Mind Pump: Raw Fitness Truth - 2232: Age-Proof Your Muscles, Bones & Brain With Dr. Gabrielle Lyon

Episode Date: December 21, 2023

Sick vs. healthy muscle. (2:36) The best test for looking at the health of skeletal muscle. (8:30) The difference between fat and its influence on your hormones. (10:20) Why the way we have intellectualized medicine is backwards! (15:00) “The wider the waistline, the lower the brain volume.” (20:57) Why you are never too old to build muscle. (25:02) Why the food pyramid is the worst social experiment we’ve ever had. (29:52) Going down the scary direction of becoming more planet-based from animal-based sources. (31:50) Have we been misled with sodium? (39:18) Does fasting affect men and women differently? (40:54) Diagnosing the different avatars she sees in her practice. (46:02) Concierge vs. Western medicine. (54:52) The misconception that physicians are paid to prescribe. (57:04) Should people stop seeing their doctor if they’re obese? (59:00) Her take on GLP-1 antagonists/semaglutide. (1:00:51) Her favorite peptides and why. (1:10:10) The newest technology available for providers to look at skeletal muscle health. (1:12:29) The different training archetypes. (1:17:38) The resistance training revolution is here! (1:21:50) Related Links/Products Mentioned Forever Strong Summit - January 14, 2024 in Austin, TX For a limited time only, Mind Pump listeners get a free LMNT Sample Pack with any purchase: Visit DrinkLMNT.com/MindPump Special Launch: MAPS 40+ ** Code 40LAUNCH at checkout ** Promotion ends December 24th, act now for $80 off + 2 FREE eBooks! December Promotion: MAPS Old Time Strength | MAPS OCR 50% off! ** Code DECEMBER50 at checkout ** Forever Strong: A New, Science-Based Strategy for Aging Well – Book by Dr. Gabrielle Lyon D3 -Creatine dilution and the importance of accuracy in the assessment of skeletal muscle mass Effects of Dietary Protein on Body Composition in Exercising Individuals The Association between Vegan, Vegetarian, and Omnivore Diet Quality and Depressive Symptoms in Adults: A Cross-Sectional Study Research finds semaglutide treatment is associated with remarkable reductions in alcohol use disorder symptoms Mind Pump #2192: Dr. Jordan Shallow & Dr. Adeel Khan The Resistance Training Revolution – Book by Sal Di Stefano Mind Pump Podcast – YouTube Mind Pump Free Resources Featured Guest/People Mentioned Dr. Gabrielle Lyon (@drgabriellelyon) Instagram Bret H. Goodpaster, PhD | AdventHealth Research Institute Layne Norton, Ph.D. (@biolayne) Instagram Adeel Khan, MD (@dr.akhan) Instagram Jordan Shallow D.C (@the_muscle_doc) Instagram DON SALADINO (@donsaladino) Instagram Bedros Keuilian (@bedroskeuilian) Instagram

If you want to pump your body and expand your mind, there's only one place to go. Mind, hop, hop, with your hosts. Salda Stefano, Adam Schaefer, and Justin Andrews. You just found the most downloaded fitness health and entertainment podcast. This is Mind Pup, right? Today's episode, we brought back one of our favorite guests, Dr. Gabrielle Lyon. Now, she is at the forefront of what is called muscle-centric medicine.

In other words, we're not overfat, we're under muscleed. In today's episode, we talk all about muscle and how important it is for health, how important it is for your metabolism, and the difference between healthy and unhealthy muscle. Believe it or not, a pound of muscle is not just a pound of muscle. It's quite different from one person to the next

depending on their health. She talks about all this and more in today's episode. Now you can find her on Instagram, oh, excuse me, you can go to her website, Dr. DR, GabrielLion.com. So it's G-A-B-R-I-E-L-L-I-L-Y-O-N.com. She's got great offers on there, but also she's hosting a forever strong summit on

January 14th in Austin, Texas. You got to go check that out. Now this episode is brought to you by some sponsors. Elementy, this is an electrolyte drink that you add to your water. So it's a powder. You add it to your water. No artificial sweeteners, no calories, and it has the right amount of sodium for pumps, performance, and recovery. It's a great company. In fact, we're so impressed with their product. We're actually investors. Go check them out. Go to drinklmnt.com forward slash mine pump, and element he is offering our listeners a free sample pack with any order. Also, brand new workout program launch, maps 40 plus. if you're 40 years older, older, and you're a fitness fanatic, okay?

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dot com. Use the code for zero launch that'll give you $80 off and you'll get two free ebooks with that. The first ebook is the health babes guide to balancing your hormones. And the second book is the for phase histamine reset plan, both included for free Hormones. And the second book is the Four-Face Histamine Reset Plan. Both included for free with that launch. By the way, this promotion ends December 24th. So make sure you act now if you're interested. All right, here comes the show. Dr. Lionel, welcome back to the show.

I'm so happy to see you guys. Your show always crushes on our podcast. People love what you have to say, what you do, we love it. I wanted to get into, I want to start this by talking about sick versus healthy muscle. I, ever since talking to you, I've made posts about this and talked about this, your example of like the rib eye versus the filet, like that was a great visual,

but can we go into more depth? Because lean body mass, we think is lean body mass, right? So bone, organ, muscle muscle fat mass is fat mass What's the difference between five pounds of not healthy muscle and five pounds of healthy muscle? It's a great question, but before I answer that I just wanted to say thank you to you guys because I do not think my book or The platform that I have would be nearly is successful without you guys. Oh, thank you so much.

So thank you so much for your support. When you start studying the royalties, did you say after I send my five year old to your house, the question, what is healthy muscle versus unhealthy muscle is a very important one. And it's something that is not routinely looked at, which is when we think about it is a huge flaw, right? We look at adipose tissue, we think about adiposity, but we don't think about the health of skeletal muscle. And when I think of healthy skeletal muscle,

as I would hope that everybody does, you think about it as a filet. It's a little bit different because there's something called this athletes paradox. There's intramuscular fat, which is fat after the fascia around the muscle, between muscle groups. And then there's intra, with an A, intramuscular fat. And that could be what you would say would be healthier fat versus non-healthy fats. So let me explain that. So intramuscular fat is something that both obese or individuals

that potentially have type 2 diabetes, et cetera, would have. It's fat within the muscle fibers. And the athletes' paradox is that athletes, a lot of endurance athletes also have intramuscular fat because they use it for energy. Is it for readily available fuel? Yes. And did their body adapt that way because of the intense training and potential lack of...

Probably interesting. Probably yes. But the reason I say that is because, you know, when you think about that picture of a filet, you would imagine that that filet doesn't have any intramuscular fat. But the athlete paradox, there is a continuous flux. So it's not fat necessarily that just stays there and builds up over time, but it's energy that's utilized.

So it's a difference between fat that's sitting there versus fat that's being deposited, used, deposited. Yes. You said endurance athletes. Is this not seen in strength athletes? Is it different? From what I've seen in the literature, it's just not as well studied. Okay.

So we don't know. The majority, and maybe there is more and more information, but typically when we think about fat within the intramuscular fat, a lot of it is based on endurance. And I will also say that when you think about unhealthy fat, this marbled rib eye, is that we see that there is an inverse relationship. So you are thinking about two groups of people. So one group is healthy, highly active, insulin sensitive. And they also have fat within their skeletal muscle. And then the other group would be

less insulin sensitive. So insulin resistant, more obese, maybe type 2 diabetes, those individuals will have higher amounts of intramuscular fat. And it is inversely related to insulin sensitivity. So for example, your skeletal muscle will be less likely to utilize glucose than another type of healthy tissue. So it's the fat in the muscle, in the context of these other... Exactly. ...metrics when I look at that determined. Today, study the fat that's within this muscle to see if there's a different fatty acid composition. If we're dealing with anything like brown fat versus white fat,

is there a difference? Another great question. Really, the person I would point to would be his name is Brett Goodpasture. He is really the guy because there's all different kinds of fatty acids and fats, whether it's ceramides or diase. So, glycerol, there's all different kinds of fatty acids and fats, whether it's ceramides or diase. So glycerol, there's all different kinds. And I think if you were to say, what makes a skeletal muscle unhealthy, you would get a million different answers.

So I think the overarching theme would be, is this muscle static? Are you not utilizing it? Is it weak? Is it not strong? And what are the other components that have now infiltrated it? So, for example, through advanced aging, we see increase in connective tissue, a decrease in ratio of skeletal muscle to fat, we see sarcopenia, obesity genic sarcopenia. So really in the context of the human and the activity of the human and the age.

I think this just highlights how complex the human body is, right? You can't just look at one thing and say, well, here's what we're seeing. It's almost like, and now you would be, my back is sore. Okay, do you do anything? No, I do nothing. I sit down all day long versus my back is sore. Well, what do you do? Well, I exercise a lot and I run a lot and I do, you know, some hard labor.

So it's a different problem. One would be very bad. The other one not necessarily. So bad. Yeah. And I think, again, as we progress in this concept of muscle-centric medicine, it's going to become more into the forefront of how do we identify healthy skeletal muscle? You know, what are the metrics that we look for?

How do we look at it as a vital sign? So it's not just the amount, but also the quality, the thickness. And I think that that's really where things will advance to. It seems like the move would be to get, first get this tested, so you have an idea of where your baseline is. And I imagine like many other things, there's gonna be a massive wide range

and individual variance to athlete, to person. And so probably the most important thing would be, like, okay, let's figure this out. What my ratios are, where I'm at, and then where I go from there maybe is okay. Yeah, I definitely think that that's the direction that we're going. So when we look at where we are now,

people use Dexa or InBody, all of a sudden. Do you have a preference of any of those? I was gonna ask you. I'm gonna say something cheeky, and then I'm gonna say what I really think. So I'm gonna say neither, because I don't think either are great when it comes to looking at the health of skeletal muscle,

and then all the providers and PhDs are gonna go, well, you know, that's stupid, because that's what we have. Got it. And I'll say, yeah, you're right. That's totally what we have. In an ideal world, I think we are gonna start

looking at skeletal muscle directly. The test to do that is called a D3 creatine test because creatine is what is in skeletal muscle. It is not available to the public yet. It's heavily used in research. I would love to see that become available to the provider. And that's not looking at excretion of like, through like how the kidneys are filtering it or like current test. No. And what's the D-3 Stanford?

So it's a deuterated creatine. Okay. And it's a tagged creatine. So basically they've developed this way of being able to identify how much skeletal muscle mass somebody has. So it's just looking at skeletal muscle. It's been validated in babies, adults, older adults. And again, the researchers that did this is named as William Evans and Hellerstein is the other guy. And that is amazing. If we can begin to use that, I think it could be the same as checking blood pressure. Wow, wow, that powerful.

Okay, so back in the day, when I used to think of muscle versus fat, I would think, okay, muscle, it influences hormones, there's receptors, it puts out certain signals, fat just sits on your body. That's not necessarily true either, right? Because fat also has some hormone on its own, has some kind of hormonal influences. So what are the differences between fat and its influence on your hormones versus muscle and its influences? Yeah, that's a, I really like that question. One of the things that I didn't mention about inter-muscular fat, the fat around muscle and fascia,

is that the more fat that you have, it does, it is inflammatory. And it does create cytokines. And then these cytokines create systemic inflammation. That is very well established, low grade inflammation. That is a problem. The counterbalance to that is healthy skeletal muscle. Contracting healthy skeletal muscle produces counter regulatory myokines.

And that I think really helps buffer, so if an individual just go with me or so, if an individual is struggling with obesity, or an individual is struggling with excess amount of body fat, contracting skeletal muscle can help balance and buffer those low levels of inflammation, even if you haven't completely rid yourself of, say, excess subcutaneous fat.

I think that that's an important point because it's not just about long-term goals, it's about executing in the short term. You know, this reminds me of, or points to, is we've looked at fat now for so long. We now know there's brown fat, there's white fat, there's, if a woman stores body fat around her hips and thighs, there's more omega-3 fatty acids in there, probably better for the brain of the baby that should be carrying versus around her belly. And visceral body fat, very bad, other types of body fat, not as bad. We know very little about muscle, we just know muscle.

You have it. I know, I know. Or you don't. And there's no different, of course, of course, there's a difference between healthy versus unhealthy muscle and then it's influence on the hormones. Okay, so you said if you got body fat, a lot of it, puts out cytokines, muscle puts out myocines which kind of offset that and buffer the inflammatory effect.

Okay, so I'm gonna paint a scenario to you, very oversimplified, I know you're a doctor and you're gonna hate this, but I'm gonna put it to you anyway. Guy comes in, needs to lose 35 pounds, 35 pounds overweight. They want to improve their blood markers, they want to become healthier. Do you make them lose body fat first? Or you make them build muscle first? I mean, so 35 pounds overweight, he's gonna have much, I think the benefits of focusing

on skeletal muscle are gonna always outweigh the benefits of focusing on adipose tissue. Because when you create healthy muscle, you really improve your metabolism and the efficiency of utilization. So I would focus on skeletal muscle. So adding to that, does that ever change? Thank God that's what we do.

I know. We're in alignment. Yeah, right answer. So does that ever, because I feel like that's, we, and we talk about this, that that would be, that's no matter what someone's trying to lose and they come in, they say, I'm a hundred pounds, ten pounds, doesn't matter. I always focus on building muscle first, right? Building the metabolism.

Is there ever a case where it's, you wouldn't do that? I think the case where you wouldn't do that is if the proportion of body fat is so high, let's say it's like that. It's in a word, they have to, you know, again, this is just hypothetical. What if there's 600 pounds? And you have to get the weight off because they have to go to surgery.

Then I would focus on, you know, losing that body fat. That's so weird. And that would be protein-sparing modified fast. Okay. Where that they used to use for situations like that. Yeah, it's emergency. I see clients like that. They manage a gym and we had an obesity clinic.

I think people will come in with, you know, these are gastric bypass candidates. And it was emergency, like for a lot of these people. Some of them could barely walk into the gym. And it was like, okay, wait, I get some, it's way off. But I would always try and get them stronger just because it improves their mobility. You just brought someone up and reminds me of an old store. You know, it's crazy is that I actually had people,

I had two different people that tried to hire me back in the days to actually put weight on so they could qualify. They could qualify. Yeah, did you know that? Yes. You know that you can be too light to qualify. They could qualify. Yeah, do you know that? Gashirobe. You know that you can be too light to qualify. Yes. I had the same thing.

I got to gain weight. Never forget that person sitting down with me. Medical system. Oh yeah, I'm looking to get a gastro bypass. But I need to add another like 10 pounds of fat. Can you help me get fatter? Yeah, I can get fat. Talking about the health benefits of muscle one of the more

Antibolic hormones and the both male and female bodies testosterone. I mean, they're you know insulin can be anabolic growth hormone to an extent And you know the interplay between all the other hormones, but testosterone is pretty anabolic like it's pro muscle tissue in both men and women Why is it so demonized? Why are we so afraid of testosterone when somebody has low testosterone to put them? Is it purely because it's a performance enhancing drug or it's been put in that category? Is it dangerous?

We got to be careful when we use it because you can overdose on it like what's the deal? Let's take a look at where the medical system has been. The medical system in and of itself is not set up for optimization period end of story. You broke your leg, let's fix it, you have an infection, The medical system in and of itself is not set up for optimization period end of story. You broke your leg, let's fix it, you have an infection, let's fix that. You have diabetes, here's some drugs.

We don't say what about if you have low muscle mass, unhealthy skeletal muscle mass, what are we going to do to prevent aging? I just think the way in which we have intellectualized medicine as a whole is backwards. Because of that, it's set up where things that would potentially help with longevity and help with aging are thought of as, oh my gosh, how are we, why are we doing that? And I think that that's the same thing with testosterone.

I mean, I've mentioned this before, testosterone is not FDA-approved in women. Yeah. How is that possible? Yeah, you guys have it. It's the most, yeah, it's the most abundant hormone that we have. How is that possible? I'm hoping that that changes because we recognize that testosterone, I'm not talking about super physiological levels.

Yeah, we're not talking about bodybuilders competing on stage. No, and by the way, they continue to lower the standard of what testosterone is. So if the minimum testosterone a handful of years ago, the numbers was maybe it's 350, now it's, you know, it could be 200. I mean, it's not quite 200 it's, you know, it could be 200. I mean, it's not quite 200, but do you see what I mean? So they keep lowering the standard of what we will tolerate as low.

Wow. Now, is this because, because I know for the last, I know it's five or six decades, I don't know if this is true in women, but we've, I know we've seen this in fertility in women, but we've seen testosterone levels dropping in men pretty consistently probably for the last five or six decades. Is that why they're changing the standard?

Because the average keeps going, I mean, I read a study that showed something like, like a 60 year old man in 1980 has like the testosterone of like a 20 something year old today or something crazy like that. Yeah, I think that that is one reason why they are lowering it. Because if you lower it, then you're now within normal range We don't need to treat it. Hmm

Maybe it's also testosterone cheap. It's not a very expensive I don't know exactly why but what I can tell you is that patients do much better with more optimal levels of testosterone and the other aspect of what we're seeing is that patients do much better with more optimal levels of testosterone. And the other aspect of what we're seeing is that, you know, there's been a lot of conversation about how it's bad for heart. It's bad for your heart. I was bad for the, you know, prostate disease, etc. And they're not finding that. They are finding that it is very protective in many different domains of health and wellness for an individual. Well, I think it's disingenuous because we're not comparing apples to apples. So we're not looking at comparing, let's say, men with suboptimal or low testosterone to men with optimal. They're looking at men that abuse testosterone and say, oh, there you go.

See, it causes heart problems. It causes left ventricular hypertrophy. It causes. But these guys are taking 10 times the dose that you would take to be in a normal, a lot of the lines of their other lifestyle versus two. And also when you think about test, let's take thyroid replacement.

Thyroid replacement is super common, no one blinks an eye. Nothing. I think in the next 10 years, that's gonna happen for hormone replacement. If you are not on hormone replacement, people are gonna be like, oh, it's gonna be the equivalent of, oh, you have low thyroid, why are you not taking

part? Why are you taking that? I agree. I think, but it's going to take 10 years. Yeah. You know, it's interesting to me when I learned this not that long ago, if you took a person and gave them 10 times their normal amount of testosterone, they might get some side effects, but they would be okay. You can't do that with almost any other hormone. If you do that with insulin, they'd die. If you do that with thyroid, they'd probably die. If you do that with insulin, they die. If you do that with thyroid, they probably die.

If you do that with estrogen, they'd be a raging bitch. Yeah. I'm kidding. I'm kidding. So although testosterone could do that in some people too, but yeah, so it is interesting that it's gotten this kind of negative, you know, like what's going on. And again, it points all to,

I think maybe not knowing the real health benefits of muscle, muscle being relegated to, well, this is what keeps you mobile, but not what keeps you healthy and what contributes to longevity. It's all about keeping fat away. Yeah, and I think the dichotomy between muscle and sport. So really, skeleton muscle has not been thought of

as the pinnacle of health and wellness. It's always been thought about as sport. So with sport, people think about performance and enhancing drugs into a testosterone, but it shouldn't be that way. It's more important in my opinion than even thinking about fat. Yeah.

And if we were to close the gap of the conversation, that muscle is really the pinnacle of everything. It is the pinnacle of how you're gonna be able to show up. I've never had a patient say to me, you know? I really regret being strong. I mean, that was a huge mistake. And you'll never hear that. But if we begin to kind of close the gap

of what muscle really is and then begin to think about, what are the things that we can do to enhance skeletal muscle health, then testosterone wouldn't be so much of a black sheep. Versus, oh, there's obesity medication. People aren't like, oh my gosh, you're taking medication for obesity. The other thing is the connection between muscle and cognitive health. I mean, obviously your brain controls muscle, moves it, contracts it, there's proprioception. That's involved, which involves the brain as well, is the insulin

sensitivity aspect that muscle contributes to, which we know is probably a major player and dementia and Alzheimer's. Maybe if we help make that connection, because when you think of healthy brain, there's that old myth of the meathead. He's an idiot. He just works out or they're stupid. And then there's the brainiac who's really skinny doesn't have any muscle. But that's couldn't be further from the truth. Yeah, actually, I never thought about that. That's a really good point. So I did my fellowship in geriatrics, in nutritional sciences and geriatrics, which means a huge part of that was looking at memory and aging and body composition.

You know, a geriatrician is someone who studies an individual over the age of 65. And at WashU, where I was, there are specialists in Alzheimer's, Alzheimer's dementia. There's vascular dementia, there's Alzheimer's dementia, there's Louis body dementia, all different kinds. But when you think about preventable causes of dementia or cognitive impairment, you have to think about the metabolic implications. The brain is an organ just like the pancreas in the liver. And when you are metabolically unhealthy, when you have excess body fat, when you have higher levels of glucose, you are more and you are excess body fat, when you have higher levels of glucose, and you

are more insulin resistant, these things all over time affect the brain. And when you train, exercise, of course, does a multitude of things. There's probably nothing more impactful than training. Diet is probably not even as impactful as... For longevity. Yeah, I've seen the studies on that. It's crazy. I mean, it's exercise. When you think about exercise, you think about contracting skeletal muscle, contracting skeletal muscle releases these myocines. One of these myocines is BDNF that impacts the brain for neurogenesis, cognition. We all know that. Of course, endorphins, everybody talks about. Then there is, again, that implication

of metabolic correction, of utilizing exercise in skeletal muscle, utilizes glucose without the need of insulin, becomes very important, especially when you think about brain health, because brain is very, it is very affected by body composition over time. So the wider the waistline, the lower the brain volume. And I know that that's a very robust statement to make,

but you'll see in the literature that the better your body composition, the lower your body fat, the better your brain function. Now, what's interesting about what you're saying, because so many thoughts flying through my head, so you said training is more important for longevity than diet. We've placed more of a focus on diet because when it comes to the scale moving down, diet will do that faster than

just exercise. In fact, you can exercise not lose a pound. You could obviously cut your calories and lose a pound. And because we've tied body fat to everything, then that is more of an important thing. The other thing too is I've seen this data and I would love to confirm it with you. Obviously, if you're super overweight, you see increased rates of mortality or whatever. The underweight, people who are very underweight probably have worse outcomes or just as bad. They do. So what is that showing? I think part of that, especially as you age. So one of the things as a jury tradition, surprisingly, they do not recommend that you lose weight.

Depending on, obviously, this also depends on how over where you are, because if you were to get injured or you were to get sick, the body has to readily use stores of energy. Energy. Yeah. And so that is why, I believe. And then also, but, you know, in the same hand,

you're not going to be able to survive without skeletal muscle. So when you think about cancer cakexia, which is this highly catabolic state, the thing that kills you is the loss of muscle. Again, so, yeah, underweight is a... Yeah, because underweight means not enough fat, but also means not enough muscle. I don't know anybody with a lot of muscle who's underweight, further high or whatever it can do.

Right. What's the minimal dose to positively impact somebody who's like concerned about this? Like we got someone who's listening that has a gram-o, a gram-po, or even a parent that's aging that hasn't exercised at all. What would you, like, what does a literature say about, like, if you at least do this weight training wise, it makes this big of an impact? Yeah. It's really fascinating at how malleable skeletal muscle is and how dynamic it is.

There's literature in 85 year olds that they can improve muscle mass and strength. From very limited activity, it could be from sitting to standing. That's what I did. I trained people in the age group for years and they would come see me once a week and Dr. Lion I would do maybe 20 to 30 minutes of Exercise with them and the rest of the time was like talking and resting and you know whatever So we would get through maybe a grand total of six sets of Some very like okay, what you just said sitting down standing up. That like a foundational exercise. But that was probably high intensity training for them.

Oh yeah, and they would get, I mean, their health would improve dramatically very short per time. And they thought, oh, I don't know, I could get stronger. And, you know, there's evidence we worked on some of these earlier studies, the early 2000s, where they looked at two groups of women, and this was at the University of Illinois, two groups of women, and this was at the University of Illinois,

two groups of women, and one group had the food guide pyramid, and I'm gonna get to the exercise piece, they ate the food guide pyramid, which is a total disaster, right? We know that, what is? Paid four by big food. Terrible, terrible disaster, and then the other group had a double the RDA of protein,

and they, in both were isocloric, but I'm wanting it to the exercise component. And what they found when they looked at the synergistic effect of exercise of dietary protein and exercise, they did three days a week of stretching. So that was the exercise intervention. So it was really limited. It was three days a week of yoga and then, you know, some walking. They were able to maintain their muscle mass. And they were able to maintain their muscle mass even on a lower protein diet.

And I'm not advocating a lower protein diet, but it was the point is that the influence of exercise, even some basic movements. So if someone is listening here and they're not doing anything, number one, don't do the food guide pyramid, right? That's like a bad idea in general. But if you are eating not an ideal diet just by doing three days a week of exercise, which can include yoga, you'll have an impact. It's more than what they're doing. You also, you said something that we try and communicate all the time, what. I think it's so important is when Sal said the getting up and down. He said, yeah, that was probably like high-intensity training. It's so important that if you're a coach and trainer that you understand that like meeting

them where they're at, like yoga could be a lot for somebody who's never done anything or not moving. And so sometimes I think as trainers, at least I was guilty of this as a young trainer is thinking, oh, we got to be in here for an hour or at least three to guilty of this as a young trainer is thinking, like, oh, we got to be in here for an hour or at least three to four days a week. Can I even do this? And it's like, man, I'm taking somebody who's 50 something years old, never lifted weights in the life before.

It's like, man, just getting this person to come in here and practice these movements. That's huge. Dr. Lion, one of my clients was, she had a walker. And one of our exercises was letting go of the walker and just trying to stand as tall as she could. And we were timer for 10 seconds at first I was 15 second and it was a strength training exercise for her and I think a big message here is how do we get people to start early? Like really early. We all have kids. How do we get them to start early so then it doesn't become a habit or a situation that they have to change you know

I don't want and I can appreciate people coming in in their 50s. I've never done anything, but I want to get to the point where we have a bunch of trainers in the room now, and we're all relatively fit. I mean, you guys are fit. I'm relatively fit, but that we think about how do we become responsible for our fellow human? Because at the rate that we're going, we're going to hit a tipping point where the normal is going to be overweight or obese. We're getting close.

But just the normal population. And so then the question becomes, there's going to be just too huge division. There's going to be a group of people that are fit and then a group of people that are not exercising. And how do we get the other individuals who don't quite understand the influence to get on board? Yeah, the political implications are that are huge because it's already like this, by the way,

when you pay your health insurance and you're healthy, you're subsidizing for the unhealthy people. So when you have 60% or 70% of the population, that's obese and sick, that means the other 30% are gonna support that 70% with the costs percent of the population, that's obese and sick, that means the other 30% are going to support that 70% with the costs of trying to keep them alive and all of their health issues. You mentioned the food pyramid. Why is that so bad? I mean, that was the biggest social experiment I think that we had. So the food pyramid was

really when everything changed. And the food pyramid was a diet that was, 45% carbohydrates. And the base was grains and carbs and protein was maybe 10%. And fats, it was a social experiment. And what is it called? I mean, do you think there was, was there good intention behind it? Or do you think that that was completely manipulated

by like the food industry and so on? Like, what's your theory on that? Like, did we go into it thinking, because you say experiment, like, oh, we think this is a good idea. Or do you think it was manipulated or played with? I think a lot of it is not based on health. A lot of the initiatives and a lot of the information that we have received for decades is not solely based on evidence-based information.

That's so ironic, though, because you're giving health advice, but you're not listening to it. It's challenging because, for example, when you think about the food guide pyramid and you think about these protein recommendations that haven't been updated since the 70s, where did they come from? And really, is it because they established that this is the amount of carbohydrates? Was there really evidence for that? There was a seven, was it called a seven country study dog?

Who is a doctor that did that? Antikaze. There you go. He took out two countries. I didn't fit that criteria. Right. I mean, there's a lot of, and it's interesting when you look back at the history, it's never been about the science only.

It's been about policy. It's been about, you know, there's a religious aspect to it. There is an emotional aspect to it, and it's really damaged our society, and it's really damaged going forward. There's a big push or narrative that's out there that is trying to push the average person to a plant-based or vegan diet almost, and sometimes directly, but usually kind of insinuating that the protein is not good. Animal protein is not good, it's not healthy.

What do you would happen if the average person just said, I'm going to go plant-based, I'm going to not eat meat, eggs, and milk? Well, right now, 70% of our diets are already plant-based. We're pretty fat and pretty unhealthy. If we are going to further reduce that, or rather increase that plant-based number, what's going to happen? We're not going to go in a better direction. Right now, we're 30% animal products, 70% plant-based products.

If we listen to the narrative, and that's from NHANES data, so that's the largest data set that we have. So if we were to take a step back and then actually execute on those recommendations, I mean, it's going to be another disaster. You know, like the same thing with cholesterol. So there was that whole period of time that we should reduce.

I don't remember if it was in the 60s. It was, maybe it was a little bit later, but time magazine came out with this article where it had like butter and just browning face or something like that. Or maybe it was eggs in the frowning face where there was this recommendation that we should reduce our cholesterol to 300 milligrams of cholesterol. Everyone's all heart disease was going to go away. They did that, nothing happened. And I think that actually heart disease went up and they ended up taking out cholesterol guidelines in 2015. So people did exactly what they were told to do and nothing happened. The food guy pyramid, people did exactly what they were supposed to do, everybody got fat.

There's that cover right there. Eggs in bacon. Eggs in bacon cholesterol. And they were wrong. They were totally wrong. Super wrong. I almost feel like this direction towards vegan in a way from animal products is even scarier. Oh, it is. It is. I mean, I think that's worse than just trying to avoid fat or avoid cholesterol. Right.

Like, going all plant-based for the majority. I think that where sour is alluding to is that people already that eat the average diet have a really hard time hitting the adequate amount of protein they need to sustain muscle mass on their body. Well, we're not doing it. We're not doing it. And think about it this way. So the recommendation at point eight grams per kg is point three seven grams per pound.

So if you're a hundred and if you're a hundred and 15 pound female, that's 45 grams of dietary protein a day. Now, these numbers were developed, the RDA was developed on high quality protein. So the RDA is developed on high quality animal-based proteins. The recommendation of 0.8 grams per kilogram came from young men to maintain nitrogen balance, which in and of itself is not a health outcome. So now if we believe in do you believe that the RDA is enough? No. No. The RDA is the minimum to prevent

efficiencies. The RDA is based on animal based proteins. If we then go plant-based and we further reduce, our dietary protein, you tell me what's gonna happen. Hold on, let me illustrate this. Just so people understand just how insane this is, okay? It's already hard to get protein from plant-based sources. Now, I know people will see those pictures of, you know, this many beans or whatever. You go ahead and try it. hard to get protein from plant-based sources. Now, I know people will see those pictures of, you know, this many beans or whatever. You go ahead and try 100 grams of protein

from, you know, non-animal sources. No, it's gonna be an ounce of it. No, it's gonna be terrible. And now, you're talking about protein quality as well and studies are very clear on this. Unless you're protein, it takes super high. When I say super high, like, I weigh 205 pounds, I'm consuming 200 grams of protein. Unless your protein it takes super high,

and there's lots of studies that show this, that animal protein versus plant protein, one gram of animal proteins, it's equivalent to like one and a half grams of plant protein. So not only is it hard to get the protein from the plant sources, but you also need more of it to do the same work, so we're literally gonna make it impossible

for most people, unless they supplement like crazy. Wait, but wait. So we're talking about protein as a generic concept, and I agree with you. Now, how are you gonna get iron? You're bioavailable iron. How are you gonna get creatine?

How are you gonna get B12? So if we've just focused on dietary protein and go more plant-based, could we get enough? Yeah, but what about everything else? What are we going to do to the other physiological needs? Well, we could just give you a prediction based off of that. Like, let's say because it is feeling like it's going this direction that we're pushing this and more and more people are going plant-based.

Are there things that you knowing what you know already already, like we're going to see an increase in this? We're going to see like, you know, all the symptoms of being deficient. We love to, all right, here's what's going to happen. Here's what's going to happen. Well, you know, it's very interesting. So it's like a lot of the younger people are the influence that are arguing for plant-based. Yeah.

20s, maybe early 30s. Again, as a geriatrician, that you don't see geriatricians say to anybody go more plant-based. Like, that's terrible medical practice, terrible advice. We are going to see rates of osteoporosis, of sarcopenia,

because we are going to, because we, everyone in this room, we are going to change the narrative and people are going to start to test muscle mass directly. We are going to see an exponential level of low muscle mass. We are going to see osteoporosis like we've never seen it before. We are going to see injury, fractures, and falls like we've never seen. I'll add to that. You can see higher rates of depression and anxiety and mental illness as well, which are all directly connected to. You mentioned B12 deficiency. You mentioned

iron deficiency, both of which can make you feel more depressed or and or more anxious. You didn't talk about vitamin D deficiency, which is also going to be more common, which definitely is connected to depression and anxiety. By the way, people look this up, look it up, look at the rates of mental illness in the ones that I talked about and people who are plant-based versus people who are omnivore diet. And you're not even comparing like a healthy omnivore diet. You're just looking at the general unhealthy population and you see that the rates are much higher. But you know,

we could always give them, you know, enziolytic and antipresson. You know, and the other aspect is that we have beef consumption that is down, dairy consumption is down, but like all of the high quality foods, they're lower than they've ever been before and ultra processed foods are higher. And then if you look at other countries, the other countries would think it's crazy to say, you know, yeah, get rid of Go More Plant-Base. They, it is a luxury that we can even have this conversation.

But yeah, so back to your point, what is going to happen if we go more plant-based? Well, again, the RDA is a minimum to prevent efficiencies. It's based on animal-based products. Now we're going to further reduce that. What's going to happen? Okay. So cholesterol, they were wrong about that consuming cholesterol.

They actually, FDA in actually says it's no longer a nutrient of concern. So they even said this themselves. That's the fact. Yeah. What about sodium? Sodium is, you know, bad for you because it's high blood pressure, avoid it. Everybody, I go low sodium diet. There's products out there that are all low sodium. Have we been misled with sodium as well?

I actually, I believe so. I'm obviously not a sodium expert, but I believe that we have been misled. It is an essential nutrient. And I think that if you look back at the history that sodium is something that animals always search for, there's salt licks or whatever it is, it's very difficult to get into the diet.

The other aspect of it is that when you think about high sodium diet or high salt diet, will there be some individuals that are sensitive to sodium? It's probably maybe 20% of the population. And the majority of people are not going to be affected by sodium. And it is essential. Could we also be looking at a correlation? I think if you took a thousand everyday people, just regular people, so no controls.

And you just took out the people, or identified the people consuming the most sodium, there's probably a correlation between that and heavily processed foods or fast food. Totally. Okay, so I think that's what we're probably dealing with, because you need a whole food diet, and you salt the hell out of your food, it's not that much salt.

Right. Okay. Right. And I, again, I think that we have been really misled about sodium. And is it really a sodium issue or is it a processed food issue? Is it the lack of potassium? Is it the lack of other things?

Okay. All right. Staying on the diet topic, fasting, I remember that became kind of big here in the space. And it was, you know, people were touting. It was so great. We were cringing every time we saw people say fast to lose fat, not necessarily good idea. Here's something I noticed as a trainer in a coach,

all of us noticed this as well. And then you see messages, even the fast things, L.A.S. who think it's so great. It seems like women have oftentimes a more negative, if they do have a negative effects from fasting, they seem to be more lack for lack of a term sensitive to the potential negative effects of fasting. Is that true?

Is there a difference between men and women, how they react to fasting and what about fasting in general? So let's talk about fasting in general. I don't necessarily believe that there is a magic to fasting. I think that it ultimately comes down to calorie control. The goal, the question is, why are you fasting? I don't think there's anything wrong with fasting. I think that is it for bowel rest?

Is it for, you know, everyone uses the magic term autophagy? How long would someone have to fast for it? I think that there's multiple ways to get an end result. But fasting definitely allows for calorie control. Definitely allows for calorie control, definitely allows for gut reset. It can definitely help some aspects of circadian alignment, depending on when you're eating versus when you're fasting. Does it affect men and women differently? I think that there's a lot of influence of hormones that we don't, that they're so variable

for women in particular that we don't know. And that I was talking to our mutual friend, Lane Norton, we were just texting the other day and I was saying, you know, what are your thoughts on the hormonal aspects of fasting or exercise, etc. And, you know, he, I think Kim and I were very much in alignment. There's so much variability. There's just so much variability. I think that we're very behind when it comes to looking at female physiology just in general. That being said, you know, if a woman's body perceives that she is under too much stress,

and I'm using kind of nebulous terms because I think that this kind of relates to fertility, sure. That if a woman's body perceives that she is under too much stress and let's say, again, I say this cautiously, that cortisol is elevated over time or she becomes a menoriac because of perceived stress and you add fasting into that, I think that that can be a negative. You know, rather than eating earlier on and, you know, allowing the body to kind of settle. Okay. Is there a low body fat kind of factor to that with a woman, especially? Yeah. You know, it depends on the woman.

Yeah. It really depends on the woman. Again, obviously, you want to make sure that she is having a regular menstrual cycle and that she is ovulating. Should we say, you know, 20% is ideal for getting pregnant? I don't know if we can say that. It's certainly very individual, you know? Do you, when it comes, you just mentioned, you know, a woman's cycle.

Is that a really good indicator to a woman that she's healthy versus not? I would say so. Yeah. Because I use that quite a bit as a trainer. Like if I had a female athlete, if she lost her period, I knew we were going too hard or she was dieting too much.

I knew right away. Yeah. And I think that that's a really good perspective. Yeah. Unfortunately, it's accepted in the female sporting world. I know. Oh, you lose your period. It's a part of the game.

I know. And in the military, same with women in the female sporting world. Oh, you lose your periods. It's a part of the game. And in the military, in same with women in the military, if they're training really hard, it's the first time it goes. You mentioned hormonal fluctuations. Yeah. Now, I know as a man, they say, if you get your testosterone levels checked, do it in the morning. That's when it's highest. That's the most accurate reading of your high levels.

But our hormones are pretty stable. Month in a month out compared to a woman's cycle where she gets these really kind of, you know, in comparison, radical changes. How do you test the woman's hormones that? Because she could be at any moment, any time in a cycle. Yeah. Do you? You should be able to tell.

For the most part, you should be able to tell based on looking at everything. Okay. FSH, LH, and then you have ranges for that time. Yes. Estrogens, progesterone, testosterone, yes. You should be able to tell. Okay. And then ratios of estrogen and progesterone, what are we looking for during the, what is

it, what is it you're looking at when you look at other? So I used to look at those, I don't look at them anymore. Why? I just, I feel like you have to really, again, because the, the cycles are so variable and people are so variable, it depends on how it ultimately goes to how the woman is feeling. I think when you're early on in your medical practice, you're testing everything, you're testing everything, you're testing everything all the time.

And then over years of clinical practice, you'll hear a woman and she'll be saying, listen, I'm having a lot of anxiety, I can't sleep, X, Y, and Z, and you might look at her blood level of production on, which is typically low anyway, but you know that she needs it. And you know that there isn't going to be a downside. And with her levels of estrogen, you know, from a clinical perspective, if a woman is still menstruating, you're not really going to give her estrogen.

So I don't look at those ratios anymore. I know it's crazy, but... No, that's actually true. That brings up a really interesting question. Off air, we're comparing how Western medicine does things compared to how you do things with patients. We should know better too, this is how we were with trainers. How much we were by the book when we first started, then how much we throughout the book.

Exactly. Later on. I would love it. It is. You need to know that stuff. It's very important. You can realize, okay, now none of this matters. It's like, it doesn't matter. It's like, need to know that stuff. It's very important. So can you realize like okay now? None of this matters is it's like I mean matters, but it's like okay, but and this is probably why there's this like This belief or and I wouldn't say belief because that even even insinuates that it's not true. You talk to a lot of women

And they say a lot of women have this complaint about going to the doctor. They gaslight me they ignore me They don't hear about how I feel they look at my lab., they tell me I'm fine, tell me I'm crazy. And what you're saying is that's why. Because you're just looking at the numbers and not listening to what she said. So what are so take us through. I'd love to hear some like questions that where you're at in your career now compared to where you when you first started, right? Yeah. Like what's different that you ask now? And like, what are like huge clues for you that maybe you wouldn't have asked to even see in about that?

Yeah, so the first thing that I do in my practice is you gotta figure out who the person is. There are archetypes of people. And when you figure out who the person is, you'll get to, it'll be a whole different perspective of what you're gonna hear. Okay, explain that. I'll give you an example.

So, I take care of a lot of females and a lot of guys. And a lot of men that are very successful, very driven, type A individuals. And the first thing that I'll say is like, how are you doing? And every single one of them, I'm great. That's great. That's great.

That's great. I'm great. And so, I already know, right? I'm already know. And so, the next question I'm going to ask is, so the last time you had a big sale, a big launch, a big thing, whatever it is, how did you feel afterwards? And the guy that says, no, I was neutral.

It was good. It's just what I do. His answers are going to be so much different than the entrepreneur that says, a crash and burn doc. A crash and burn every single time. Oh, interesting. So that's an example of, so now I know that the entrepreneur, so the entrepreneur typically that has gone in,

they're very neutral, even though some of the entrepreneurs are traveling to different countries all the time, like all over place. Yeah, huge book launch and just totally stable, right after. You know, like just totally capable. And then the other entrepreneur, and I'll give you an example because where they are in their career is totally different.

The other entrepreneur does this huge event in Vegas every year. And every year I wait for the call about how shitty he's gonna feel afterwards, how he's gonna be off his diet and he's gonna be not training. And so that's, so when I get a perspective of who the person is. So for example, the guy that is neutral going in, I know that he's going to be very steady and stable. I can ask him what he ate three weeks ago on a Wednesday, and he'll probably know because he's consistent. He is probably very tight on his vices.

He will probably execute on his blood work. He probably will not want a ton of contact, but he'll want me to be on top of all of his stuff. Interesting. And that's one type. And then the other type that is having these massive ebbs and flows, probably he's going to be bad at getting his blood work done. He's probably going to micromanage or overthink every kind of treatment, whether it's testosterone

replacement, etc. And also going to be very detached from how he truly feels. So this is cool because we have coaches and trainers in here today that are listening to this. And we kind of talk a little bit about this. Now that you've learned this, like you can read these different archetypes. Do you fork, like you're meeting, you're already, in your head, you're like, okay, I know, I know this. Do you forecast it for them? Like do you like, you're going to be like this, you're going to tell me that. Yes, you're buying, yep. Oh, that's so good. And then they trust you. Yes. And then it is a relationship where they feel understood.

I think that one reason why I have personally been successful as a physician is I understand who's in front of me. I can relate to them. And I get them. I get where they're coming from. And a physician should get the person. It's not about the labs. Yeah, yeah. It's not about, you know, as a physician, you should be good at diagnosing an illness. That's your job. What are the pros and cons of each of those archetypes? You said some of the things that they're going to be good or bad at, but what are some of the other things that each one is...

Oh yeah, and they're different. I'm sure. They're multiple different archetypes, but I think for your listener, there's the reluctant patient who has been everywhere and has tried everything, but they're jumping around from thing to thing, and there's all kinds of things. So the pro patient, like the person who's able to be neutral,

right, and that's just an example of you, you tell me your habits, and I'll be able to tell you where you are in your career. I am telling you, you tell me your habits, I don't even need to know what you do, and I will tell you what level you are in in your career. Oh, that's cool so the

The good thing about kind of that CEO type is that you know you have to get someone else on board You know you need to get their assistant on board their wife on board have to tell me I don't even deal with that guy Mm-hmm. I just go right to the white I just go right to the wife. I was gonna say, I was gonna say, hey, Katrina did that. I don't even wanna hear you. I don't even hear you. I group text with the wife, like, hey,

do this motherfucker get this shit done or not? Just bypass them completely. Those guys, extremely successful. I hope she's gonna make me feel okay about it though right now. Extremely successful, as long as they have someone in their... Very handsome. Come on, yeah.

Show up here at this time to get this done. Yeah. You know, like they will try to cancel the appointment. They will try to move it. It is... It is standard. This is weird. It is standard, right?

You have to have, if they're supposed to be on this medication or this supplement, it has to already be sent for three months a renewal has to come up They will move they will do this in fact if they need blood work You better have someone sent to their house So that's Yes, so we are very skilled at dealing with these patients We are skilled. I don't even send you just like you don't even have to know just do the thing Yeah, so awesome the

The other type of patient who is kind of a more of a rookie entrepreneur or a rookie individual, those guys are more challenging. They will put off a lot of these tasks. They will put off you have to be on top of them at all times. Do you think that's because they're at the place in their career where they haven't figured out that they might need that assistant or they need that person? They still think they can handle everything with you in their phone.

And also, they fail to recognize that there's this kind of interchange that happens, right? That they think that they can outrun their physical health. And you can't. So for all the trainers listening, listening you guys behind me, or if you're listening to this, as high as you are going to go is solely based on your physical health and wellness. And you cannot. That's your limiting factor. That's a limiting factor. It's you.

Always. And the people at the top, they know that. They just know it. And so they are not trying to, and yes, there is a grind, right? We all grind in the beginning. But then all of a sudden, there comes to a point where we're like, okay, if I keep grinding this, there's this predictable, I'm gonna go high and burn out.

Go high and burn out. How long you gonna do that? You know what you're highlighting right now? Just broadly, is the difference between like concierge medicine or private medicine versus working with your insurance companies in those, I mean, you said you gotta know the person, right? But the current system really almost makes it impossible.

Impossible. And here's why it's so important. I'll use one of the most medically treated for lack of a better term's conditions that we have is pain. Pain is one of the most treated. Over the counter and prescription wise, people will use medications for pain. You can't really separate your perception or the physiological what's happening with the pain and how you perceive it or your relationship. You can't separate the two. We know people who are depressed,

who get out, get out of depression, all of a sudden pain goes away. Some people respond to pain medicine differently. Other pain seems to be phantom. We don't know what the hell's going on. It's a very strong psychological component. Yes. But without working with the person, how could you,

that's just one, that's just one thing. Energy is another one. Like, you know, there's definitely physiological things happening. That's why people don't like their doctors. Yeah, so okay, so. This is why they go in and they go, oh, I mean, it's so funny when you say your doctor like, oh, yeah, hi, to hide behind.

Okay, so what's the big difference? Okay, how long do you spend with a patient at concierge or what would that look like versus like typically I go to the doctors what looks like? Well, first of all, it's this is, I'm going to say this for the provider. If you are in a place that there has to be I'm going to say this for the provider.

If you are in a place, there has to be a good match between the provider and the patient. There is, it has to be a team. So for example, if you come into my practice, you're interviewed because it has to be a good match for both people. So my initial visits an hour and a half. Well. An hour and a half at the patient. Yeah, yeah, typically you go to the doctor five to five.

You don't even get 15 minute visits and only three of it's with the doctor. Yeah, that's the other, it's the truth. Yeah, it is, that's all you get. So you should have, in your life, you should have a good accountant, a good partner, and a good doctor. Mm-hmm. I like that.

Because you got to be able to call on those people at any point in time. Yeah, and you know what's interesting about this? Because people look at the math and they say, oh my God, it's so expensive. They say this also about exercising, paying for a gym, eating right, whatever. But it's really expensive to be unhealthy.

Yes. Also, time consuming people like, I don't have time for this concierge doctor. I don't have time for an hour and a half for a visit. You think you're gonna have time for sickness. If you don't have time for this concierge doctor. I don't have time for an hour and a half or a visit. You think you're gonna have time for sickness. If you don't have time for health, you're definitely wrong. What are some of your biggest, I guess, pet peeves

with the current system in terms of testing and not testing? Like, what are some of the big issues you have with some of the ways that they operate? I think that it's very algorithmic. Really, they really look at the basics. And you're not going to catch anything with the basics. You'll catch big stuff, but you're not going to catch this stuff like the precursors before

things, for example. When you go to a doctor and you look at a lipid panel, they don't necessarily measure apobie. Apobie is really important for cardiovascular disease. When you go to the doctor, they might measure a fasting glucose level, but they don't necessarily measure fasting insulin. Just very small things like that. When you get your thyroid panel done, typically a physician doesn't do, they just do a screening test for TSH. They don't do free T3, free T4, antibodies. Do you think we over-prescribe?

Yes. Okay. I guess they get out of the same. Yes. We have 40 million people on statins. Yes. Well, it's okay. So I'll be more specific.

Yes. Do you think we're over-prescribing antidepressants and enzialytics, especially to women, and they're feeling those symptoms because of hormone imbalances, nutrition deficiencies and the fact that they're not active and we're just like here, take this, feel better. And I will say there is this misconception that physicians are paid to prescribe. That has not been my experience. That's not been my experience. I have not seen that in clinical practice.

But again, we have to think where does this education come from? Where is this unifying education come from? So the people at the top educate physicians to then execute on this thing, because physicians want to do the right thing. I know you guys have a coaching program where you're training up other coaches. And so the question becomes, where is this top down approach? So if a physician was taught to do something different and maybe deploy a different treatment modality, then they could have probably better impact. Yeah.

They're working with the tools they were given. They're working with the tools. And unfortunately, if you tell a contractor to build this house and you only give them a screwdriver and saw is gonna do what he can with the device. Yes, and unfortunately, I remember I watched a lecture from obesity medicine, which is so funny that there's an obesity medicine division. And it talked all about this plant-based diet

and about how bad red meat was. And obviously this physician talking was an nutrition expert. They didn't have any, they had ulterior motives, I suppose, but then that was the message that was portrayed to all the other physicians. And so then they believe that and they deploy that information. And again, so becomes really challenging.

Do you think people should stop seeing their doctor if their doctors obese? Ooh, that's a spicy question. What I will say is that it's important to find a provider that models what an individual believes to be as the importance of health and wellness. So that's how I will answer the question by, yes, that's good. I believe that you have to feel as if the person is doing what they're telling you to do and they are doing it themselves. Yeah, I think that's important for anybody who's helping someone. Would you go to a trainer that was overweight? I mean, unless they were, they've been losing weight for a while and they're on that journey,

I mean, it's hard, right? Because you don't believe in what you preach. No, I tease you like dodging like Neo there, but I do think that you bring up a good point because I would consider a trainer if there was something specific that I was looking for that I thought that person that provided. They had a very specific skill or something. You're like, you could learn from them. Like maybe they were just brilliant at teaching biomechanics

and I know that I'm not good at it and I can get that from them. And also, well, we should clarify. So I wouldn't care if a neurosurgeon was obese or not. Right. So I suppose it just depends on what is it that you're ready? But I get what you're saying, that's like when you're trying to get someone to adhere

to changing their lifestyle, one of the biggest roadblocks, this is anybody, by the way, you go to a spiritual leader, you go to whatever, when they look like a hypocrite, you don't wanna listen to them, because they're telling you to make

all these hard lifestyle changes. And the first way that you're gonna discredit them when you hit a roadblock is to be like, you don't do that. Why would I listen to you? We do that to our parents when we're kids. Yeah, I was just thinking that. Yeah. How do you feel about the GLP1 agonist? So this is blowing up right now. These are exploding. Yes. They're all over the place. To the point where I actually talked about this on the show,

major snack food manufacturers are meeting together to try to figure out this problem, because people are going to eat less of their food. Losing customers. They have used physiology and pharmacology to outsmart the bad guys. So, what do you think about that? Are they how effective are they to use them with your practice? Okay, so we are talking about, there's GLP, one agonist, which that would be the semaglutide would go. We are Everyone's talking about ozempic and then there's trizepitide which is gonna be the next really hot topic and if it hasn't been already

Mungerno these medications are in critons and GLP and GIP are both producing the body and I and GIP are both produced in the body. And I will say, I think they're incredibly effective. I think they're safe and very effective. We have not seen, and by the way, the GLP-1 Agnus, they have been around for a long time.

I think that they first came out 2009. OK. So that's over 20 years. They've been around for a very long time and I think that they have very good safety side effect profile. People will say what about the black box warning with this thyroid cancer and that was I think it's an incidental finding and also the rodent models. There's the GLP, the receptors are highly concentrated in thyroid for rodents, not for humans. Okay.

So I think that is kind of misguided some of the information. What do I think about them? I think they're incredibly effective. And for a GIP or a GLP-1 agonist, you might lose 13% body fat for tricepidide or mongerno, you could lose 22%. Wow. Now, let's take it a step further. What is the risk of, you know, what are the outcomes that we're looking for? What are we trying to protect people from? Themselves, obesity, when an individual is very obese, lots of things go wrong. Get fatty liver disease,

is very obese, lots of things go wrong. Get fatty liver disease, you can get scarring, get cirrhosis, you can get all, like the list goes on, athlete's sclerosis, hypertension, etc. So these medications, if we know, for example, someone loses 10% of their body weight, could reverse fatty liver disease. could reverse fatty liver disease. These medications provide people a way to do that. I mean. What about the muscle loss that we see? Is that just a result of the fact that they're not, they're just eating less or not eating protein

and not letting weight exercise? So I have not been able to find a mechanism of action. And I, in fact, think with trizepa tide. I think it's going to improve, so trizepa tide or a monjourno, I believe that we're going to see improves insulin sensitivity and skeletal muscle. Which should be muscle preserving? Yes.

Okay. So, I think that the information out there right now is that they just haven't looked at skeletal muscle. I think that it is a benefit. I think that eventually they are going to use it in very low doses as a prevention and not as a treatment for obesity or type to diabetes. Wow.

So as a trainer, I just, this is, I could guarantee this would happen. You take the average person, it doesn't exercise, just have them eat less. They're gonna lose muscle too. That's just how the body metabolic adapts and the other kind of stuff.

But I'd rather have them lose weight. Yeah. I mean, they burden on society, lose muscle too. That's just how the body metabolic adaptor. But I'd rather have them lose weight. Yeah. I mean, they burden on society, the burden on their family, the burden on the healthcare system if they are overweight and obese and cannot regulate food intake. Right. Right. But what I'm saying is you have a strength train and, you know, monitor the protein intake and you offset that. Yeah. Not only do you offset it, they probably build muscle. Yeah. And I can't speak to this too intelligently but I was looking at

GLP and GIP and I believe that they increase during exercise. They do. Okay, so He was an expert on that. Yeah, you know, it's interesting too. There's reports of people smoking less drinking less. That was what I was gonna ask. That's what's fascinating. Wait, would you be able to see that all the time? So we prescribe these medications and in my practice. What happens? I just these were I believe it's like a reward pathway. I don't know exactly why it's working, but what we see is that those that have binge eating disorder or have any kind of addiction, it really seems to mitigate across the board. Across the board. It doesn't matter what it is.

That is so weird. That's so odd. There was something about the inflammation in the brain. Yes. Yes. It affects there are these receptors in the brain. Yes. And so that contributing to making better decisions as well, like when you're in a better

state mentally. And I'm going to go on a limb by saying this and part of me in my mind is saying, oh, don't say this, but I should definitely say that. Is that I think that when we think about optimization, what we're going to see is probably a combination of not the GLP one Agnes, but the tri-zepatide, the dual agnes with hormone replacement. People are going to feel amazing. And again, we operate in this environment that is unnatural. When I'm not saying that we're in an unnatural environment like we are living in the sticks, you know, my dad lives in Ecuador, the jungle, whatever. I'm not talking about that.

I'm talking about an environment where we have constant stimulation, constant phones, constant food, and our drinks, and our cells, like all this stuff. I think that the component of the tricepidide actually will help, I don't know if it's like refocus, but it definitely eliminates the noise of the wanting. Which in a world where, let's just talk about food for a second. Yeah.

Like on my phone right now in 10 minutes, I could have whatever flavor or food experience I want. It's right. Brought in here right now while we're podcasting. So. The only thing you can't get is a great hotel. So just saying his. I know because I love. So just saying the G.O.P. one agonist could totally help Justin with his Pokemon obsession. The trizap time. It's the dual agnes that I think is really the winner here. The trizap

tied. It's an increase. What do you hear is what they're gonna find? We know that it increases fat and weight loss, but I think they're gonna find positive effects on skeletal muscle. And the thing is, here's the crazy thing about humans, is when they hear repetition over time, they believe it to be true. So in the social media space is you're hearing, oh my gosh, and again, I'm going back and

forth from a GLP versus a dual agnist, a GIP, but we're hearing over and over again about how some aggletitis bad and these GLP and aggness are bad and these incretion hormones are bad. Doesn't mean it's true. That's what we're hearing. You know what's, you know what we're seeing right now? We've talked about this on the show. I'm going to keep saying it too, so that people can say oh mind pump said this. Yeah, we are gonna we are in the propaganda war and

What you have now for the first time which you've never had before they actually work together forever is Big pharma and big food usually big pharma works with big food and they would love a drug that lets you eat more garbage and lose weight But it's then they found a drug or substance or peptide. It makes you eat less. So now big foods like oops, let's do the propaganda. So I'm seeing articles where it's like, whoa, this is weird, like I never saw, never thought I'd see this. So why, what kind of thing are you saying?

Oh, they're meeting together, that was the big one. Like you have these heads of these companies they're sitting down, they're saying, holy cow, people are gonna eat less of our products. How do we maneuver and position ourselves? You also see, imagine the billions of dollars that are gonna be lost if people just want to eat black foods and the nestleys

and that people have this, and you know, 20% or what, 10% of the population eats 10% less snack food. That's billion. You also, a company's are gonna lose. Also, we just saw this. Recently, peptides, you could get them from a compound pharmacy, doctor can, you know, and you're fine.

All of a sudden, FDA is like, hey, we gotta stop doing this everybody. Yep. I 100% think it's a GLP on agonist because they're blockbusters. And if you get it from a compound, so some of the glutide is the generic name for the peptide. We go V or ozempic is the brand name one. They're the exact same compound. One is expensive and bought from Big Pharma. Another one's made it of compounding pharmacy. Of course they're going to

want to shut those down. So yeah, they're actually, they've tried to shut down a lot of just the peptides in general, which is interesting. And again, is it because, you know, as a physician, I think about it from, you know, kind of two perspectives. I wouldn't want to give anything to anybody that I didn't know was done correctly. Sure. Was, you know, was it done in a sterile environment? And there are definitely certain regulations

from big pharma. Compounding pharmacies that are private, they have different regulations from what I believe. And there's all, there's just a lot more variability. That being said, the overarching question is, should these things be available at a lower cost? Yeah, I mean, that's insane. So yeah.

Do you work with other peptides too besides those? Oh, yeah, we work with the ton. What are your favorites? It depends. I mean, like BPC157, whether it's a coral or a pest. But it's been around for a really long time. You know, whether it is oral or injectable, depending on what the need is, we see a lot.

For if an individual, for example, has come back from overseas and has had a lot of GI distress, which we see a lot of infection, whether it's parasitic infection, et cetera, gastritis, whatever, the oral BPC seems to work wonders. Obviously, you have to address and identify the pathogen, but one that is treated, it can be very helpful. And then, again, BPC157 from an injectable standpoint, depending if an individual is a responder or not.

I had mood improvements from BPC injectable. Ah, where does that? I just felt really good. I still take it every day. I also take it now with th weird is that? Yeah. I just felt really good. I still take it every day. I also take it now with Thomas and Beta, which I just started that. So I'll let you know what the verdict is on that. It's a very interesting space. Is that the most exciting thing right now that we're seeing in medicine in general right now is like the, I mean, availability of these peptides that you think is most exciting?

They've been around for a long time. I think what's most exciting is the trizepa tide and kind of the, I think that that you think is most exciting. They've been around for a long time. I think what's most exciting is the trizepityd and kind of the, I think that that's really exciting. Yeah. The trizepityd because that's newer, now available. What was the name of, with Dr. Khan was saying they're doing now where you could like inject something and then it works almost like a,

like you only have to do it one time. Oh, that's the full of a statin. Yeah, the full of a statin. Yeah. Oh, I know who you're talking about. He's friends with Jordan Chalo. Yeah. I love that guy.

One of my favorite people. Yeah. I know exactly. They've been case therapy. Yeah. Yes. They've been case-thin like an E. coli. Yeah.

Yeah. Yeah. Carrier and then. Do you see stem cell being more accessible like in terms of treatments for average person? It's interesting because these things that they're talking about now we've used them for a long time. Yeah. The providers that I know they've been doing all this stuff for a really long time. So it's not necessarily new. Is it just becoming more accessible? I think so. Yeah. It's illegal, right? Like a yeah, I don't I, right now I still hear people going to Costa Rica to do it. Yeah.

Go back to muscle. Earlier you were talking about ultrasound, machine specific. Do you use the same ultrasound? Is the specific ultrasound? What do you look at? So it's the programming. So basically, what we're talking about is what are ways to look at skeletal muscle health that can be utilized by a provider.

So right now, depending on the provider, you can use ultrasound and look at thickness and, you know, muscle aspects of muscle health. But I think that, you know, so we are going to be opening up a brick and mortar clinic. I know everyone's going to cringe. In Long Island, Colleen Johnson, my head PA, Colleen is gonna really be heading off that initiative. And what we're gonna be starting to do is working to collect data on looking at,

it's called muscle sound. So we're gonna be looking at skeletal muscle under ultrasound, and it will be able to tell us, it's basically what they use right now in the ICU to look at nutrition status, whether it's sarcopenia or tectia, but it'll be able to show how much muscle glycogen. What? You can tell how much muscle glycogen you're doing.

So this is so unenvasive. Is it like the one you get that way you just put a little gel in real? Exactly. Wow. And I do think, again, but we all know that the skill of the ultrasound, the person doing the ultrasound varies, but that is where things are going. So in my ideal world, what we're gonna look at

is we're gonna have ultrasound, we're looking at skeletal muscle health. We are using a deuterated creatine to see how much muscle and we will still use dexifer body fat percentage. Not for the lead body mass. Do you, what muscle do you typically, I mean, is it standardized? Is it always the same as the vastest lateralis?

Or what muscle are you typically looking at with this? Well, I mean, we haven't implemented it yet because this is newer technology. Is it newer technology? It's been around for a while, but just for the way in which we would utilize it, I think that the biceps are always frequently done. But then again, vassus lateralis as well. It's close to the surface. I'd be so curious with this long-term data. Is there any studies?

I'll let you know. Yeah, let me know, yeah, for sure. And two, in terms of the aging process, and over time, where, where say the person doesn't change a whole lot of their behaviors and you can see an actual drop off or when if it's not really that substantial of a drop off, if they're consistent, in terms of them being able to have more muscle potential, or is there anything like that right now?

No, but I think there's another perspective to what you're saying about that's really important. Is the literature that we look at for muscle protein synthesis is, you know, I think it's incremental the way in which we can detect change over time. So for example, you know, if we think about aging population and we think about dietary protein

and we think about resistance training and how that affects the physiology of muscle protein synthesis. So right now we're talking about the actual fibers, we're talking about the actual tissue. And now we're talking about a physiologic response. So there's the physiology and then kind of the infrastructure. And I think that the change, we don't have a great way of measuring incremental changes over time. And yeah, because we can just look at, okay, muscle protein synthesis means we're synthesizing protein.

But you can't, you're not right now looking at a muscle, you gain point one's and- I think that it's gonna be, I think that there are challenges with those types of things. So if we think about muscle health as a whole, we think about the strength aspect, the strength mobility, which is all the stuff you guys do phenomenally well,

which I do think should be included in a general assessment of any human being. A patient comes to the office, we know how much they squat, we know how much they deadlift, we know how fast they can run a mile. All of these things, I think that that would be incredible if that was the standard of care. That's the capacity. What is the capacity of the tissue? Then the muscle protein synthetic response, the actual incorporation of amino acids, protein-synthetic response, the actual incorporation of amino acids, how does that look? We don't really, I think that the changes over time are probably pretty subtle and challenging to look at.

And then the imaging aspect of what does that tissue look like? And that's kind of how I think about that. And then, of course, you add in the blood work. What is the level of glucose after a meal that the disposal is happening? How much can the skeletal muscle dispose of glucose? So there's kind of the whole picture. So just to sum it up, what I'm saying is the strength, the actual performance of the tissue, the what the tissue looks like under ultrasound or MRI or CT, which

we're not going to do, obviously CT because that's too much radiation. And then how is it responding to the influence of meals? What is the health of that tissue? Very cool. It's going to be a lot of data. I want to go all the way back to where we were. We're talking about the archetypes of your patients, because I'm fascinated in that, because I think there's a lot of parallels

in what you do with what we do. Tell them why he's awesome. I'm just gonna tell them I'm searching for. And also, my book I have a training archetype. I bet you guys have seen this. Okay, yeah. Oh yeah. See, this is so interesting to me.

And I'm also, like, and again, because we have trainers that we're talking to and we have here today, I'm always looking for tactical things that I can take away, that I can give these people. So when you think of those archetypes you were describing to me, what are some general things or tips that you've learned you give that like. Let me give you the training architect. So I cover this in my book. So in my book, and by the way, I talk about Don Saladino, who you know, he doesn't like you. So there's a couple training archetypes.

So the really successful CEO is going to be a performer. Meeting, well, I mean, depends. Because I think about Badra's Koolian and he can get the job done no matter where he is. But some CEOs or the archetype is the performer. That you put them to train by themselves, they're going to be a shitcho. Like it's never going to go well. Do you know what I mean? Like they're not going to do it, they'll, they've got the time scheduled, but they're going to be training solo, no one's around,

and you're telling, okay, go do, it's Monday, it's Bench Day, do this. They're not going to have a great training session, because this group of individuals, the performer will always do better being witnessed. Doesn't mean that they need someone yelling over them, but they need to go into the gym, where there's other people around, and that is a performer through and through. Don't need to talk to them. They don't want you to talk to them.

They don't want you to recognize them, but they need you around because they are so competitive that they need to be witnessed. Fuck off, dude. Fuck it, so much stuff. They are so competitive. It's so huge. This is so interesting to me though,

because if you go way back to all the conversations we've had on here, shut up. We've had one of the biggest debates we used to have was like training at home or training at a place that, and I'm like, I have this like, I don't know what it is, but going to the gym. It's a performer. And also the gym can't be empty.

Yeah, of course. There has to be people, whether or not. That's why I suck in this gym, but I need to go to like a gym gym. So that is a performer through and through, right? Like they need to be with this. Do not talk to them, but the busier the gym, they'll turn on the music.

The more distraction the gym, the better they're gonna do. That's okay. Okay, the better they're gonna do. You know this person, if you are a coach and you are trying to get your really successful patient and they're gonna tell you know this person if you are a coach and you are trying to get your really successful Patient and they're gonna tell you that they don't have time you tell them. Okay, really how did how was it the last time you trained in your home gym? Mm-hmm

And so you get on them and they've got to go to a gym, okay? Visitor the gym the better the they will turn it on awesome the solo. There's a solo the solo artist or whatever those guys on. Awesome. The solo, there's a solo, the solo artist or whatever. Those guys don't fucking talk to them, they'll get it done no matter what. Like they're going to train at home, it doesn't matter. Give them, they'll play the music super loud, have a full playground, I bet you itself. Right? Oh yeah, full playground, turn on the music, don't disturb them, they'll get it done. Yeah. They love it. And then there's like the chameleon where basically they don't they don't care if it's internal external motivation, they don't care where they are. They'll do it. You guys want to do a Zumba class? They got it. It's fun.

They'll show up. They'll show up. Any time anywhere. Yeah, they'll show up anytime, anywhere. They will totally train anytime, anywhere. They will show up anytime, anywhere. Yeah, they'll show up anytime, anywhere. They will totally train, anytime, anywhere. They will show up to train. That's so true. You name it, they don't even have to be good at it, but they kind of are like, yeah, let's go. This is such good information though, for you to show up.

I'm just curious because I mean, that's when you're trying to hold somebody accountable or motivate them or guide them through their health and fitness journey and you're constantly telling, oh yeah, it's okay, you can train at home, but yeah, they've never proven themselves, they can continue to do that. I would much rather, I work out anywhere,

but I would much rather work out by myself with no one else around. Yeah, and so that's the time for you where you're thinking about things, where you're processing things, getting out your anger, whatever it is, that's your time. Yeah, so they cry. Yeah, it's real hard that's your time. Yeah, it's when I cry. Yeah.

That's real hard to be. Yeah, I heard it take me. Awesome. Well, this is always awesome. How's your book sales going? You're on a best seller, you're destroying it. Yeah. I just found out yesterday I actually hit the list in Canada.

Wow. So number six in Canada, it's in this morning Vietnam just bought it. Yeah. So it's in 11 countries now. Wow. Thank you for doing this because we were talking earlier and we were talking about why there's a misconception around strength training. I don't think this was on air.

Why people view strength training this way, especially women, whatever, and I was talking about pop culture and the history of it. There was a running revolution that started in the late 70s because of a book. It was combined, of course, with a popular movie. It was the complete book of running, hit the shelves, right around the time Rocky came out. And everybody started running. I think that you are really helping the next revolution,

which is gonna be around strength training, around building muscle. I really do. And under muscle. And gyms are, I don't know if you. And, and, and gyms are chain. I don't know if you knew this, but big box gyms, when they're building them are changing their footprints. They're taking space away.

Let's cardio and group classes and moving it towards weights. So we may be at the very beginning of this new, very positive trend that will finally have a massive impact or enough of an impact to reverse this terrible trend that we've been on so. And I want to thank you for being a big part of that because we need a medical professional to, you know, because I'm just a trainer, right? And a strong female voice.

That's right. I feel like that, I mean, that's what people always ask from us. Oh, you guys need another woman to come and say this. We'll just keep bringing you back. We almost made Justin transition because we we like people who will help us to talk about him. He was up good though. He actually was.

He'd be hot. Anyway, thank you so much for coming to the show. We really appreciate what you're doing, and just keep doing it. You're helping so many people, Dr. Lai. Thank you so much for having me, and your guys' support means the world, so thanks. You got it.

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