and refined program, what happens? question for you on that a couple things that come up yeah because we haven't really gone into the the training aspect of this so for most people who are listening taking a step out of me yeah knowing that our audience is mostly women what is the fundamentals that they have to be thinking about yes yes it comes to the training aspect we've talked about dietary protein yeah we talked about being over you know like putting too much focus on the fat side and not enough and being undermuscled

yes being under muscle yes so what about the training piece well i well number one one, I will tell you that exercise physiology is a science in and of itself. And I am not an exercise physiologist. So for my practice, we have those individuals that will make a program for an individual. What I will do is I'll provide you with some general, very basic guidelines that I think would be beneficial and usable for your listener. Number one, with all this talk about muscle, people are going to think, oh, well, there's always talk about muscle is cardio any good. And I would say cardio is absolutely important and a

great base to start with. Cardiovascular activity is really good for mitochondria function, which is the powerhouses of the cell, which is really important for energy. Overall energy, feeling very vibrant, it's really good for blood flow. Also, you know, we talked about muscle as an endocrine organ. Muscle, when you contract it, it secretes myokines. And myokines are proteins that travel throughout the body that have different impacts on different organs. So they act locally. They act in an autocrine, parochron, and endocrine nature, which is fascinating to think that the benefit beyond exercise is not just the activity for cardiovascular health. So I say cardiovascular activity and I pinpoint cardiovascular health and mitochondria function,

but that exercising muscle does so much more. The contracting skeletal muscle actually also interfaces with the immune system. And I know that I'm getting a little bit off track, but I think understanding the why is so important. if we provide them the why, then the execution becomes easier. So if we can shift the perspective that when an individual is getting a baseline of physical activity, that that exercising muscle is doing so much more than feeling good and training and getting strong, but you're actually contracting this tissue, which is having a hormonal effect on the whole body through this interface of these myokines. It is fighting and balancing inflammation. And it is augmenting immunity. And we're

hearing a lot about cytokines. You've heard about TNF alpha. Cells of the immune system produce inflammatory cytokines. And exercise in and of itself has a counter-regulatory nature. So exercise and muscle secretes myokines like interleukin-6, and interfaces has like a yin-yang-yeng effect and dampens down inflammation, which that's amazing. So if you're worried about inflammation and you're worried about an out-of-control immune system, one thing that an individual can do is to start exercising. So that's fascinating. Now, is there any consideration, you know, a lot of my friends that have been the longest, including my brother-in-law, who's a cardiologist and everything, who's into, like, functional medicine.

Is there also a component of people who rigorously exercise the injury piece? For sure. I don't know anybody that isn't like five to ten years into their sort of exercise regimen that hasn't had to deal with some sort of like serious injury component in some direction. I think that I think it's an interesting concept. And again, number one, it's likely humans in general. we don't have the same movement patterns. We are sitting.

We're doing things unnatural. I was joking with you before. I needed a booster chair for this, right? So I'm kind of in an unnatural position. So there is natural wear and tear. And that is a component to it. Right. And that being said, though, you're either going to wear out or rust out.

So you might as well wear out. And there is a whole movement of workout programs. I'm part of one here in Los Angeles. So I just started called functional patterns. Cool. They're way more about getting you to move as you naturally did, which also includes having you breathe in a way that's more there. And then there's a lot of different workout type things like primal movements that are less

about isolated weights in very specific categories on isolated muscles, but more getting you to do things like we would have done on our hunter-gatherer days. Yes. And I will say from a baseline perspective, getting in the recommendation is 150 minutes of moderate to vigorous activity. which, okay. And then I would also layer on three to four days of resistance exercise. And starting with hypertrophy is a great place to start. Hypertrophy, you know, they say it's whether it's eight to 12 to 15 reps, the muscle doesn't go, oh my gosh, you've hit 15. I'm going to grow now. But really, hypertrophy training is based on volume.

It's very hard to mess up, especially if an individual is untrained. So I think that hypertrophy training, which is, again, resistance exercise three to four days a week, going to a higher perceived exertion. They should be working hard. It is not about going and lifting 15 pounds. Again, it is going and doing and lifting to fatigue. It's really effort. It's effortful. Another thing that I think is really important to incorporate once a week, and depending

on a training age, is high intensity interval. training. And that is really going to a max out effort for a defined period of time. For the person that's, yeah, for the person that's, you know, maybe has very limited movement, right, even, you know, focusing on as a first step that 150 hours, sorry, 150 minutes, 150 hours would be a lot. My husband might do that. Yeah, not even have enough time in the week, 150 minutes of getting in that rigorous activity a week, right? Couple low-hanging, ways to achieve that that you feel? Well, it depends. So you're saying for someone who's not very mobile. Right. Right. Let's start off with that individual. So that would be just walking. That would be

doing any kind of movement because for them, that may be where they need to build their base. And again, high intensity training could be sitting and standing out of a chair. Yeah. You do that out of times. It's actually very difficult. And for someone who is untrained or has gone through lockdown and COVID and not been able to get to the gym, those kinds of things can be very valuable. Yeah. That would be a great and easy place to start. And I know it might sound trivial, but again, we know that the more activity individuals do, the better off they're going to be. Yeah, we did a whole little mini episode on walking and how just simply walking more, which, again, we have people of all different ages and backgrounds, but that's a great place to start.

You'll improve your metabolic health. You will. It's a good way to, you know, you incorporate all the aspects that were built into the process of EMDR, right? and a sense of having perspective in your life. It's a great way to connect with family, friends, social, loved ones. So it's an easy lift and it's a great place to get started. Yeah, and this is funny, no pun intended, there's the Drew study that came out. And there are some issues with the study, but it focused on walking and movement.

And it showed that those individuals who walked more actually had lower white blood cell. And that was good in terms of you don't want your white blood cells to be high. That can be an issue. but it was in a more optimal range for individuals. So it was a way of looking at, is that exercise prescription impacting individuals? Let's go back because you mentioned, you know, in the context of, you know, diet, and we're kind of jumping back and forth here, you mentioned that you were vegetarian at one point in time. Give us the history of that.

What was the motivation? Yeah. I, again, you know, it's interesting. I come out and I have these conversations about being and feeling that animal-based protein is very important. And it's, it comes from a place of experience, but that doesn't mean that I am anti-vegetarian. And in fact, I was vegetarian for many years in college. And do you have maybe now some vegetarian patients? I do.

Of course. And vegetarian friends. Yeah. Or vegan. Yeah. Or vegan friends. It, again, it shouldn't be a dividing component. It really, again, health is individual and there are ways in which we unify it.

I was not able to maintain my training. At one point in my life, I was very physically fit, and I just could not keep up with recovery and injury, and my iron levels were low. What was the first sign for you, looking back now at the time, that you were not able to keep up with your training, or maybe this diet that you thought was doing great, or maybe even work?

I was hungry all the time. Okay. I was hungry. I could not stop thinking about food. I was having a lot of feet, leg pain. I was iron deficient. I was just really struggling. My gum started bleeding.

It was terrible. And what was your original motivation in the first place? Because I really liked animals. Yeah. It was more of an emotional, spiritual decision for me. And I cried the first time I had chicken. You know, Liz Lipski is my godmother. You know Liz, right?

Yeah, yeah, yeah. So I graduated high school early and I moved in with her. And I was vegetarian at the time. And I remember I called her and I was just crying because I started with chicken. And I actually had felt exponentially better once I started to incorporate more animal proteins. But that is my story. Do you think quality of the animal proteins that we eat matters? And additionally, there's this conversation that's happening today more so than ever, which is, well, we're not even really eating animals in the way that we previously once did.

Why just focusing on the muscle component and not eating, you know, whether it's nose to tail or organ meats or other stuff like that. Any thoughts on either one of those two? Quality first. Let's talk about that. Okay. Quality. If I'm hearing you correctly, you're defining quality as. So let's talk about it from each of the common proteins that are out there. So let's talk about chicken. That was the first thing you have. A lot of chicken these days primarily fed on corn and other things like that. People have come on this podcast before, whether it's a Dr. Gundry type person or somebody else who is okay with people having some animal proteins.

It says, you know, when we can, we want to be steering in the direction towards having, you know, not the high omega-6 chicken that's out there. and instead having, you know, pasture raised. So any thoughts on that component? Yeah, I can appreciate that. I would say are the majority of omega-6 is coming from chicken, or are they coming from other processed foods and processed fats? So that would be the first question I would ask.

So in total, if somebody did an omega index, which is, you know, a great test, no affiliation. That's right. We use that all the time. That test, actually was a big part of me starting to incorporate fish in my diet because my omega-6 to omega-3 ratio was out of whack. I've written about this and talked about it before on the podcast. So if their omega index was out of whack based on the ideal ranges that have out there, you would first say, let's look at the processed food that you're eating. I would. Not necessarily the animal products, which even if they're a little bit higher.

Right. Because so the question is what again, if we're looking at a health endpoint, how much chicken is it going to take to raise that omega-6? How much dietary chicken would you have to do? Do you know the answer to that? I don't. I don't. I don't. But I think that the question would be before we say I'm only going to eat pasture raise.

So I'm of the philosophy that high-quality protein comes first no matter where you get it. And people may or may not, you know, totally disagree with me. but I would much rather eat high quality protein, whether it is conventional or organic, than I would be eating some other kind of processed food. Because protein is really important. The question becomes if the chicken is fed corn, well, okay, I need to see some evidence

that that chicken breast is going to raise my omega-6 index. I just don't know if, you know, what kind of dosing we're talking about. And because I advocate for high-quality protein, I'm very careful about how I were to think about something like that, right, how I would, because those kinds of recommendations make and impact people, right? Not as accessible prices up. Exactly.

Exactly. So then why I think that's very dangerous to say to someone, don't eat chicken because it's going to increase your omega-6 index or your omega-6 ratio. And I would say, well, the majority of that is probably coming from processed foods, you know, or, you know, seed oils are a problem. but really it's likely excess calories and excess processed foods. So that would be one part. The other part is, you know, beef, whether it's conventionally raised beef versus organic beef,

there is some new evidence to support that there is higher amounts of omega-3s in grass-fed beef, which makes sense. In terms of conventional, well, number one, are we eating beef to get your omega-3s? I guess, I'm not really sure. Right. It's still quite low compared to meat to fish. Exactly. So this becomes an important conversation in terms of arguments that we'd be making as to why or why not we would do organic or not.

In terms of conventionally raised animals, they spend the majority of their life. And first of all, there's 750,000 ranchers. And there's a thousand conventional beef entities. whatever that is. So the majority of the beef that we get, whether it is conventional or organic, come from ranchers, which is interesting. When we think about conventional, they spend two-thirds of their life grazing in pasture. And then they go to a feedlot to be fed corn or their corn finished. And the reason I bring this up is because I do think that there's a lot of misinformation about the practices of these, you know, animal husbandry or cattle raising.

And ultimately, I believe whether you get your quality protein from conventional organic, me personally, I prefer organic. I think regenerative agriculture is very beneficial. And I'm sure that your listener would also agree, but that wouldn't be a barrier to entry for me. And it wouldn't be a conversation with you if we didn't touch on some of the stuff and the conversations around climate change and people's focus on that. What is your high level take when people talk about animal protein?

Of course. Being a big driver of that. I think that there is a lot of narrative and a lot of bias out there. And when we think about climate change in the U.S., we're thinking about fossil fuel, industry, and electricity. So you're looking at 80-some percent is coming from that. 80 some percent is coming from industry and population-based things like electricity and travel. Out of all of that, out of 100 percent of the contribution to climate change, we're looking at 9 percent as agriculture, which includes vegetables and fruits and grains and cattle and dairy.

Of that 9 percent, 3 percent is animal-based products, whether it's cattle or dairy. The rest is vegetables, fruits, and grains and things of that nature. So if we care about climate change, how is it that we are scapegoating cattle, which, by the way, it's not this black and white picture, right? Our red meat consumption is down 30% since 1975. We utilize cattle and then they grow. It's not, we're not having an exponential burst of herds. you know, you're talking about something relatively stable, where we can really have an impact is if you live in, I don't know, Alaska, then you shouldn't be eating your avocados.

That has to travel, transportation, right? I also think that we must understand that marginal land is cannot. So if we have, and I got this from Frank Mittlauner. Have you heard of Frank Mittlaher? No, I haven't. If we had a piece of paper, I'll just give you the visual. So Frank Mitt-Lahunner is from UC Davis, and he is a world expert in climate change. This is what he does.

So it's always great to hear a world expert weigh in on matters of climate change. So he explained it this way. He said, imagine a sheet of paper. This is all the world, this one sheet of paper. And now fold this into a postcard size. Okay, so you fold into a postcard side. Postcard size. He said, this is the inhabitable.

this is like the land mass. Okay, so we went from a 8 by 10 to a postcard size. This is a land mass. Now he pulls out a business card. And he said, okay, well, here is the business card. And this is the farm, this is the land in which we can create on. He cut it from one third to two thirds. And he said, this two thirds is marginal land.

You can do nothing but graze cattle on this land. or graze ruminants, I shouldn't even say cattle, is this grazing. And one-third is our farming land. So that is a visual of what we are looking at. We're talking about one-third of this land mass, right? And saying, okay, well, what are we going to do with that marginal land? The idea that we would eliminate all cattle because cattle or ruminants are contributing in some massive amount to climate change is in And the data would support that we are looking at industry, electricity, and transportation.

Food waste is much more impactful than cattle. The majority of individuals waste food that has to go to landfill. It has to decompose. The estimates are like 40% of food is wasted. Well, so perhaps rather than scapegoating something else, which is very interesting that that becomes the target, right? it doesn't totally logically make sense. Again, this goes back to a theme that I believe to be true is we must have transparent conversations.

So if the evidence doesn't support that ruminants are the root of all evil, why is it constantly being brought up? Who profits from this? Because it's not the consumer. It's not someone who's driving towards health. In fact, what's happening is they're getting very mixed messages. And I believe a lot of them, You know, you were vegetarian at one point in time.

You're probably telling other people that that was the right thing to do. Right. Maybe, maybe not. Mine was more like, I grew up that way. Right. But I was vegan for a little while as well, too. And I really thought that I had the answer. Yeah.

It worked great for a long time. You know, it worked great for a long time. And then until I didn't feel good. Yeah. Mine thing was, you know, I wasn't training hard like you were. But I started incorporating fish to my diet first because I got into functional medicine. I started running the labs. I did the omega-quant test.

And I saw, okay, for me, this. is out of whack a little bit. And I think that that's the part that I'm really excited about because honestly, like I'm in this space, but I'm not a physician. I'm just kind of like a professional amateur, right? I know enough to ask what questions, but even there's times where I feel confused. Genuinely. But the things that I'm trying to really focus in on, because I know that my diet will continue to shift, there'll be things and experiments that I run, is that I'm, to the best extent, not everything can be seen through blood work or scans and other stuff.

But if I at least put a watch on that, I can do different experiments. For a while, I was having a lot of added saturated fat in my diet. And that personally didn't work very well for me. That probably I could see that not being able to do. That didn't work for me through my lipids off. And also got a little bit of like an endotoxemia type reaction. My gut got messed up. Fixed that.

Felt great, right? We're still able to keep high quality animal protein in the diet. There were some things that I removed out of the added saturated fats that were there. And I was able to both catch it because I felt some symptoms. But a lot of times, you know, you don't feel things right away. And it's a slow bubbling of like the frog in the water. But having access to like blood work and looking at things at least feels like, okay, I can try different experiments. I can see, see how I feel.

But let me just look at some of the basics and see if I'm on the right track or not on the right track. Yeah. And I also think that it's an evolving, like you said, it's an evolving experiment. And it depends on the season. It depends on the goal at the time. Right. Are you trying to grow? Are you trying to go through a fasting period? Like what is the goal? And the human body is very adaptable, which is why we do see some people do phenomenal on a vegetarian-style diet. And I believe that there are some reasons why to the reason as to why that is. which is some of the newer science in terms of might change everything that we know about protein metabolism. Talk about it. Can you do a little preview? Sure. So this is, these are only proof of concepts, but there is some data coming out that the

individuals that are eating a very high fiber diet are able to scavenge and generate the bugs in their belly some of the essential amino acids. That's interesting. It's amazing. It's fascinating. If it pans out to be correct. And essentially their gut is looking more like a ruminant's gut. A ruminant, you know, a cow is an upcycler of nutrients.

So it takes low quality proteins and is able to upcycle into a higher quality protein. And when you're looking at these proof of concept, again, super early, what is it, you know, amount of fiber that they're looking at inside of this study? Yeah. Well, again, these are rodent models. but I hate to give a number. Okay, got it. I would hate to give a number because it would be translatable,

and I don't want to give you wrong information, but Don Lehman was a part of that study. It would be interesting to see as that translates to humans. I think that that's very real. I do think that we are going to find out that some individuals have the capacity to generate through their gut microbiome essential amino acids. Now, is that going to be enough for optimization?

probably not. And it will probably be more of an eight-week period. So an individual can go through eight weeks of perhaps a lower protein diet. Again, this is all speculation, but I do think that that's important. And it's going to be interesting to see how that pans out. I think what we're ultimately going to look at and what will ultimately be ideal for the human is cyclical, is cyclical nutrition. Because we generally came out of seasons. No, I believe, and again, this is my speculation. Yeah, these are just your throwing stuff out. I believe that optimizing for protein, so in my clinic, I recommend one gram per pound ideal body weight. For me, I'm 115 pounds, maybe 120 pounds. I eat 120 grams of protein. For you, whatever your weight is. And try to get a good chunk of that.

Yeah, in divided meals. I don't snack. I tend to, you know, I'll do two meals and a, and a snack or not a snack, a smaller meal, but I try to divide that up. Again, that's not a ton of protein. And then the idea is, I believe, so there's something called this integrated stress response where when you take away the essential amino acids to the body, the body goes through this process of autophagy, and I'm not an expert in autophagy, but it's really the upregulation and removing the damaged cells. And I believe that there is some benefit to upregulating this system. And it's really a methionine restriction, which is essentially what Volta Longo is talking about.

But I believe that Volta Longo is talking about it indefinitely for all people at all times, except if they're older. I don't agree with that. I think the benefits are eating to optimize skeletal muscle. for the majority of the time. And if an individual will go through, say, one week every three months of a methanine restriction, which is unbalancing those amino acids, which creates this integrated stress response based on methyionin restriction, which would be a largely plant-based vegan diet for a couple days every three months.

I think that that will likely be a sweet spot. And again, I have no data to prove this. But based on the trends that I've been seeing, seeing with my patients and just putting it all together makes a lot of sense. Interesting. Yeah. I mean, that'll be good to follow and see because every year it seems like we learn more and more components. The other thing that I think about is that, again, as you've mentioned, you know, if we get people to sleep better, if we get these minimums, which for the vast amount of population for movement, those 150 minutes is not even close. Right.

Right. If we remove out ultra-processed foods, right? Already we're like ahead of the game. Ahead of the game, right? So just anybody who's listening that feels like, oh my gosh, I'm so confused. I don't even know where to start because I just heard another podcast and they came here. It's just so important to realize like you're already so ahead of the game. Largely, a lot of these conversations we're talking about here.

And you'll hear sometimes both sides of the equation say, we don't have the exact study that I would like to see that proves this or that or whatever it might be. I would not argue that for protein, though. No, you've mentioned that there's a lot of really great data on protein. Yeah, yeah, yeah, yeah. There's not maybe the longevity data that some of the people are looking for, right? Following periods for long, following individuals for longer period of time? Yes, but we do. So, yes, it is very difficult to do longevity studies, if not nearly impossible,

because those are, in essence, going to be lower quality data, right? It just is that way. but we can take aging individuals and look at them independently. And though that data is very important. So there are tons of geriatric. There's data on older people who have a higher percentage of muscle mass as just a higher protein, improved grip strength, all of these endpoints. And you know, there's ways in which you can do muscle biopsies and you look at the tissue.

We do have high quality studies on older individuals. And it doesn't mean that we've tracked them over time because, again, randomized control trials are different than observational data. Got it. Got it. So going back to what I was sharing before, and thank you for that clarification. You know, there's so much, but largely these conversations that we're in in this very specific world, we'd be fair to say like, this is really talking about optimal, right?

Yeah. This is really talking about optimal. Yes. We are talking about optimal living. And, you know, I truly believe that if we provide clarity, and I really do feel that if an individual optimizes for protein, everything else falls into place. Again, and the reason I believe this, because it is solution-oriented. Skeletal muscle is solution, and especially you and I believe in root cause. The root cause for these diseases is not adiposity, that's symptomology.

Where does that come from? It comes from defects in the skeletal muscle from the place of glucose disposal, from the place where calories go that generate this adiposity. So if we believe that root cause medicine is real, then we have to believe in skeletal muscle. The way and the mechanism for how we protect and optimize skeletal muscle, especially as we age, is we must optimize for protein. And to me, that's a non-negotiable. Right now, the Enhanes data would suggest that we are 70% plant-based. Right now, whether it's processed foods, added fats, added sugars, we are 70% plant-based. So we've tried this, you know, eating.

And most people, it's funny because most people would say they look at the world and they say, we're not. But we are. But we are based on the production value of the food. Yeah. And we are. And this is not, again, this is, I'm not making this up. This is. And it's primarily because of ultra-processed foods.

It is. The majority of, yes. Chips, you know, fries, everything. So is that by calories or by volume? That's a really good question. I believe it's by calories. Okay. So based on our total calories, actually most people are getting...

70% of our calories are plant-based. Got it. Of that 30%, the rest 30% is animal-based foods where we get the majority of all of our protein, all of our calcium, all of our iron. all of our zinc. And again, the goal is what are things that a listener could do to take away? And if you build the house correctly, which is you build the house of muscle, you avoid the midlife muscle crisis, which seems to happen to people, you have to optimize for protein. And I will say, I feel so, and you've known me for years, I have not changed this message.

No, it's been the same message from day one. It is that important. It is that important. It is underrepresented. We are missing the mark. The paradigm of thinking is backwards. We are completely focused on adiposity. And the way in which we can solve for this, if we change it to a more empowered view, we optimize for skeletal muscle.

And the mechanism by which we do that is understanding our protein needs. We put in place protein. We understand on a very fundamental level that animal-based protein is different than plant-based protein. It is not an emotional conversation. These are based on amino acid numbers. This is just what it is. It's not saying that we're taking the emotion out of it.

It is absolutely essential to meet an amino acid threshold need for a meal distribution to protect tissue. The majority of your listeners are women. They are either perimenopausal or postmenopausal. This is the time for them to not be confused because that window for flexibility and mistakes closes. This is the time that you do have to optimize for protein. It is the one thing that will help this idea of longevity. It will help survivability.

It will help blood sugar regulation. It will help fatty acid metabolism. If you cannot protect your skeletal muscle, you're constantly going to be chasing your tail. You'll constantly be confused. So I hope. Also, I just want to add him one more thing. You know, when my mom got diagnosed with breast cancer, she's doing great today.

Amazing. Amazing. She had an incredible team around her, functional medicine doctors and other stuff that she started working with on a practical level, increasing her protein. And in the case of breast cancer, you know, they wanted to have her having higher quality fats because some of, and I know they might have. be some confusion here. So I know we're getting towards the end, but it would be good for you to toss in your thoughts. If somebody has active cancer, they do believe through the angiogenesis process

that cancer can leverage protein and sugar as two of its main sources of fuel for growth. So they wanted her a little bit higher fat until the cancer was subdued and she was in the clear and then even ramped up her protein even further afterwards. But they immediately switched her off of a lot of the animal, sorry, plant proteins that were there and getting to incorporate fish. Because on a practical level, she just was craving other foods way less. Yeah. I think you bring up a really good point. And active cancer is a whole other ballgame.

Now, number one, there is some good data to support a ketogenic or higher fat diet in relation to cancer. As it relates to protein and cancer, I don't know the answer because I feel very mixed. And I would leave this to the oncologist and those in that expertise because, number one, cancer is a very highly catabolic state and there is a destruction of skeletal muscle. And when skeletal muscle is destroyed, depending on the kind of cancer, it becomes very difficult to survive. That being said, is protein, you know, through its stimulation a growth promoter? Yeah, it is. But if we're following all your recommendations way ahead of time, hopefully knock on wood for everybody who's listening, we are less likely because most cancers, you know, the vast majority

are lifestyle driven and sugar fuels cancer. Well, really, adiposity is one of the biggest risk factors. Right. Being overweight. Being over fat is one of the biggest risk factors. Right. So hopefully knock on wood again, that nobody ends up finding themselves in that situation. Right.

If you do, again, surround yourself with the team and you can come up with the right personal decision for you. But I felt I snapped you out of. I just had a question because personally I was very interested in that topic. Unfortunately, you know, I know a lot of people that have cancer and are kind of going through that process. But you were so eloquently in the final stages of giving us your sort of court thesis of why this matters. And I want to set you up for that again.

Yeah. You know, for the folks that are listening here, you know, you have that limited window of time period to really set the foundation. And this is why you're driven by the work and the mission that you're. Yes. Don't miss it. Do not miss the opportunity by the noise and the confusion. We have very high quality evidence over half of a century of data to support the impact of muscle. This is the ultimate in strong medicine, truly. And if people really care about longevity and being able to function at a high capacity, you have to care about your muscle. That needs to be the focus. Dietary protein is

the vehicle and of course exercise resistance training these things that may not come natural to people are actually a non-negotiable what percentage if you balance it out because it's both of those right it's the working out and the resistance training and it's the added in a high quality protein i hate to pick but training stimulus will likely impact you more but i i would hate to pick right because you can't really do one without the other sure but a training stimulus is likely more And it's, I think it's important for people to hear that because that's how you honestly feel. But number two is that even if you have your own feelings and thoughts about it, right, but you agree with the core sentiment. So let's say you prefer to be vegetarian.

You prefer to be vegan. You prefer to, you know, have less protein, whatever. Fine. Fine. Fine. But do not miss out on the core message, which is there's so much data showing that muscle is one of the keys to longevity. Yeah. So how are you going to get that muscle?

especially as you age, if you're not eating that protein and you're not working out, you're rolling the dice in terms of like what's going to happen to you next. You are and it becomes really important to understand again that that window closes, that you have to act before you are motivated to do it. And oftentimes we cannot use information overload as a distraction. And that happens. And it doesn't need to. So, Dr. Lyon, this has been great.

I really appreciate you coming back on the podcast and sharing your message. And thanks for putting up with my questions. They're great. I feel like we have so much more to talk about. So this is great. Give us a rundown. The new show. Yep.

It's out there now. Yeah. I just, yes, just the intro. But it is the Dr. Gabrielle Lyon show. I would be so grateful if people subscribed and liked and rate it. I also have a YouTube channel. So the show will be on both. and I'm happy to answer any questions.

Will you host any debates on there? Yes, I will. I will. Yeah? I will. You know, I'm not the person to know enough about both sides to be able, but I love to see people who are well educated like yourself. And actually, I want to see more debates in society, right?

Yeah. Friendly debates, right? Like you don't have to discount somebody as a human being. I agree. You don't have to attack their character. Absolutely. It's actually really beautiful to see two incredibly smart people. who are very passionate about their side and everybody wins.

Like, let's have more debates, right? So if you ever host one, I'd be happy to, you know, share it with my community. That's exciting. And it'll be a combination of you interviewing people as well as maybe doing some solo. It'll be both. Right now, I have a YouTube that is mostly conversations with my mentor. Again, he's in his 70s and it's probably cringing that I'm saying that. But he again, this is some of his pivotal work.

It's very rare that you get to meet someone who actually discuss. a meal threshold response or a scientific discovery. And I really, he's an academic, which means he doesn't venture out into the public much. Yeah. And I find that his work, you know, has influenced me for the better part of two decades. So it's many discussions with a true academic scientist that is, that is able to reach the general population. At what point in time in your studies did he come into your life?

From the beginning, undergrad. And was he part of the reason that you stopped being vegetarian? No. No. So you're even learning about his material and still being vegetarian. Yep. Got it. I mean, that's a whole other podcast.

Yeah, yeah. But he is, you know, one of the things that I think I learned so much from, it's not just the science information, but there is something to scientific integrity and intellectual integrity. And that, you know, as I watch this very fine scientist, ask me questions and challenge hypotheses and be the first to point out if I'm wrong, it's just a very interesting experience. That's great. How lucky were you to have him in your life?

Still. Still. Yeah. That's incredible. And the book is coming out in October. Actually, next October. Next October. Next October.

Okay, got it. So stay tuned, everybody. Stay tuned. When there's a link. We'll keep you posted. I am accepting patience. People can apply on my website. also have a great newsletter, all education-based, and I'm very active on Instagram and Twitter

and now SageSpot, which is a very cool new platform. I've not heard of SageSpot. I thought I knew it all, but that's great. It just launched today, actually. And what's the deal? The deal is that people will be able to interface with me. Okay, cool. On a more personal level. Like ask you questions and everything. Yeah. Oh, I love that. I love that. Well, we'll have all those links in the show notes. Dr. Lyon, I really appreciate the commitment that you have to your message and being willing to be challenged on your ideas because you believe them to be so important and centric to people feeling better that you are willing to be

temporarily challenged or uncomfortable because you know that the truth, at least as you see it and want to present it to the world, is important to get out there. So I just want to acknowledge you for that. Thank you. And I appreciate you. And I know you have a close friendship with my business partner, Dr. Markeye. in. Thanks to the world of you and you've helped a lot of people in our world. And just thanks for coming on the podcast. Of course. Thank you. Thank you so much.