The Dr. Hyman Show - JJ Virgin: Does Protein Prevent or Cause Aging?
Episode Date: March 6, 2024View the Show Notes For This Episode Get Free Weekly Health Tips from Dr. Hyman Sign Up for Dr. Hyman’s Weekly Longevity Journal Get Ad-free Episodes & Dr. Hyman+ Audio Exclusives JJ Virgin is a tri...ple Board certified nutrition expert, Fitness Hall of Famer, and four-time New York Times bestselling author. With over three decades of experience in the field, she has become a trusted authority in nutrition, weight loss, and wellness. She is the author of four New York Times bestsellers: The Virgin Diet, The Virgin Diet Cookbook, JJ Virgin’s Sugar Impact Diet, and JJ Virgin’s Sugar Impact Diet Cookbook. This episode is brought to you by Rupa Health, BiOptimizers, Thrive Market, and Momentous. Streamline your lab orders with Rupa Health. Access more than 3,000 specialty lab tests and register for a FREE live demo at RupaHealth.com. Tackle an overlooked root cause of stress with Magnesium Breakthrough. Visit bioptimizers.com/hyman and use code HYMAN10 to save 10%. Head over to thrivemarket.com/Hyman today to receive 30% off your first order and a free gift up to $60. Head over to livemomentous.com/mark for 20% off creatine, collagen, and all of their best-in-class products. In this episode we discuss (audio version / Apple Subscriber version): The shocking percentage of muscle, strength, and power we lose every year (12:58 / 11:21) How the science and perspective of weight training have evolved (Spoiler: it’s not just for gym rats anymore) (15:55 / 14:36) What is the difference between strength, power, and hypertrophy? (18:00 / 16:22) My personal experience overcoming chronic pain through resistance training (19:35 / 17:58) The Protein Leverage Hypothesis (This is why you overeat food when you undereat protein!) (25:20 / 23:41) The most important way to start your day (36:26 / 32:28) JJ’s tips for creating “metabolic spanx” and taking advantage of this “sugar sponge” (43:10 / 39:12) Why we should stop using scales as our only parameter of body composition and what do do instead (56:11 / 52:13) How your nighttime routine impacts your body composition (1:09:13 / 1:05:15) Learn more at jjvirgin.com.
Transcript
Discussion (0)
Coming up on this episode of The Doctor's Pharmacy.
It's a choice to be excited about aging or to fear it.
So what if in your 40s and 50s you went,
okay, my choice is that I'm going to be able to play full out in my 80s and 90s.
And so I better train for it now.
Hey everyone, it's Dr. Mark.
We all know that as functional medicine practitioners, our time is precious.
So imagine having more time to focus on what truly matters,
helping your patients achieve optimal health. Aruupa Health is here to make that a reality.
With Rupa Health's user-friendly portal, you can order thousands of lab tests from over 35 leading
lab companies. And the best part, it's completely free. No more juggling multiple invoices or
dealing with administrative headaches. Rupa Health simplifies the lab ordering process so you
can get the data you need without the hassle. So sign up for free today and experience the power of streamlined lab ordering. I love it, and I know you will too.
You can find out more information by going to rupahealth.com. That's R-U-P-A health.com.
When I was just starting my medical journey as an ER doc and family doc, magnesium was a critical
element of our care. We use it to treat all kinds of things from arrhythmia to constipation to
preeclampsia,
which is high blood pressure and pregnancy. It turns out that magnesium is critically important
outside of the emergency room too. In fact, it's one of the most important minerals for all aspects
of our health. It participates in over 300 to 600 different biochemical reactions in your body,
and yet over 80% of the population doesn't get the amount of magnesium they need from their diet
alone. And that's why I'm such a big advocate of Bioptimizers. Their magnesium breakthrough supplement is the only
supplement on the market that offers the full spectrum of all seven types of magnesium,
specifically formulated to reach every tissue in your body to provide maximum health benefits.
Bioptimizers is offering my community 10% off. So just head over to magbreakthrough.com
forward slash Hyman with the code Hyman10. That's magbreakthrough.com or slash Hyman with the code Hyman10. That's
magbreakthrough.com or slash Hyman with the code Hyman10 at checkout. And now let's get back to
this week's episode of The Doctor's Pharmacy. Welcome to The Doctor's Pharmacy. I'm Dr. Mark
Hyman, and this is a place for conversations that matter. And if you're like me and you're
looking to live longer and stronger, you're going to love my conversation today with my longtime friend, JJ Virgin.
She's a triple board certified nutrition expert, fitness hall of famer, four-time New York Times
bestselling author. She's had over three decades of experience in this field and she's become a
trusted authority in nutrition, weight loss, and wellness. She's the author of four New York Times
bestsellers, The Virgin Diet, The Virgin Diet Cookbook, J.J. Virgin's Sugar Impact Diet, and J.J.
Virgin's Sugar Impact Diet Cookbook. Her practical and evidence-based approach to health has garnered
the recognition from major media outlets, making her a sought-after guest on shows like Dr. Oz,
May It Rest In Peace, Rachel Ray, The Doctors, and many others. She actively contributes to
health and wellness community through speaking and online programs and her podcast, Well Beyond 40. And
her expertise extends beyond nutrition and weight loss as she advocates for a holistic approach to
health that encompasses mindset, exercise, and emotional wellbeing. Now let's get into what we
talked about with JJ today. We had a great conversation. Fat and carbohydrates have been
in nutrition headlines for years. And what should you eat? Low fat, low carb, high fat, high carb.
And JJ and I dive deep into why protein is actually the macronutrient we need to focus on,
particularly when it comes to powerful aging, to body composition, weight loss, and overall health.
It's sort of that neglected nutrient.
We dive deep into the relationship between protein intake and muscle growth and maintenance,
as well as why muscle is essential to metabolic health, hormonal health, brain health, immune
health, and longevity.
She also explains, and I love this, she calls muscle our metabolic spanks. I love that. She shares her three keys
to aging powerfully, and we discuss the surprising reason why so many people experience resistance
to weight loss. Why can't you lose weight? We're going to talk about that. As we age
and our hormones change, it becomes harder, yet even more important to build and maintain muscle. JJ talks about how
to start or expand on an exercise routine at any age. And I did that. I didn't start till I was
59 doing strength training and it's changed my life. Now we explore also the vital role that
sleep plays in weight loss and also repair of muscles. It's not just about going in the gym
and pumping iron. It's also letting your body repair and heal. And JJ shares her non-negotiables
when it comes to supplementation, as well as her thoughts on living with purpose as you age
powerfully. Now, let's dive deep into my conversation with JJ Virgin. Welcome back on the podcast, JJ.
So great to have you. How are you doing? I am great. I've missed you. I miss you too.
Was COVID kind of prevented us from hanging out more, but I'm so glad we get to talk today.
And, you know, you and I were just chatting a little bit before the podcast about powerful
aging.
And, you know, I wrote a book called Young Forever.
You're coming out with a new one.
I don't know what the title is yet, but you really are an example of powerful aging.
I remember being in the gym with you like 10 years ago.
And I was like, I'm pretty fit.
I exercise a lot.
I was hurting.
I was hurting.
It took me like a week to recover from being in the gym with you for a half an hour.
I know.
And you never came back to the gym with me, Mark.
No, I was so sore.
I couldn't do it.
One and done.
So yeah, you said you started training when you were 16.
I didn't start till I was 60.
But the good news is you can still make a huge impact.
And I noticed my body changed dramatically
as I started to change my diet
and change my fitness routine
to incorporate strength and strength training.
And you really have been the leading kind of advocate
for this for a long time. And, you know, you really have been the leading kind of advocate for
this for a long time. And I, I think your work is so important and your understanding of human
physiology, biology, nutrition, how to apply it, how to uplevel your health, how to optimize
muscle mass, muscle function, and optimize your diet to enhance all that. You're like the master
of this. And I kind of really look, you're like the master of this.
And I kind of really look up to you, actually, in terms of this field,
because it's something that often gets neglected in medicine.
Who the heck talks about muscle? I never took a course on muscle other than anatomy,
and I never really learned what it does and how it's involved in everything that matters as we age,
from not only our mobility and functionality, prevention of frailty and falls and all the things we care about, but also our metabolic health, our hormonal health, our brain health, our immune health.
I mean, pretty much everything is connected to muscle.
So we're going to get deep into all things muscle and health and powerful aging today. And I think, you know, one of the things that
we really see is that, you know, particularly women starting in their 40s start to kind of
lose ground, right? We notice weight gain, especially around the belly, a little brain fog,
fatigue, mood fluctuations, and it's sort of the opposite of aging powerfully. So what's going on here? Can you unpack what's
happening and why this happens to people? And by the way, men get it too.
Men get it too, but they get a little later, let's be honest. And I'm just so excited that
muscle's finally getting its due. I will tell you, you know, back in my real work has always
been in exercise science. That's what I was doing my
grad and doctoral work on. But back then, Mark, everything was about cardio, right?
Yeah. And in fact, I was even taught in graduate school to not have someone lift weights until
they lost the weight, which couldn't be more wrong. Like that couldn't be more wrong. Now,
the good news for me in graduate
school, number one, I did all my research in graduate school on lifting and developing
strength. And I was like the rogue student because everything was being funded towards cardio.
So I was like, but I was actually paying my way through graduate and doctoral school.
And what I recognized very quickly was that I was not going to get paid as a personal trainer if I was making people worse,
especially in Los Angeles, where I was doing this and getting people ready for films and stuff.
I helped Brandon Routh with Superman Returns. You had to have the results.
Now, a lot of my clients were in their 40s and 50s.
And, you know, men and women, that's why I say I really see what happens in women in their 40s.
It happens, starting to happen younger now in men because of all of the xenoestrogens
and the stress.
But it really is something that hits men more in their 50s and early 60s.
But in their 40s, that's where women are starting to see estrogen really
fluctuate. And boy, you see extra estrogen starting to fluctuate and starting to decline.
And all of a sudden, you start to become insulin resistant, you start to become hungrier, you start
to gain fat, you start to get depressed, you know, all of those things start to happen. Now you look
at it and think, it's my metabolism. But I don't know if you saw that study that came out that showed that really metabolism doesn't shift much until about 63. And so it's not really metabolism. metabolism of course you've got basal metabolic rate age sex uh genetics i look at muscle mass
in there and thyroid and then you've got total energy expenditure which is that plus your activity
level throughout the day and thermic effect of food and when you balance that out it was really
about 63 where things started to shift i think all that, what's happening in your 40s and
50s is setting ground for that. And I don't think it has to happen. Like, look at you now,
I would argue that your metabolism is better now than it was in your 40s.
Yeah, for sure. Don't you think? For sure. I mean, I think we could go to the gym together now
and we'd be like, you'd be an equal, you know, partner in the gym. Yeah. I think I'm getting
there. I'm getting there. I still, I still, I still got a ways to go, but I, I, I do notice
that, that, uh, you know, when I, when I don't do this training, training, I notice things drop off
and when I'm consistent with it, it's just incredible what I see in my body, even at 64 years old. So I'm kind of amazed
at how the body can at any age actually repair. And this is critical. When I was at USC, I was
doing my doctoral work at USC in the ex-phys department, but was ex-phys and gerontology
and nutrition. And we had people coming in in their 70s, 80s, 90s.
And it was crazy to see what they were able to do. And it's important message for everybody
because there is still this thought of, oh my gosh, it's too late for me. Whereas the reality
is that if you were in your 60s or 70s, just starting lifting weights, you're going to see
way bigger changes in your body than I'm going to see,
right? Once you're getting fitter, it's difficult. Getting to that point, boy,
you start to see these big changes, which are so motivating. So you look at what's happening in your 40s and 50s, because it's really setting you up either way. And I heard that study from
you about how people who have a positive mindset about aging live seven and a half years longer.
And I went, all right, well, that's an easy one.
I'll have that.
I'll take that.
And what it really came down to then to me is, well, that's a choice.
It's a choice to be excited about aging or to fear it.
So what if in your 40s and 50s you went, okay, my choice is that I'm going to be able to play full out in my 80s and 90s. And so I better train for it now, I can start to offset the what is happening with
estrogen, because estrogen is really going to create insulin resistance, less muscle mass.
But if I can offset what's happening with the hormones, with diet, with exercise, with,
you know, lifestyle and potentially hormone
replacement therapy, then I don't have to go through that. I'll just skip that piece,
right? Which we can do. Yeah. It's so, it's so interesting. And what also you sort of talk about
is, is just these changes that are, are avoidable, like changes in our sex hormones, like
changes in estrogen, you mentioned the drop in testosterone, the change in our thyroid, insulin, stress hormones.
All of these are basically regulated in part by the quality and amount and health of our muscle, which is something I really never learned in medical school.
So can you talk more about that?
Even when we talk muscle, we don't talk quality muscle. Like, you know, when you look
at muscle, you've got muscle size, which we all talk about, you know, oh, you've got less muscle,
but what about the strength of the muscle? How about the power of the muscle? When you really
look at the statistics of what happens with aging, we lose muscle. And they say now it's like starting around
30, you start to lose it. But let's say 40 plus, it's up to 1% a year. But strength is 2 to 4%
a year and power 6 to 8% a year. And so here's what's interesting about this. The way you train,
you know, when you look at exercise, I think one of the biggest challenges we have with exercise is it's this huge category. And so exercise could mean going out for a walk,
although I'd argue once you're conditioned, that's not exercise, it's activity. Important,
but different. In order for something for me to be count as exercise, it needs to be progressively
overloading so that your body will adapt and get better, right? But the way
you train to build muscle is different than the way you train to build strength, which is different
than the way you train to build power. So all of it can get really confusing.
That sounds a little confusing. So can you unpack that? Because it sounds like three different
things. And does that mean you have to do three different kinds of training or how does it work?
Well, I'd love to start back from, okay, if you're
listening to this and I kind of divided people into buckets, the person who's really doing
not much of anything, the person who maybe just walks, the person who's going to like a group
X, like yoga or Pilates and the person who is athletic and, you know, doing a lot of different
things. And I think the first place we really need to start
is to get that eight to 12,000 steps in a day, which that range now it's, it's sure more is
better, but there's this bell shaped curve. And when you get to, I think 8,000 steps a day,
you reduce your cardiovascular risk factor by something like 46%, then it's 64% at 12,000. Then it starts to just kind of drape off.
So the very first thing is, geez, we just need to move more.
And because what I don't want to do is have someone go, okay, I'm going to exercise.
They exercise 20 minutes a day and sit the rest of the time.
Yeah, yeah.
Like today, I'm sitting.
I'm sitting too.
I have my stand-up desk and I'm sitting.
Okay.
However, I do have a walking treadmill under my stand-up desk over here.
I just think it's weird to do that on a podcast.
I see people with like these bicycle things under their feet.
So, under the desk, you just kind of bicycle all day long.
Well, there was that study that showed that people who did gastrocnemius, like calf raises all day long, actually had better blood sugar control. Just
calf raises while they were sitting. But who the heck's going to do that? But anyway, back over to
that. So let's go, let's get the activity in. We've got all these fitness trackers now. So just
look at your Oura Ring, Apple Watch, Whoop, Fitbit, whatever. Just do that. And I like, Mark, to start
with one thing at a time, because if you give people a whole lot of things to do, what do they do?
Nothing.
Nothing.
No thing.
So I always go, what's the thing?
So after you've got that done, my next place to go is just a very functional resistance training routine, because you will build muscle and strength when you first start.
We don't
have to get as fancy there. And when I look at training, we need to think of training as something
that we're doing to get better at life, not to get better at training, right? And so ideally,
we want this to be as functional as possible, thinking about what would I really like to be
able to do when I'm 80 and 90. When I lived in Palm Springs, I went to see a client and I said,
what are your big goals? She was an 85-year year old woman. She goes, I want to make sure
that I can keep wearing my stilettos and dancing. And I'm like, I love you. Okay, let's do that.
And so what do you want to do at 80 and 90? I want to be able to get off the toilet by myself.
What about you? Right? I mean, you think about the things I want to be able to
pick something up off the floor. So in looking at that, we need to do those activities in the gym,
in a controlled environment. And I find that as we age, we tend to do less, which means we can do
less. So we do less and less and less, right? But if you went in there and you started to do great ranges of motion,
things like squats and deadlifts and bent over rows and pushups, the things and pull-ups,
the things you think you can never do, but boy, will those make a major difference. And the first thing you focus on when you go in is you focus on form because when people talk
about going to failure, going to fatigue,
it's the form that stops you. You never push past that, right? So when we're in the gym,
and I'll tell you in all the years, because I started lifting weights at 16 with the high
school football team, I have never gotten hurt in the gym. I've gotten hurt one time in the gym
because there was a piece of broken equipment and they didn't have an out of order sign.
I literally flew over it.
Like that's the only time I got hurt, a piece of broken equipment.
Other than that, like I have a tendonitis.
But it's all the form.
It's really, it's all the form.
It's all the form.
It protects you from getting hurt in life.
And so when you think about what happens as we age, we lose, we lose muscle size, strength, power,
that size is going to protect our bones. The minute we start resistance training,
we start to become more insulin sensitive with the, you know, what is it now? 6.8% of the
population metabolically healthy. I'd argue it's probably less than that because I think the norms
are off, you know, insulin sensitivity, you can start restoring it so quickly, just by starting to lift weights. And, and then you look at, you know, flexibility,
balance, range of motion, all of these things, when you're doing more functional exercises,
like a squat, like a deadlift, like a push up, those require your core, those require some
balance and proprioception. It's huge.
So that's where you start with someone.
Once you get past the initial training, and I built out a program that says, here's how you start.
Here are the simplest things that you can do to get started.
Here's how you start if you've got bad knees or bad back.
And here's the other thing I would argue.
If you have bad knees or bad back, it's even more of a reason you need to be doing these things. You know, early on when I was like an early exercise physiologist, the way they taught us back then, they said, if you have a bad back, you should just do abs. And I push back. I go, but if you have weak back muscles, why would you ignore them and strengthen your abdominal muscles, you would
reciprocally inhibit your back muscles and make yourself worse, not better. So we need to work
through these things again, in a controlled environment. So we don't hurt ourselves in life.
It's true. You know, I actually what you're saying is so hitting home for me, because I had back
surgery in 2020. And I was a mess, I had a bleed into my spine. I, you know, the surgery went okay,
but then there was a complication with bleeding and I just, everything was sort of off. And I,
I had so much pain. I barely walked. I was just miserable. And I started training with Tom Brady's
team, like the TB12 system and the physical therapists. And I was like, wow, I realized how much of my system wasn't
balanced and how I wasn't in symmetry in many ways and how I actually was weak in areas I didn't know
I was weak. And so I began this training program and, you know, I noticed that my back pain got
better and I felt better and now I can do everything and I'm great. And it's just,
it's kind of a surprise. Uh, I was like, well, you think, oh, well, you don't want to lift weights.
You don't want to stress yourself. You don't want to hurt your back, but if you do it properly,
you can, you can do it even if you have injuries. And particularly when I have an injury, it was
even more important. I, when I have an injury, like if I did something stupid with tennis or
I tore my rotator cuff. I literally can train myself through
it and out of it by doing proper exercises that help strengthen all the right muscles in the right
way so that I can actually recover faster from the injury. So I think it's people often stop,
and this is really important for people to listen to. When you have something wrong,
it's usually beginning to the end. People stop. Oh, I hurt myself, or I can't do this,
or I can't do that. Instead of going of going wait i need to figure out how to recover from this with the proper training so i
don't hurt myself and i prevent this from happening in the future you know i jumped off a golf cart
to see my fiancee and she hit her head and cracked her head open i was like and i twisted my knee and
i never had any issues and i tore my meniscus but i was supposed to go trekking in nepal and i was like oh shoot i can't have to cancel the trip i'm worried about it but i called up my guy and I never had any issues and I tore my meniscus, but I was supposed to go trekking in Nepal. And I was like, Oh shoot, I can't have to cancel the trip. I'm worried about
it. But I called up my guy and he's like, no, let's go through these exercises. And I start
all these different kinds of knee strengthening exercises, muscles around it. And I was fine.
So I think, I think the body has this incredible capacity. So JJ, I want to, I want to dig a little
bit to three things that, that you talk a lot about that are the keys to powerfully aging or aging powerfully.
Mindset and a few other things.
So can you talk about what those things are?
And then let's dig into all these a little bit more.
So I've done this very carefully because I always like to make it so simple and memorable.
Right. very carefully because I always like to make it so simple and memorable, right? And when I first started introducing these, I actually was speaking in the Maldives. Someone asked me to come speak
in the Maldives. What do you say when someone asks you to come speak in the Maldives? You say,
yes, right? Sure. Absolutely. So one of the things that I taught was to eat protein first. And it was such,
so much fun because I was then at the buffet and everyone's meandering around the buffet
saying eat protein first. I'm like, perfect. So there's these three things that are so easy to
remember and so powerful. Eat protein first. Eat protein first. And I'll tell you why I say that.
Lift heavy things. And i always get asked how
much should i lift you know and i go it depends what's heavy for you and then the final one it
was funny when i first did this i was like sleep like a baby and then i went wait a minute my kids
never slept through the night so it's sleep through the night those three things there's
they're really bigger like sleep through the night really is talking more about recovery because we build muscle in recovery not at the gym actually but i'd love to dig into
the first one because the wild thing protein first yeah here's here's why i'm saying this and
and there's so much cool research coming out now about protein because for the longest time think
about it because you and i have been like in this world together what now 30 plus years i mean i've been at it for 40 years
you're still like the same i don't know i think you look better i like you've always said great
you just keep getting better you're like wine there you go anyway um the reason i'm looking at this is I thought, gosh, you know, you look at
so many of the diet programs out there and they talk about manipulating what I call the energy
macros, carbs or fat, and they don't talk about protein. But what's so interesting is when you
manipulate protein, like I'm thinking of one study I just looked at where all they did was they had one group that were 15% protein,
one group that was 25% protein. Calories stayed the same. Their weight stayed the same after 12
weeks. However, the 25% protein group put on two and a half kilograms, might've been three
kilograms of lean mass. They dropped two kilograms of fat mass.
Waist circumference went down. Wow, right? Wow. No exercise, no change in calories. And then
I've got a buddy here living in Florida. We have University of South Florida nearby. And
the only physique and performance lab in the country is here. and it's run by Dr. Bill Campbell.
And this is all of his research is around protein.
He likes to study women.
And that's what he's found is like if all he does is push protein up with taking it
away from fat or carbs, doesn't matter, that people start to hold on to or build more muscle,
lose fat.
Now, the reason I focus on this is number one,
because I keep hearing from people, I can't get that much protein in. And I developed a protein
calculator to help people figure out what that is. But I think a safe thing is like one gram per
pound of target body weight. But if they're like, how do you eat that much protein? Well, have you
heard of the protein leverage hypothesis? No. okay so ravenheimer and simpson so
these were locust researchers out of australia and what did you say locust locust locust like
like insects you mean like yes little buds yes those so they can't say i'm up on my locust
research i can't believe you don't know about this. Anyway, so they found it locusts and they found it in
rodents. Now they found it humans. And when I was reading this, I went, oh, you'll get this
immediately. What it shows is that we will continue to eat until we have enough protein,
that our body will do this, which can cause us if we're eating a lower protein diet with more,
especially ultra processed foods or fat and carbs, we'll overeat in order to get adequate protein.
So we're looking for love in all the wrong places.
So, well, especially look, think about this. When you eat these ultra-processed umami foods
that trick your body into thinking it's tasting more protein, because you know,
ultra-processed foods, you tend to eat 500 more calories a day. But so first of all, that's one
reason I want people to eat protein first, but the other pieces are this. And I created the seven day
protein challenge where all they do is, is don't change anything else. Just figure out how much protein you should be eating using my protein calculator, put that in,
track it, and let me know how you feel. Better satiety because we know that protein's the most
satiating macronutrient, you know, slows down stomach emptying. We know it's also the most
thermic like protein, 20 to 30% of the calories from protein are expended in the digestion and assimilation
of protein versus five to 10% for carbs, basically negligible for fat. So we've got that.
But I heard that you basically burn about 7% more calories when you eat protein, right? Because
you're, it takes so much work to actually metabolize and digest the protein.
Yeah. And you think about it like in our like in our total energy expenditure for the day,
what can we manipulate? Because basal metabolic rate, we can manipulate over time by adding more
muscle mass. So we avoid that metabolic adaptation that you saw with the biggest losers,
where they ended up at the end of their time at the ranch with a metabolic adaptation where
they were 500 calories lower than they should
have been based on their weight, which is what we never want to have happen.
Meaning the metabolism slows down because you lose muscle and fat. And if you don't keep the
muscle up, you end up having a slower metabolism at the end of the weight loss, which is not good.
Exactly. I mean, how would you ever be able to maintain it then you know and
then you go back up but so thermic uh the total energy expenditure is activity that exercise plus
activity right and then food so if we're pushing up protein and dropping carbs and fat just like
dr bill campbell did and saw people lose fat without changing their total calories
so it's it's an easy you mean all calories are not the same oh come on well all calories are
the same but where they come from isn't like when you look at it okay a unit of a unit of calories
calorie in in a lab but not when you eat it yeah but not when you eat it like you and i have been
arguing this forever and boy did we get our butts kicked early on, didn't we? Yeah. Yeah. Gosh. Still, still,
it's still amazing how many people are stuck on the old ideas, calories and calories and calories.
And it doesn't matter where they come from. If it's Coca-Cola or, or a ribeye steak or
olive oil, it's all the same, you know? Yeah. Yep.
Hey everyone. It's Dr. Mark. Now, sometimes when I'm traveling, I need snacks.
I don't always snack, but I like to have healthy snacks available. But if I'm traveling, it often
means I'm tempted to reach out for whatever's quick and available rather than what's healthy
and good for me. But thankfully, Thrive Market has made it easy for me to order my favorite snacks
online to travel with in my emergency food pack. And I literally have a day's worth of rations in my backpack at all times, so I don't
get in a food emergency. The convenience of getting my food quickly shipped to my doorstep is a huge
time saver and helps keep me eating the right kinds of food that help me meet my health goals.
Some of my favorite snacks from Thrive Market include Chomps free-range turkey sticks,
Hue mint chocolate snacking gems, Gimme Organic olive oil seaweed snacks,
and their private label pitted olives,
which are green olives.
They're yummy.
And they even have a price match guarantee,
so you know you're getting the best prices
on your favorite brands.
You can join Thrive Market with my exclusive offer
and get 30% off your first order,
plus a free $60 gift.
Head over to thrivemarket.com forward slash hyman today.
Plus orders over $49 are shipped free
and delivered with carbon neutral shipping from their zero waste warehouses. That's thrivemarket.com
forward slash hyman. I'm a big proponent of supplements because our food just isn't as
nutritious as it once was. But how do you decide between all the different supplement brands out
there? Which brands should you choose and who should you trust? That's really the key, isn't it?
Trust is everything when it comes to supplements and that's why I choose Momentus. Their products
are developed in collaboration with leading experts like Dr. Andrew Huberman and Andy Yelpin
and are used by 90% of the teams in the NFL as well as nearly 200 pro and college locker rooms.
Moreover, their unparalleled commitment to rigorous third-party testing and independent
certification means you can be sure that what's on the label is what's in the product and absolutely nothing else. I take Momentous Collagen and Creatine Daily,
two supplements that work together to repair and power the body. Momentous Collagen is a
clinically researched formula that delivers 15 grams of collagen in support of type 1, 2,
and 3 collagen in the body. Momentous Creatine uses creatine monohydrate, the gold standard
in creatine supplementation. Together, they help me keep my body well-oiled and running smoothly.
So if you're like me and you want to take supplements that are made by
and used by the best in the world, go to livemomentous.com
forward slash mark for 20% off creatine collagen and all their best-in-class products.
That's L-I-V-E-M-O-M-E-N-T-O-U-S.com forward slash mark for 20% off.
You've got all of that.
You've got, you know, the trigger for muscle protein synthesis.
But I think just in terms of diet alone, looking at the popularity of the GLP-1 agonist,
what is one of the big things that GLP-1 agonists are helping us with is hunger and cravings.
What is the big thing that protein helps with? Hunger and craving's a GOP one agonist, right? So like, what if we were to and we know as we age, we have anabolic resistance. We know already that the RDA is about half of what we should have. And that that right now, I think it's 46% of the population doesn't hit the RDA, which is half of what we
should have. And that we should have, I just was reading one study that said we should be 67%
higher than the RDA. I go, but no one's hitting the RDA. So we need to-
Just so people understand what that is. That means the minimum amount of protein you need
to not end up having a protein deficiency disease. It's not the optimal amount you need for health or for muscle building. And that probably is double that. So I think, I think, you know,
people just kind of misunderstand these guidelines. Like what is the RDA for vitamin C? It's the
amount you need. So you don't get scurvy. It doesn't mean the amount you need for optimal
collagen formation or proper immune function or many other functions of vitamin C.
It's interesting though, there's just still a lot of fear around protein. And when I had Dr.
Bill Campbell come over to tape a podcast here since he's local and he said, how much protein you're eating? And I'm like, oh, one to one and a half grams per pound of target body weight. He
goes, every single lean woman I've ever worked with
has eaten that type of protein amounts, every single one. And so once you know that success
leaves clues, it's like, why make this hard on yourself? Who can white knuckle themselves
through? And the challenge is when you look at diets and look at the average diet out there,
because this is the big argument about GLP-1 agonist. But my argument about that is that's any poorly designed diet.
You're going to lose a lot of fat-free mass, of which some of that skeletal muscle mass
and good luck getting it back.
It's like 35% of the weight loss can be from fat-free mass.
But not-
In English, that means when you lose the weight, you lose not just fat, but you lose
muscle, which is really a problem because then your metabolism slows down. And this is what the
drugs, the GLP-1 agonists like Ozempic do. They basically cause about 40% of the weight loss as
muscle. And so unless you're really rigorous about strength training and massive amounts of protein. And it's hard to kind of prevent that.
But I've now seen enough people go on these and not have that effect because, and here's my
thought, if I was the benevolent dictator of the GLP-1 agonists, I would say you cannot have this
unless you're going to do a DEXA scan every three months. And you are going to make sure that you're
eating one gram or more per pound of target body weight, and you are going to make sure that you're eating one gram or more per pound of
target body weight, and you're doing resistance training. And a lot of that's to overcome that
anabolic resistance that happens as we age, where we now can't trigger muscle protein synthesis like
we used to with protein. So we need more to push that threshold. That's exactly right. So back up
a little bit on this whole idea
of the protein leverage hypothesis, because I'm not sure I completely got that or the listeners
completely got that. What does that mean? What are the practical implications of it? And then
we can go into anabolic resistance because I think that's important. Okay. So with the muscle protein
leverage hypotheses, if you are not getting enough protein, you will keep eating to get to that level of protein.
So if you're not eating protein specifically, let's say you sit down, you have a big plate of pasta and maybe it has a couple shrimp on it.
Right. And you're having some bread.
You'll overeat on that until your body goes, oh, okay, I got enough protein. Whereas if you sat down and ate a plate
of salmon, and just think about this as a restaurant. If you sat down at a restaurant
and you had a big grass-fed filet, and then they came by with another grass-fed filet, and they go,
hey, it's on the house, it's your birthday. You'd be like, yeah, no thanks, right?
There's that restaurant in Texas where if you
could eat a I think it's a 70 ounce steak or something like you get you can eat it for free
it said no one ever you know but but yet they could eat the same amount of calories I'm sure
in like cake bread and pasta right so yeah right you can, you can have your little pasta meal and then they'll
wheel by the dessert cart and say, Oh, the desserts on the house. So what you're basically
saying is that, is that we're going to keep eating until we feel satisfied. And if we,
if we eat protein, it's going to make us feel satisfied. So we won't need to eat so much. So
since we'll reduce our raw calorie count and intake, which will help us metabolically lose
weight, right? And there's more. So there was another study that came out that showed that
people who eat protein first actually make better food choices. They tend to eat more vegetables.
They tend to do better. So I just looked at this and went, well, what if? I love the little hinges
that swing the big doors. What is one simple thing you can do that all of a sudden you'll notice a difference and notice a difference quickly.
Right. Like that was Virgin Diet. Oh, if you pull out dairy, gluten, corn, like the literally the thing with the Virgin Diet is'm not even saying, hey, cut out that other stuff. All I'm saying is eat protein first. And I'll tell you a funny story. I had this client, this gal, a friend of mine, she's like, okay, I'm ready. You know, she's right on the verge of morbidly obese. And she's like, I'm ready to do something. I'm like, okay. So I was like, get a DEXA, you know, gave her a workout program with resistance training and HIIT training,
gave her eat protein, like gave her all the stuff, gave her too many things, I will admit.
And she goes, okay. She didn't do anything except she said, I did the protein. So she pushed out
some of the garbage ultra processed foods. I didn't tell her to do that. I said, just,
you know, she ate the protein and she started doing resistance training
two days a week.
And as we know, diet's the biggest lever, you know, for really helping with the fat
loss shift.
She lost 25 pounds in six months.
That was the only change.
Now she's ready to go to the next step.
But I thought, you know, this is really an easy way to meet someone where they're at,
where all you're focusing, and it might be a week, maybe it's a month, maybe it's like her and it's six months.
Who cares? You know, it's tell you get that one really dialed.
And guess what? Once that's dialed and you go, now I'm ready.
I I think about this. It's not just critical for being able to hold on to muscle as you lose fat, but it's also critical for being
able to neutralize toxins that are released in your body fat when you are ready to start to
write. Think about it. Like I look at you explain it for everybody, but this, this makes me nuts.
And it just literally came up yesterday. I was talking to someone and they go, Oh yeah,
my wife and I are on a juice cleanse. I go, what? You're a doctor. What are you doing?
I go, so you're activating all those toxins, but then you don't have the amino acids from protein to neutralize them so that you can then excrete them. And so when you think about it,
here we are storing toxins away in our fat so that we protect our body. And then we decide we are going to go on a fat loss program and we'll do a calorically restricted juice cleanse, except we've just
freed up those toxins and we don't have the neutralizing agents on board.
Yeah. You know, I think just to stop on that for a sec, I, you know, I, when I began learning
about functional medicine and learning about detox pathways very scientific you know here's phase one detox phase two detox here's
all these pathways that you need to mobilize toxins excrete them and and phase two detox
pathways are you know glucuronidation glycine conjugation acetylation methylation uh you know
these are are all needing amino acids from to do these detox mechanisms.
So it's literally like not having the basic ingredients to process the release of the toxins.
And just for everybody's reminder, we're basically cesspools. do fat biopsies on all of us, you would see enormous loads of these environmental toxins,
whether it's pesticides, phthalates, PCBs, dioxins, all stored in our tissue because we live in a
toxic world and it gets stored in our fat. And so when you start mobilizing fat, these come out.
And actually there's a phenomenon that happens, people need to know about, where there's a
resistance to weight loss. And part of that resistance is because of how these toxins
affect our metabolism and how they slow our thyroid down and how they basically screw us up about where there's a resistance to weight loss. And part of that resistance is because of how these toxins
affect our metabolism and how they slow our thyroid down
and how they basically screw us up
as we're starting to lose weight.
So we kind of get some ground going and then we stop.
And that's partly because of the detox issue.
And I think the protein concept here
that you're talking about is using these proteins
to support the amino acid needs
of our phase two detox pathways.
So I think it's a little geeky scientific, but this is not just something like,
oh, detox, like I'm going to a detox spa or get a wheatgrass enema.
This is actually very scientific here.
And actually what we do in functional medicine is understand how to
activate these various pathways with the right nutrients and the right amino acids.
And it's so critical for our health.
Yeah.
And it is such a nutrient dense activity, right?
And it's not talked about.
You look at all of these weight loss clinics and I'm like, they're not, they're never talking
about this piece of the other part of that.
And when I was so deep into weight loss resistance, I found that research you just talked about
by Tremblay, I think in Montreal about how our body temperature would shift down in order for
us to hold on to that fat so that we wouldn't release these toxins if we couldn't excrete them.
So this is a thing that's like when you really look at it, you go, right, I want to hold on to
or better yet, we should be focusing on building as much muscle as we possibly can. Like that is my big focus now is like, I want to, I want to go into my seventies, eighties,
nineties with as much muscle as possible, like quality muscle, you know, strong, powerful.
And so really important message, JJ.
I mean, that is just to stop there.
What you just said is sort of the key take home here is that you want to go into your older years with lots of muscle.
The more you have, the more you'll be able to do, the higher function you'll have in life,
the better metabolic health, the less disease you'll have, the more you'll be able to do what
you love to do. I mean, it's fine getting older. If you have a great mind, you want to sit in a
wheelchair and read your books, fine. But like, I think a lot of us just want to be able to do stuff.
And why not play tennis when you're 100 years old, right?
And why not ride a horse?
Why not do the things that actually you love?
Because your body can.
And if we start to lose muscle and we don't provide the antidote, which is protein and
strength training, it's going to happen.
Like, it's just going to happen.
Well, you're not even going to be sitting in the wheelchair, you know,
reading your books because we know that exercise is probably one that is,
I'm going to say is the best thing we can do to keep that,
to avoid cognitive decline. Right. I mean,
being an F alpha, like we need to exercise for that.
It's super important.
And it also gives us that margin of error. Like I call muscle, your metabolic spanks,
it holds everything tighter. And I say that because so many women, Mark, still, like every day I get hit on Instagram by this, I don't want to get big. And I go, you know,
I had been working. Yeah, right. I hear that get big. And I go, you know, I have been working.
Yeah. Right. I hear that. Right. Right. Like, cause I've been really pushing on creatine. I hope you're taking it. Um, but I've been really putting on creatine. They're so afraid
that they're going to get big. And I go, first of all, you want to put on muscle, but I will tell
you. And it's interesting since I've been really pushing
on putting on muscle because I decided for my 60th that I was going to get into the best shape of my
life. I'm actually back where I was in my early 20s before I tried the vegan diet, which completely
like trashed me. But before that, I'm back to that place. But I think I'm actually even stronger than that now than I was back then, which is crazy.
But what I hear and in putting on more muscle, I'm actually having trouble keeping weight on.
And so is my husband. We weigh ourselves every day. And I'm like, I'm 10 pounds less than I
used to be. And I'm having trouble keeping weight on. You know, it's like, it's crazy
because your muscles metabolically active tissue
and it makes you very insulin sensitive.
And it's also a sugar sponge.
So you want carbohydrate to go into your muscles
to be, to sit there.
So they can be energy for your exercise sessions.
You don't want them to be going on your belly
to create that belly fat that, you
know, as estrogen goes down, women will tend to shift from having fat on their thighs and butt to
a belly where they can produce estrogen. So we want to avoid that visceral adipose tissue,
right? And resistance training and high intensity interval training are super key for that too. So
metabolic spanks, sugar sponge. I love it.
So the other thing you talk about is anabolic resistance.
And before we get into sort of the next steps of your three-step program, I want to talk
about this because it's something that most of us don't realize.
As we get older, it's harder to put on muscle because when you're younger, you have a lot
of hormonal inputs that support that.
Your sex hormones, or thyroid hormone,
and things tend to change hormonally as you get older. So what is anabolic resistance?
What do we do about it? And give us the download. Yeah, so in your 20s, up until your 20s, you know,
teens, 20s, a lot of your muscle hypertrophy, is hormonally driven. And then we start to
rely much more on our diet nutrition and specifically, and this is Dr. Donald Lehman.
I think you've had him on the podcast. Yeah. Leucine and that leucine trigger of 2.5 to 3
grams of leucine to start to trigger muscle protein synthesis. So our body,
our muscles go through a process just like our bones do, you know, we break down, we build up.
And so we go through muscle protein synthesis to build a muscle protein breakdown. So you want to
get rid of the old stuff, get bring in the new stuff, just like our mitochondria do.
And ideally, as we age, you know, one thing
that happens as we age is we do more breakdown and less buildup, you know, so that's a problem.
We're losing muscle mass. We don't want that. We want it to be even, or if you're building muscle,
you better have more muscle protein synthesis and muscle protein breakdown. As we age now, this is driven by two things, resistance training and amino acids.
And as we age, our body gets worse at using those amino acids to trigger muscle protein
synthesis.
So we have to push harder.
And in fact, I was just listening to Dr. Stacey Sims, who's amazing exercise physiologist,
nutrition scientist, who talks a lot about women
and, you know, women all through their lifespan and was saying, you know, women really, you know,
50, 60 plus should be doing at least 40 grams of protein at breakfast. I look at this and I go,
if we think about it, we go to bed. So now we're going to do muscle protein breakdown as we sleep.
We should in the morning make sure that that first meal really hits hard so that we can trigger muscle protein synthesis.
So how much is that?
30 grams, 40 grams, 50 grams.
I think some of it depends on, you know, you get better at this as you do resistance training.
I haven't seen this yet, Mark. I'm dying to
see the difference between a woman or a man on HRT and not, and what's going on here.
Oh, interesting.
Like think about it. What would, like I have been on estrogen, progesterone, testosterone
since, remember when my son got hit and everything went sideways. So 49 years old, my son is in a near fatal car accident. And fortunately,
all my friends around me are hormone docs. And so everyone was helping me because everything
went sideways. So I've always been on, I've never been in that place where estrogen just
went into the toilet. I've always been replaced.
But it would be interesting to look at the difference because I think the Women's Health Initiative just really did women a disservice. Yeah, no, it was premen and provera, wasn't it?
What a disaster. And so you look at it and go, well, if estrogen is really this driver for muscle,
like testosterone is for men, could you offset a lot of
these things that we think happen with aging, maybe they don't have to happen as much. And
then you combine it with getting that optimal protein. Now we know that the more resistance
trained you are, and the more quality muscle you have, the better you're going to be here,
you're not, you know, so I'm going to assume though, is if you're just starting out,
you're not well trained, let's make sure I'd rather see you err on the side of too much protein than not enough. I think that's a high risk.
So basically the idea is as you get older, you don't actually respond to protein the same way.
So you'd actually need more protein. Right. And then we also don't have as good a digestion.
Think about it. Our stomach acid's lower. We're not breaking down protein as well. Our appetite supposedly is lower and not eating as much. So all of those-
And I think the protein first thing is so important too, JJ, for the morning. I think
people don't understand that when you eat protein on a fasted state after training,
you'll have the most impact of building muscle. It's like turns on the engine, like boom, right?
It's just going to crank mTOR. So here's what's interesting too on fasted versus non-fasted
workouts. And we can also talk about like TR, time-restricted feeding or intermittent fasting,
all of that world. And it's different for men and women, but
fasted workouts versus non-fasted workouts. And I think the big thing that, the big thing that
came out way back when about this, and I remember hearing it and going, well, that's dumb, you know,
and it was all about, well, you want to work out fast and so you burn more fat. And I go,
but the reality is, and I was wearing a CGM during my workouts to see how high I could get
my blood sugar to go. And I was cranky. I got it up to 220. And I was like, right, because I was
just pushing it. If you are doing high intensity work, hard lifts, high intensity work, you're not
using fat, right? You're not. You're using either your phosphocreatine system or you're using
glucose glycogen. So this whole idea that we should go into a fast
workout fast and so we burn more fat. I'm like, no, that's you burn fat when you're sitting around,
when you're walking around at the lower level states is when you're going to preferentially
burn fat. And the reality is what we want to be really good is burning stored body fat. So we
have to be a car that can shift from body fat to fat to carbs.
We need to be able to use all the different fuel sources. And the challenge I have with
fasted workouts is I tested it all out. I'm always my first guinea pig. My workouts were 30% less.
When you were fasted, really? What do you eat before you work out? So I always like to be my own guinea pig. So I tested for a month doing fasted workouts,
and then I went in and I could push so much harder. So here's how I designed this. And this
is really- Fasted when you weren't fasting.
When I was not fasted. Now, I'm kind of obsessed with Dr. Sachin Panda's work. Like I think this, this, the, it just makes sense
that you should eat based on your chronobiology. So eating about two hours after I wake up,
I like to wake up, meditate, cold plunge, red light. And then, and we just got a really fast
sauna so we can do some cold heat, cold heat. And I do that in the morning because
I don't want to do a cold plunge after my weight workout and, and, you know, right. Blunt the
muscle protein synthesis situation. So yeah, then I eat and I like to eat about two hours after I
wake up and then I will go to the gym about an hour or two after that. So that's my perfect world
when I can do it is that is waiting about
about two hours after I wake up to eat, letting everything wake up and then stopping eating two
to three hours before bed. I like to do three to four, but sometimes it's the worst cases too,
but better is three to four. So, but here's the thing. I hear you. I love that routine and I love
it, but the truth is, I mean, I got to work, wake up,
work out and then have my shake. And if I, if I have something before I work out, I'm like,
I feel like I can't really exercise. And that's why it just depends on the person.
Like I can do cardio fine. I can go do a HIIT workout. It's not going to hit me,
but resistance training is very different.
And so, you know, you should have something, even a little something before you eat.
I'd say test it out. Maybe just a little bit of a protein carb hit, not the fat, but a little protein carb hit. Just see it. See what it does for you. Even if it was like a hundred calories,
I also have been taking, um, I do creatine every day. I think creatine, especially for women is one of the most important things that you can do. Um, I love to
put a pin in that and talk about that, but I want to go back to fast workouts. They actually
compared fasted, non-fasted workouts and fat body fat expenditure. And they were equal,
like your body corrected. So it didn't matter.
So if people are doing it for- But they were fasted around fast,
right? So I think you really have to look at your life, your schedule, how you feel,
and how hard you can work out because it is always going to be that quality of the workout
that matters most, right? I mean, especially for when you're looking at building muscle, which is different than building strength or building power.
But hypertrophy training is really, you know, the volume that you can do.
Yeah. And the progressive overload of that.
So it can be multiple reps volume or it can be heavyweights, lower volume.
This is the total load you mean?
Yeah. When I was in school, it was,
if you wanted to build strength, it was one to five reps. If you wanted to build
muscle, it was, it was eight to 15 reps. Now we know it's, there's way broader spectrum,
mainly for strength exercises, which I don't have someone do until they have a good foundation,
a good hypertrophy foundation. Strength is, is three to five sets, three to five reps, three to five minutes break.
It's really heavy and it's as hard as you can go till your form starts to go sideways.
And when I do strength work, I prefer to do it on machines.
It's just safer.
Like a leg press is going to be a way safer situation than a squat.
So hypertrophy training can be anywhere from six to 30 reps.
I mean, there's a huge range.
Now, I personally don't have time to do multiple sets of 30 reps and nor do I like it.
It's not fun, right?
So I still think that eight to 12 rep range. But the important thing is, if you're continuing to progress about 10% a week, and everyone's, you know, I like to every eight to 12 weeks, take a like a little what we call a deload week. But if you're doing that, there's a lot of different ways you can do it. How do you progress? If you can't get the weights heavier, add another set, add more reps, right? There's all sorts of ways to progress that you can do so so you kind of talk about this sort of strength training so now so we've talked about the diet
eat protein first i think that makes sense um and let's talk about the strength training piece
because you're talking about lifting heavy things, building muscle. So it's muscle strength,
muscle power. And there was a third thing you mentioned. So it's size, strength, power. And the reason this is important is we want quality muscle. And so quality muscle means you have
fillets, not ribeyes, right? We don't want fat infiltrated muscles. And this is where
it gets really important, Mark. And I will take it to the story. And Tim doesn't mind me telling
everyone he was a skinny fat. He was a normal weight, what they call normal weight obesity.
He was 25% body fat. We went to do DEXAs. And I was the same DEXA at 59, same body fat, same weight at 59 than
I was at 39, which is remarkable. And that's what you want. But the challenge is for most of us,
as we're aging, if we're losing up to 1% of muscle a year and our weight stays the same,
it's not the same weight. And it's ridiculous to me nowadays that you go to
a doctor's office and they put you on a scale. Like looking at total cholesterol, it is a
meaningless, silly number. So you would have looked at Tim and never guessed that this guy-
No, I didn't know that.
You wouldn't know. You two look like brothers. You have the same body type, everything. And all
of a sudden, but he was always he was always 10% body fat.
And I think he is now too.
Like now that, and here's the funny part.
Like I was telling him to do this stuff and he was doing it about 80%, right?
And then he gets to the DEXA and, you know, it wasn't me saying, Hey, look at that.
He had the DEXA.
And so the DEXA showed that he had 25% body fat.
What I love about a DEXA is we think of them for bone mineral density, but, you know,
they're incredible for showing you where your body fat is. If you've got visceral adipose tissue,
where your skeletal muscle is, is it even, right? And so then, and it's very actionable.
So I think we should be doing this every six months.
It's inexpensive. It's really easy to find these things. And then what you do is you go home,
you get an inexpensive bioimpedance machine for home that looks at your total body water,
not that accurate. You take the average over time, but you can see the trends and that's all you're
looking at. It's just like, you know, is your aura ring going to be as accurate as doing some kind of a sleep study? No, but it gives you
trends. So we're just looking at the trends. You do that. You do a tape measure once a week. I
actually have a Bluetooth tape measure and a Bluetooth scale. So everything just reports into
my phone so I can see trends. And that way you can tell as you are doing things, is my,
is my skeletal muscle mass increasing? Is my visceral adipose tissue decreasing? Am I going
in the right direction or not? Because, you know, if you are doing a program and you're continuing
to lose muscle, something isn't working here, right? And again, like we said, you really want
to be looking at the goal being how do I pack on as much muscle as possible? And if you're a woman
listening, and that just made you gasp and go, I don't want to get big, we would be lucky to put on
a pound of muscle a month. If you put on a pound of muscle a month for every month. You know, I can tell you what happens because I had
a client like this. She came in total normal weight, 25% body fat, which is at the upper
edge to me of where a woman should be, you know, had always done cardio and some Pilates,
had never done resistance training. She wanted to lose 10 pounds. Well, over the course of a year, she lost 10 pounds of fat. She put on 10
pounds of muscle. She went down to clothing sizes. She went to 18% body fat. She looked amazing. And
but you know what, Mark, she wanted to lose 10 pounds. At the end of the year, she was still
like, but I want to lose 10 pounds. I'm like, you lost 10 pounds of fat. Like you, you're actually two clothing sizes
smaller. You can eat more. You feel better. It's this thing we women, you know, we need to get over
this. And that's why I really want to get off of, of using the scale ever as anything you have to do
body composition and you have to see it as a biometric
tool. And we got to get off this whole chasing weight. If we chase building muscle, we will
become more insulin sensitive. We'll have a better metabolism. We'll be able to burn fat.
We'll improve everything. And we won't make ourselves crazy and shamed in the process.
That's just amazing. I think so many myths you're busting,
JJ. It's crazy. I think, you know, I want to sort of loop back on kind of what you were saying a
little bit earlier about body composition because so we went by pretty fast. And I think this is
really important. You know, a lot of people talk about the body positive movement, healthy at any
weight and, you know, it's okay. It can be metabolically healthy. And I think there's a
lot of challenges with that. And I think, I think people say, well, don't focus on BMI. It's not
that accurate. Your body mass index, don't focus on the scale. It's not accurate. And, and, and I
believe that's true because what really matters is your body composition.
If you're Shaquille O'Neal, your body mass index is 35. That doesn't mean you're obese. It means
you're a giant with tons of muscle. So it really depends on the composition of your body and where
the muscle and fat is and how much muscle you have and how much fat you have.
And it's really hard to know that by looking at a scale or looking at a body mass index. So
what really I want you to do is unpack this sort of what we're looking for on this DEXA scan.
This is a test that you use for bone density, but it's a machine that also does body composition.
It's a bit different software, but essentially it's, it's a less than a chest x-ray.
It's less than one flight from New York to LA.
And it's a really important test to determine where you're at in your metabolic health.
So talk about this subtle idea of a body audit and what's going on and how do we, and tell us about Vicky, because I think she was, she was a key person that you wrote about. Yeah, I know the two Vickys there, but,
you know, just like you do a macro audit where you track your food so that you can see what,
you know, how many calories you actually really do consume. I think that the, the stats are,
we overestimate, underestimate by like 25 to 40%. We want to do the same thing.
We really got to understand what our weight is made up of. And I'll tell you what, this is a
very empowering thing because there is nothing more frustrating than thinking you've been really
good and then getting on the scale and nothing changed or you went up a pound and we all,
everyone has done this and geez,
maybe you're retaining a little fluid. Maybe you're constipated. Like, you know,
there's so many things that's, that's why you really want to be focusing on your body composition
and you won't know unless you look. And again, we can do this at home correlated with an inexpensive biome pedant scale. Gosh, they're like 20 bucks now.
Yeah, right.
Right.
You know, I have a $5,000 biome pedant scale at the house that I've had forever, professional
grade one.
But back in the day that I used on Dr. Phil, back in the day, these things were really
expensive.
Now there's one that's equally, you know, equally valid for a hundred bucks.
So, but you want to validate this. The DEXA is really
the gold standard. So you just decide I'm going to go in because people go in to get the DEXA for
their bone mineral density, but you know what? Bone mineral density is like blood sugar. It's
a lagging indicator. So blood sugar lagging indicator for insulin resistance. Like what
if we were just checking insulin all along the way? We would not have the blood sugar problem.
And bone mineral density is really a lagging indicator of sarcopenia, which do you know it's like I think 13% to 17% of people 50 and above now have sarcopenia, have low muscle mass.
And you would never catch that stepping on a scale.
You would never catch it.
And so here's what's important about getting on a DEXA is you're going to, of course, you're going to find your bone mineral density, but
you're going to find out your skeletal muscle and you're going to see your skeletal muscle.
And you're going to see how much do I have in my arms, my legs, my trunk? Is it even,
and what is it relative to other people, my age and what do I need to do?
And I want to be, I want to be like, I want to be a star student here.
I want to be in the upper 25%.
It's called appendicular lean mass index or appendicular skeletal mass index on the test.
And then you're going to look at body fat.
Now, here's the thing.
If we're going to look at levels of risk, your real risk on that,
that you're seeing in the DEXA is low muscle mass and high visceral adipose tissue. People tend to
get all blown out about like, you know, their size. Well, if your body fat's mainly on your
thighs and hips and you don't have visceral adipose tissue. Right. It's like not a big deal. But what we know for women specifically is as they age, now men will be different with
insulin resistance and then maybe converting more testosterone to estrogen.
But for women, as they age, estrogen goes down.
We take that subcutaneous, that thigh fat.
My mom called it shifting sands where all of a sudden your butt fat goes to your gut.
You know, you got belly fat where you didn't have it before.
And you really want to see that because that's that dangerous fat.
So, but you can affect it, you know.
And again, what I look at is if I have a dex and I go, all right, we have to build some
muscle and you seem to be way weaker in your size.
You've got fat infiltration,
you know, here you've in your, in your upper body, you've got visceral adipose tissue. What do we
need to do? Like, what do we need to, or, or, you know, your right arm has more muscle mass on your
left, right? We can start to now put your body back into balance, which is another reason why I
like doing resistance training with more dumbbells,
et cetera, to help us not favor our strongest side because we always will. But that's what
a DEXA can show us. And then we go home and we use our biomedicine machine and we use that. We
just do it every day. We get up in the morning, pee, get on the biomedicine machine. It goes into
our phone. We track the trend. We don't get
emotionally involved. It is not a mean friend. It's a biometric tool. You would never take your
blood pressure and beat yourself up about what a bad person you are and that you blew it the day
before. Never. You know, right? So we need to behave the same with this. This is information
that will then let us know what we need to do, what's working, what doesn't.
I love to combine that.
Like, I think tracking your food for at least a month is one of the biggest game-changing things that you can do.
Right?
I mean, if all you did was just track your – that's why I tell people, let's just track and focus on protein.
Don't – nothing else.
But I know that just by tracking,
you'll make better choices. And then you put the protein in. And I know that if you're eating protein first, you'll make better choices, right? So we put that stuff together. And it's really
important, Mark, for someone to do bioimpedance when they're increasing their protein, because
they may either see that even though they're in a caloric deficit, their weight's going down very
little, or they may see maybe their weight goes up a little bit at first, especially if they've maybe
added in some creatine and now they're building more muscle and they're, and they're freaking out
and yet their clothes are fitting looser and they look better naked. So, you know, that's,
that's why we have to really understand what's going on. Because if you haven't lost any weight, but you've dropped body fat and put on muscle,
holy smokes.
You know, the other Vicki that I talk about was this poor one.
The first Vicki was the one that lost 10 pounds of fat, put on 10 pounds of muscle.
And, you know, here's Tim Tim who literally now has gone from 25%
to 18% to 14%. I just did the Tanita at home. He was 11. We're about to go do a DEXA. So I
sense he's somewhere now in the eight to 10%, but his weight has only dropped five pounds.
Wow. So, you know, and this has been now a year and a half but very solid on his protein very
solid on creatine like doing all the things that you need to do so so jj this is so fascinating i
think it sort of upends a lot of our kind of conventional wisdom around what to eat and what
we should be doing with exercise as we age let's in the few minutes we have left let's talk about
some of the other pillars you have a third pillar pillar, which is sleep. And then just a few minutes about supplements. And
then like, you know, we'll sort of kind of wrap it up. But tell me why sleep is so important and
how does that relate to weight loss and diet and exercise? You know, back when I was obsessed with
weight loss resistance, sleep was obviously one of the things I looked at the most, because just if someone slept more, you know, because you know, the research of failure to get
the recommended seven to nine hours of sleep a night, even if you're eating healthy and exercising
is a risk factor for obesity, because of elevated hunger hormones because of insulin resistance. So, you know, first part,
just for fat loss, sleep is mission critical, but muscle repair is happening when you sleep.
So we have to make sure, and that's why I really, I'm also focused on in terms of the bumper meals
for protein, that you make sure that your breakfast and dinner have really got that two and
a half to three grams of leucine in them that you're doing that. You know, I think really for
our age, it's 40 grams or up of protein at those meals and a minimum a hundred grams of protein
overall during the day, but probably more. I'm getting 140 to 180 grams a day.
That's a lot. That's about what I'm getting. I'm lot. Well, you're about six foot tall. You're probably
close to me. You're six. Aren't you six, three, six, two, six, two, three. As I shrunk a little.
So, you know, so sleep, when I think of sleep, I'm also thinking of all the different things
that we need to do to recover and repair. And so it's sleep, it's Epsom salts baths, it's foam rolling and massage,
it's sauna, it's cold plunging and red lights. So all the things that you can, if you can get
access to these things, and if you can't, if you don't have a cold plunge, we literally got a cold
plunge and we put it in the house, but you can have a cold shower. You know, if you don't have a cold plunge, we literally got a cold plunge and we put it in the house. But you can have a cold shower.
You know, if you don't have a sauna, take a hot bath.
All these things are going to aid recovery.
But sleep being the most important of all.
Like we've got to prioritize sleep.
And I think there's an idea just like we think we don't need to eat as much as we age.
And sure, caloric needs might go down some. I would argue that if you are doing the
activity that you need to do and building muscle, it's not going to be as much as it would be
otherwise, that that's really more of a devastation of your metabolism. But we also don't have less
sleep needs as we age. I think probably what happens is we've got more cortisol, we've got
lower progesterone in women, and we're just not sleeping well. But we need to prioritize it and
make it happen. Yeah, I think sleep is key. I think most people forget about how important
it is just in terms of your metabolic health, immune health. If you just don't sleep, you're
going to crave carbs. You're going to be tired. I don't know if you know, when I met Tim,
Tim used to eat a little bit higher. He would eat sugar and he slept five hours a night. And I'm
like, well, this isn't going to work. This is the problem. And it's funny because I got him sleeping eight to nine hours a night
and boom, he immediately lost weight. Like didn't have sugar cravings anymore. You know, just
weight dropped off. And he's like, gosh, I, you know, I, I need to eat more. This is not working.
So it can, it's that traumatic. Like these,
again, when I look at these things, I go, what are the biggest levers that if you were just to
do these things, like you just said, okay, I'm going to eat protein first. I'll eat the amount
that I need and I'll eat it first. I'll make sure I get it in. And then I'll just focus the exercise
that I am going to do. I'll do resistance training and I'll focus on big compound movements
rather than doing a little bicep curl or tricep extension. You know, I'll do a pull-up or a dip
or a push-up and then I'll make sure that I get, I prioritize my sleep. I'll make it a priority.
I'll get my seven to nine hours every single night. Just those three things. Do you know,
like I think we'd have probably, we'd flip the metabolic health parameters. We'd probably have 6.8% of the population who wasn't metabolically healthy.
It's true. It's not that hard. I mean, it's not that hard. We have the science. You went Pactoma, there's so much more. One last thing. You take supplements. What are the supplements you take and why? So I'm going to tell you the ones I think are most important.
Most important.
In this area, because I'm like, you mean the 50 supplements I take?
But the ones that no matter what are my non-negotiables.
Yeah.
It's creatine.
Holy smokes.
I don't know when you started to take creatine, but I only started taking it, gosh, I don't even think a year ago.
I'm like, why wasn't I taking this? Do you know women have 70 to 80% less tissue stores of
creatine than men? We make about a gram a day, but we really need more than that. We need tissue
saturation. And when you're doing high intensity exercise, if you're really pushing it, you have to use this system in your body called the phosphocreatine system.
It's creatine-dependent.
So you can work out harder, recover more.
Also, for women, they found, like, major importance for mood, for cognitive decline.
Like, women on antidepressants who were given creatine had a way bigger effect, way happier mood.
Really?
Yes. Yep. And effect, way happier mood. So really, yes. Yep. It's and wrinkles, skin, mood, bones, muscles, recovery. I mean, it's like, it's incredible. And women
need it more. And they're so afraid of taking it. Because every time I talk about on social,
I get bombarded, I'm gonna get bloated. I'm like, you know what, just creep it up.
You'll be fine. And if you are the one of the fortunate ones that actually is going to get
more water in your muscle, which you could see by doing your biomedicine scale, celebrate that.
You want that. That's good. You know, like we want, we want muscles that have got good water in them. That's good.
So that would be one.
I know you and I are both fans of Mito Pure Urolithin A.
That was another one.
Like I do one thing at a time.
And wow, did I notice a difference when I started taking that in terms of how hard I
could work out?
So that is one.
Yeah, huge.
Some of the ones I think that are really important, and there's more research coming out now about vitamin D helping with, right? So, you know, we think of vitamin D, pro-hormone, bone health, immune health, but also now more is coming out about it for muscle mass. Same with fish oil. Like I always thought, well,
it's fish oil. Like I know fish oil helps bone remodeling, but you know, they're starting to
talk about fish oil, possibly for an anabolic response. The latest research showed that with
frail people that it improved gait speed. I was thinking, oh, I wonder if it's the
anti-inflammatory effect, because if you've, if you're inflamed, which we know there's inflammation, it can block muscle protein
synthesis, but it's apparently a different way it does that by improving your sensitivity
to amino acids. So maybe it's pushing you out of, you know, it's, it's, it's helping with that
anabolic resistance. It's still kind of, we'll see, but you know, those are my like, for this, I think those are some of the
key ones. I also have really focused on getting in my electrolytes and being I know you're well
hydrated, as you've already proven today. But I think this this information from Rick Johnson
about dehydration, and how when you're dehydrated, you will convert glucose to fructose in the liver
and store it as fat. You're basically becoming a camel. I'm like, holy smokes. Well, thanks.
Yeah. I mean, I think that's true. People don't realize that we need not just hydration,
but intracellular hydration. For example, if you overhydrate with water, you dilute your blood,
you can end up with
coma seizures and death, right? Well, Brooke Shields just passed out because of it. Remember
that in the news? Yeah. People need to think about drinking electrolytes with their water.
And this is not the sugary stuff. I use one that's called Light Show. I like it. It's a
little scoop I poured in. It's got a teeny bit of stevia. There's another version of it that has
none of that. And it's just, it's like a little bit of salty water, but I don't mind in. It's got a teeny bit of stevia. There's another version of it that has none of that. And it's just, it's like a little bit salty water, but I don't mind it. It's profound in its
effect. I mean, I noticed when I, when I work out or when I'm on a hot sunny day playing tennis and
I actually drink it, it's like, it's like the energizer bunny just gets turned back on from
the droopy little guy. So I think, I think it's important to get intracellular hydration. So I
think this is just such a wealth of amazing information.
JJ, why don't you share in closing what it means to you to live with purpose and age
powerfully as you get older?
So I have a theory about the blue zones in that when you really look at the unifying
factor between all those different areas, they're super active.
And I know I was looking at some video you
did somewhere where the guy was pulling his cart and he was walking up the hills. They're super
active doing powerful things, right? But they also have a purpose. They're relevant in their society.
They're regarded as elders, which we suck at in the United States. Let's be honest.
When I look at this, I think this is such an opportunity for women, especially because if you look at it, okay, we're aging. If we left that
unchecked, we'd lose muscle size, we'd lose strength, but we'd really lose power. And women,
their whole lives have tried to shrink, be smaller. I mean, you know, being six feet tall,
people always say, oh, you're so big. And I'd always say, No, I'm tall. Like, I never wanted to be big. And then I thought, well, what happens if we show
up bigger, if we show up more powerfully. And I really think that as you start to get stronger,
like the way you do one thing is the way you do everything like you start to get stronger in the
gym, you get stronger, more powerful in life. So it's my big goal that this message goes beyond just,
you know, physicality. That's beautiful, JJ. It's such a beautiful framework. And where can people
learn more about your work and how to apply this? Because you've created so many resources for
people. You're coming out with a book in 2025. It's going to go through this, but, but for now, where can people find information that
will help guide them toward the strategies that you sort of outlined in this podcast?
So we created a very simple, again, I wanted to prove a point, very simple challenge that
gives them a protein calculator. So they figure out their range, their personal range for protein
based on their age, sex, genetics, type of diet, and then a simple seven-day protein challenge.
And that is at jjvirgin.com forward slash protein first.
That's great.
Protein first.
So JJ, thank you so much for everything you've done, for being my friend for decades and
decades and being on this journey together forever.
And it's just great to see you thriving and doing well.
And it's just an example of how we can all age powerfully.
So thanks so much.
Thank you.
Thanks for listening today.
If you love this podcast,
please share it with your friends and family.
We'd love to hear your comments and your questions
and please leave us a rating and review.
And of course, subscribe wherever you get your podcasts.
You can find me on all social media channels
at DrMarkHyman,
and you can also subscribe to my YouTube channel
at DrMarkHyman.
I'm always getting questions about my favorite books,
podcasts, gadgets, supplements, recipes, and lots more.
And now you can have access to all of this information
by signing up for my free Mark's Picks newsletter
at drhyman.com forward slash Mark's Picks.
I promise I'll only email you once a week on Fridays
and I'll never share your email address once a week on Fridays and I'll
never share your email address or send you anything else besides my recommendations. These are the
things that have helped me on my health journey and I hope they'll help you too. Again, that's
drhyman.com forward slash Mark's picks. Thank you again and we'll see you next time on The Doctor's
Pharmacy. This podcast is separate from my clinical practice at the Ultrawandel Center,
my work at Cleveland Clinic and Function Health, where I'm the chief medical officer. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I'm the chief medical officer.
This podcast represents my opinions and my guests' opinions.
Neither myself nor the podcast endorses the views or statements of my guests.
This podcast is for educational purposes only.
It's not a substitute for professional care by a doctor or other qualified medical professional.
This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your
journey, seek out a qualified medical practitioner now. If you're looking for a functional medicine
practitioner, you can visit ifm.org and search their find a practitioner database. It's important
that you have someone in your corner who is trained, who's a licensed healthcare practitioner
and can help you make changes, especially when it comes to your health.