Modern Wisdom - #696 - Dr Gabrielle Lyon - How To Build More Muscle & Supercharge Your Longevity

Episode Date: October 21, 2023

Dr Gabrielle Lyon is a functional medicine physician and Founder of the Institute of Muscle-Centric Medicine. Most health advice focuses on shedding excess weight. But what if your longevity, healthspan, resilience and quality of life was more determined by gaining muscle than losing fat? This isn't a bodybuilder's coping strategy, it's new science backed by mountains of data. Expect to learn why the quality of your life is a direct correlation to your muscle health, whether it's more dangerous to be over-fat or under-muscled, whether exercise is more important than nutrition, Gabrielle's favourite hacks for getting more protein in every day, whether protein timing matters, if it's possible to achieve this with a plant-based diet and much more... Sponsors: Get 15% discount on Mud/Wtr at https://mudwtr.com/mw (use code MODERNWISDOM) Get 20% discount on House Of Macadamias’ nuts at https://houseofmacadamias.com/modernwisdom (use code MW20) Get an exclusive discount from Surfshark VPN at https://surfshark.deals/MODERNWISDOM (use code MODERNWISDOM) Extra Stuff: Get my free Reading List of 100 books to read before you die → https://chriswillx.com/books/ To support me on Patreon (thank you): https://www.patreon.com/modernwisdom - Get in touch. Instagram: https://www.instagram.com/chriswillx Twitter: https://www.twitter.com/chriswillx YouTube: https://www.youtube.com/modernwisdompodcast Email: https://chriswillx.com/contact/ Learn more about your ad choices. Visit megaphone.fm/adchoices

Hello everybody, welcome back to the show. My guest today is Dr. Gabrielle Lyon. She's a functional medicine physician and founder of the Institute of Muscle-centric Medicine. Most health advice focuses on shedding excess weight, but what if your longevity, health span, resilience and quality of life was more determined by gaining muscle than losing fat? This isn't a bodybuilder's coping strategy, it's new science backed by mountains of data. And today, we get to go through it. Expect to learn why the quality of your life is a direct correlation to your muscle health, whether it's more dangerous to be over fat or under-muscled, whether exercise is more

important than nutrition, Gabrielle's favourite hacks for getting more protein in every day, whether protein timing even matters if it's possible to achieve this with a plant-based diet. And much more. This episode is brought to you by Mudwater. Mudwater is a coffee alternative with adaptogenic mushrooms and Ayurvedic herbs, provides energy without the anxiety, jitters, or crash of coffee. The blend includes lion's mane for alertness, cordiceps for physical performance, charger and Rishi for immune support,

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site-wide, plus a free box with your first purchase, if you go to houseofmacadamians.com slash modern wisdom and use the code MW20, a checkout that's houseofmacadamians.com slash modern wisdom and MW20. A checkout. This episode is brought to you by Surfshark VPN. Protect your browsing online and get access to the entire world's Netflix library for

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so it protects and gives you access on your laptop, your iPad, your phone, and even your smart TV. Plus, there is a 30-day money back guarantee and an 83% discount with three months free. All of that is available if you go to surfshark.deals slash modern wisdom. That's surfshark.deals slash modern wisdom that's surf shark dot deals slash modern wisdom. But now ladies and gentlemen please welcome Dr. Gabrielle Lyon. You say the quality of your life is a direct correlation to your muscle health.

Why? Because muscle is the organ of longevity and your capacity to show up and execute anything and everything that you want in your life depends on your strength. And in order to build physical strength, it requires mental strength, it requires fortitude, it requires resiliency. And right now we have this conversation about longevity and health span. What does that actually mean? That actually relates to the tangible plasticity

of skeletal muscle. And by the way, we were kind of joking around podcasters in Austin. But when you think about skeletal muscle, you often think about bro science. You think about the big dudes, skeletal muscle is so much more than that. And in fact, the health of your life

depends on the health and the quality of your tissue. Interesting. Obviously, the byproduct of building muscle, discipline, resilience, being able to overcome hard things, consistency, motivation, so on and so forth, somebody quite easily could say, well, I get that with distance running. I get that with rowing. I get that with doing yoga. What is it specifically about muscle building that is important for longevity? Well, when you think about skeletal muscle, there's a couple of things that you have to think about. Skeletal muscle is the primary side for glucose disposal.

Right now, if you look at the CDC, and they'll give you a list of causes of death, it'll put cardiovascular disease, it'll put cancer, it'll put diabetes, it won't put obesity on there, and it won't put lack of skeletal muscle. It'll also have Alzheimer's. What you'll see is that these diseases at the root all have its place in skeletal muscle, first and foremost. So if you care about any of the top eight or nine causes of death, you have to care in skeletal muscle, first and foremost. So if you care about any of the top eight or nine causes of death,

you have to care about skeletal muscle. Now, what's the next level to that? Could endurance running be great? Yes, it's amazing. Is yoga great? Sure, absolutely. You have to also train for strength and train for life. Having skeletal muscle is like your body armor.

We've all had friends, family members that have gotten sick. If they were amazing in endurance training, but had very little skeletal muscle, what is going to protect them in those moments of catabolic crisis? So we don't age, Chris, we don't age linearly. It's not as if that this slow decline. What happens is there's an insult, and then there is a rapid decline.

And then depending on your capacity to step back up is based on your ability to have healthy skills and muscle in part, it's called cannabalic crisis. What do you mean when you say insult or catabolic crisis? So for example, if you fall and you're injured or you get sick and you have pneumonia for a week, when you're younger, your ability to get back up to baseline to be more physically active is more flexible. As you age, we've all seen it. As you age, an individual grandmother breaks a hit.

She'll never be able to rise back up to her baseline level of functioning. Potentially she could, but as she gets older, the ability to return to a more youthful baseline decreases. And that has to be trained for. You have to be able to be strong, you do have to be able to build muscle. And skeletal muscle is interesting. The skeletal muscle is a nutrient sensing organ. Skeletal muscle is an organ system.

It's a nutrient sensing organ system thatal muscles and organ system. It's a nutrient sensing organ system that senses the quality of the diet. And specifically, these amino acids, specifically lucine, I'm sure we'll get into it, but that efficiency goes down as we age. If you train and eat and do the things you did in your youth, you're not evolving. There's mental evolution, there's all kind of more esoteric evolution, but you also have to keep up with an evolving physiological process and a biological process. And that's where focusing on hypertrophy and strength,

obviously they're not the same, but focusing on skeletal muscle as a tissue, as it relates to medicine is paramount. So I understand definitely from the literal physical body armor perspective. Somebody falls if they have more muscle that is supporting around their joints. It means that there's going to be less atrophy. It means they're going to be able to get back to function more quickly. But you went through this whole litany of other things, like Alzheimer's, Parkinson's, dementia, heart disease. Talk to me about the mechanism

of what having skeletal muscle is doing that helps to mitigate the onset of that or delay it. What skeletal muscle doing to our health span? Well, can I start with just a very short story, a very short story to bring the listener in? Because they're thinking, dude, Chris is jacked, he's bringing in these tough big dudes, talking about muscle. That's right, everyone is thinking,

everyone that's listening, they can't stop thinking it. They try. Look at you, they can't. You've had Stan Effording, you've had Chris Blum said, people that I just know and love. Let's talk about muscle from a different perspective. And I promise I'll make the story short. I did my fellowship in nutritional sciences and geriatrics.

And I did that at WashU for those, the listeners that don't know it's a very rigorous program. It's considered the Harvard of the Midwest. It's very challenging. And I actually didn't want to do geriatric medicine. The deal was, in order for me to study nutritional sciences and obesity medicine, I had to get funded. And the way that I was going to get funded was through geriatric training.

So during the day, I was working with individuals that were over the age of 65, and they were the majority not healthy. On the Alzheimer's unit, in nursing homes, end of life, palliative care, it gets extremely depressing when you're seeing 30 patients a day talking to their families about what their wishes are, except, right? And I think any doctor would attest to that. And then early mornings, when you're a fellow, you have very minimal quality of life,

especially if you're a combined research fellow. Waking up at four in the morning, doing fat and muscle biopsies, and then in the evening doing cognitive testing. And I fell in love with one of the participants. And she was in her mid 50s, a mama three. And she was like so many women that we know. She always put herself last.

She yo-yo died it, weight watchers, you name it. She did everything. Every single thing that we told her was the right thing to do. I imaged her brain and her brain looked like the beginning of an Alzheimer's brain. And I realized that we failed her. We failed her, the medical community failed her. And I couldn't stop thinking about it.

I needed to find a solution that how was it that we were giving this information, move more, eat less, follow a food guide pyramid, how are we not getting this together? What is happening? And then I started thinking as I'm rounding in the nursing homes and I'm seeing these patients and I'm seeing them die and I'm watching kind of this spectrum. And I realized that it wasn't that they were overfat. It was that they were undermuscled

and that we have been trying to fix the wrong paradigm for the last 50 years. And that the diseases and the disease process that I was seeing in, we'll call her Betty, was beginning in her 30s. Like this began in her 30s. And this constant iteration and plethora of information of focusing on what we have to lose

at the quote obesity epidemic. It's not an obesity epidemic. Obesity is a symptom of unhealthy skeletal muscle. Obesity, and like you mentioned, Alzheimer's, the things that ride along with it have roots in skeletal muscle decades and decades before they become an issue. And I wanted to frame that for you because that's what's critical to understand. We have a whole population focus on what they have to lose. We have over 40% of the population focus on the wrong thing.

We are setting them up for failure. It's not an obesity problem. Skeletal muscle is at the core. Skeletal muscle, Skeletal muscle, insulin resistance. There's some great data that one of the hallmark studies came out of Yale looking at 18 year old college students that had no outward signs of insulin resistance when they became sedentary.

Pathology in Skeletal muscle started. Skeletal muscle is a primary site for glucose disposal. I know that we've got a lot of mutual friends. When they're running and doing a million miles, skeletal muscle, where they're going to put their carbohydrates, it's going to be stores glycogen in skeletal muscle. People talk all about carbohydrates. Nutrition is more electric than probably religion.

Skeletal muscle is, again, this site of carbohydrate disposal. It is a site of fatty acid oxidation. We have 40 million people on statins. Why not focus on the health of skeletal muscle prior? We have a mitochondrial density in skeletal muscle. When skeletal muscle contracts, it releases myocines. Skeletal muscle is an endocrine organ system, interfaces with brain for neurogenesis. You name it. Skeletal muscle interfaces with the immune system. And in multiple different ways,

it releases interleukin six, which is a myocine, the most famous one, also releases glutamine, contracting skeletal muscle releases glutamine, which directly feed lymphokine, the most famous one, also releases glutamine, contracting skeletal muscle releases glutamine, which directly feed lymphocytes, cells of the immune system. So if we are truly going to change the paradigm of health, we have to frame the question correctly. So that's what skeletal muscle does. And then of course you look at naked

and all the other dating things that you're talking about. There's all that other stuff, okay? So, you look good naked and all the other dating things that you're talking about. There's all that other stuff. Okay, so there's look good naked and then be strong and capable and age well and be able to do the things that you love so that you can show up for the life that you've created in a strong and capable way. I often think about my kind of heritage training in my 20s and how I was 18 years old and I got to the center for sporting excellence at Newcastle University and I was I think I was about 63 kilos which is just not heavy. I'm built to be very small and built to be very very slight. I remember the first day it was about two and a half years later, I hit 70 kilos and I was like, I am massive. And now I walk around it like a, a portly 88. And

I'm like, God, I wish I was 70. It was so much easier to move around for now, 70. But I think about the fact that the reason I started training is because I wanted to be more attractive to girls and I wanted to feel more powerful. I want you to look and feel like a man, right? Even though you've still got the body, if you're an, like, ectomorphy kind of guy, 18 years old, you've still got the body of a teenager. You don't have the body of a man. And I didn't want that. I wanted to change. But it's kind of like, um, come for the gains, stay for the longevity, right? That you arrive because of how it makes you look and how other people respond to you and the progress that you see in the mirror, but it seems, as you're saying here, that downstream from this,

the benefits that you get from a physiological perspective, from a longevity, health-span perspective, are pretty drastic. So if it's the case, if there is an unseen mechanism which we could be using a pathway physiologically, which would mitigate people from getting ill and help us to defeat disease more effectively and blow off glucose and improve insulin sensitivity. All of the things that you've just listed, why is it the case that there is such an obsession with BMI, with losing weight, with reducing fat? I spoke to Stan Effeting. with BMI, with losing weight, with reducing fat.

I spoke to Stan Effeting. Stan Effeting said on this very podcast, he was talking about the pivot between moving from sugar to a spartum, aspartame on diet drinks, and he said what people don't consider is the sheer impact of the weight loss itself will be so beneficial that any increase

that you are concerned, even though the concern about, like Aspartame is like 8,000 cooks a day, you'd have to drink in order for you to hit some sort of threshold that would be dangerous. Even him, the strongest bodybuilder on the planet, was telling me weight loss is very important. So talk to me about this relationship between obesity, like being overfat and undermuscled as you call it. Like what's this relationship? Where is it important and what kind of gets missed off in this conversation? Well, first thing I think it's really important to recognize is that we don't directly measure skeletal muscle mass routinely. Again, this flies in the face of, have we been asking the correct

question? And in my mind, the answer is no. We use dexa, which is a dual x-ray. We've all heard of dexa. And that actually measures bone and fat. And then there's lean body mass. And lean body mass includes everything. We've been directly measuring adipose tissue and bone, but not skeletal muscle, first and foremost. So we have to recognize that when we

talk about skeletal muscle, when we talk about how much we haven't had a consistent way of looking at it. Just one that it, which we will eventually. So there's something called D3 creatine, which will eventually come out. It's a tagged, it's a deuterated creatine. It's tagged. You'll take a pill. You'll be able to pee on a stick and see how much muscle mass you have. But up until that point, CT MRI or not really feasible for everybody to be doing and especially tracking over time. So the big picture is we haven't been directly measuring skeleton muscle mass. We have estimations at best.

Secondly, we measure body fat because that seems to be at a certain level. We know that that can cause implications, whether it's 30% or more body fat. We know that there is an increase in inflammation, potentially triglycerides, hypertension, etc. That is important to know. But again, this just goes in the way of thinking of looking at that wait until a problem comes and we know that this is the problem. There is data to support that it actually, it is the

loss of skeletal muscle versus the increase in body fat that may be more detrimental. And again, I think that we're going to start to see an emergence of more data as we begin to directly measure skeletal muscle mass, but you will see that the survivability of an individual, they will have a greater survivability, the more healthy skeletal muscle mass they have. Do, you know, whatever it is, 50% of Americans are obese, maybe more than 50% of Americans are obese are overweight. Presumably, someone that has to carry around that much surplus fat has to, if you were to

lean them out, they must have an okay bit of muscle underneath. Julie, is that not the way it works? Well, in the data, it says that they have more muscle, and I'm so glad you brought this up. Have you ever had a rib eye steak? Many times. Many times. Have you ever had a filet? Yes. Have you ever had a rib eye steak? Many times. Many times. Have you ever had a filet? Yes. Okay. Individuals that have obesity, not all of them, but typically what happens is you get fat infiltrated into skeletal muscle, intramuscellular fat.

While an individual may have more muscle, it talks about nothing about the quality of that tissue. You want your tissue to look like a filet. And actually, when we talk about pathology of tissue, what skeletal muscle really requires is flux. It requires activity. It requires stimulation, not just walking. I mean, walking is great, but people are saying,

well, just walk, you'll do that. It's not, frankly enough, but it's that flux, that utilization of glycogen, fatty acids are used primarily by skeletal muscle at rest, which is interesting. The health of skeletal muscle is determined by its activity. While an individual could be obese and have potentially more muscle, one has to ask the question, is it healthy skeletal muscle? That's interesting. and is it healthy skeletal muscle?

That's interesting. Yeah, because I remember seeing this, it's an illustration of a normal sized person and a really, really overweight person and it's an x-ray of the inside of them and you see that the bones that both people's bodies are scaffolded by are exactly the same. And yet you look at the amount of mass that is scaffolded upon them and you go, wow, that is crazy to think that somebody that's 500

pounds or 600 pounds is only being held up by the same buttresses that a person that's 120 pounds is. Yeah, yeah. And I think what's so fascinating is that it goes to the point that this is very plastic tissue. You can change it. It's very pliable and you literally can add mass to an organ system in a healthy way. Last time I checked, you can't grow your liver.

I'm not talking about alcohol. But by attention and awareness, you can make very specific changes that have a measurable outcome. And with deeper, and by the way, Chris, 50% of Americans don't exercise. Yeah, we'll give explain given that we know, however many percent of people are overweight, so on and so forth. What's the stats? When you look at it from your lens, right, the bros lens? What is it? What is it that people are or are not doing when it comes to

protein intake, resistance training, muscle mass, grip strength, ability to pick something up? Is it like some ungodly percentage of fathers can't lift a daughter after four years, older, something? Yeah, I mean, well, I think that you're changing the conversation because your guests are all in order to be a guest on your show, you have to be at least 250 pounds. I think. You have to at least be, so I appreciate you having me on because I am substantially left in the car.

No, it's the deadlift. It's the deadlift numbers. You've got it wrong. It was deadlift 250 pounds, not B250 pounds. Okay, perfect, perfect. So 50% of Americans don't exercise. wrong, it was deadlift 250 pounds, not B250 pounds. Perfect, perfect. So 50% of Americans don't exercise. You know, I'm not exactly sure why, but the reality is 100% of people eat.

If I were to say which is going to have a bigger impact on skeletal muscle health, it would be training. The influence of exercise and its effect on all of the homeostatic mechanisms in the body is profound. It influences every organ system. However, you could go your whole life without exercising. We're not saying that that's healthy, but you essentially could. 100% of people have to eat. And you really must begin to pay attention to this, especially as you age. And listen, the human body is totally flexible.

You talk to Stan, he'll eat a certain way, you talk to Chris, they'll eat a certain way. The human body is amazing. The question becomes, what is the ultimate outcome that you're looking for? And from my perspective, my perspective of muscle-centric medicine, skeletal muscle is the pinnacle of health and well-being.

Muscle-centric medicine, I love that. Yeah, so that I coined that in 2015 and began to develop it and that's something that we teach to other providers. Very cool. It's almost that thing. I think I read in your book something about the relationship between a mother's fitness and the health of her children.

Yes, yes. Ladies, train. Women need to train and you need to also continue your activity well-pregnant. You're not just departing and deploying behaviors, but there is some epigenetic change. The healthier and more fit the mother is, the better their offspring will be. Wow. Yeah, what's the 30,000-foot view of training while pregnant? Well, first of all, they say continue to do what you do. There's very little data in literature on training while pregnant.

I can tell you what I did and I can tell you what I tell my patients to do. Throughout my pregnancy, I swung kettlebells, I lifted heavy things, I wasn't trying to do a one rep max, but I was incredibly active. By the way, I also had hyperemesis gravity. Do you know what that is? That sounds like some Egyptian pharaoh, no. Something that you will never experience and thank goodness, it's basically where you're throwing up all day long. I mean, it is aggressive. It is aggressive. It is a something that they don't sell you on pregnancy in the beginning. But number one, you have to understand that you're going to feel bad, so you might as well train anyway. I felt terrible. I would swing kettlebell through up, swing kettlebell through up. I mean, it was a sight to see, man, when I went into the gym, instead of

having a water bottle, I had like a bug that just gives the worst. Yeah. I think they lost a lot of gym memberships. I bet they did. The doctor over the fast side, hurling everywhere. So, is there anything, are there any movements intensity levels that you would say, you know, there's a girl that's listening or a guy that's having a kid with her. And it's like, darling, don't do what, like, don't try and pull Sumo. I don't know. Like, is there something that you would try and avoid people from doing? And that's what bad bees maybe, I don't know. Yeah, I mean, it depends, right? So they'll say that activity and walking and moving and lifting will actually

can induce labor later on. Again, obviously, people have to figure out how it's going with their pregnancy and what their individual provider recommends. But listen, giving birth is like a sport. So doing squats, doing those things, it's very difficult to deadlift pregnant and swing kettlebells, but you should be able to carry,

you should be able to move. And again, it just depends on the individual, but my best advice is be fit, going into pregnancy, and continue it. Is there anything that you've looked at to do with dad fertility? Let's say that there's a guy and a girl who want to get pregnant. A bunch of my friends have had, do they call it,

conception moons, which is kind of like a baby moon, but it's before. It's like, we're gonna go, one of them was really, really keen to give his daughter a French name so I went to Bordeaux in an attempt to conceive, didn't happen. I'm pretty sure it happened when they were in Nashville or something on the way back.

We got a poor part on the moon. Call a kid, call a kid rock. So what about for dads? I've heard a lot of my friends, they'll go like, dialing in the diets, adjusting these sorts of things. Is there anything that you've seen for improving fertility, improving the quality of sperm for men?

Yeah, certainly diet plays a role. Diet plays a role in fertility. And this is also multifactorial. It's not one thing. You can't just have a good diet and all of a sudden, you don't even know your children's names. Like that is not happening. But I would say that the obvious would be have a good diet, have foods that are rich in zinc and proteins. The other thing that I would say is we do know that the better body composition and individual

has, the better their sperm, potentially the health of their sperm is, resistance training, is plays a role in that. The other aspect that I will say, because I'm a physician, is clomid, or in clomaphein. I don't know if you've heard of that. So selective estrogen receptor modulator, very safe, it's been used for quite some time. It's typically used in women,

but we use it a lot for men. And it can help improve sperm volume. How long can guys run and clomaphine for before you get, before you would start to be like, yeah, time to back it off now, mate. You could, the way that there's multiple ways in which you could run it, but we run it for, we'll run it for 25 days on and five days off, and we could run it for every day. So my husband actually, I don't know if you noticed, but my husband was a seal for 10 years, and now is a urology resident. So he works at Baylor and this neurology, which is where men's health was born. So lip-shults, have you heard of lip shots? No.

What? You got to get him on, or Moe had carried. These guys are major in andrology. These were the guys that created, you know, where we talk about TRT. These are the guys that created this medical practice. And I could say really an appropriate joke when I'm on. Nah, okay.

Right. Yeah. In your opinion, is exercise more important than nutrition? Yeah. Wow. Do I have to pick one? You got to prioritize. 100% of people eat. So get that right. It's interesting to me to think about this pivot now from what has been quite an obsessive diet culture for 40 years, 30 years, some time ago.

At least. At least. Yep. And now thinking, well, what are the reasons why the diet culture is so much more fervent and religious, as you mentioned, compared with training culture. Like the five by five and the five three one and the GVT and the push pull legs and the five day split guys aren't doing it out on the internet. The only people that they all hate together across fitters, right?

So that's fine, but it's very interesting to me, and I wonder whether this will become a battleground as more people plan to flag because they're very passionate about. My training modality is an important part of who I am as a person, and it's, I think a big chunk of the nutrition argument comes from almost like a fear of death. A lot of people that are into this are doing it because they want to improve their health, spend, improve their longevity. And me attacking your approach when it comes to nutrition foundation is kind of the same as me saying, you think you're going to live a long time, but you're not. And I know that you're not. So it hits very, very deep.

And I don't know whether people have that same amount of existential attachment to their training modality. But if what you're saying here, muscle-centred medicine continues to grow as it has been, it's going to get to the stage where you are going to have religious fights over what split should we do? You're absolutely right. And I think that's interesting when you think about training and you think about nutrition. Part of the reason why people, again, this is just my opinion, are so at odds with each other is because they are unaware of the lens at which they're viewing something through.

It's almost as if they're pawned. So if you look back at the history, let's say you look back at the history of nutritional sciences, which by the way, isn't that old. You look back at the history and after the Great Depression, moving into World War II when the Americans and the backs were against the, and we're going to lose a country. They drafted the first million men, and the first million men were unfit for war. 38 percent of the first million drafted were unfit for war. They said things like they had flabby muscles, they had poor eyesight because of vitamin

A, they didn't have any teeth. Obviously, because of the Great Depression, there was a lot of under-nourishment. This became a real threat. This was the first time that the U.S. really identified that nutrition was a real threat. They issued a series of, I don't want to say propaganda, but a way of educating. And what they issued was, in one hand, they said, are you going to support Uncle Sam?

And in order to support Uncle Sam, here's what you're gonna do. And what they said was, you're going to eat high quality proteins, you're going to eat liver, and eggs, and beef, and dairy, because you need to have strong muscles. This is in the 40s. No idea.

They said, you're going to minimize processed foods and you're going to eat fruits and vegetables and even have some, like it was like sodium electrolytes. I was really shocked when I saw that part. And then they said, are you going to help Hitler? And they showed an individual who was skinny and scrawny. And here is the way you're going to help Hitler. You're going to not eat high quality protein. You're going to eat processed foods. You're going to eat white bread. In the 40s, they established these guidelines

and they started this whole campaign about how we could be stronger and more capable, and vibrant, and courageous, and that's what we needed. Then, obviously, all these high quality foods were shipped overseas to the soldiers. They're started to for need increase in processed foods. You have Sylvester Graham and John Kellogg Sylvester Graham was a minister. I don't know if you've heard of him but he was kind of the move that the godfather of this what do you call vegan movement? And he started to talk about the idea that in order to be a moral person,

you needed to reduce any kind of animal products, you shouldn't drink, you shouldn't have sex, you should eat very plainly. And he got a really Influent to follower. And that was a Kell, who then made granola and a Graham cracker. And this... How much legitimacy is there around the Kellogg origin, trying to saw the men cook them into low testosterone?

Give me your 10-file hat on and let's go. Let's go. Fine. I mean, I wasn't around at that time. I wasn't there. But I think what happened was there was an early recognition that high quality foods were imperative to help them on this and when we're gonna lose the country this became a high priority. Then obviously we have a nation to feed and ultimately a global, a global industry and just a global feeding zone, right? We have to do those things. Process foods, which are under two different jurisdictions and commodities in these whole foods require money, they get money, they make money. Whoever has the money controls the narrative.

So whatever the agenda is, whoever has the most fortitude behind that gets to control the narrative. And this is kind of circling back to the question of why is it so crazy? I wake up and I choose violence, Chris. I post something and I go, oh man, I cannot wait. Just, just, and I have to do it. So we talked offline before. And if you have a certain skill set,

then you have a responsibility to share that. Is that true? I think so. I've been a physician since 2006. I've seen a lot of life and I've seen a lot of death. And so why I even started talking about this is because I saw so much misinformation. And here I am as a geriatrician at the bedside of like, oh, signing this death certificate,

and then this death certificate. And all these people are talking about how, you know, going plant-based is going to save the world. And all this other BS and not thinking about how that is going to influence the midlife people and what that end result is going to be. What is the impact of going plant-based on people that are no longer 23? I think that we are going to see an epidemic of osteoporosis and sarcopenia like we've never seen before. What is that for people that don't know? Sarcopenia is a loss of skeletal mass and function, and osteoporosis is bone density.

And could you be young and plant-based? Could you get all the protein? Again, this is a very, just like a very small perspective, this idea that plant and animal foods that it's all just about protein. Protein, we talk about generically, but protein, that's 20 different amino acids, nine of which are essential. Those are nine essential.

Those are individual nutrients. These things are not interchangeable. We're not just talking about dietary protein. We're talking about food as a food matrix and the things that ride along with it. For example, if you're eating high quality protein, you're getting creatine, you're getting carnitine, you're getting touring, you're getting ancereen, B12 iron. These things are necessary for young children and women. And as you age, it's not like your appetite increases, the lower your quality of protein,

the lower your diet is in protein, the higher it needs to be animal-based. Because you're not just eating for dietary protein, you're eating for other nutrients. And so what do I think you could be plant-based and healthy? I think that the body is very adaptable. I think we're going to start to see ways in which maybe they got microbiome plays a role, but do I think it is an ideal diet for an aging individual? Absolutely not. I don't.

And this is both an experience. Looking at the way to improve your body composition, what are the principles of optimizing body composition in your opinion? Well, nobody likes to hear this, but you track your money and you track your speed, right? Say yes, Chris. Sometimes. Monday Wednesdays and Fridays.

You got to track your food. It's just a reality. I know people want to do intuitive eating. I'm sorry guys, just get a sense of what you're actually doing. And it's annoying, but if you have goals and you know that you need to hit those, you have to be able to track. Like that.

What is your, I'm gonna stop you and get tactical each step of the way. What is the most seamless way that you have found to track food? Because it's not my fitness pal. And I will fight you if you say so. So what I do is different than what I think is the easiest thing.

Right, what's the easiest thing? Like chronometer, just an app. What's your favorite? What do you tell your clients to use? Chrono meter. Why? Because it has just like nearly everything in there. All these different nutrients. Again, typically the label only has 14 different nutrients.

Is that, is chronometer the one where you can take a picture of your food or you can speech it in and say like one slice of toast with three eggs, hard boiled blubla. Well, again, I haven't been using it because I didn't tell you what I do. What do you do? I haven't even know what this tapped into the matrix version is.

It is called the pen and paper. Oh God, that's lame. Oh no, are you saying? Super lame. What are you talking about? You can write it and then you can look at it. I'm old school. I'm old school, man.

Yeah, I'm old. Yeah. Okay, so I write it down, but then I know exactly what I'm doing. And also, by the way, my food diversity is not huge. And you're going to be talking to our good friend, Pedro Esculean. I want you to ask him what he had for lunch three weeks ago on a Wednesday. He'll be able to tell you. Is it because it's the same thing that he had for lunch every other day? Yep. Consistency. So once you know what you're doing, then like smooth sailing. Well, I mean, this was what a really interesting

insight from Alex Homozi. He says that most people work really hard at trying to alter their diet and alter their caloric intake and stuff. But really, your diet isn't a diet, it's probably five meals that you've got in the locker that you eat very, very regularly. And it's a case of just nudging these five meals, right, or getting rid of one entire, okay, I don't do the bolognese anymore, because it turns out that I'm an addict for cheese and that cheese is making it to 2,200 calories. Right, it's not that complicated. But if you were to go on social media, you would spend at least six months in paralysis. True. What doesn't get? Doesn't get managed. So you need to be measuring the food that you're taking out. Yeah, at first, at first. And I'm going to walk you through.

And I actually talk about this in my book for Everstrom. You know, we haven't really mentioned it. But I wrote this book for Everstrom so that it could be something applicable for everybody. You literally can read it. It talks about the history. I know that you read it. And it's, you know, at evidence-based, it's an evidence-based manual.

And when you think about how you put together a diet, it's quite simple. What I recommend and what the data would support is .7 grams of protein per pound body weight, or a ideal body weight if you wanna go higher, so simple. So you're what, 88? 180, come here 180. Okay 180. Is and you're happy with that weight, feel great?

Yeah, I should recomp, I need to lose a bit of weight. I actually did a dexa at fountain life in Dallas a few months ago, and it came back at 19.5%. I was like, if I'm 19.5%, I'm the leanest looking. I don't know where this weight's gone. It's like all in my foot or something. And then when I do an electrolysis, I'm much closer to kind of 13.5. So I don't know whether the dexa was having an off day. Yeah, clearly, clearly having an off day. That's interesting. And then it'll be interesting to see as you track your skeletal muscle. But again, we have to understand that that is, do we know your optimal skeletal muscle? I would say we don't.

So yeah, 180. So I think I tried to hit 180. I tried to go for one gram per pound. Right. But it's hard. It's hard. Why is it so hard for me to hit high volume protein? You're not hungry. The body, you're not hungry. So dietary protein number one, I want to mention something that I think often gets overlooked as we talk about, quote, macronutrients, is that protein need is really the only macronutrient, the changes as you age. The intake or need of carbohydrates and fats, like who cares, doesn't actually change. But the biological and physiological processes of the body require more protein as you age,

more protein as you go through if you have a catabolic crisis or if you're going through cancer or if you get burned. No other macronutrient changes in that way. So we have to get the story of dietary protein right. We just, we have to because it is the most effective macronutrient when it comes to body recomposition, when it comes to body recomposition, when it comes to body recomposition, when it comes to understanding that each of these amino acids

have diverse biological roles. Again, we are talking about dietary protein, but if we look at these other amino acids like Threanine, Threanine is essential for musin production in the gut. Triptophan is important and essential for serotonin production. Fennelalanine is critical for dopamine production. Lucine is critical for m-tore signaling, which is important for muscle protein synthesis.

So we talk about protein, but what we really are talking about are these individual nutrient needs, which, by the way, I think that that is the next iteration of the protein conversation is really looking at these limiting amino acids. But I'm digressing, so I'm going to go circle back to the .7 to 1 gram per pound ideal body weight. Everybody who does that, in my opinion, is going to do better. When it comes to people who say, Dr. Lyon, that sounds great, but I get to 90 grams of protein a day and I'm just sick. What do you advise to your clients? What are your best hacks for increasing that protein intake?

Are there any recipes, any food types, any, what is it that you give to people? Well, the question is, why are they really struggling to get that? It is very satiating. It does influence GLP and PYY, gut hormones. The question is, why are they so full? Is it because potentially they're metabolism, they've had some kind of adaptive thermogenesis, or is it that they just don't have a protein appetite? So the first thing that we do is we get a sense of what their total calories are.

That's the first thing you need to do. You have to know what you are ingesting, again, like you said, what you measure changes, tracks, blah, blah, blah. Understanding that hitting that first meal of the day and hitting it early on, again, a lot of people talk about fasting and pushing that fasting window later, I think that there is something to be said for eating after you are coming out of an overnight fast.

Your muscle is primed to be stimulated, whether it's an hour to two hours after you wake up and then stopping eating later on. So you begin to retrain your body through feeding patterns. The fastest way to increase dietary protein would be a protein shake, whether it's a way protein shake, that's my favorite, or even a way concentrate. So it doesn't have to be an isolate, a concentrate, concentrate has immunoglobulins, lactoferin, alfylactylbumen, other. Again,

thinking about food more than just the macronutrients. I think the old school way, and you know, we could tease Stan about this, who's kind of evolved more into the more nutrient-dense foods, but the old school way is just thinking about the macronutrients. The new school way is thinking about the other low molecular weight molecules and things like amphesinins and other compounds that have metabolomic properties, other intermediate properties. One of the things that I used to was, I got into fasting when David Sinclair first came

on the scene probably five years ago, ish. I went to go out to see him in Boston and he tells me all of this amazing stuff and I still think there's a lot of there there with it, but I noticed that my composition suffered. I didn't. I felt soft. I looked soft comparatively. And one of the other things, I've been through every pro science diet. I did carb-backloading, then I went into carb-night, then I did skip loading. Did you ever do skip loading? No, this is impressive. I've never even heard of that one.

Right, so skip loading was go carb free throughout the week and then on a Sunday, eat as many carbs as possible. It was advised to try and have a full box of cereal just for breakfast. And it was like, if you can get yourself to like a kilo of carbs by the end of the day, that was considered a win. And just every single different one, what I realized was I'd kind of inculcated this sacrifice reward dynamic. I often cheat. If I am going to cheat on my diet, I'll do it in an evening time very rarely in the morning. I think this is quite common.

How many people are picking up a Mars bar first thing in the morning, but they may be doing it on an evening, the world powers depleted, they're in the house, whatever, whatever. But my sleep is really, really negatively impacted when I eat, even within like two and a half hours of going to bed, which is awful because out here in Austin, everyone wants to go for dinner at eight o'clock at night. I'm like, right, okay, dude, but by the time I finished eating, that's nine, which means that I can maybe get some good sleep by midnight, and it's a Tuesday, right?

So yeah, I'm coming round to the idea that still, you know, have the window if you want to do like a 16-8 if that's what you like the sound of or like, you know, even in 18-6, but I think that pivoting that window a little bit earlier and then trying to maybe cut off calories at 6 p.m. at night, something like that. Sounds like a pretty good way to start it. I think it's a great way to start. And then understanding the next macronutrient that I think about is, well, before I say that, I, number one, the data supports that the 24-hour dietary protein intake is most important, meaning how much protein you have during the day, right, within a 24-hour

period. I would say that protein distribution matters and there is kind of two schools of thought. One is that just make sure that you're getting it all in. It doesn't matter how you do it. I would say if you believe that, then you wouldn't believe any meal distribution study or any study that indicates muscle protein synthesis happens because it happens at that first meal. For all the majority of the literature that I've ever seen, it's always about this first meal, which in my mind means that a meal distribution matters. It's not just about this 24-hour period where you're just having one meal in the day.

So for the listener who's thinking, gosh, you know, they're thinking two things right now. They're thinking, does Chris really have 19% body fat? And then the second thing that they're thinking is, well, how am I actually going to move the needle if I want to lose weight? And I would say, obviously, you figure out your caloric intake. I talk about that in the book. There's, it's just super easy. It's a calculator. And then you begin to segment out how you were going to ingest dietary protein. I wouldn't go above 50 grams per meal. You know, for someone like you, I'd probably hit 40 to 50 at that first meal, for sure. It's not very much data for

that middle meal. And then potentially that last meal, probably closer again, 40 to 50. 40 to 50 grams of protein in a food is a massive amount. Like it's a very, very large amount of meat. That's, it's like two scoops of way protein. Oh, that's true. If you were looking to do it through supplements, but if you're looking to do it, let's say that we're having it through salmon or we're having it through eggs.

I mean, how many eggs, what's an egg? Eight. That would be six. Yeah, six eggs would be about 30 grams. When you're gonna... Six eggs is no joke. Okay, hang on, hang on, you brush past this forcing 50 grams of protein.

Six eggs, so it's five grams per egg-ish. Yeah. Right, okay. So you're talking about 10 eggs. 10 eggs is a lot of eggs. We better get started. I, it's so it seems, but this is my point, right? You look at this plate and I think,

even for me now I see it now in myself. I'm like, oh God, every single, I think you did an Instagram, you did an Instagram post about this, right? You hit your protein. Oh, I'm a marathon. You hit your protein goals for the day and then you realize, God,

I've got to do it all over again tomorrow. Oh, a marathon. I have an amazing team that makes me, they tell me I'm more relatable if I look like an ass. Uh-huh, yeah. How's that going? No, it's so terrible. But yes, you are not alone in that.

Now, I'm going to challenge you. Austin, so we live in Houston. I have been down to Austin and they have a lot of restaurants. I can't even believe, I mean, they have a lot of restaurants. You go and you order and one of those restaurants, a like, filet. And this, my friend, is your eight ounce filet. That true or not true. Well, time seven, I mean, you're getting almost 60 grams of protein and a tiny little filet

that you spent $75 on. So it can be done. almost 60 grams of protein and a tiny little filet that you spent $75. So can we done? Fair enough. I should go for filet more on the first thing in the morning. Okay, so we are making sure that we measure because that's the only way that we can manage this stuff. We are prioritizing protein within a 24 hour window. We're aiming for 0.7 grams per pound of body weight or ideal body weight. We're also then considering that there is a little bit of protein timing going on here in that much more than about 40 to 50 grams of protein in any one meal is probably going

to be a little bit wasted, presumably from an efficiency perspective. But just I'm pretty sure Stan taught me under 20 grams under 20 to 15 grams. It can actually be metabolized in a different way. So it's like the sweet spot appears to be more than 20 less than 50 something like that. Yep. I would say that that is right. When you're getting below 20 again, you're not hitting that loosey and threshold and loosey is one of the essential amino acids. It's that branch chain amino acid. And my mentor of 20 years was the guy who put the science behind a lot of the literature that we stand on today. This idea of protein dosing, this idea of a meal threshold,

this was some of his work that he put out into the world, which is incredible to see this innovation before they knew that Lusine somehow stimulated muscle, but he really connected the dots and then translated it over to humans. And this idea that something below a Lusine threshold, so the average Lusine threshold for an adult is two and a half grams. By the way, the RDA for Lusine, and we'll talk about this in another podcast, is between two and a half grams. By the way, the RDA for losing, and we'll talk about this in another podcast,

is between two and three for the whole day. But the actual, the actual influence and more optimal amount is two to three grams of losing per meal. Yes, there's an imbalance here between what is being recommended and what is optimal. I mean, the aging population is the fastest growing population. I was just looking at data earlier.

But so the idea of the 20 grams or less is it will get counted towards calories, but it's not going to do anything for muscle in that way. Okay. So just to round out the timing thing, which I think some people will be considering, because everyone likes to obsess over stuff that doesn't really matter, is the big hammer mover of this, not less than 20, not more than 50, spread it out over, you know, no one's eating less than like a hundred grams, no matter how slight you are. Therefore you need at least three meals a day. Are you bothered at all about a post-exercise window? No. No. No. I think that is it beneficial? I would say that the literature would say,

no, it's as long as you're eating that protein, does it have to be right after you train? It doesn't. I will say could there possibly be some benefit eating after you, if you are untrained and you train and then you are older and you are prioritizing protein, would your body be primed for a bit more efficiency? Quite possibly. Could I get a lot of pushback on the scientists, from the scientists? In that, yes, it's something that I was

having a conversation about this morning. And from the literature, they would say, there's really not great data that the post exercise window is helpful. My argument would be, well, there's probably a place for it. It just seems like there's bigger, there's bigger fish to fry here. Totally, totally. Yes, you have to protect body composition at all costs. We have to stop focusing on what we have to lose and we really have to hone in on what we have to gain. What are, we mentioned earlier on that your body

is the average of the five most common meals that you cook. What? I guess I've never heard that. Well, I've just made it up. That's why. Why, what are your most eaten meal preps? Like what has most of your body been built on over the last few decades, do you think?

Eggs, frittata, turkey, beef, dairy. I'm actually a lower fat person. And then I try to- I don't agree with high fat, either. My body really doesn't like it. I don't do well on that. And then adding in a lot of anthocyanins, some macchiaberry, which is that really rich purple color, and I just try to add in, whether it's blue algae, I mean, I try to add in

really colorful things. Why? Because I think that there are biochemical properties in them, that again, we just, there's so many, we just haven't gotten to it. Cool, okay. What about superfoods? If you were to rank order, you want to get the best protein profile,

you want to get the best nutritional profile while getting protein and what's your top five? Well, before I answer this, do I have to actually eat it? No, but if it tastes disgusting, then it doesn't count. So, yeah, maybe. But not for you, for personal taste. Liver is disgusting, but it is so high in nutrition.

Women that are anemic, individuals that need vitamin A, that's how you're able to vitamin liver is amazing. Amazing iron source. Add some. One ounce is a day. I mean, I, whatever you can stomach without throwing up, holding your nose, eating it, however you have to do it, I think it's valuable.

I would say one more. Getting tactical. I've got it. I've got it. I've got it. I've got to hack for it. Salt the living shit out of it when it's frozen, throw it in an air fryer for two minutes either side

and it doesn't really taste like liver anymore. It probably doesn't, it probably tastes like cardboard. Two minutes. Either side? You crazy? You crazy? You're crazy. You're crazy, lady. Okay, okay, so liver's first, but you've got an issue with that. You're bigger to, bigger to it against liver. Okay, so what's second? A lean beef. A lean beef is amazing. Again, why? Because it has creatine, anceurine, touring, iron, zinc, selenium. These are all bioavailable vitamins and minerals. Really important. So that would be my next one. What cuts would you be looking at? I don't actually care. So I get really lean cuts. I get it from Buff Cow. Have you ever seen a peed Monties cow? Yeah, I'm with I'm sponsored by peed Monties. Yeah, they're great. They don't sponsor me. Come on guys. I'll intro you to the

guys. I've got an entire freezer filled with peed Monties in there. I literally had some filet before I came in. But only, but how many ounces? Two, eight. Fair, fair. So, lean beef is amazing. The next thing that I would say with the next superfood from a bio-available source of protein could be eggs. Eggs is great and way protein, also great, but again, a way concentrate. Again, chicken, I don't eat a bunch of chicken. Salmon is good for omega-3 fatty acids, but it is a little on the fattier side. And over time, you do have to worry about mercury. We test that on my clinic. You do have to worry about some heavy metals and

two-none of those kinds of things. One of the things that always feels like a rate-limiting step on salmon for me is I really struggle to make good salmon at home. Like it's kind of, it's just not, you know, throw a steak in the air fryer, it comes out, you get it wrong by five minutes, either side, it's still edible. You throw salmon in a frying pan and care for it like a small baby chick and it just ends up atomizing itself all over the kitchen. It's very easy to get wrong. And that just limits how much I can eat salmon at home. I like it when I go out for food, but I think it's like rough to try and make good at home.

I would agree, I would totally agree. So basically we've covered liver, Holdrenosanita, lean beef, piedmontis, choose a buff cow, eggs, whey, and salmon. So I hit my five. Mm-hmm, mm-hmm. That's good, that's good eggs, weigh, and salmon. So I hit my five. That's good, that's good, Mike. Okay, fair enough. Talk to me about the relationship of sleep

and muscle building of what we're going on here. Yeah, there's, I actually just interviewed Dr. Emily Lance on my podcast and she is out of the Galveston group. She's a scientist out of the Galveston group. And one of the studies that she worked on was that I was looking at sleep and muscle protein synthesis. Sleep one night of sleep deprivation can suppress muscle protein synthesis by 18%. Can you imagine cumulative over time? That's not good. That's my life. That's me. That's being a club promoter for a decade and a half. Yeah. Yes. And I will say one of the other things that we see. So muscle protein synthesis

on one hand is suppressed. But there is some data coming out that if you are sleep deprived, then kicking up training. So like the military personnel, they go through four days or five days of hell week. I should know this because I've never heard the end of winter hell week. It's just, you know, right exactly like that's hard. But there is some evidence to support that training during that time, during a time of sleep deprivation can help support the tissue, which makes perfect sense. It can mitigate some of the effects from lack of sleep. So we hear about downstream some of the concerns that people have around. You are more likely to like salty foods, more likely to reach for highly processed foods, more irritable or willpower, all the rest of that stuff,

but what you're talking about here is a much more direct mechanism from even if you go full bedrass cullion and wrangle your willpower and you don't eat the cookie and you do the thing, you are still creating a glass ceiling on your ability to build muscle just based on how much time you had to sleep. And no amount of breath work or meditation or like ratchet hip hop is going to be able to get you past that.

So yeah, I think I mean, it's just, it's just another, another reminder that everybody is probably forgetting. And again, we're getting tactical on this one. I quite like the fact that we're doing this. You need to try a sleep tracker, whether it's an eight sleep mattress, whether it's a whoop, whether it's an aura ring, obviously, if you use whoop, that would be great because I think that they're an awesome partner. But the main thing that you learn when you use a sleep tracker is you are not sleeping anywhere near as much as you think you are. Like that's, I can save you from having to buy one,

right? It's great if you do it and it's important to learn this lesson first hand, but the lesson that you learn as soon as you start using a fitness tracker is, oh, I thought I was getting eight hours of sleep, but it turns out I was actually in bed for seven hours 45 and my active sleep was six hours 20. Oh, fuck, like that's the realization. That's what you spend most of your time.

And now for me, even if I don't have this on, I know I'm like, look, if I need eight hours sleep, I gotta be in bed for nine hours. Like I have to, even if I try and crank my sleep efficiency as best as possible, bit of latency, bit of lost sleep efficiency, some micro-awakening start the night. It's like, guess what, it's hard to hit.

And by the way, in no offense to the sleep ninjas out there, sleep is annoying. There's a lot of other things that I would rather be doing than sleeping. Sleeping? Yeah, it is, right? But I will tell you that in when I was a fellow and we were in the memory and aging clinic, one of the risk factors for Alzheimer's was we always asked about sleep deprivation over time because when you sleep, this is when the brain cleans itself these glial cells.

That and actually sleeping with a phone by your head. Yeah, I mean, anyone, no one in my audience still has their phone in the bedroom. Can we have no one for the whole time? Not one for the eye, no. No one at all, or else they are no longer allowed to listen. Okay, so when we're looking at this sort of relationship sleep to a muscle building,

is there anything else I wanna get onto training? But before we get into that, we've talked about diet, we've talked about recovery. Is there anything else we're missing in kind of the middle you that is life beyond now training stimulus? I think the big picture is eating whole foods. It doesn't have to be complicated.

It should be high protein from my perspective. There's no reason that when you have the luxury to eat that way, you don't. It is a luxury and a privilege to be able to prioritize dietary protein. Other countries don't get that. And it is a highly nutrient dense source of calories and a non-negotiable, especially as individuals age. You know, when you had mentioned

that when you were really into fasting and and you were reducing food intake, that that it just it may not be an ideal mechanism. Right. Just like fluffy. I was fluffy. We don't want you fluffy., we just ruin your image. So I'm not supposed to be fluffy. I'm fucking 19.5% body fat compared to according to that Dexascan in Dallas. That should ruin your day for at least a week. I think I need to go on a slight cut. Here's a point, here's a question I've had in my head actually. There is somebody that's listening who is both over fat and undermuscled, right? There is someone who just doesn't have the body composition that they want and they know that they

are off on both ends of the scale. If it was me, not knowing your world, what I would do for me is I would probably die diet myself down because I'm going to get the aesthetics way quicker by becoming Lena first, which I can crack out in the space of six months and then building my muscle up from there. But what would you do? What would your advice be? Would you just try and recomp through everything? How do you go about this?

Because motivation is going to be gauged as much by the mirror as it is probably by anything else. So we need to satiate that in people. Yeah, if it were me, I would focus on what I have to gain versus what I have to lose. If I had very little muscle and a lot of body fat, then from my perspective, I would not actually be focused on anything aesthetic. I would assume that I was not as strong as I should be and not as physically capable as I needed to be. I would focus primarily on being a human that was physically strong. And I'm not saying necessarily training for strength, but maybe you would train for some strength and some hypertrophy, but I would just start putting

in the reps. I would start putting in the reps. I would obviously see what my baseline diet is. Prioritized dietary protein is very difficult to store protein as fat. It's very difficult. Like you said, you're like, ah, it's 90 grams. If I have one more buffed cow,

I'm going to shoot myself. It becomes very difficult to overeat dietary protein. And there may be some impact on this adaptive thermogenesis. The body is very smart. So if you start reducing calories to rapidly, the body will adjust. But dietary protein, and from my perspective, one of the reasons why it has this more

thermic-effective food, thermic-effective feeding is that it's so valuable. And it does stimulate muscle protein synthesis that the machinery of that may take more energy than the energy required to utilize carbohydrates, could be 10%, fats could be 5%, and protein could be anywhere between 15 and 20%. Again, depending on the study that you look at, and foods are not just primarily one thing. If you are an individual who needs to lose weight and build muscle, could you do both at the same time you could?

Would it be as effective? No. I would say you start with what you have to lose because that individual, what you have to gain, because that individual didn't get there by focusing on what they had to gain. I guarantee you they have spent a lifetime yo-yo dieting or having some feeling of just, you know, it doesn't feel good in your body if you're not feeling well, right? I think that we can all agree on that potentially again.

I don't know. This is what I would do. I think that I like your framing around people are told that there is something that they have to lose. It's all about getting red, getting red, getting out of this body. It's like an anti-building mentality within your physiology. I don't think that that is particularly constructive. We've danced around it. We've got all of the things in place, but we actually need to go out there and build some muscle now. We need some training stimulus.

If you only had 10 exercises for the rest of time to build and maintain as much muscle as you could, what would they be in Y? 10? 10, that's it. That's it. It seems like a lot. I would definitely do a squat, right?

I would do a wide squat. I would lower a lower on my back, a wider stance just because, yes, so I would definitely do a squat. Why? Why low bar? Why wide squat? Just my physiology is the way I'm built. Okay. Why low bar, why why does squad? Just my physiology is the way I'm built. Okay, okay.

Yeah, I'm built. So I actually decided side note that it was a great idea to do a 50 hour event that was non-stop. And so as I was training for that, I tore my hamstring off the, I evolved it around 80 some percent off the bone. It just really, it wasn't my smartest decision. Yeah, so it's been this process of repair. Let's just say that.

So I've had to modify some of my training. So a squad, a wider sand squad, some kind of deadlift, whether it's a sumo deadlift or some kind of deadlift because just the mechanics and also the full body movement of a squad, I would also say a farmer carry. We have to also begin to choose and this is what I think about this is I think about all the older patients that I've seen, being able to carry groceries, being able to carry a toddler, being able to, you know, it's amazing. When we think about traveling, you know, I travel a lot. I also have two very little kids. I have a two-year-old

and a four-year-old. If you want some birth control, I will send them right over to you. Right over to you, man. Right over to you, man. And you'll see, be careful. You'll hear people say, oh, be careful about putting this overhead. You know, the weight limit shouldn't exceed this.

And it's just a whole backwards way of thinking about it. No, no, no, no. You are afraid to then go into the gym and lift a 50 pound weight, but you will have no trouble lifting your or struggling to lift your 50 pound toddler to put them x-y wherever you're putting them. Why, given the fact that you've already got a good bit of midline activation with your squat and especially with your deadlift plus you've got grip work with your deadlift, what are you getting out of the farmer's carry that you haven't activated already?

Well, you're getting motion and you're getting something that translates to real life. It's, you know, when we are, if we're really talking about health span, we have to talk about the things that will destroy health span and the reasons why we require help. Why do we go into nursing home? What are the things that really affect quality of life? The number one thing that affects quality of life is physical mobility in my opinion. And I've seen this. So not being able to, can you imagine, not being able to climb upstairs, not being able to carry your

groceries, not being able to put them up? I mean, I was just traveling here to Las Vegas and there was a couple in front of me that couldn't put their luggage on their carry-ons on the conveyor belt. No, I'm the conveyor belt. I was like, do I help them? Do I help them? But if I help them, they're never going to get exercised. So I was like, you watched this person struggle with a one-rept max and luggage carry. But I know it was terrible. I really struggled., no, because if that is the one moment, they're going to be able to pick something up and move in a rotational way to put it there, which is how we move. Homeboy's grandad's got doms for the next two weeks because you didn't help him move

his 15 pounds suitcase. Okay, three. We've got a squad, bubble back squat, low moment arm, wide stands, a deadlift, and a farmer's carry. What's next? So the exercise, I think that this is not necessarily a weight lifting exercise, so we didn't specify, but doing some kind of an interval on an assault bike or an airdine, being able to push out above a 90% VO2 max, just really hitting it. You proved yourself you can do it. It feels awful, but it is a way to improve insulin sensitivity.

It's extremely effective. And I really do think that as we are training in the gym, it's not just about the machines, it's not just about the bands, but it's about being fit and capable for real life. It's true. God forbid there is an emergency. You better be able to show up and be a capable human.

This is, you know, I think Peter Atia's biggest flex from a training perspective at the moment, or his kind of biggest obsession, when I spoke to Milly this year, and he's saying, you know, Vio2Max is one of the best predictors that we have of someone's longevity. And I was like, what? I thought it was all zone two. I thought it was all to do with resting heart rate and variability and blood oxygenation and galvanic skin response. He's like, just straight up, V.O.2 Max, what do you V.O.2 Max?

So that was surprising to me to hear that. And I do think that we are, I think that there is someone of a discrepancy in the literature when it comes to muscle mass and strength. Right now people will say strength matters and muscle mass. It's not about the actual mass, it's really about the strength. I think that we are at the precipice of literature changing as we begin to directly measure skeletal muscle mass through some of these, you know, more advanced ways like this D3 creatine. And I think that that may challenge.

Right now, if VO2 max is the greatest predictor, I think we're also going to see a change in the literature when it comes to muscle size and strength. I mean, that is going to be next. And I, yeah, so I'll say that. No, just that it's interesting how there are theories about the way the way that the human body works, but we don't have the measuring tools to be able to make it happen yet.

So what we do is we find proxies for that strength. There's a pretty good proxy for muscle mass. There's very few people that are very strong without being at least a little bit muscled, but what's the genuine mechanism that's going on here? Is it the only thing that we can measure accurately is hand grip or bench press or 30-cal jump or whatever? I actually just had a conversation with,

I work with a PhD, her name is Alexis Cowan, she did her PhD at Princeton, she's now at Penn, she's really helped with the Institute of Muscle-centric Medicine. And we were going back and forth about grip strength. I think that, again, this is another, you know, Chris, my perspective is just because something is spoken about over and over and over again,

doesn't make it true. It doesn't mean that we're looking at it from the right perspective. And yes, we could say grip strength is a biomarker, but if we take a step back, we have to ask ourselves, are we potentially born with a certain threshold for grip strength? Is it really the end-all-be-all? Are we sure that that's true? And the next layer to that just goes in line with when we're talking about skeletal muscles. So right now we're talking about VO2-max, but again,

that's because perhaps we've had the tools to measure it. And then bringing to the conversation, which is often missed, is that we don't highlight the things that we're doing well. I'm sorry, we highlight the things that we are potentially doing well without the insight of potentially the things that we're not. And the oversights in just measuring indices. What is your favorite evidence-based protocol on an ad-ign or an assault bike for improving VO2 max?

Great question. I actually work with a trainer. I don't do any of the protocols myself. What does he make you do? Carlos, Carlos is a major asshole Oh, I'm in the worst. I mean so Friday right before I left we just did Max effort it was it was 20 seconds all-out effort trying to push me above or 290 90% and then he would give me 10 second rest

So I don't know if that's I felt like like I could to bat a style thing, but holding it for, like doing it in 30 second intervals, how many rounds do you do? He only have me do three minutes. Thank God. Yeah, that's still, that's six rounds, right? That's all, that's enough to kill you. Okay, cool.

So you've got only four things. What, anything else? Are you bothered? No, no, no, let's keep going. So, we said a squat, we said a deadlift, sumo de la for me, we said a carry. I definitely think that you should be able to do an overhead carry.

I think that you should be strong in an overhead position, even though obviously, it's probably not totally stable. For the reason that I just like, I'd like to see you be able to do that over time. I also think being able to do things like push-ups, getting off the floor, you have to be able to do push-ups, you have to be able to develop that upper body strength. Also, let's see what else? What else do I think is a non-negotiable? I mean, I think a Turkish get-up is great.

do I think is a non-negotiable? I mean, I think a Turkish get up is great. It takes coordination, it takes capacity, you have to get balance, and then Gunnar Peterson would say, Gabrielle, you have to add in something rotational. So any rotational whether it's a swing or a something rotational, he said, because you know... Being able to throw punches at a bag, something like that. Yeah, I mean, the force of his interest in you've brought up two things that get you down to the ground with the push up and then specifically Turkish ghetto, which I was thinking about earlier on. Aran Alexander from the Align podcast has, he is one of these huge proponents of sitting desks, right? So a floor desk. And I have, in the other house through there, I have this tiny little

what look, I think it's meant for Japanese calligraphy. So I think it's meant for when you're sat doing your fancy Japanese like penmanship or something. And I've got varying heights of meditation cushion behind it. And his whole thing is get yourself down on the ground, spend half an hour to an hour a day with your hips below your knees if you can. And I have to say sitting down there feels so nice, like glute mead, opens all of that out when I get into that kind of cross-legged position, and you can lift your hips up and actually lean forward, which feels really lovely on your lower back. That feels like it kinda decompresses a little bit.

Like it's so nice, like all of that's really, really good. So I am in, I'm down for ground stuff. Yeah. That sounds very interesting. I cannot wait to see that and. It's never going to be made public. I mean, it's remaining private. That's, if I went full Austin psychedelic bro mode,

I wouldn't be at a standing desk. I would be on the floor, and I would be like twirling a, what is it, like a fucking ayahuasca stick between my fingers while I'm doing it. Okay, so that's so that you've got three more, three more things that you can introduce. I do think again, so we talked about how we would use grip strength, so you're developing grip strength,

you're developing, you're being able to carry. I don't know if we talked about a swing, but I do think that you should be able to swing. You should be able to do some kind of dynamic movements. I think that that is important. And again, how do you translate these things to real life? Turkish get up, so we have squat, sumo deadlift, we have a throw up on the devil's tricycle. We have some kind of push up, right, pushing up after off the ground. We have

kettlebell swing, farmer carryama, Carrie. What else? I know, so you gave me 10. 10, yeah. And then, you know, you might say. Phil Heath wanted, Phil Heath wanted 11. And Bumstead also like rolled his eyes at me only giving him 10. So you've got bags of spec capacity.

You and you need to date. Woof. I mean, I think also you should be able to. Wait, wait, wait, where are we gonna get Jack? Where are we gonna get Jack Dams from here? I was actually thinking that, but you said, but your question was that you could only do for a... For the rest of time, to build and maintain

as much muscle as you could, what would they be? Maybe I would be tempted to maybe throw in some sort of pull-up, like you haven't got much of that scapular retraction, so I guess in the deadly, that's a lie, in the deadly, if we have. Okay. There, there.

Carth raises. If Alex Hormosi was here, he would say Carth raises because he calls, he keeps on texting me and telling me that Carth's at the front garden of the body, and I'm like, at best, they're the backyard, right? At best they're the backyard. They're not even on the front of your body. And I'm like, at best, they're the backyard, right? At best they're the backyard. They're not even on the front of your body. You can't make this. Wait, by the way, women don't care about calves.

He would say, that's because you haven't seen my calves. That's what he would say. I know that he would. He would say, what about these calves? And I would say that's your backyard. But okay, yeah, cool. I think what's really interesting, and I'm loving asking this question to pretty much all of the health and fitness people that I speak to, it's really indicative of where they're coming from from a health and fitness perspective. It's obviously you've got that, like, sort of geriatric care background because you're thinking, training for life, right? Like no one else has said, oh yeah, I'd love to put a farmer's carry in because, like, so what?

Like I just presumed that my deadlift or like my row or something is gonna be able to get me through the carrying side, but the, you know, that control-actual moving thing, that being able to stabilize the trunk while the hips move underneath you, I think that's really important. So while the hips move underneath you, I think that's really important.

So yeah, we've ended up, I think we've got like maybe a library of 80 exercises. Now you're the first person in all of them that hasn't said dumbbell side lateral raises. But that's hilarious. That's okay. But I will say my perspective comes from, you know, I talk about, I did my training as a geriatrician, but my patient population, we take care of elite warfighters. My patient population is we service elite warfighters and like CEO, Maverick guys that are just super physically fit. And they, I would say, I mean, I don't know

what all of them are doing, but I would say the majority of them have a lot of well-rounded training programs. Right? And my perspective is as a mom. I have two little children. Can you imagine if I went down to pick one up and one's pissing on the wall and the other one's doing something else? I have to grab the other one. I have to be able to move fast enough so my new drapes don't get ruined. That's obviously the priority. When it comes to tempo, rep ranges, set ranges, what are people getting wrong in your opinion? I think there, now first of all, there is a phenomenal paper and that I think that anyone

who is really interested in these repetition continuum, the paper is called Loading Recommendations for Muscle Strength Hypertracy. Hopefully, I'll get it right. Local endurance, a re-examination of the continuum repetition. Or the repetition continuum. Very, very sexy title for a paper. Please translate. Amazing. And really, basically, it highlights

that we've got this strength hypertrophy endurance. So we've really put things into buckets and that maybe the evidence doesn't support that, that there's multiple ways to get stimulus. So what do I think that people are getting wrong? Potentially that, you know, if you're just going eight to 12 reps, maybe that's just hypertrophy. But for older individuals, they potentially could do lighter weights and go for longer and still get hypertrophy of influence. So I think that this rep range continuum could be re-examined.

Okay, what's your thoughts on time and attention? All valuable. Tempo stuff. All valuable and always to change up your training program. Because what you're looking for is really a physiological adaptation, right? And there's multiple ways to get that. Multiple ways to improve muscle hypertrophy and strength and endurance. So what you're looking for is where your stimulus is and where you need to potentially push on the lever to improve. In my mind, again, as a physician, do have to track improvements.

It's not just that you're tracking your, whatever you're eating, your beef or twinkies or et cetera. You also do have to track weights the same way. Now I think a baseline recommendation, you know, in my book, I want people to know how many pushups they can do. This morning, I did 600 pushups here in Vegas working out with Ben Newman. It's a terrible idea. Why? 600? Why? Stupid number. I said this and obviously it wasn't all at once, but I was just seeing myself. What an idiot idea that is. You should have done less. You should have said, have you thought about doing fewer? Yeah, exactly. And by the way, they all did probably more than I did.

But again, so that's the number one thing. I think people are getting wrong is that it's either... And I used to say, you know, my own personal belief is that you have to work really hard. And that's just a belief that's not necessarily in the evidence. I think that there's something to be said, there is evidence to support this idea that the influence of what you are doing, whether you're lifting light, whether you're lifting heavy, that the molecular influence is somewhat different, right? And that makes sense. But my belief had always been that you should train harder, and that was the only way to do

it. And that is not necessarily what the evidence supports, which is disappointing. But for the people that want to punish themselves with 600 press ups on a morning in Vegas. No, I can see why that would be a personal insult. When it comes to people tracking their sets and tracking the workouts, there is an app called Heavy Set, which is by far the most seamless and least intrusive of the workout tracking things that I've ever found. It's phenomenal. It links up, I don't have one, but it links up with your Apple Watch.

It can track tonnage, it can track progression, it can, you can work in supersets and drop sets and rest pause and myoreps and all sorts of other craziness and it'll tell you what your proposed one rep max is based on all of the calculations. It's really good and I think it might be even be free if you don't need to use anything fancy. That's heavy set. It's definitely available for iOS. It might be available for Android as well. What else? What given this global perspective of stop focusing on fat, stop focusing on muscle, these are the principles from a dietary perspective. These are the principles for a training stimulus perspective. Sleep is important. Is there anything else that we're missing from this card?

Yeah. I want to point something out because it's important for the conversation. We've talked about skeletal muscle. We've talked about nutrition, influence, and skeletal muscle. We've talked about the history, we've talked about exercise. I would say that a lot of people will recognize these things as important. Contracting skeletal muscle releases myocines. Myocines are hormones, they are molecules that are released from contracting skeletal muscle. There's 600 or more. The first myocin I think was discovered in 2000 by Patterson in Copenhagen.

So this is not that old. And I just want to reframe the conversation into what does it mean from a muscle-centric medicine perspective, a medicine perspective. Contracting skeletal muscle, we've all heard about these cytokines, cytokines like interleukin six, interleukin 15, and the cytokine storm, and it had its moment.

Exercising skeletal muscle, the degree at which you are exercising will influence the amount of interleukin six, and interleukin 15, that when released from skeletal muscle, interfaces with the body differently than those interleukins that are released from macrophages. So there is a blunting effect from an inflammation standpoint, which I think is important to point out.

Also, why is that important? Because it's leveraging skeletal muscle tissue that you have conscious control over to augment your immune system and to augment your inflammatory response. So it's a something that you can do consciously that is going to tap into a system which is largely run on autopilot. Yes, yes. And contracting skeletal muscle releases glutamine.

glutamine is a semi-essential amino acid that, you know, the requirements depending on if you're under stress or highly catabalt state, etc. But contracting skeletal muscle when it releases glutamine, glutamine serves as a fuel source for lymphocytes, white blood cells. So doing an action consciously, I mean, you can't tell your heart, I don't know, you live in Austin, there might be people that could tell their heart to pump at a certain rate, but for the most part,

unless you're whimmed off, you're probably going to have a difficult time telling an organ system to do just the thing. It's the only thing that you have that kind of control over. So, this influence of contracting skeletal muscle, we talked about Alzheimer's, it releases BDNF and irresin and capsaicin B, which stimulate BDNF release in the brain, which help with neurogenesis, with brain function. This is critical in changing the conversation of muscle as it is thought of in this way of looking good naked and training all important and the only things that we have actionable control over. But also reframing the conversation from an immune perspective, from a perspective as an endocrine

organ, really, really critical. Very interesting. Yeah, I'm going to be watching carefully, I guess, over the next few years to see if the pivot does happen. It seems like diet culture, which is what it is currently, right? It's diet culture is very ingrained. It's the dominant ideology for improving fitness and improving health. I suppose if you were to take somebody that is however many hundred pounds and get them to lose 30% of their body mass, a lot of their outcomes are massively going to improve,

but I would guess that for a lot of the people that are listening to this podcast, they're actually thinking, okay, I understand that that's important and in a charitable aspect, I want to remind people, whole foods, and do all the rest of it. It's like, okay, what's the next step? What's getting yourself maybe from 50 to 70 or from 90 to 95? Yeah. Yeah, I wonder how much of this muscle-centred medicine is going to be something important. I mean, like I say, the benefits are massive because it's one of the few things that you can do that is hard, that is immediately gratifying, or in the short to medium term is gratifying,

and also has long-term health impacts. And you can't say that for many other training modalities. You know, you get really great at rowing. You don't look that different. You may feel great. And you know, the metrics on your whoop will say, oh, wow, my resting heart rates in the 40s. But really, you know, if you train, push-pull legs for six months,

and you eat 0.7 grams per pound of body weight in protein, you look worlds apart. If you're someone who's even like up to a probably pretty well done trainer, right? Like, if you've been training for even a while and you stick to that, you're going to look great. So yeah, you have the opportunity to kind of come for the gains and stay for the longevity. I think that's, I think that's a relatively easy sell. I think it's an easy sell and I'll tell you, one of the aspects of being a physician is, and I say this all the time, is that a good physician recognizes patterns of diseases, right?

A good physician, that is your job, that is your craft. You need to be able to recognize patterns of illness, an effective physician, an effective physician recognizes patterns of people. And that is how you move the needle. We can talk about all of this stuff, but the reality is there are certain archetypes of individuals. And one thing that I will tell you is that individuals must feel worthy of doing the thing that is going to move the needle. There is a self-worthiness threshold that people have. They will only ever be as fit and lose as much weight or gain as much muscle. If they start to feel too good or look too good, it's a whole litany of, do I deserve this? Do I feel worthy of this? Can I really have these

things? And I have been a practicing physician for a very long time. And then the second layer to that is understanding that you have to close the gap. You show me who you are today, and the habits you are doing today, I can tell you a handful of things. Number one, I can tell you how successful you are. There is a spectrum and an archetype of innovators and mavericks and CEO archetypes.

I can tell you, based on your habits, where you land on that spectrum. Number two, the actions that you take now in your health and wellness. Today, I can tell you what your life will look like in the future. Your present is your future, especially from a health perspective. An individual that moves the needle has to be aware of their weaknesses. We are in a culture where it's all about, what are your strengths and how are you doing and you're so amazing.

I don't care anything about that. I need to know where you fail, where you fall off, and you have to know that because it's predictable. Every single time, for example, every time, Chris, I bet you, if you did not mitigate when you did those live events, you probably, if you did not mitigate when you did those live events, you probably, if you were not aware that at the peak of that event, there was going to be a component of vulnerability.

Right after you would have fallen off your nutrition plan, you would have felt a little depressed and you would have stopped training. Did that happen or did you mitigate that? Yeah, we worked around it. You worked around it. You plan for it. You probably went in with a more neutral mindset, thinking, this might go well, this might not. This is my first thing. This is so cool. You neutralized it. It wasn't that big of a deal. And again, I'm putting words in your mouth. I don't know. You neutralized it. You must be able to close the gap between who you want to be, your future self, and

who your, the actual actions that you are taking. Because time is limited, and if you continue to do the same thing, then you have to fast forward, and the pain of failure over everything else is more effective in moving a patient to action. You said in a different interview, I heard you say, if you think you don't have time for fitness, how are you going to have time for sickness? And I think that's a good way to look at it. Everybody is busy. Everybody has lots of things to do.

Everyone has more emails to answer than time to complete the workout. But yeah, I feel it. Dr. Gabrielle Lyne, ladies and gentlemen, where should people go? They want to keep up to date with your work. They want to check out the new book. Where would you send them on the internet? Well, you can go to my website, drgabriellyne.com, and you can find all our offerings there.

I also have a podcast, the Dr. Gabrielle Lyne show, which I've been trying to get you on Chris for, I don't know, at least like six months, I'm going to convince you, I'll say, I'll bring you like some Frittata's, whatever. You can also get my book on Amazon. It's called Forever Strong, depending on when this comes out. And I have a great newsletter. I put it out, a ton of free content, YouTube, and I have a full practice. We have a team so people can check out my website. Hell yeah, Gabrielle, I appreciate you. Thank you.

Thank you. of death.