Feel Better, Live More with Dr Rangan Chatterjee - The Crucial Importance of Strength Training, How To Make Healthy Habits Stick & Living a Strong & Healthy Life with Dr Gabrielle Lyon #418

Episode Date: January 17, 2024

My guest today believes that the single biggest problem with our health these days is not that we carry too much fat but that we don’t carry enough muscle. She believes that if we start to focus and prioritise our largest organ – our muscle – we can burn more fat, improve our body composition, decrease our risk of disease and increase our energy levels.   Dr Gabrielle Lyon has a doctorate in osteopathic medicine and is board-certified in family medicine. She earned her undergraduate degree in Human Nutrition from the University of Illinois and completed a research & clinical fellowship in Nutritional Science and Geriatrics at Washington University. She is the founder of the Institute for Muscle Centric-Medicine™ and the author of a brand new book, Forever Strong: A New, Science-backed Strategy for Aging Well.   Dr Lyon first appeared on my podcast about 18 months ago. In that conversation, she made the compelling case that the quality of our lives is directly related to the health of our muscles.  She explained how having more muscle can improve our metabolism, reverse insulin resistance, reduce our risk of disease, protect our skeleton and improve our mobility and balance. She also explained the critical role of resistance training and the importance of consuming adequate protein.   In this conversation, we pick up where we left off. We cover: The crucial importance of muscle mass for all of us The relationship between the health of our muscles and the health of our brains The role of mindset when it comes to implementing new health-promoting behaviours How to make healthy habits stick Her exact exercise recommendations for both the time-pressed individual and the time-rich individual How to reframe stress to make it work for us The impact of sleep loss on our ability to build muscle Why Dr Lyon is not such a huge fan of goals!!   This is a truly empowering conversation, built on the idea that ageing well is a choice. It is jam-packed with practical, real-world insights. I hope you enjoy listening. Support the podcast and enjoy Ad-Free episodes. Try FREE for 7 days on Apple Podcasts https://apple.co/feelbetterlivemore. For other podcast platforms go to https://fblm.supercast.com. Find out more about my NEW Journal here https://drchatterjee.com/journal Thanks to our sponsors: https://zoe.com https://calm.com/livemore https://drinkag1.com/livemore Show notes https://drchatterjee.com/418 DISCLAIMER: The content in the podcast and on this webpage is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor or qualified healthcare provider. Never disregard professional medical advice or delay in seeking it because of something you have heard on the podcast or on my website.

Skeletal muscle is the cornerstone for health and wellness, and it's 40% of our body. If you do not have healthy skeletal muscle, you do not have a healthy metabolism. Over time, skeletal muscle that is not exercised and unhealthy becomes less efficient at utilizing energy. The body becomes insulin resistant just as the brain becomes insulin resistant. Our metabolic health has a direct impact on our brain function. Hey guys, how you doing? Hope you're having a good week so far. My name is Dr. Rangan Chatterjee,

and this is my podcast, Feel Better, Live More. My guest today believes that the single biggest problem with our health is not that we carry too much fat, but that we don't carry enough muscle. She believes that if we start to focus and prioritize our largest organ, our muscle, we can burn more fat, improve our body composition, decrease our risk of disease, and increase our energy levels. Dr. Gabrielle Lyon has a doctorate in osteopathic medicine and is board certified in family medicine. She earned her undergraduate degree in human nutrition from the University of Illinois,

and she completed a research and clinical fellowship in nutritional science and geriatrics at Washington University. She's the founder of the Institute for Muscle Centric Medicine and the author of a brand new book, Forever Strong, a new science-backed strategy for aging well. Now, Dr. Lyon first appeared on my podcast about 18 months ago. in that conversation she made the compelling case that the quality of our lives is directly related to the health of our muscles. She explained how having more muscle can improve our metabolism, reverse insulin resistance, reduce our risk of disease, protect our skeleton and improve our mobility and balance. She also explained the critical role of resistance training and the importance of consuming adequate protein. It really was a fantastic

conversation that I would highly recommend you go back and listen to at some point if you have not already. Now in the second conversation, we pick up where we left off. Yes, of course, we do recap on the importance of muscle health, but we also cover a lot of new ground, including what is the relationship between the health of our muscles and the health of our brains? What is the role of mindset when it comes to integrating new health-promoting behaviours into our lives, how we can learn to reframe stress to make it work for us rather than against us, the impact of sleep loss on our ability to build muscle, and she also explains why she's not such a huge fan of goals.

Instead, she prefers a focus on standards. goals. Instead, she prefers a focus on standards. This is a truly empowering conversation built on the idea that aging well is a choice. It is jam-packed with practical real-world insights. I hope you enjoy listening. So Dr. Lyon, you believe that all of us need to be focused on the health of our muscles, whether we want to burn fat, live longer, improve our hormonal profile, increase our energy, or reduce the risk of getting sick in the future. You believe that our muscle health is really, really important. Why? The quality of our muscle is the cornerstone for overall health and well-being. And quite frankly, it's the organ of longevity. There's nothing more important

than skeletal muscle. It is different than this idea of looking good in a bikini and athletic performance, which is, you know, when we think about skeletal muscle, that's often what we think about. I'd love to start with a story that will really highlight where this came from. I did my fellowship in geriatrics and nutritional sciences. And by the way, as you know, as a physician, geriatrics is over the age of 65. It is end of life. There is palliative care involved. It is nursing home rounds. Quite frankly, it was something that I didn't want to do. But in order for me to have an advanced education in nutritional sciences, it was the deal. I had to make a deal. In order for me to do a two-year clinical fellowship, I had to work as a geriatrician and get my fellowship

training in geriatrics. And in the mornings, early morning, I did obesity medicine research. And during the day, I would see patients in the hospital, in the nursing home, in clinics, in memory and aging clinics. And then in the evening, I would go back to doing obesity medicine research. And one of the things that we were looking at was body composition and brain function. And there's always that one patient, right? I'm sure you've had that one patient that changed everything for you. Any trainer listening will have that one client, any other physician listening, any person will have the influence of one person that really changed the trajectory of their life. And for me, it was a woman named, we'll just call her Betty.

She was a mom of three kids in her mid fifts. She had always struggled with the same 20 pounds. We know a ton of people like that. 20 pounds over a lifetime, always put herself last, showed up for her family, showed up for her friends, and did exactly what the medical community had told her, which was eat less and exercise more. And quite frankly, I gave her the same advice. We imaged her brain and her brain looked like the beginning of an Alzheimer's brain in her mid fifties. As you can imagine, in her mid-50s. As you can imagine, it really struck me. It struck me because during the day,

aging and Alzheimer's was very real to me. And I was seeing the implications it was having on the family and the friends and the people around individuals who have cognitive impairment. I realized that she'd done everything we told her to. And in the process, she lost weight, just as many people lose weight, go through process of yo-yo dieting. But she also lost skeletal muscle and destroyed her metabolism and impacted her brain. So I started thinking, okay, how is this the standard of care? So I started to really begin to put these pieces together. What was the one thing that all these patients had in common in the nursing home, in the hospital rounds, in the dementia unit? It wasn't that they were over fat. It was that they had unhealthy skeletal muscle first,

and that we had been trying to fix this obesity epidemic for the last 50 years. And all of the things that ride along with obesity, Alzheimer's, cardiovascular disease, you name it, hypertension, insulin resistance, these are not diseases of obesity. In fact, these were diseases of skeletal muscle first. Insulin resistance. Insulin is a hormone released from the pancreas that moves blood sugar out of

the bloodstream into the cells. And I realized I had this aha moment that in order to get people healthy, and if we really truly cared about longevity, we had to course correct the way in which we were thinking and shift our focus from the pathology of fat to the building, the maintaining, the cultivation of the health of skeletal muscle. And that's really where this concept of muscle-centric medicine came from. And of course, I'm sure you have questions and I am going to talk to you about exactly what skeletal muscle does, why it's an organ system. But I think it's important that everyone put themselves in the framework of understanding that we've had a narrative of constantly focusing on all these other diseases as if they're out there. But truly these diseases begin in our 30s. It's a powerful story. And yes, we all have, I think, as physicians,

as healthcare professionals, as personal trainers, we all have that one patient, that one client that started to change things in our brain that made us question some of the things that we've been taught or certainly question some of the ways in which we were practicing. But you mentioned there Alzheimer's in the brain. You've also mentioned the importance of skeletal muscle. Now, I think for many people, they're going to go, well, yeah, I get it. Skeletal muscle is important, but what on earth has it got to do with the health of our brain? Yeah, it's a really great question. You originally asked me, why do I believe, why is my working hypothesis that skeletal muscle is the cornerstone for health and wellness? Let's talk about what skeletal muscle does. Number one,

it is an organ system. It is an organ system that you have voluntary control over. Quite simply, this means it's the only organ system you can directly do something about with conscious thought. You cannot exercise your liver. You cannot exercise your heart specifically to tell it to beat 135 beats a minute. Maybe if you're Wim Hof, it's possible. But for the rest of us, we're unable to tell our thyroid to produce T4. We are unable to tell other organ systems exactly what to do.

Skeletal muscle as an organ system is under direct voluntary control. What does this mean? And what does it do? Skeletal muscle is your metabolic sync. This means that the food that you eat, primarily, let's say you were eating carbohydrates, 80 some percent of carbohydrates are disposed of in skeletal muscle. You hear a lot of people talk about elevated levels of blood glucose, elevated levels of insulin.

These are directly related to the health of skeletal muscle. How could a listener visualize this? Think of skeletal muscle. How could a listener visualize this? Think about skeletal muscle as a suitcase. I love to pack for a trip and let's say I am going on a trip for four days and I pack for 30. Think about your skeletal muscle as that suitcase. So for example, I am way overeating carbohydrates and skeletal muscle only can hold so much carbohydrates in the form of glycogen. If I am not exercising that skeletal muscle or I don't have a lot of it or it's unhealthy, I have nowhere to put that glucose. Eventually that glucose stays in the bloodstream, goes to other tissues. We see an increase in fatty acid deposition all over the body, not just in skeletal

muscle. Over time, skeletal muscle that is not exercised and unhealthy ends up looking like a marbled steak rather than a filet, which is exactly what it should look like, it becomes less efficient at utilizing energy. Skeletal muscle is one of the primary sites for mitochondria. Mitochondria, which I know that you've talked about, often is the powerhouses of the cell. It's where we generate energy. Skeletal muscle is a primary site for fatty acid oxidation. People are worried about their cholesterol and they're worried about triglycerides. Skeletal muscle is a primary site for utilization.

When we think about metabolism and metabolic regulation, skeletal muscle is the primary site and it's 40% of our body. This is just one aspect from a metabolic perspective. When you talk about brain function and the health of skeletal muscle, if you do not have healthy skeletal muscle, you do not have a healthy metabolism. The body becomes insulin resistant just as the brain becomes insulin resistant. You know, Alzheimer's is often thought of as type 3 diabetes of the brain, which means our metabolic health has a direct impact on our brain function.

And we know that the lower the waistline, the smaller the waistline, the less body fat an individual has, the better over time the brain will function. over time, the brain will function. It's just remarkable to think about all of the different things that skeletal muscle influences. Yeah, as we discussed the first time you came on my show about 18 months ago, many of us for years have just thought about it as a physical thing, you know, dumb muscle. It's a bit more if you want to look big and be a bodybuilder, but otherwise it doesn't really matter. And we very much have undervalued the importance of skeletal muscle. One of the key points we mentioned in our first conversation was that as we get older, above the age of 30, unless we're doing something about it, we are losing our skeletal muscle every year, right? We did cover that in

quite a bit of detail the first time around. And Dr. Line, my first book that came out at the end of 2017 set out what I consider to be the most important four pillars of health, food, movement, sleep, and relaxation. And in our first conversation, we covered in detail food, specifically protein, how important that might be for skeletal muscle. We mentioned the kinds of exercise that you recommend. You mentioned, I think, you like HIIT training once to twice a week, strength training three to four times a week, and a good cardio base. For example, walking 10,000 steps a day, something like that. I definitely want to revisit some of these things in this conversation. But two of those pillars,

sleep and stress, we didn't really cover. So I wonder if we could start off by talking about the relationship between sleep and skeletal muscle. Most certainly. You know, it's a very interesting tie, sleep and skeletal muscle. And I'm going to highlight some of the emerging research, which I think is quite fascinating. One thing to keep in mind is that the research surrounding skeletal muscle has largely been based on performance, which is why we've truly missed it as a medical profession, which is why the world still thinks about skeletal muscle as this performance organ. And it's so much more than that. It

interfaces with the brain, the other endocrine organs, just everything. And sleep and skeletal muscle is interesting. Here's what is commonly thought about. When you get good sleep, you will have better recovery. This is a time that growth hormone is released. It allows for optimization of hormones. We do need to get into deep rest. It also is a time where the brain cleans itself. The glial cells of the brain clean itself. We do know that sleep deprivation over time has significant effects on cognition.

has significant effects on cognition. One night of sleep deprivation can impact muscle protein synthesis by 18%. So it can decrease your ability for your body to create this robust response. And muscle protein synthesis is a physiological process in which amino acids are incorporated into skeletal muscle. It's what we would consider a biomarker of the health of skeletal muscle. It's one of the ways in the literature in which skeletal muscle health is measured and also that muscle is doing what it should be doing. From a muscle protein synthetic response, skeletal muscle is highly plastic and highly responsive to diet and exercise. When you have suppressed muscle protein synthesis, and 18% is a pretty robust suppression with one night of sleep deprivation, and that I think that the data was four hours or less, impacted the ability for skeletal muscle to respond to, again, muscle protein synthesis. And this could be thought of under the influence of

both amino acid influence or training influence, because those are the two ways in which we stimulate muscle. Now here's the catch. A lot of the military operators will go through periods of time where they have sleep deprivation. And what some of the data suggests is that if you go through a few days of sleep deprivation, one way to counteract the influence of sleep deprivation. One way to counteract the influence of sleep deprivation on skeletal muscle is actually pumping up your exercise, which is completely counterintuitive. You would think that if you have gone through a week of sleep deprivation, you should probably just rest. And in fact, that's not what some of the data suggests. Some of the data suggests that an individual should really kick up their training during that time to protect metabolism and to protect and counterbalance the influence of lack of

sleep because a whole host of other things. So muscle protein synthesis is just one portion of what muscle does. We know that with lack of sleep, and we see this in shift workers, there is an increase in insulin resistance. There's an increase in insulin resistance, there's an increase in blood glucose, all of these things, I believe, to be centered around the influence on skeletal muscle. It's really interesting that if you don't sleep well, you decrease your sensitivity to the stimulus of training the next day, right? You mentioned muscle protein synthesis goes down. And as you say, you could

then make the case, well, one shouldn't train. But that new bit of data there, that's fascinating, that actually you sort of insulate yourself from some of those negative effects by training. insulate yourself from some of those negative effects by training. When I spoke to Professor Matthew Walker on this show a few years ago, I remember one of the things he said to me was, if you're losing weight and you're sleep deprived, then the majority of that weight will come from muscle as opposed to excess body fat. So the whole system, the whole body is connected, right? And that's why I really love these four pillars as a way of looking at everything, including skeletal muscle, is because each one of those four pillars influences the other ones. Yes, it does. You know, we don't exist in this silo. And I'm so glad that we're talking about

stress because it's often something that people don't necessarily ask me about, but I think that it's a critical importance. Sleep definitely influences the way in which our metabolism works. Skeletal muscle has probably the biggest influence, by the way, on our entire homeostasis. If you were to ask me, what do I believe is most important? Is it food, or is it training, or is it name something, ice bath, etc.? I would say the influence of exercise trumps nearly everything because of its influence on all other body systems. That is how impactful training is for people. And when we talk about stress, I'm going to throw a loophole here. When I say stress, or you say stress, that could mean, I don't know, the kids are home for Thanksgiving. That could mean I have to go to the DMV, the Department of Motor Vehicles, and I don't

know if I have my right paperwork. It could also mean the death of a loved one or the sickness of a family member. We have one word to define various different states or experiences or life tragedies, you know, on any scale. Nowhere in the human language do we have another word that describes all of these different things. Yeah. And, you know, and I will say the evidence supports that how we imagine and think about stress truly does influence our physiology. Yeah, I think it was a paper I read about if you consider the stress to be adaptive for you as opposed to harmful, it has a different physiological effect, which is absolutely incredible. The way you think about that stressor

will determine its effects on you. I have seen this in real time in my patients and I have to say it's one of the topics that is not discussed, but is probably one of the most critical. When we hear stress, we typically think of, what do you think of when you hear stress? What is the response? I mean, normally it's a negative word, isn't it? Because I think we're talking about this chronic, unrelenting stress that we never switch off from, we never allow ourselves to recuperate from. But of course, not all stress is bad. We need stress to be our best selves, don't we? I think the problem for most of us these days, and why stress has such a negative connotation, is because

we're no longer having our stress responses activated now and again, because there's a wild predator approaching our camp. We're having it activated chronically by the state of our lives, our email inbox, the kids we're having to look after, the elderly parents we're having to care for, the negative comment we saw last time we went online, whatever it might be. These are the multiple stressors that are firing themselves at us. And a lot of the stress researchers would argue that the way your body responds is very, very similar, whether it's a physical stress or a psychological stressor. Yeah. And I would say that I absolutely agree with you. What we hear

is stress, and then we hear fight or flight. Fight or flight is the stress response that we are all taught about. There's an increase in catecholamines. There's an increase in blood pressure. It's a very sympathetic response. Now, I would also say that that is an initial stress response. And that stress response is a physiological response. There are two other stress responses. There is tend and befriend, which is somewhat of an attunement response. And this is, for example, I have two very little kids. When I see them in distress, instead of going into fight or flight, I go to tend and befriend. What can I do to make their life better? Some people, when they are stressed, rather than go into fight or flight, will turn to reaching out to help people.

I would say that that is my initial stress response. This does a few things. It increases serotonin. It increases oxytocin. It allows us to bond. The other stress response, which I see with a lot of individuals, is a courage response. And the stress response, which I see with a lot of individuals is a courage response.

And there was, and the courage response is actually something that can be cultivated. And how is this important? And how does this relate to the health of skeletal muscle? Well, I would love to tie that all back in. And the courage response is something that also can be trained. I'll give you an example. My husband was an elite military operator. He was a Navy SEAL for 10 years. He loves jumping out of planes, which is insane. If I were to get up and jump out of a plane, I am sure that my blood pressure would be 500 over 300. I would be so scared and there would be a whole host of things going through my head and it would certainly be a fight or flight response. My husband getting ready to jump out of a plane might have a slight bump in blood pressure. He might have a slight increase in some of these catecholamines, but his response is courageous. It is much more facilitating. It is

of action. And that is another stress response that we are often not taught about. And there was a very interesting study that took individuals who were deathly afraid of snakes, put them in an MRI machine, put a very large snake on a conveyor belt that would then move towards an individual's head. I'm freaking out just hearing this. Okay. Right. I would be too. it out just hearing this. Okay. Right. I would be too. And initially everybody had a fear response and they were looking at fMRI images. They were also measuring various aspects of their body

chemistry. But what happened was the second time the individuals were coached up into what could be considered a courage response. And what they saw was different aspects of the brain lit up. And they were mounting, there was evidence that they were mounting a different stress response. And this was one of courage. So this goes back to saying that fight or flight is a response and courage is a choice. Fight or flight is a response. And courage is a choice. And if we can readjust our understanding of stress, humans are very interesting.

And I'm going to tie this back into this obesity narrative. Once we hear something over and over and over again, humans believe it to be true. And we believe that that is the framework for understanding, just like with an obesity epidemic that we've been trying to fix for the last 50 years. We focus on the pathology of fat. And I would argue that if we ask the right question, then we'll get the right answer.

And I think that that can be translated to stress. I think that we have been taught over and over again that we have this one stress response and we should reduce stress. And it's a fight or flight response. I would say that that is a repeated narrative that we can readdress and make individuals much less, I don't know if the word is fragile, but much more resilient in the way in which they interpret their environment. And what becomes so important, I know that this is really about medicine and kind of this muscle centric approach, is that when we do things like train, this does create for some people

an initial stress response. We begin to cultivate courage. We begin to cultivate behaviors that allow us to acquire skeletal muscle, which take drive and a different way in which we interface with the world. And I hope that that's not too esoteric, but truly the message that I'm trying to deliver

is one of strength. And with that message of strength, I'm going to challenge the way in which we have traditionally thought about medicine, but also challenge the way in which we thought about mindset. And I believe that stress can be enhancing. And I believe that when we recondition individuals to also believe that, then they can have a different control of

their physiology, which will allow them to take massive action. I just love what you just said. I really do. In fact, one of the things I enjoyed the most about your latest book, Forever Strong, was how you covered the psychological aspects of change as well as the physical ones. Because what I'm writing about, the things I think about more, are these mindset issues. Because actually, once you've got the foundation of mindset right, I find that those downstream behaviors of food and movement, whatever it might be, are so much easier for people to incorporate into their lives when they have these self-limiting beliefs. It doesn't matter how many podcasts they listen to, how many books they read, they don't take action. So I was going

to bring those things up with you during this conversation, because I think you give a masterclass in that in Forever Strong. The other thing I just wanted to comment on, you mentioned your husband who was a former Navy SEAL. I think this is a really important point. If he was jumping out of a helicopter 30 years ago, right, I imagine he may have been really, really scared. But by training it, by practicing it, by developing his confidence in it, he's now at a point where he can actually enjoy it, whereas you haven't done that. So you or me, we're going to freak out when that happens. What does that tell us? It tells us that the stressed response or much of it is internal. The same external event is happening with jumping out of

a helicopter, but how we interpret it is determining the impact on our bodies. And how we interpret it depends on our experience, our level of confidence, what we've practiced. And again, you can tie that into exercise. You can tie that into muscle. The more you practice exercising, the more you train, you are working out your stress response system. And therefore, whatever that stressor is in life that comes before you, you're better able to handle it. I have to tell you something. I am so grateful for you and your openness to have this conversation. It's actually one of my most favorite topics because as a provider, as a physician who still sees patients, you know, a good clinician is really good at recognizing patterns of diseases. We can all agree on that. But an effective

physician is good at recognizing patterns of people. And I have been a physician since 2006. And I will tell you, I have seen what makes individuals successful. And if you allow me, I would love to share some of the aspects that I have seen that really change the narrative for people. And every single person listening to this podcast will be able to take what I am saying and implement it immediately. Yeah, please. Okay, I'm going to tell a quick story time. We have plenty of time. The mental wellness app Calm are also sponsoring today's show.

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And every year, I wait for the call. The call that comes after the big event. And that call is, I am depressed. I'm not motivated to train. By the way, he's super fit. I am eating junk food. And I just, I know you want to see people. I just want to lay in bed. And every year he's shocked by this. He's shocked by his own human nature. And you're

thinking, okay, so let's break this down. Everybody's striving to do things, whether you are a mom trying to get your kids to a big event, or you are a business owner, or you are a doctor, or you are a writer, everybody has some level of thing that they are working towards. And once you are at that pinnacle, right? So let's say when your next book comes out, you will be spending months and months and months prepping for this thing. You will be spending months and months and months prepping for this thing. And then you will be at the top of the world. You have this high level of dopamine drive and obviously other neurotransmitters, but we'll just relate it to dopamine.

And at that peak, at the pinnacle of success is where people are most vulnerable. And right after they reach their most successful moment is their second point of vulnerability. I am going to circle back how this all relates to mindset and what these individuals listening, guys out there listening, guys and girls out there listening, what you can do. As high as an individual is going to go is as low as they are going to go. It is predictable and it is human nature. The best of the best are very neutral and they practice neutrality and they practice ways of dopamine preservation. If we think about the neurotransmitter dopamine related to drive and motivation, again, to say it simply, when you have a big event, this is your place of

vulnerability. You will look for the next car to buy, the next thing to do, the next food to eat, the next thing to buy at the peak of your success. There is nothing that will take you off track faster than not understanding this. As high as an individual is going to go is equally as low as they were going to go. I did this massive push here for the book Forever Strong. How pumped up do you think I allowed myself to get before the day before the book release? I would imagine extremely pumped up. Extremely neutral. Here's why. Because I knew that as high as I was going to get with this book release would be as low as I would go.

You hear people that go off and do some kind of physical event, following that physical event, whether it's running a marathon or taking a test or doing the thing that they had trained to do, become extremely depressed afterwards. Have you heard that? I have heard it. I've experienced it myself. And I'm delighted to hear that you have presumably gone through a process to get to this point where you're able

to maintain neutrality even the day before your very first book launch, which for many people is a hugely exciting moment. But I totally agree with you. I've had it before when I wasn't emotionally neutral and I'd have the highs and lows. And for the last few years, I say the last two or three years, I feel generally pretty neutral a lot of the time. It doesn't mean I don't enjoy life. I enjoy life more now than I ever have. Because of that neutrality, people will often say, yeah, but I want the highs. I don't mind the lows, but without the lows, I don't get the highs. You can have it, just not with that same amplitude. And it's much more sustainable. For me, Dr. Lyon, a lot of that is coming from, I guess, the sort of things we were talking about

related to your husband jumping out of a helicopter it's come from the fact that I understand deeply that a huge part of my response is down to me and I've worked very hard and cultivated this skill I don't think it's something you're necessarily born with't think it's something you're necessarily born with. I think it's something you can get better at. One of the ways I've done it is by looking at every day as a school day. So every time for the last years when I would get emotionally triggered by the thoughts or the words or actions of somebody else, instead of thinking they were the problem, I would reflect it back

onto me and go, why is this bothering you, Rangan? Do you expect to walk around the world and expect everyone to say the things that you want to hear? No, that's completely unrealistic. So therefore, I can't control other people's words and behavior and actions, but I can control my response. And so by doing this as a diligent daily practice, I've now got to the point where a lot of that is default. I'm bringing it back to health for people tuning in who want to have more vitality, they want to live longer, they want more energy, they want to lose weight, whatever it might be. I, like you, Dr. Lyme, believe that this is one of the most important skills because if you can maintain that neutrality, it's easy not to go to the alcohol. It's easy to not comfort eat the sugar or the ice cream because those things are, in my experience anyway, they are usually downstream consequences of these kind of upstream patterns.

It's so brilliantly stated. And I will say congratulations because the best of the best have that level of neutrality. Again, I take care of patients that are the best in the world at what they do. They do exhibit that neutrality and it is something that they have learned over time. And by doing that, they don't have the highs and lows. And it's exactly what you're saying. It's not that you are not excited about something, but it is a moderated excitement. And I can give individuals very practical tools,

which we're gonna talk about right now, what they can do to begin to build that neutrality muscle over time. Exactly what you said. So you are able to think of every day as a school day, which is genius, and begin to think about what are some of the things that may be a negative experience. For example, for you, maybe it's comments. You're very much in the public eye. That does take time to kind of build up that neutrality. Here's a couple of very simple things that people could do for dopamine preservation. We'll just, we'll identify it as dopamine preservation.

Go through your week and don't celebrate every win. I am not talking about not being kind to yourself. I'm not talking about belittling yourself. I am just saying that don't celebrate every win. Intermittently celebrate a win of doing something great. Flip a coin. You flip a coin, heads you celebrate, tails you don't. If you are an individual who loves loud music and some kind of stimulant before you go to work out, whether it's caffeine, et cetera, flip a coin. One day have it, the other day don't, and you don't know which day that's going to be. You begin to build up these muscles of dopamine preservation. Let's say you want to go shopping and you can afford to buy something,

you flip the coin, whether you get it or you don't. And over time, you begin to then translate that to these big events and things that people are doing. Again, little things will then translate to big things because it is about the long term, the way in which we want to show up for our family, for our work. It is a long-term game. And the highs and lows make people very vulnerable to human nature in a way where the habits that they create, the habits that you create in your 30s, 40s, and 50s become much more difficult to break each defining decade. So if someone is listening, really begin to initiate some of

these practices and you can begin to change your habits very, very quickly. And it won't be a habit that you have to deal with emotional eating in your 50s. And that's just one aspect that I think is extremely beneficial. The other thing is, people talk a lot about positivity and they think, I'm going to do this exercise and diet program because I'm going to lose weight X, Y, and Z. I would say that that is not an effective strategy. What is an effective strategy is if you can collapse your future self with your current self. And let's just say, caring what people think. If you care what people think and that consumes your mind, caring what people think. If you care what people think and that consumes your mind,

imagine the cost of that behavior and that thought process if you do it for a year. And then if you do it for five years, and then you do it for 10 years, imagine the cost on your life. You could do that for diet and exercise. Let's say you have kids and Friday night, you've done great all week and you sabotage yourself every Friday night because that's how you relax. Imagine what that toll is going to be if you continue to do those habits over a year. Each time you repeat a habit, you are much more likely to repeat that habit again. So when you collapse your future self with your current self, and yes, it does have a bit of a negative spin, but it's kind of like, what was that movie, that Christmas movie with the three angels? Do you remember?

Gareth's in the background. He's saying it's a wonderful life. It's a wonderful life. That is an example. If someone wants to see what I'm talking about, watch It's a Wonderful Life. It will snap you out of whatever you are telling yourself instantaneously. Yeah. You do. You have to collapse that future self with the current self. I think what we're talking about here is so, so important and so, so undervalued generally in the health conversation that takes place everywhere these days. It's all about more information. And look, I'm all for giving people information. And in our first conversation together, you gave a masterclass in protein and resistance training. And hopefully we can cover some of those things again today.

But I think people even with that information don't always manage to make change. So let's imagine a scenario and given the time of year, it's January and someone is thinking, this year something is going to be different. You know what? I'm getting my stuff sorted in 2024. And in my view, if you don't take a different approach, why is it that 2024 is going to be any different than 2023 or 2022 or 2021? So instead of trying to buy a new book or a new diet plan or a new strength plan, whatever it might be, sure, do that. But you need to go a little bit further upstream as well. So can you relate what we're talking about now to people wanting to create healthy behaviors? I have a great solution for this. Are you ready? The solution is we set standards. We don't set goals. Standards for how we show up,

standards for how we execute. You no longer need to set goals. If you have a weight loss goal, this sets you up for failure. The first thing that people should do is set a standard for how they want to show up. For me, I show up, I train. It is a standard that I have set for myself. I eat a certain kind of way, a certain amount of protein, certain kind of carbohydrate. It's a standard. It is not a goal. And when we shift away from goals, because goals are variable and you have an opportunity to meet that goal or you have an opportunity to fail at that goal. But when you set a standard for the way in which you function in your everyday life, and I encourage people to write it down. What is the standard that you are going to set for yourself and then execute on that standard?

An individual will find that everything else falls into place. It's really interesting because you're saying set a standard, right? Say what you're going to do and do it. You know, be accountable. In fact, there's a section in your book, I think, called Erecting Guardrails for Accountability, which I really enjoyed. And something you said in that section was, you need to know what integrity is and what your responsibilities are to yourself. That was really, really powerful for me. What do you mean integrity and your responsibilities to yourself? Nothing will undermine how you feel about yourself if you have standards that you set and that you don't keep.

And for me, there was a period of time where I was all over the place. I was training a lot, many hours of the day, and it was taking away from the things that I needed to do. And that might be the opposite problem some people have, but it wasn't being truthful to the integrity that I had set for myself. For me, training and an hour a day is plenty. Anything above that is me running from whatever it is that I'm supposed to be doing because I'm quote training and I'm doing something healthy. When you set a promise to yourself, whether it is you're going to eat a certain nutrition plan, and I don't care actually, quite frankly, what plan that is. You can define it, which you should, exactly what you

are going to do. If you are comfortable having a drink on the weekends, that gets written out. You define what it is that you are going to be doing. That is your plan. You make a promise to yourself that you're going to keep that plan. And every single time that you don't, you come out of alignment. And what is the best effective way to put something back into alignment? I mean, from my experience, it's a consequence. You have to have a consequence for your action. If a consequence is big enough, it makes you reevaluate what it is that you're doing. If a consequence is big enough and it allows you,

you know, it's like with a little kid, if you change their focus, they'll forget why they're angry. And it's not that the thing that they were angry about was an important thing. Maybe I didn't scramble the eggs in an appropriate way. Right? You're laughing because you have kids and maybe the eggs got thrown in my face and then I show them some new handwriting book that I got them and all of a sudden this is the thing.

So it's very rarely that it's a thing. And what I appreciate so much, and I'm so thrilled that you're a physician talking to me about this, is that I could give someone the perfect program. I could say, we must exercise our skeletal muscle. 50% of people don't exercise. Maybe 24% of people are even meeting that daily recommendation. By telling people to do the thing or increase dietary protein. None of that matters. It's not going to happen. If the brain chemistry and the initial framework for understanding is not addressed, then an individual will never see success. I completely agree. Gabrielle, when you were mentioning your commitment to yourself,

I think you mentioned it was one hour of training per day. And you said, I believe, anything more than that is too much and is you trying to, in some ways, run away from the more important things in your life. Now, I think that is such a key, key point. Many people will do this. Many people will not have the awareness that they're doing this. And I want to tie this into this broader concept, which is, I think people take on too much, particularly at times like January, where they think, right, I'm going to overhaul everything. I'm going to eat fantastically well. I'm going to do Dr. Lyon's plan. I'm going to strength train

four times a week. I'm doing 10,000 steps a day. I'm doing HIIT training twice a week. And they do it for two or three weeks when the motivation's high. And then real life gets in the way and they fall off. So when I hear you saying that your commitment to yourself is one hour of training per day, no more than that, I think it's really, really powerful. You seem to have found what works for you. It doesn't mean that's going to work for someone else. That's what works for you in the context of your life. And there was a section in your book when you're talking about mindset and overcoming resistance, where you said you admitted to previous thought loops that you had. And you said this, my thought loops told me I would never be

fit enough, which drove me to train for hours per day whilst neglecting the other aspects of my life. Can you speak to that a little bit, please? I think it's really important that we understand. I will say this first, that motivation comes and goes, and you have to plan for that. You cannot be shocked by the fact that you will not be motivated. I was able to address all of that stuff many years ago. There are many times now I do not feel like training. I have two very little children. My husband is a first year surgical resident, which means he works 100 hours a week. Here's what I do. I am not surprised by the fact that I am not motivated to train. What I do is I have it all set up. For example, I have training partners that I know are going to be meeting me at the gym.

I am not going to let them down. I would never not say I'm going to show up for something and then not show up for it. I know that when I get off of a plane, I will go and I'll train. I don't feel like it. I'm already trying to, every Saturday we do this, or every Sunday we do this big group workout.

Every Saturday night, I am trying to talk myself out of how I'm not going to be going and showing up for Sunday. Yet we're all surprised that we're going to start on a program January 1st and then we're shocked by the fact that we're not motivated by in two or three weeks. Plan for that. You're not going to feel motivated. You are going to feel motivated the first week. Failure to understand and plan for the fact that is absolutely going to fall off is a complete misstep. You plan for that. You have your teammates in place that you are going to show up for because if you're not willing to do it for yourself, you will definitely show up to do it for another person. And yeah, that's all I can say about that. I am definitely not motivated a lot of the time, but I still will show up.

I think relating also to your one hour a day of commitment to training, I think is this idea that there's a cost to everything we do. There's a consequence to everything. So in the modern world and the way we're living these days, many people feel time pressured all the time. And then they will hear, let's say you on your first podcast with me, you gave some recommendations that some people are going to find very tricky to fit into their life. Your advice was that most people need a good cardio aerobic base. That could be with 10,000 steps of walking a day. You thought they need some form of high intensity training, maybe once to twice a week, and some form of resistance strength training, ideally three to four times per week. Now,

for some people, they're going to go, no chance. There's no way I can do that. Let's push back on that. And let's say that you truly don't have time. There are ways to make it happen. Before we get back to this week's episode, I just wanted to let you know that I am doing my very first national UK theatre tour. I am planning a really special evening where I share how you can break free from the habits that are holding you back and make meaningful changes in your life that truly last. It is called the Thrive Tour. Be the architect of your health and happiness. So many people tell me that health feels really complicated, but it really doesn't need to be. In my live event, I'm going to simplify

health and together we're going to learn the skill of happiness, the secrets to optimal health, how to break free from the habits that are holding you back in your life, and I'm going to teach you how to make changes that actually last. Sound good? All you have to do is go to drchatterjee.com forward slash tour and I can't wait to see you there. This episode is also brought to you by the Three Question Journal, the journal that I designed and created in partnership with Intelligent Change. Now, journaling is something that I've been recommending to my patients for years. It can help improve sleep, lead to better decision-making, and reduce symptoms of anxiety and depression.

It's also been shown to decrease emotional stress, make it easier to turn new behaviours into long-term habits and improve our relationships. There are of course many different ways to journal and as with most things it's important that you find the method that works best for you. One method that you may want to consider is the one that I outline in the three question journal. In it, you will find a really simple and structured way of answering the three most impactful questions I believe that we can all ask ourselves every morning and every evening. Answering these questions will take you less than five minutes, but the practice of answering them regularly

will be transformative. Since the journal was published in January, I have received hundreds of messages from people telling me how much it has helped them and how much more in control of their lives they now feel. Now, if you already have a journal or you don't actually want to buy a journal, that is completely fine. I go through in detail all of the questions within the three

question journal completely free on episode 413 of this podcast. But if you are keen to check it out, all you have to do is go to drchatterjee.com forward slash journal or click on the link in your podcast app. Let's say, realistically, you might not have an hour a day. You can get in there, then maybe you're an individual who needs to do more high-intensity interval training. And that could be accomplished in 20 minutes. There is a baseline physical activity that you must meet. You must be out and moving. We are not designed to be sedentary and we must rethink this domestication of humanity. I'm with you. Like for most of my life, until the last two or three years, I would say

I prioritized intensity, right? So for a variety of reasons, throughout my adult life, I feel I've been under huge amounts of stress. There's that word stress again. Now, I would always move my body. So listeners of this show will know that I do a five-minute strength workout every morning whilst my coffee is brewing. Now, you may argue that five minutes is not enough. I'll take it. But I would say I keep in pretty good shape from doing that now. Over the last two years, things have changed. As I have got older and I look in detail at the research on movement and exercise, I'm like, hey, Rangan, listen, if you want to be a capable, strong, resilient human being, you've got to move your body. So I am now committing to one hour's movement a day, right? And I love these daily things because if it's daily, it's a habit. Now, it doesn't mean I'm

going to run every day, right? Some days it will be a one hour fast walk. Other times it will be a run or whatever it might be. But by making it a rule, by making it a standard, then I'm accountable to myself. And I want to tie that in to this time of year, right? Even if people just commit to one thing and they do it, I think that is the best thing you can do. You give yourself evidence that you do what you say you're going to do. You are onto something, my friend. And what you're also onto is shifting a narrative and a way of thinking of how we have to age. Does this take time commitment? Does it take physical effort?

Is it sometimes uncomfortable because the last thing you want to be doing is push-ups and squats in your kitchen? Yeah, it's a drag, potentially. But the outcome is so beneficial when you are leveraging this organ of longevity from a lifetime trajectory of it's like putting money in the bank. You are doing what you need to do. It's an organ system. It is an organ system designed for movement. Yeah.

When you are sedentary, your muscle becomes insulin resistant. When, you know, it goes back to this analogy of the suitcase of going on a trip for four days, but packing for 30, you are creating flux within your skeletal muscle. The other thing that you are doing that one must recognize is that skeletal muscle is currency. But it is the only currency that cannot be bought, cannot be sold, it cannot be traded for. Skeletal muscle is a currency that must be earned. And you are earning it daily. And through that process, you are becoming a certain type of person, someone who is physically strong,

someone who is mentally disciplined. You are becoming a certain person capable of having skeletal muscle. And the two are not different. Yeah. In that chapter, I think it's chapter nine, you say, don't think of training as an activity with health benefits. Instead, consider it as a baseline requirement for wellness and an essential component of maintaining health and protecting longevity. That is exactly how I see it these days. That is exactly why on most days, I'm not perfect. Yesterday, I think it was 40 minutes, it wasn't an hour. But by having that as a standard, I'm constantly having to justify to myself when I don't meet it. So what's really interesting is that since I moved to this,

you're moving for one hour a day model, and I'll give Helen Hall, my coach, huge amounts of credit for this. She's an incredible movement coach who I work with. It means now that even when I get 40 minutes, I'm like, oh man, yeah, but I didn't get the hour in. Whereas if I was just leaving it to do it three or four times a week, then, you know, I may have missed yesterday because I was really quite time pressured yesterday. But because my commitment is an hour, I'm like, you know what? Just get out. Just do it. It was raining. It was dark. I was actually outside. I picked up my son from school. He was having a lesson, an extracurricular lesson, and I was waiting. And it would have been easy to stay in the car. It was warm, listen to a podcast, put the radio on, whatever. And I was like, I had this nagging thing at the

back of my mind. You've not moved today. You've not moved today. So I didn't even have a raincoat with me. I thought, you know what? Screw it. I'm just going out there. I'm getting this walk in. And you feel incredible. You get energy. Yes, I got a bit wet, but I honestly don't care. So I don't want to sidetrack this, Dr. Lyon, but I think these things are, these are the important foundations we all need upon which to build our behavior habits. You held yourself to a higher standard, which is incredible. And you felt good about it. Remember, we're not training to become better at exercise. We are training to become better at life.

You are doing actions that allow you to become better at life. And if people understand as they are going into the new year, let's say you don't like exercise, fine. Think about how you are going to cultivate yourself to become better at life. You just talked about how going out in the rain, it's dark and cold, and you got your physical activity. You also kept a commitment to yourself. You also put a notch in the fact that you are much more likely to go ahead

and take that action in the future. It didn't matter that it was raining. It didn't matter that it was cold. You're actually, yeah, you're cultivating your muscle, but you're also cultivating your resiliency. It makes you an individual who's not willing to negotiate and you're not negotiating with yourself. The brain does a lot of things.

The brain likes comfort. The brain tells us not to do all these things. But the brain is just an organ that pumps out thoughts. That's just what the brain does. It doesn't mean that they're relevant. It means that one can be discerning. You can have all the thoughts that you want. But when you commit to an action, you don't wait on motivation. You don't have to force yourself into doing anything. You might have a moment of negotiation, which is exactly what you did, but you took action. You're much more likely to take action in the future and you build upon that, which is exactly the goal for society. How do

we become stronger and more resilient as a society mentally, which then begets physical resilience. For that person who wants to get into strength training, let's say they heard our first conversation together and were inspired, but life got in the way. They haven't quite got around yet to bringing resistance training into their lives. Or perhaps someone's coming across you, Gabrielle, for the very first time and is going, wow, I didn't know skeletal muscle was that important. Let's maybe go through a couple of scenarios here. For someone who's never done anything, and let's say they're in their 40s, how would you advise that they start

getting into resistance training? Well, you had mentioned that you have a great coach. And I think now that we have access to online coaches and there's just a whole host of information, find a modality that works and be under the guidance of someone or at least curate information. There's tons out there. Because when you start, you are going to have much more of a response than someone who has already been training. Just doing basic body weight stuff like push-ups or squats or moving your body or doing lunges, this is an amazing place to start. You are doing something again. When we talk about resistance training, moving your body weight would be considered resistance training.

Then you graduate to bands. If you want to use bands, I think that that is very, very, very helpful. It is easy to do at home. And then after you graduate from bands, and let's say you are doing things, I think being able to squat, get off up off the floor, because again, we are training for life. Being able to do a pushup, you have to be able to fall well, you have to be able to push yourself up off of the ground. Let's say you don't want to do any of those things. Then you pick up a couple heavy bags and you walk and you carry them. Eventually you progress to kettlebells. What are actions that you do within your normal life

that will allow you to get better at doing those things. We know that people have to carry groceries. We know that you have to, if you are traveling on an airport, that you have to put your suitcase overhead. We know that it is very critical to be able to get off the floor if you were to fall. Begin to think about things within life

and put actions to those things. Let's say, I don't know, you don't want to buy weights. So maybe you spend $20 and you get a weighted vest on Amazon. There are a whole host of opportunities and options. And there's only one wrong way to do it, by the way. And that's by not doing it. Yeah, I circle that quote in your book. There is one slam dunk way to exercise wrong. Don't do it at all. So I think that's empowering. You know, at the start of this conversation,

you mentioned how you did geriatric medicine early on in your career, as did I. My second or third placement as what we call the senior house officer, so our second year as a junior doctor, was in charge of the care of the elderly ward at the Western General Hospital in Edinburgh. And when we think about these functional movements, and it's hard, right? I get it. In my 20s, I wasn't thinking about what do I need for when I'm 70 or 80, right? But something so practical that people probably don't think about unless they've seen it with, you know, like we have in our patients, to go to the toilet, you need to be able to squat, right? And it is something that people take for granted

until they can't do it. Again, I know that may not land for someone in their 20s or 30s who's listening, but I hope it does because nobody wants to be that person when they're older. I don't think anyone would choose to say, yeah, you know, when I'm older, I don't think anyone would choose to say, yeah, you know, when I'm older, I hope that I can't get up and down off my own toilet. I mean, no one wants that. It doesn't mean people can't have a quality life when they have that with help, for sure. But that's a very real thing for people to think about when we're thinking about functional exercises and what we need to be able to do, right? And it's also not if challenges are going to happen, it's when. It's not an if thing,

it's a when thing. You train for life and you train for sickness. And I know that that sounds morbid, but the more healthy muscle mass you have, the more resilient you are going to be in midlife and later on. And the time to take action is now. The best time was yesterday. The second best time is today. You have to take action and you have to do it regardless. It's not that it's going to get easier. So if people could think about what the future is like, you don't have to think about yourself. If you're in your 20s, you're like, you don't have to think about yourself. You know, if you're in your 20s, you're thinking, well, that's in another 30 years. And I will tell you that as someone who is not in their 30s, as you and I are both not in our 30s, that the actions and habits that you develop now are much easier addressed now than they are later on. dressed now than they are later on. Being strong and being capable and taking the action necessary is your best health insurance possible. It is not an if, when these things are going to happen,

it's a when. Whether someone gets the flu and they're laid up in bed, an older person might lose two pounds of muscle if they are on bed rest for seven days. The more healthy muscle mass you have going into any kind of disease or illness, the more capable you will be to fight it off. Also, I have never heard a patient say to me, you know, I regret being strong and capable. I regret that. Never in the history of ever. There's something also about strength training or exercise or training full stop that I don't think people talk about enough, how it makes you feel, right? When you can lift something heavy, when you're able to go on a one hour hike in the hills and you're able to do that, you come back and you've given yourself a shot of

resilience. You feel like a capable, strong human being. We can talk about what having muscle mass does to lower inflammation, improve the health of your immune system, lower your risk of cancer, all those kinds of things. Great. But it also does something arguably more important than any of those things. It gives you confidence in yourself. I know. Isn't it amazing? Muscle is the cornerstone to longevity. And what is longevity? It's not just living longer. It's living happier. It's living more capable. It's being able to fulfill what you intended to fulfill.

You're absolutely right. It makes you more confident in the way in which you show up in the world. It makes you more physically capable. It's incredible. It also makes you more physically capable. It's incredible. It also makes you more independent. Yeah. You said start wherever you're at. There's plenty of online resources now. You said if you can get a trainer, get one. Let's just think of two more scenarios, okay?

One scenario is that person who thinks, trainer, you've got to be kidding me. I've barely got enough money to pay the bills, put the heating on and feed my kids. So to them, they may be thinking, no chance can I afford a trainer. I may not even be able to afford a gym membership. So I want your take on what that person can do. And then I want you to move on, if you don't mind, Gabrielle, is to another person who thinks, you know what, I'm pretty good. I've been listening to Ranga's podcast for a few years. I've been implementing some of the advice. I've got energy. I've lost a bit of weight. My mental well-being's better. I'm now prioritizing health in a way that I never was. What is optimum? What would you ideally have me do? And let's say

this person is in their 40s or their 50s. I wonder if you can give them your top prescription based on what I've just told you. Those are two great questions. We'll start with a person who is really struggling financially. YouTube is free. I would suggest going to YouTube and finding bodyweight exercises. There are a whole host of ways that you can get healthy if you have access to a computer or a phone, or even the library. So the library is free. You can go to the library. You can get online there. You can go to YouTube and there are actions and ways in which people can execute immediately. Again, it doesn't cost anything to do push-ups. It doesn't cost anything to do squats. And what happens is over time, you can continue to increase the amount. So let's say when you start, you can do 10 squats,

then you can do 20 and you continue to push yourself, which would lead me to the second question that you asked. So number one, if finances are very tight, YouTube has a ton of free resources. If you do not have a computer at home, you can go to the library, a free public library and listen there. Yeah. And I just want to add to that something we were talking about before about self-limiting beliefs. That individual, if they go to work somewhere and they have colleagues, there's always that colleague somewhere who takes pride in their appearance and is really buff and clearly works out regularly and likes to train. We're often fearful about asking others for advice or help. You know, I challenge someone listening to this, if you're that person, go up to someone who you know trains and say, hey, listen,

you know what? I want to make this year a really good year for me. I can't afford a gym. I don't know where to start. Would you mind showing me two or three simple exercises that I could do by myself at home? I think it's another, I know some people get really scared about doing that, but if you can lean into that fear and actually go and ask someone, people want to help, right? People who train, they'd be delighted to say, hey, listen, no worries. I was there once before, 10 years ago. I didn't know either. I'd start with A, B, and C. So that's all I was going to add to what you just said there. I love that. I love that. Now let's talk about the next question

that you had asked is someone is in their mid forties. They're already prioritizing their health. What is their optimal goal? I love this question. My challenge to them would be, you should be training to get better at multiple different modalities. You pick one and you train that up for 10 to 12 weeks, depending on whatever your goal is. For example, let's say you are really great at doing bench press, squat, and you've been training in this hypertrophy zone. I would challenge you to get better at high intensity interval training. And how would you do that?

Well, you would measure it. So for example, if you were gonna go on a rower, you would say, you would test yourself, find out where you're at, how long is it gonna take you to row 500 meters? You'll get a baseline and then you'll continue to improve that. Or you can do a skierg or a airdyne bike,

but really understanding that the key with training, just like the key with life, in my opinion, is that you strive to become better at the thing. If weightlifting is easy for you, continue to do that. Now pick something else. Maybe you're not good at yoga. Maybe you're not very flexible. Lean into that. There are so many fun ways to train. Let's say I don't have time to go to the gym. I will find a creative way to train that potentially I'm not good at. I'll throw a Bulgarian bag, which is a kind of off-centered bag. I'll throw it over my shoulder. Maybe that's

35, 40 pounds. And then I'll pick up a kettlebell and I'll be walking in my neighborhood. So I'll have a Bulgarian bag and a kettlebell in one hand. I'll walk up and down. Maybe I'll lunge, turn around, I'll do it again. Might be something that I'm not good at, but I'm always trying to leverage the movements that potentially I'm not good at, but I'm always trying to leverage the movements that potentially I'm not good at. Because that's what life's about. You don't just continue to do the thing that you are good at. You do that and then you add to it and you get creative and you figure out your weaknesses and you leverage your weaknesses because fitness is multidimensional. Let's say you love training hard. Maybe you need to add in some yoga and get

more flexibility. Maybe you need to add in more stability work. Yeah. I love that. You're clearly off the, maybe a similar mindset to me where you're, you have no problem going out into your neighborhoods, wearing crazy stuff or putting weights on your back and going rounds. Okay. putting weights on your back and going rounds, okay? I think that would be me. Whereas I think many of my patients, a lot of my family, a lot of my friends would go, no way. But that could be applied in your house, right? Let's say you've got stairs. Well, you could pick something up and go up and down your stairs, couldn't you, right? You don't have to do it in public if you don't have that kind of, I don't know, self-confidence, You don't have to do it in public if you don't have that kind of, I don't know, self-confidence, whatever you might want to call it.

Or maybe you should, maybe you should cultivate it. And the first three people that look at you weird, good, keep going because then the next time you do it, you're not going to feel uncomfortable. Yeah. Or maybe, you know, you can keep testing yourself where, uh, I don't know, your kid's headband, be crazy. But it's just that initial restraint that we put on ourselves. You can do it. We're touching on something which I think you covered towards the end of your book in the section about environment design. And you talk about these four, I guess, avatars, the performer, the solo act, the chameleon, and the reluctant. Can you explain how you came up with those four and just walk us through each of them?

Because I think all of us will go, yeah, that's probably me. Oh, that's probably me. That's my partner. That's my brother or whatever it might be. I really loved it. Yeah. Well, really, these came from, and by the way, there's probably more, but this came from just and by the way, there's probably more, but this came from

just seeing patterns of people. And once you figure out what kind of person you are, you know how to get the best of yourself. So a soloist is a person who they don't care about external stimuli. They prefer to train alone. They will either turn music on or not. It doesn't matter. These are highly, highly driven individuals that are working out their not. It doesn't matter. These are highly, highly driven individuals that are working out their own stuff. Doesn't matter where you put them. Doesn't matter who is there. Doesn't matter. These are the people that will train, like David Goggins. David Goggins isn't going to care who's around, right? He doesn't matter whether someone, whether there's a camera there or whether there's not,

that guy's getting it done. A chameleon type of patient, you can really put them in anywhere and they'll make it happen. One of my best friends, Don Saladino, who if you guys are looking for training, online training, he has many, many programs. This guy is such an athlete, it doesn't matter. He can train alone. He can train in a programs. This guy is such an athlete. It doesn't matter. He can train alone. He can train in a group. You drop him in anywhere and he's dominating. He just loves training. The reluctant is a few things. A reluctant patient is they actually do want to get better, but they'll tell themselves that there's no point and they've tried everything. So what's the point? I'm just going to stay at home and eat whatever I want. And, you know, what's the point of me, you know, training because my body composition is not going to change. It's not really going to matter.

And those are the people that there's typically a lot of pain involved, right? That they're just not, they haven't really identified that there's a risk that they might not achieve the thing that they're looking to achieve. Which, by the way, just taking action allows you to get better either way. And I think that that's really important. And what was the last one? There's one more. The performer. Oh, the performers are the best.

Now, these are a lot of the people that you will see on stage that are very much out in public that do better being witnessed. Meaning, they can go to a gym. They might not want to train with anybody or want you talking to them, but they need to be in an environment where people are witnessing them. And it's not this because they will push themselves knowing that they are being witnessed. And again, it's not this ego thing. It's just the way in which they seem to function best. Many entrepreneurs, again, they'll be so competitive within themselves, but they don't necessarily want to do it solo. And they don't necessarily need a training partner, but they will have to go to a gym to quote, get the environment right. Yeah. So I'll give you an example. I take care of a very well-known entrepreneur

and he was training as a soloist. How good do you think his workouts were? Terrible, terrible. Cause he didn't want to go to the gym. He didn't want people to recognize him. But for a performer to be training solo, it's like the kiss of death. So he'd go to his home gym, do a couple reps,

be on his phone. This is boring. We put him into the gym. Even if the gym, we find out when the gym wasn't busy, go to the gym, would go there with a trainer and kind of keep people at bay. Completely crushed his workout. So knowing how you navigate your environment is crucial because you leverage your environment for success. Yeah. A huge part of this conversation has been about getting to know yourself better, understanding yourself, knowing your limitations,

knowing your patterns, knowing when you go off track, right? I had planned to do a masterclass on muscles today with you, and we've probably done a fraction of that. But nonetheless, I think this is so, so valuable for people because this is really where it's at if you want to make changes. So in the remaining time then, I want to go through a few sort of almost like a quick fire run through different topics that maybe you've used to people. So you've been practicing medicine for years now. Yes, yeah. What are the top five blood tests that you would recommend people do on themselves

to get a snapshot of their short-term and their long-term health? Now, in no particular order, understanding your fasting glucose levels understanding your fasting insulin levels understanding your triglycerides so that's three understanding your hormones whether you believe in hormone replacement or not really getting a sense of where your free hormones are for men what is your free testosterone? For women, what is your estradiol? Depending on where you are, your progesterone also is helpful.

Looking at ApoB, which is a very important marker for cardiovascular health. Also knowing your LP little a, this is a genetic marker. And this also helps you understand your risk for cardiovascular disease. Those are just a handful of things, a full thyroid panel. That's important. That's important for energy, metabolism, muscle function. Most people don't correlate thyroid with muscle health, but I will tell you early on in my career, I had a lot of Hashimoto's and hypothyroid patients. And one of the things I started seeing with the volume of patients that I was seeing is they would constantly be getting tendonitis. They would be getting issues with tendons. And one of the things that can impact tissue turnover at tendons is thyroid hormone. So looking at

what your thyroid hormone is. I think that there's some argument to be said for an omega-3 index. I typically like to see my patients around 10. Another vitamin D number would be great. There's a whole host, but the top numbers, I would say, if you just wanted to do a few, would really be the ones related to metabolic health. Insulin, fasting insulin, fasting glucose, triglyceride levels. Those would be really the top three if I had to pick. Yeah, mine are pretty similar as well. And of course, depending on where you live, depending on which country it is, depending on where you are in the world, you will have different levels of access to some of these tests like an Omega-3 index, LP little a, ApoB. These are not available everywhere. Certainly, they're not available currently in the National Health Service in the UK. You have to pay privately

to get those tests. And many people would argue that they are well worth paying for if you have the resources to do that. But I completely agree. There is so much that we can learn just from a fasting glucose, maybe a HbA1c, your average blood sugar. Oh yeah, I totally forgot about that. There you go. Triglycerides. Even those three, you get a lot of information from. Again, insulin, fasting insulin is not that commonly available here in the UK. I hope that changes given how prevalent metabolic health is. Okay, so there are some blood tests that people can think about doing. What are some of your favorite strength exercises, Dr. Lyon? Definitely squats are important. And it could be a regular squat. It could be a sumo squat. Again, just depends on the positioning of your feet. I also think some kind of kettlebell activity is important. And that could be a Turkish get up, which is a little bit of a complex movement.

but you could start with a kettlebell swing or kettlebell carry. I like it because the kettlebells make me think of ways in which we move that are not as easy as say like a dumbbell. I do think a deadlift is really important because that's a full body exercise and that can be done with a sumo deadlift or a regular deadlift. And then I think adding in some unilateral activity, which could be a walking lunge, moving things into motion. And I've thought a lot about what exercises are best. And I don't know if I have an answer because it really depends on how the person has been moving for their life. Many people are very sedentary. We don't have strong glutes. moving for their life. Many people are very sedentary. We don't have strong glutes. So really working on your glutes and posterior chain are important. I do think upper body strength is extremely important for both men and women. And that could easily be a plank or a pushup.

And I could go on and on, but to just bring it back, bring it back home, definitely be able to do some kind of squat, definitely be able to do some kind of dead home. Definitely be able to do some kind of squat. Definitely be able to do some kind of deadlift and definitely be able to do a kettlebell carry or a swing. Yeah. Thank you. Dot Sline, just to finish off this conversation, there is so much you have shared in the first conversation with me on my podcast, in this conversation, and of course, in your brand new book, Forever Strong, which is just a phenomenal resource for people who are wanting to improve the quality of their lives. Right at the end of this conversation, for someone who has decided, yeah, that's it now. I'm sick of not prioritizing myself. I'm sick of not putting my

health and wellbeing first. The time has come now for me to change things. Given everything you know about health and wellbeing, and you can cover stuff from our first conversation as well in terms of first meals, protein, all that kind of stuff. Could you just list off some of your very top practical tips that will help anyone at all if they're in the business of improving their health? Yeah. One thing that 100% of people do is eat. So getting your nutrition right. 100% of people do that. That would be prioritizing dietary protein, whether you're animal or plant-based, it doesn't matter. I want you to prioritize dietary protein. My recommendation would be one gram per pound ideal body weight. Your next question is going

to be, what is my ideal body weight? I'm going to say, I don't know your ideal body weight. The last time that you felt great in your own skin is where I would start. And that's one gram per pound ideal body weight. The way that I would distribute protein, that first and that last meal are really critical. The first meal having between 30 and 50 grams of dietary protein when you're coming out of an overnight fast. This is great for any age, whether you are in your 30s or 60s. This is the way to help maintain the health of skeletal muscle. That last meal of the day is also critical because you're going into an overnight fast. Again, the goal is how do we protect skeletal muscle? Nail that first and that last meal. Priority number one, get enough protein. You do

not have to go as high as one gram per pound ideal body weight. You could do 0.7 to one gram if that made you feel more comfortable. Getting that first and last meal of the day appropriate. I would also say that for carbohydrates, one way to think about it is to understand, for carbohydrates, one way to think about it is to understand, are you carbohydrate sensitive? Do you have a good body composition? And again, how would you test that out? You would look at your body fat percentage. If you felt that you had weight to lose, calorie control is critical. Most people will say it doesn't matter how many calories that you consume. I disagree with that. Understanding how many calories you are currently eating to be at the current weight that you are and adjusting appropriately. I typically recommend no more than 50 grams of carbohydrates per meal, depending on what your total carbohydrate intake is. You have to determine that. The current recommendation is around 130 grams. But the way in which you mitigate insulin, a robust insulin response,

would be to have a tight amount of carbohydrates per meal. And what works really well is if you do a one-to-one protein-to-carbohydrate ratio to make it super easy if you are someone who enjoys carbohydrates. A one-to-one protein to carbohydrate ratio. So that means in the morning, if you are having 30 grams of dietary protein, you can have 30 grams of carbohydrates with that. The next thing that I would say is you have to train. If I were to prioritize what kind of training that would be,

my first recommendation would be to do some resistance exercise. Two to three days a week. I'll give you a day less. So I'll say two to three days a week. And the less you do it, the more you're doing full body. The more you do it, the less you have to do on that third day. But resistance training is a non-negotiable. And then I would say the last thing is know your weaknesses.

Don't be surprised by them. Plan for them. They're coming. And they're totally predictable. You cannot be shocked by your own human nature. And when you plan for that, then you can follow the first three or four recommendations I just gave you. Gabriel, fantastic advice. I really appreciate what you

are doing. You're spreading the message of health and well-being. You're spreading the message that skeletal muscle is really, really important. The new book, Forever Strong, a new science-based strategy for aging well is fantastic. Thanks for coming on the show again. Thank you so much for having me. Really hope you enjoyed that conversation. Do think about one thing that you can take away and apply into your own life. And also have a think about one thing that you can take away and apply into your own life. And also have a think about one thing from this conversation that you can teach to somebody else. Remember, when you teach someone, it not only helps them, it also helps you learn and retain

the information. Now, before you go, just wanted to let you know about Friday Five. It's my free weekly email containing five simple ideas to improve your health and happiness. In that email, I share exclusive insights that I do not share anywhere else, including health advice, how to manage your time better, interesting articles or videos that I'd be consuming, and quotes that have caused me to stop and reflect. And I have to say, in a world of endless emails, it really is delightful that many of you tell me it is one of the only weekly emails that you actively look forward to receiving.

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