The Dr. Hyman Show - Muscle Is the Key to Longevity (Not Fat Loss) | Dr. Gabrielle Lyon

Episode Date: January 14, 2026

Longevity isn’t just about what you eat or how you train—it’s really more about whether you believe your body is worth investing in. On this episode of The Dr. Hyman Show, I’m joined by my longtime friend and colleague Dr. Gabrielle Lyon to explore why muscle may be one of the most overlooked drivers of long-term health. We focus on practical, accessible ways to build strength as you age, and why muscle plays a much bigger role in your health than most people realize. We explore: • How strength training supports your blood sugar and metabolic health, beyond what the scale can show • Why muscle quality—not weight—is a stronger predictor of long-term health • How building strength helps you stay mobile, capable, and resilient as you age • What most people miss about protein and muscle health Aging well is something you can actively support, starting with how you care for your body today. And strength is one of the most powerful places you can begin. View Show Notes From This Episode Get Free Weekly Health Tips from Dr. Hyman https://drhyman.com/pages/picks?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Sign Up for Dr. Hyman’s Weekly Longevity Journal https://drhyman.com/pages/longevity?utm_campaign=shownotes&utm_medium=banner&utm_source=podcast Join the 10-Day Detox to Reset Your Health https://drhyman.com/pages/10-day-detox Join the Hyman Hive for Expert Support and Real Results https://drhyman.com/pages/hyman-hive This episode is brought to you by Timeline, PerfectAmino, BIOptimizers, Mau Nui, Made In Cookware and BON CHARGE. Receive 35% off off a subscription at timeline.com/drhyman. Go to bodyhealth.com and use code HYMAN20 to get 20% off your first order. Head to bioptimizers.com/hyman and use promo code HYMAN at checkout to save 15%. Learn more about the health benefits of venison and how to get yours, head over to mauinuivenison.com/hyman. Head to madeincookware.com and use the code HYMAN for 10% off your order. Upgrade your routine. Head to boncharge.com/hyman and use code DRMARK for 15% off. (0:00) Introduction and Dr. Gabrielle Lyon's background (1:00) Protein's importance across ages and muscle benefits (3:28) Muscle: A neglected organ and its metabolic roles (8:01) Assessing muscle quality and functional health (13:09) Resistance training and muscle rejuvenation strategies (19:33) Muscle's immune and hormonal functions (22:29) Myokines and body composition analysis (26:17) Strength training and innovative techniques (32:05) Muscle as the organ of longevity and protein's significance (38:12) Dietary guidelines and protein requirement debates (48:08) Amino acids, protein turnover, and intake strategies (59:48) Metabolic flexibility and creatine's benefits (1:00:21) Sponsor: Timeline's research on urolithin A (1:02:20) Mitochondrial health and muscle-centric medicine (1:08:14) Muscle health's mismatch with chronic diseases (1:10:20) Dr. Lyon's longevity practices and quickfire questions (1:16:03) Strength's importance during menopause and cold exposure (1:18:51) Dr. Lyon's career highlights and resources (1:20:17) Closing remarks and disclaimers

It's amazing to me how ignored this is in medicine, and it's such a critical part of health. We have this epidemic in this country of not only obesity, but sarcopenia. And you put together a hypothesis, which is that maybe it's not that we're over fat, that we're under muscle. From the 70s to roughly early 2000s, muscle wasn't even thought of. Then we started focusing on body fat percentage. Now, as we continue to transition, we're looking at biopetence, and now we're beginning to think about overall muscle amount, but it doesn't end there. The real important marker is the intramuscular adipose tissue. It's the quality of the muscle tissue. Dr. Gabrielle Lyon is a

board-certified physician with advanced training in nutritional sciences, geriatrics, and metabolism from Washington University in St. Louis. She is redefining health and longevity by placing skeletal muscle, the organ of longevity at the center of aging, disease prevention, and human performance. So let's get into the protein thing because, you know, this is a, hot topic. Number one, age. The older you are, the more protein you need. Period. Number two, physical activity. The more sedentary you are, the more protein you need. Really? Yes. I think building muscle is probably one of the best ways to lose body fat, but also to correct your metabolism, lower inflammation, improve your cognitive function. Improve your immunity. Help your

sexual function. I mean, pretty much everything. More muscle, better sex. Now we have everyone's attention. I'm 66 and I've never felt more excited to explore the world and challenge myself in a healthy way right down to myself. This spring, I'm riding my bike across Cuba, and to ensure I have the strength and energy to really enjoy all the experience has to offer, I never travel without my timeline powered by mitopure. From decades working with patients, I've learned something important. Diet, training, and prioritizing recovery are essential, but they aren't always enough, particularly as you get older. I don't want to miss a moment, and that is where mitopure comes in. Mideaure is the only clinically proven urolithin A supplement that renews your mitochondria,

helping you feel stronger, clearer, and more resilient with deep, steady energy that actually lasts. Right now, you can get 35% off a subscription at timeline.com slash DR Hyman. That's timeline.com slash DR Hyman. In my practice, it's unmistakable. Balanced blood sugar is the core driver of sustained energy, sharper focus, and a healthier metabolism. In fact, I wrote the blood sugar solution because managing glucose isn't just about avoiding sugar. it's about giving your body the tools to use fuel efficiently and stay balanced. That's why I recommend berberine breakthrough.

This isn't a stimulant or a quick fix. It's built on two clinically researched ingredients, Inno Slim and Gluconage, that help your body support healthy glucose metabolism and maintain steady energy all day long. No more carb crashes, no more afternoon fog, just one daily ritual that keeps your energy consistent and helps you feel strong, focused, and resilient. To learn more, head over to bioptimizers.com slash hymen

and use promo code Hyman during checkout to save 15%. And if you subscribe, not only will you get amazing discounts and free gifts, you will make sure your monthly supply is guaranteed. Hi, Brielle. Hi, welcome. Yeah, so great to see you. Good to see you, too. We've been buddies for a decade plus. We were chatting.

I remember you used to come to my house and hang out and kind of shadow me in my clinic and see patients with me. And, you know, you've kind of taken your whole career and exploded it in in this whole field of muscle-centric medicine. And I remember you used to come to see me and you're like, Mark, you've got to strength. Mark, you got a train. You got a train. I'm like, ah, I bike, I bike tennis. Oh, I'm going to just do yoga. I'm like whatever, whatever.

And I always didn't like, I mean, look, I'm a tall skinny guy. So I get intimidated by I go to the gym. There's all these guys with big muscles. And I just feel like I'm, I used to do 10 pushups and my chest would hurt for a week. And I'm like, this is for the birds. And even though I know as a doctor that I needed to do it, I didn't really start until I was 59. And it was actually you that got me really going on this. You really put a bug in my ear about this and how important it was and started teaching me about the importance of muscle as this neglected organ.

Think about it. Yeah. Where is the muscle specialist in medicine? You've got a neurologist. You've got a cardiologist. You've got a rheumatologist. You've got a rheumatologist. You've got a gastronologist. Where's the musselologist? Well, hopefully we're creating a new generation of thinking about it and doctors. Right now, think about it. We have physical medicine and rehab. But that's the movement side. Yeah. What about the dysfunction that actually happens to skeletal muscle? I mean, skeletal muscle can get Alzheimer's. Skeletal muscle can become dysfunctional from an immune perspective. It is its own organ system.

And it's like the huge organ. Like you've got lots of muscle, but isn't it the biggest organ? It is. It's the largest organ system in the body. And arguably the most important organ system, of course, depending on whatever your specialty is, we actually just published a paper looking at the importance of muscle. muscle mass, strength, and sexual function. More muscle, better sex.

That's right. Now we have everyone's attention. I mean, it's amazing to me how ignored this is in medicine, and it's such a critical part of health. And, you know, we have this epidemic in this country of not only obesity, but sarcopenia. And you put together a hypothesis, which I find very interesting, which is that maybe it's not that we're over fat, that we're undermuscled. That's exactly right.

And that the muscle is the key to health. It's not just losing weight because you can lose weight and still be fat. We call that skinny fat. That's right. Then on the outside, fat on the inside. So you lose tremendous amounts of muscle as you lose weight as well as fat. And so this is a big problem for people and they end up having metabolic issues. But you're talking about a way to kind of rethink medicine from the perspective of muscle,

not just as this thing that moves around your limbs and the body. body parts, but it's actually an organ that has all the extraordinary functions that we're just learning about. And that I didn't even know about. I didn't learn about a medical school. So kind of take us through, like, what is muscle? Why is it important? What does it do other than just move your bones around? And why should we be focused on it as a key organ of longevity? First of all, skeletal muscle is the largest organ system in the body. Dermatologists, and we've always heard that it's skin, but actually skeletal muscle makes up roughly 40% of our body weight.

Yeah. And as you can imagine, the health of this tissue. For you now, it might be 50. For me, it might be 30. But regardless, it's a large portion of our body. It's the most important organ system that we have, because it is the focal point. And I'm going to break down as to why that is.

So skeletal muscle, by the way, is something that we prime our bodies for when we're young. And it is plightly. and it's never too late to built. So before we talk about all the functions, let's just pause. What other organ system do you have direct voluntary control over? You exercise your heart will get better. But you can't say heart beat 73 beats a minute.

No, I can't do that. Well, I can meditate and get it slow down. But you can say, I'm going to contract my bicep or I'm going to contract my quad. Yeah. It's the only tissue that we have voluntary control over. Yeah. There's skeletal muscle. There's cardiac muscle in the heart.

There's smooth muscle, say, in the uterus, but skeletal muscle, we have voluntary control over. Now, what are the other functions of muscle? Obviously for the architecture of our body, the building, the strength, the power. But also from a metabolic perspective, when we think, and listen, when I was in your clinic, but I would go to your clinic and I would listen to you talk about diabetes, obesity, cardiovascular disease, and Alzheimer's, these are not diseases that are separate. Many of these diseases are caused by metabolic pathology. And to say that simply, disregulated glucose, right, abnormal blood glucose, triglycerides, elevated levels of insulin.

So all of these metabolic syndrome, which are actually not caused by fat first. they are caused by dysfunctional muscle first. Dysfunctional muscle is in part at the root of cardiovascular disease, Alzheimer's, which is type 3 diabetes of the brain, type 2 diabetes, insulin resistance. So just the list goes on. So tell us, like, what is functional muscle and what is dysfunctional muscle? And before, you know, it's interesting because we're talking somewhat in absolutes, but it's not in absolutes, right?

So is the liver, does the liver play? is it fatty muscle, right? So this is a complicated organism. And so for the physicians listening, I want to make sure that it's not just comes across as black or white, right? Functional muscle is the following. Typically, muscle quality is defined based on strength, which is a little kind of misleading, right? How many push-ups can you do? How strong are you? How fast can you walk? Functional muscle is strong muscle. Dysfunctional muscle is weak. Dysfunctional muscle looks like a marbled steak over time.

You get fat that is infiltrated into muscle tissue. And also... You get a wagging ribbi instead of a filet mignon. Yes, and we're going to talk about this in terms of imaging, because I think we're at the precipice of something new. Our muscle that is dysfunctional has less mitochondrial efficiency. You and I talk about exercise as mitochondrial medicine. pushing exercise, whether it's resistance training or high-intensity interval training or endurance training.

All of this is medicine for your mitochondria. So there is the functional aspect of muscle, strength, power, mobility, balance. Then there is the metabolic component. That keeps you active in functioning as you get older. I noticed when I started doing experience training, I just felt more solid in my body. I felt more stable. And when I was younger, you felt like hike on a trail and just jump. from rock to rock and I noticed I was maybe a little more tentative, but as soon as I started

strain training, I'm like, oh, my body's like, my core is strong, I can bounce around on my legs and it was a really interesting phenomenon to notice. Yeah, and also when you think about what's important for you is how do we get injury prevention? You know, you and I see patients and we think, okay, well, as we go through life, is there this inevitable decline? And I would say no, and this an inevitable decline as we see our parents get thinner or more frail, you know, this is this kind of expected. It's expected. But really, that's not how aging happens. Aging happens in what we call a catabolic crisis model. There are discrete moments of inactivity that decrease muscle mass very rapidly and strength. Now, with that, there is this relationship with muscle mass and glucose

regulation. So oftentimes as people are losing muscle, their blood sugar goes up. Yeah. Their insulin goes up. And so now we are at a point where there is metabolic dysfunction, which becomes dangerous, because we all know that glucose is toxic to the cells if it remains elevated. I mean, we have a disease for that. It's called type two diabetes. You know, I was thinking about these weightlifters, he's like power lifters. And these guys are kind of overweight. The guy I got big guts and they're big guys and, you know, or sumo wrestlers. Like, are these guys, these guys have a lot of muscle. They do.

They're trained muscle. And are they, are they metabolically healthy? I made a mistake really early on in medicine. And I think what's so cool about medicine and learning is that we can change our opinion. Yeah. And when I was at Washu doing my fellowship in geriatrics and nutritional sciences, there was a lot of talk about fit and fat. I didn't believe it was possible. Yeah.

It didn't make sense to me. Yeah. Because I was thinking, okay, so there is. adipose tissue, subcutaneous, a certain body fat percentage of over 30 percent. Well, how can that be healthy? And you know what I found? Yes, they can. And you know why? It's actually the intramuscular adipose tissue that matters. So let's talk about this. Some of those they don't have marbles fat. Correct. And this is where I think the future of medicine is going because we are going to be, you know, in the 70s, we were very focused on the obesity epidemic. Yeah. In the

70s and it was that the nutrition outpaced our ability to kind of manage that caloric intake. But exercise wasn't even brought into the picture. Do you know why? Because our physical activity didn't change during that time. It was still the same. I mean, it was lower, but it was still the same. So the input, it was input versus output. And people really started focusing in the experts, started focusing on overall calorie consumption. Finally, up until around 2000, muscle came into the picture as a metabolic organ. But from the 70s to roughly early 2000s, muscle wasn't even thought of. But how did this then frame how we currently think? Well, there was BMI, which we know body mass index is just thought of in terms of overall size, right? There's this, you know, you do this little

formula and someone like my husband who's very muscular would have a high body mass index, which would mean he's unhealthy. Yeah, you're right, but he looks bad. on paper. Exactly. Then we started focusing on body fat percentage, right? And then after body fat percentage, if you're 30% body fat or more than, you know, you're either overweight or obese. Now, as we continue to transition, we're looking at biopetence and now we're beginning

to think about overall muscle amount, but it doesn't end there. This is just the beginning. The real important marker, and again, we're at the beginning of all this, is the intramuscular adipose tissue. It's the quality of the muscle tissue. And where can you see intramuscular fat tissue? Is it on the MRI? MRI. MRI. I was talking early on about maybe a year ago, I was talking to Jonathan about this. You're co-founder of function. And I said, Jonathan, listen, you're doing these early detection screening tests, but this is amazing. And then the next iteration is actually going to look at not just body fat percentage and not just muscle mass, but actually the quality of muscle.

Yeah. Well, we now through function and imaging, Ezra, offer intramuscular. Which is why I'm so excited about because I believe that this is the way of the future. Yeah. And now it's available to everybody. You don't even need to doctor. You just go to function health.com and sign up. And you'll also see all your metabolic pathways and inflammation. Everything else is affecting your muscle. Yes. Yes. And if we were to think about that from the listener or the viewer. That means the simple act of engaging in resistance training improves intramuscular adipose tissue, whether your body fat percentage or muscle mass changes. When you make the choice to exercise and be physically active, you're improving the quality

of your tissue in the immediate. And that becomes really empowering. I was interviewing on my podcast one of the world-leading experts in PCOS, polycystic ovarian. syndrome. So someone who's listening to this, if they're struggling with fertility, this is the number one cause of infertility in young women. And I said, I said, her name is Dr. Melanie Cree. She's in Colorado. She's an MD PhD. And I said, well, what is the body fat percentage where we're seeing all these problems? Because in my mind, as physicians, we think, well, there's a certain cutoff. So for example, we know how much protein someone should have. We know what their blood glucose levels should be we know or we should know what should their percent body fat be where they

have these problems, right? Like, we should know that. And she looks like to me, she goes, Gabrielle, it has nothing to do with body fat percentage. It has everything to do with the intramuscular adipose tissue. Yeah. And that really determines how someone responds. If you do a dexas scan, you can't tell them. No. Yeah. So only an MRI can really help you give this information. Correct. MRI, CT, or ultrasound, but ultrasound is obviously that would just be one body part, but I say all this to then bring it back to the conversation of GLP-1s, obesity, and now sarcopenia. I've always said that whole food protein is foundational. It fuels your muscles, metabolism,

hormones, and even your immune system. But here's the thing. Most people still aren't getting enough high-quality protein to truly support healthy aging. It's not just about grams, it's about amino acids. The building blocks your body needs to repair and thrive. As we get older, our bodies become less efficient at using them, which is why I rely on perfect. amino. It gives all essential amino acids in the exact ratio your body needs for maximum protein synthesis without extra calories. That means it works even during fasting after exercise or anytime your protein needs aren't fully met. Predigested and ready to use, it's especially important as you age or stay active. Meeting your amino acid needs can also help with appetite regulation and

metabolic balance, making it easier to stay strong, recover faster, and age well. Go to bodyhealth.com and use code hymen 20 for 20% off your first order. Most people hear the word red meat. meat and automatically think of beef. But venison sits in a completely different nutritional category. It's the cleanest, leanest, most nutrient-dense red meat available. If beef represents old ideas about red meat, venison represents the future ideal, incredibly nutrient-rich, anti-inflammatory, metabolically efficient, and naturally aligned with human physiology. Benison is high in protein, low in fat, and has a fatty acid profile that supports metabolic and cardiovascular health. It's loaded with highly bioavailable B vitamins that power your mitochondria, energy production, brain

function and detox pathways. And when you look at minerals like magnesium, iron, copper, and potassium, venison consistently outperforms beef. These are the nutrients most people are deficient in today. Just as important is what venison doesn't contain. Because it's not an industrial feedlot product, you avoid the inflammatory fats, antibiotics, and many of the contaminants found in conventional beef. And when harvested responsibly, venison tests far below safety thresholds for heavy metals, making it one of the cleanest animal proteins available. The best source for wild harvested venison, and the company I get my venison from is Maui-Nui-Venison. So if you're looking for a protein that supports longevity, metabolic health, and clean-e-eating,

venison is one of the smartest choices you can make. The best source for wild-harvested venison, and the company I get mine from is Maui-N-E-N-E-Venneson and how to get yours. Head over to Maui-N-E-E-Vennessin.com slash hymen to learn more. Can we, before we jump on that, I want to just finish summarizing the features of good quality muscle because it's not just that it moves your skeleton around or it's got less fat. It's actually a metabolic sink for sugar.

It actually regulates your hormones. It regulates inflammation. You talk about it's called myokines, which I'd love you to unpack. Sure. So help us sort of understand the broad range of functions that's besides just moving around your bones and walking around.

Yes. That this plays and why it's so important and why it's so important to have healthy quality muscle, not just the amount that look at, you know, you can look at a mirror. It doesn't matter. It does matter to an extent, but it really is the quality of that tissue. If we were to think about the quality of the tissue from a metabolic perspective, at rest, people don't actually realize this, but at rest, the body muscle primarily burns fatty acids for fuel.

So at rest, if you're metabolically healthy, your muscle is burning primarily fatty acids. Fat. Fat. If your diet is too high in carbohydrates, you can force. muscle at rest to then burn and utilize glucose. But this is not ideal. So when we think about... During activity, your muscle sucks up a lot of shit. Ideally, yes. But you don't want, if we're just sitting here hanging out at 0% VO2 max, we don't want to be burning glucose. We want to be burning fatty acids. That's how it was designed. But if you overwhelm the system and if you are

constantly eating, you know, if the RDA is 130 grams of carbohydrates, which is, you on average 300 grams of carbohydrates, we are creating an environment that we are forcing muscle to respond to. So number one, at rest, empty muscle, right? So activity allows you to burn muscle glycogen. You use muscle glycogen. That's a storage form of sugar carbs in your muscles. It's about 2,500 calories.

You can. You empty the tank. So if we think about what muscle does, if we think about it as a suitcase. Now, I don't know about you, but I think you're kind of a happy packer. Yeah, you're definitely a heavy packer. At least you were last time I saw you. That's where I'm going on how long.

Listen, I got to tell you, when you have your place in Lennox, and I remember we were running out, I was going in one direction back to New York City and you were going on a trip and you're this massive suitcase and you know what you're doing, you're putting your supplements in. Not even just the little pill case. I mean, the whole bottles were going. And it was absolutely hilarious. Now, why does this matter? If you think about your muscle as a suitcase and let's say you're going to

going on a trip for four days. And you, instead of going on a trip for four days, you pack for 14, like Mark, and all the supplements in the world. You're stuffing all this stuff in the suitcase, meaning glucose, and you didn't exercise it, like clothes, then all that stuff spills out. It has no place to go.

And so muscle, it's really important that you do activity to empty the suitcase of muscle so that when you eat carbohydrates, you have a place for it to go. Not your belly, but. Not your belly, but the reason I say this is because there's no such thing as a healthy sedentary person. There's no there is no such thing as a healthy sedentary person. So when we are talking about the metabolic role of skeletal muscle, we have to talk about it from an ideal standpoint, which is healthy muscle burns fatty acids at rest.

But if we are living in reality, we know that most people are eating way too many refined carbohydrates and grains. We know that most people are eating roughly around 300 grams of carbohydrates, meaning that most people that are also inactive have unhealthy sedentary muscle. And so what does that look like in blood? Or if someone goes and gets a function test, what does it look like or whatever? And it is the following. You have elevated levels of blood glucose. You have elevated levels of triglycerides.

So you are now missing. matching your nutrition for muscle health and you have elevated levels of insulin. So there are two sides to the same point. There is muscle that is unhealthy, meaning it's full of muscle glycogen. It has not been turned over. It hasn't been emptied. We get fat that then infiltrates into muscle over time, making muscle itself less effective, both metabolically and from a strength standpoint. So this is totally not ideal. So that's the metabolic part. So you get You kind of screwed up glucose metabolism. You get more insulin resistance.

You get more pre-diabetes. It's sort of a vicious cycle where you have not enough healthy muscle to actually regulate your metabolic health. But then there's other parts, like the immune part and the hormonal part of muscle. So talk about those. Yeah. And this is also really fascinating with aging because there are changes that seem to happen with muscle as we age. And that is it becomes more resistant to things like amino acids that stimulate muscle. it becomes, so there are immune cells within skeletal muscle and those become less robust.

Skeletal muscle that is not moved can then become atrophied. And also there's a nerve relationship so it becomes less responsive. There's a denervation that happens. And all of these things are thought to be as normal parts of aging. Potentially, I don't necessarily agree with because what we see is when, you increase activity, like we're talking about resistance training, non-negotiable three days a week, plus some kind of cardiovascular, you can improve skeletal muscle to then respond and look like youthful muscle. And that's fascinating. At any age? At any age. It's so interesting. I went through

this horrible catabolic state last year. I came and saw you, remember? Yeah, barely remember. I was so high on narcotics. Well, anyway, I did, I came and saw you. There was great music playing. I do remember. And I lost 25 pounds of muscle because I didn't really have any body fat. I was already like a 10 or 12% body fat. And so I just lost my skeleton and my muscle. And I was worried. You know, I was 65.

Didn't know if I could build it back. Didn't know how my body would respond. You know, I know all about this phenomenon of anabolic resistance, which is as you get older, it's harder to build muscle. And you know what? I just doubled down on everything that I knew to do, which was strength training, you know, testosterone therapy, which made a big difference because my hormones were just in the tank after the surgery, like 100, 200 or something. Unbelievable.

I had, I used creatine. I use high doses of protein. And when you say high, we should talk about that. Yeah, so I would have like 50 grams for breakfast in a protein, weight protein shake. I would put in creatine. I would put in mitochondrial, which is flu-mer. Yeah, urolithinae. A molecule that helps build mitochondrial help and reduce inflammation.

And I was just deliberate in the gym every day for an hour. And so I couldn't do anything at first. I could do was lay on the floor and we're going to actually get on the floor. I was laying on a massage table and I would put a band around my knees and just open my knees back and forth and activate my glutes. Like that's how I could. But that was enough to then begin to stimulate the tissue. And I just want to say something. I could do like 10 pound weights.

Now I'm doing like, you know, 50 pound weights. I mean, you're strong. Yeah. And you had mentioned myokines, which I think is important. Yeah. And myokines are these proteins that are released from skeletal muscle based on contraction and duration of exercise. Now, they were discovered in the 2000s, early 2000s in Copenhagen by an exercise. She's actually an MD who also is an immunologist, really.

Bendings of Pedersen. Henderson. And there are thousands of different myokines, but what is so interesting is when you contract skeletal muscle. And we're just thinking about you had an injury, we'll call it an injury or a catabolic crisis. But when you went to go contract that skeletal muscle, the myokines that were released did a number of things.

So number one, stimulates bone, as we know. So it's not just the pulling, but also help stimulate BDNF in the brain, which is brain-derived neurotropic factor. Also, it secretes inner lukin-6, which people always think about as this cytokine storm from macrophages and other cells, but when released from muscle,

it helps balance the inflammatory response. And so there's this pleiotrophic effect, there's this positive effect when these myocines are released from muscle. They do things we don't even, even know about. And so that's this idea of exercise as medicine. And by being able to dose exercise appropriately, we should be able to get these responses that are beyond just the responses by improving blood flow. Right? So there's the muscle mass and strength. You're on the ground doing

your clam shells to try to then stimulate and engage your glutes, which is really important. We know better leg strength means better mobility, better activities, daily living. But it also means better cognitive capacity. Yeah, definitely helped for sure. So really, it's such an interesting thing. You've got all these different functions of muscle, most of which have not been ignored, most of which I certainly never learned about in medical school. Doctors don't know how to assess sarcopenia or loss of muscle. They don't know how to treat it. They don't know the first thing about it. It's kind of amazing to me. And I remember when I worked at Kenya Ranch in the 90s, we had a DECSA machine and everybody would get a Dexit scan. And I was like, this is really fascinating. And we looked at

bone density, obviously, but we also did body composition. And in fact, then nobody was looking in body composition. And we were seeing, you know, all kinds of interesting things that people didn't know about in terms of where the distribution of fat was, where loss of muscle was, increased body fat. And it was such an incredible tool. But now with the imaging to Ezra, the company, the company that's part of function, we can now get sophisticated MRI assessments to see where you're at. And then you can track it longitudinally over time to see what your interventions are doing to help. And, you know, one of the things that I think, you pioneered is this idea of muscle-centric medicine. We talked about, and not just sort of at an abstract level, but how do you

actually apply this in your life? And your new book, the Forever Strong Playbook, which everybody should get a copy of. And you agree, you're going to do the training program. Why don't we start you on that? I am. And we'll do it before and after. Let's just see what happens. If I follow your Your six-week program to my muscle? Yes. I'm going to get even more ripped. Okay, but it's also not fair because kind of genetically, you're also very lean. But why don't we do that?

Why don't we do a body composition assessment before and strength assessment before and then do this for six weeks and do strength assessment after? And we'll talk about it on my podcast. I love that. And we'll talk about the results from Ezra on my podcast. I love a challenge. And I know you do. So let's...

I'm obsessed. Like, I honestly, I had to be honest, I hated strength. I hated the gym. Do you remember last time I tried to get you go to the gym? You know what you said we were going to do? You wanted to go for a bike ride instead. I know. I'm like, but now it's like I'm addicted. Well, it's non-negotiable. Now it's non-negotiable. And even if I'm traveling, I'll go to the gym. I'll bring my little bands if I can't get things. I have, you know, all these different tricks. Let's talk about a few of the practical strategies that people can do, which is why I wrote this book. Now, there is this concept of, progressive overload. Okay? Progressive overload is increasing the amount of weight necessary to get a particular outcome for strength or hypertrophy. We'll just put it all together. But the reality is it's about progressive stimulus. And the reason I say progressive stimulus is because, again, you are traveling. And there are many people that are listening to this podcast that say are in perimenopause or menopause and the last thing that we want them to do is to injure their shoulder, which maybe

they've presented with frozen shoulder or injure, listen, you know, I've had a bazillion injuries. The reason I say it's progressive stimulus is if we take a step back, muscle strength outpaces, tendon strength. Yeah. And it doesn't mean if you are listening to this and you are new to training, it doesn't mean you just have to lift heavier. Heavy is relative.

Yeah. One to two reps in reserve, meaning with good form, there's mechanical failure and then there's technical failure, right? You want the muscular failure, the mechanical part. You don't want your form to be all over the place if you're supposed to do a squat, but you're lifting it with your neck. That's wrong. Right.

And so what are some of the foundations of a great strength training program that is non-negotiable and everyone can do? I mean, that's three days a week. It's full body. It's all about how you progress over time, and the progressions could be reps, could be tempo, could be adding more volume. There's all different ways to improve muscle health. That's not just lifting heavier.

Well, you say that because I was in a bike accident and limited, but I didn't stop training. A lot of people, when they have an injury, they go, well, I'm just going to chill. and take this chance to just watch Netflix and lay in bed. You know, but I have like a broken ankle, a broken foot, you know, kind of banged up pretty bad. And I just was like, I'm not letting this stop me. And I can't lose the progress I've made. And so, you know, I'm working with someone who's helping me adapt to it.

But I'm also using these things called blood flow restriction bands. Yeah, let's talk about that. And yesterday we were in the gym and I was like doing like 10 pounds with these things on. And I'm like, normally I can do like 25, 30 pound curls. And I was like, ah, you know. And so you can do things without hurting your tendons as you get older and the deal with this injury risk and make your risk for injury a lot less but get as much or more benefit. Blood flow restriction is something that we've been using in our clinical practice forever. And let me just highlight blood flow restriction.

Yeah. So blood flow restriction was originally used in rehab and we use it a lot. A lot of the soldiers use it for rehab for injuries. And what it is is you'll put a cuff on and there's various cuffs. I use a Bluetooth cuff called Saga. Have you ever heard of them? I use Katsu. Okay, Katsu.

So this is, that's like a Japanese crispy chicken. That's a very advanced cuff. And what it does is it accludes the blood flow, meaning it will calibrate to a certain millimeter of mercury. And then it like a blood pressure. It looks like, it feels like a blood pressure cuff, but a little bit more robust. Yeah. And what it does is it allows you to train at a front.

of the weight that you would normally train to get the same stimulus. So what does that mean? So you had just said that you do 30 pound curls. You could pick up a five pound weight. Yeah. And it would signal to the body because, again, your blood is partially occluded and it sends growth factors. And there's very standardized ways of doing it.

And Dr. Jeremy Lennoxie, who is one of the world leading experts on blood flow restriction. He was on our podcast and he just gave a masterclass in how to use blood flow restriction very particular for outcomes, right? So it's it's not this kind of just haphazard use. It's what percentage are you including? What exercises are you doing? What is the injury that you're trying to work on? And it's, it's, you know, obviously I'm not there, your guys is doctor or neither is Mark, but this can be very safe and effective. Yeah. I used it when I tore my hamstring.

I still use it. I travel with these blood flow restriction bands when I don't have access to a gym as well. That's right. You can do body weight stuff and it feels like heavy weights. Yes. I mean, I get these incredible pump on my arms. I look, my arms are almost as good as yours after I'm done with my workout.

But it's extraordinary and also for more advanced aging people. Yeah. It's great. And also if you don't have a ton of room, like let's say, you know, someone is on bed rest or someone is injured by just simply inflating that cuff even by doing a partial pushup or even pushing against the wall, some kind of muscular movement actually has, again, just profound effects from injury and also maintaining muscle and blood flow, which is, again, really important.

Let's get into kind of the details a little bit because clearly muscle, as you've laid out, is such a neglect that an important part of our long-term health, you call it the organ of longevity. I agree. I think, you know, if you look at all the things you could do, I mean, when you're younger, you have a lot of trophic factors and hormones that keep you kind of going. When you get older, those change and you end up, you know, having the dwindles, we call it, in medicine. I never, wait a second, I never heard of the dwindles.

You never heard of that? No. No, you're a geriatrician. I know. We didn't. We never called it the dwindals. That is definitely not a geriatric word. that is a Mark Hyman words, but okay.

It's like, you know, you see a slow, gradual decline, you dwindle in your ability to function. David never heard of that either, the producer. Well, anyway, maybe I made it up. It's something that you kind of notice. And like you said, what we see in our aging population, we think is an inevitable part of getting older, which is this decline in ability and function than doing things.

And the truth is that that's not inevitable. Now, it takes a lot of more input and work and dedication and diligence, and I want to really get into, what does it actually take? Because, you know, people can hear this and go, well, I'm not going to go to the gym every day. No, they're not.

They're going to hear this, and they're going to go, you know what? This is the new standard because this is more impactful than any medication I could ever take. It really is. I mean, you're losing body fat's important, but I would argue along with you that I think building muscle is probably one of the best ways to lose body fat,

but also to wreck your metabolism, to lower inflammation, improve your cognitive function, to improve your immunity, Help your sexual function. I mean, pretty much everything. You're immune, everything. And also we have a direct mechanism. So one of the things that we have to understand is that, you know, in medicine we have to ask, okay, so what is the mechanism of action? So for example, muscle mass and sexual function, which we published with my colleagues at Baylor, we have a direct action. And that is what does muscle do? Muscle, strong muscle improves endothelial function. Okay, improves all vascular health. Strong, healthy muscle mass improves NO2, which is vasodilation.

Strong, healthy muscle helps improve metabolic risk factors. Helps control blood glucose, helps control fats. And it's under voluntary control. And you had said something that... Sounds like a good ROI. There's also twofold. We just have to become more strategic at the inputs that we put in. Meaning, what does that mean in terms of inputs that are valuable?

You know, as we age, you'd pointed out when we're younger, our system, you know, it's this idea of mTOR. We've all, people have heard about this, but anyway, it's this protein kinase. It's this growth fact. It's this growth perpetrator. Yeah. And when we think about it, it's in all tissues. So mTOR, and I'll get to why this is even important, not to get too caught up in the weeds, but mTOR, which is responsible for muscle protein synthesis, is in all tissues. the signaling of our muscle decreases the efficiency becomes decreased to inputs like protein.

And so when we're young, we're highly anabolic. You know, you've met my son, my little one, he's training for the CL teams, he's four. He's highly anabolic. He could have five grams of protein and it would still stimulate his muscle because he's growing. He's driven by growth factors and insulin. But when we're done growing, then this impact. has to change. And this input would then be resistance training, calories, hormones, carbohydrates, and the balance between all of them changes. So we have to get protein. Well, protein is right,

the amino acids. And that's probably the most important. The most important is the resistance training input, the mechanical input, and then the protein input, primarily lucene. So let's get into the protein thing because, you know, this is a hot topic. Still. You know, fat was the boogeyman and then carbs are the boogeyman. Now, lack of protein is the boogeyman. Black or just protein in general. And yet there's this sort of bias that too much protein is bad for you.

We certainly learned that in medical school, you know, that it can stress your kidneys, that you don't need it, that your body wastes it. It turns it into calories or energy, turns into glucose to be too much. And what you're saying is we need far more protein than most people think. And that, you know, you've got guys like Chris Gardner, who I know well, they respect him. He's a top stand for scientists. But he's very, very strong in his opinion that we don't really need that much protein, that, you know, you can get all the protein you need from, like, grass.

And I think that there's some challenges with that. And I think especially as you get older, there's challenges with that. I think the RDA, which is the recommended dietary allows, was designed for preventing deficiency diseases, like protein malnutrition, not necessarily optimal health. So when people talk about 0.8 grams per kilo, protein per day, which is, you know, 0.37 grams per pound, which is a third, basically a third of a gram per pound.

It's really so you don't get a disease. It's not for optimal health or muscle building, or it doesn't even adapt to what you need as you get older. So how do you help people understand the right, frame for protein about what we need, when we need what, how to eat it, when to eat it. Probably my favorite question, aside from one on my kids. Now, I want to just touch on Gardner and the episode that he did with Andrew Huberman because we did a response video to that with Dr. Donald Lehman, who is one of the world-leading protein researchers who's trained me

for over 20 years. I did a debate with Chris Gardner on the Dyer's CEO, and they haven't published it because it was so controversial. I would really encourage people, and I will send it to you. I would really encourage people to listen to that episode with Don Lehman. Again, Don is not out in the- It is on the podcast. And I will send you a link. Yes.

The Godreale Lyon podcast. But I am going to send it to you because it's, it addresses each statement that, because again, you know, it's fascinating to think that how we're communicating science now is like this, which is incredibly. valuable. You and I are sitting down and we are talking. But you and I have both been in medicine for a long time. Arguably, you more than longer than me. Thank God. You and I know that we would sit down and there would be grand round. And then there would be, you know, for me, it would be like experimental biology where you have these world leading experts have discussions and they would come together. And I just say that

because typically science is not debated on platforms. So for example, we would take a look at this study and we would say, okay, this is... It's sort of sequestered to the halls of academia, not in a public forum, which is now what's happening, which I don't think is a bad thing. I think it's a good thing. It is, but it creates a lot of confusion. It does. For example, Chris Gardner talking about how we're getting too much protein, you know, many of his fundamental statements were incorrect. And so put that aside, I encourage people

to listen to that. Let's talk about where we are in terms of protein and where that information came from. Now, in the 70s, early 70s, there was the McGovern Committee, which then informed the dietary guidelines. That's right. The McGovern Committee was written, do you know who it was written by? I think I do. A staff writer in their early 30s that had an economic degree. Yeah.

This person wrote the documents that then informed the dietary guidelines, which arguably we have barely changed. Yeah, and they were actually better when they were skim out. And then the industry got involved. They made them change a lot of things because they were basically talking about eating less starches and carbohydrates, but then actually they made them change it. For whatever, but we just have to understand that nutrition is an interesting aspect of medicine because, you know, it's not like endocrinology or not like gerontology. Nutrition has a lot of inputs from food supplier, from industry, from politics.

Okay, so this then changes and informs the public. So the dietary guidelines have a list of recommendations. For example, it's 10% saturated fat. Anything more than 10% saturated fat is considered unhealthy. But let's just frame this out appropriately. And then the protein recommendation is 0.8 grams per KG. Then the carbohydrate recommendation is 130 grams of carbohydrates per day. Now, let's look at just the fat component.

component. By making 10% saturated fat or more unhealthy that weaponizes food for almost all animal-based foods. For example, an egg, one single egg that has a total of six grams of protein has, I don't know, 16% saturated fat. Maybe it has like half a gram. Right? Six grams of fat. There's tons of high quality protein. coline, fat-soluble vitamins, B-vitamins. But because it as a food has 16% saturated fat, now this is considered unhealthy. Let's take one more example. If my husband who runs marathons is eating 4,000 calories a day, his saturated fat intake can be 44 grams.

Because... Because of the 10% because of the dietary guidelines, which we're going to circle back to protein, because obviously protein is the most essential. and important macronutrient in the world. The most important. But people don't realize this, but it's the only macronutrient we need in large volume.

So we need no carbohydrates or essential. And only 4 grams of essential fat acids. And we need very low amounts of essential fatty acids, but you need like literally multi-gram. You do. And every day, and here's why. We'll get to that. So 10% saturated fat or more is considered dangerous.

However, in medicine, you and I both know that there is a dose and a poison. is it 44 grams like my husband on a 4,000 calorie diet, or is it 14 or 16 if I'm having a 1,500 calorie diet? So the question is, what dose of saturated fat is then detrimental for human health? We don't have good evidence for that. The next one is protein. So protein, you'd mention that protein is set at the RDA. You said that it was intended to prevent deficiencies.

Now, I'm going to ask you a question. what health outcome is related to nitrogen balance? So the dietary guidelines of protein, 0.8 grams per KG, is based on nitrogen balance studies, a technique from early 1900s for agriculture to determine what was the minimal amount of protein needed for animals to grow. Based on nitrogen balance.

What health outcome is related to nitrogen balance? I always say it's muscle mass, but I think that's not the answer because it's too obvious. There's no health outcome that we know of related to nitrogen balance. Oh. And so rather than asking the question, is the RDA enough? A better question is, is the RDA a relevant number?

Yeah. And the RDA is an irrelevant number. Why? Because it's based on nitrogen balance studies with no health outcomes. And so how do we look at the upper limit or the, you know, like, I mean, there are certain populations like if you have kidney failure, you have to be careful what protein do you take. But aside from that. But it's not based on an RDA number.

No. And this is the thing is that rather than re-evaluating and reorienting ourselves to, you know, the indicator amino acid number or some other way of thinking about protein, we've anchored in on the RDA and then we argue about the RDA as if it's a really relevant number. It's not. 0.8 grams per KG is based on a nitrogen balance study, which is arguably irrelevant. Cooking isn't just about nutrition. It's a daily ritual that helped me slow down, reconnect,

and nourish both my body and mine. That's why I cook with Maiden. I personally choose their stainless clad and carbon steel cookware. Time-tested materials that professional chefs have relied on for generations. They're beautifully made, perform incredibly well, and don't rely on synthetic non-stick coatings. Stainless steel is the backbone of my kitchen. It's durable, non-reactive, and versatile enough for almost anything I cook. And when I want something that develops a natural non-stick surface over time, I reach for carbon steel,

especially for higher heat cooking. Made-in stainless clad cookware is built with true five-ply construction. five layers of premium metals layered together, and it's the gold standard in cookware design, delivering fast, even heating, consistent performance, and durability that's made to last a lifetime. High-quality cookware really does make a difference. It supports better cooking, more intentional meals, and a healthier relationship with food. Maiden is what I use and trust in my own kitchen. You can explore their cookware at Maidencookware.com and use the code Hyman for 10% off your order.

I've been using red light therapy for years, but in 2025, it became a cornerstone of my healing and recovery routine. What's amazing is how it works at the cellular level, energizing your cells, boosting circulation, and supporting faster recovery. The science is just as compelling for hair. Red light around 650 nanometers can stimulate hair follicles, activate stem cells, increase blood flow, and reduce inflammation, the key drivers of thinning hair. Clinical studies show it can safely improve hair density and thickness in both men and women. That's why I recommend Bond charges red light cap just 10 minutes a day, a few times a week, and you're giving your body the support it needs right at the cellular level. Try it today at bondcharge.com slash hymen and use code DR mark for 15% off. That's B-O-N-C-H-A-R-G-E dot com slash hymen code DR mark.

I mean, I don't know if you've single-handedly done this or who else is on the bandwagon here, but now protein is in everything. It's like everybody's talking about it. Right. And you and I know when we've been having this conversation, I've been having this conversation for 20 years. And it's great that it's caught up. And then it's getting the visibility it deserves and there should be good evidence and guardrails.

So 0.8 grams per KG while people are talking about the RDA isn't irrelevant number. We know, again, and I've sent this unidepressant. So what should be? What should we be eating? Well, the data would suggest beyond 0.8 grams per KG, the data suggests anywhere from 1.2 to 1.6 grams per KG, which could be on the lower end, 0.7 grams per pound. up to one gram per pound target body weight. But how do we make our protein decisions?

Your ideal body weight. No, no, your target. But if you're 300 pounds, target body weight. Like what you ideally would like to be. Yes, you can say it. Otherwise, if I'm 180 and I want to get to 190 with muscle, I have to eat 190.

Yes, but let's frame this out a little bit. And I make this very easy to think about in the book. The book doesn't have a ton of numbers, which is interesting because we always calculate the macros and calculate the calories. I made this playbook so that it's visual. And the visual component is one third of your plate should be protein. One third of your plate should be fruits and vegetables.

The other third is complex carbs or starchy sugary carbs that you earn, which we'll talk about. But the protein conversation is really important. 0.8 grams per kichi is an irrelevant number based on nitrogen balance studies. all of the data coming out largely for the last 20 plus years is 1.2 will always perform better in a number of ways than 0.8 grams. Okay. Higher protein 1.2 to 1.6. So double the RDA. What happens?

Improvement and retention of lean body mass. I didn't say muscle because we haven't really been testing muscle. Lean body mass. better regulation of blood glucose, better regulation of triglycerides. So when I was running a weight management clinic at Washu and also in our practice, in order to tell if someone is following their nutrition plan, we watch their triglycerides. Yeah, of course. Right?

140 grams of carbohydrates or less, we typically see an improvement in triglycerides by 20%. Those are the things that are most highly correlated in an acute way to the amount of sugar and starch you eat. But it's actually related to muscle health. So if muscle is healthy, you have more flexibility. So these indications of metabolic syndrome, elevated levels of blood glucose, elevated levels of triglyceride, elevated levels of insulin, they're not a reflection of metabolic syndrome. They're a reflection of muscle health. Now, we talk about protein as if it's one thing.

Protein is 20 different amino acids, nine of which are essential. But they all have different biological pathways, and there's biological. needs that are different. So for example, as we age, glutathione, glutathione production goes down. We might need three times more protein in methyanine as we age than we do when we're younger. Thionine is one of the building blocks of blue dioxide. Right. So it's one of the amino acids. When you are eating for muscle health, all of those amino acids essential and non fall into line. And, you know, someone's listening to this, well, okay, protein is protein. Why do I need protein?

well, you need protein for everything in the body, but it's not just protein, it's these amino acids. It's these individual amino acids that you need. Lucine is important for muscle health. For muscle health. You're the one who taught me that lucene was the rate limiting amino acid for turning on the switch that starts you to build muscle. Yes, but you need all of the amino acids to build muscle,

which is, you know, if we begin to just unpack what does that look like. So 20 different amino acids, nine in which are essential, you must eat them for a number of reasons. The first thing is understanding that we don't need it just for muscle. The body turns over recreates itself four times a year. Yeah. On a daily basis, protein turnover is between 250 to 300 grams a day. Meaning you are metabolizing your own body's protein and recycling it and using amino acids. They were formerly a different protein.

Correct. And at night, you are in a catabolic state. But it's not that it's turned on and off. You've got enzymes that are degrading. You are constantly requiring these proteins. It takes it from muscle. So it's not just that low muscle mass is detrimental for mobility. Low muscle mass is detrimental for healthy aging.

And we cannot meet our turnover needs with the kind of diet that we have right now. So we need more protein. So people should be focusing on point. 0.7 to 1 gram. And that's for everybody? For everybody. And the way in which you do it is important. When you're young and under 40, it doesn't matter what you do.

Protein distribution and timing doesn't matter. Meaning when you eat it. When you eat it, how much you eat at once. But as you get older, you have to learn how to make protein decisions. And there are a handful of steps that you fall to make a protein decision. Tell it to us. Number one, age. The older you are, the more protein you need.

Period. Number two, physical activity. The more sedentary you are, the more protein you need. Really? Yes. Because we were talking about mTOR, which, you know, was mammalian target of rapmise and this protein kinase complex. Can you build muscle just by any more protein without exercising? Not really. Not really. That's what I thought. You know, people will say that, but if you go back, well, number one, the other thing that we have to recognize is that the studies and the literature out there, it takes a long time. If you think about sarcopenia, it's in a span of a decade, you're losing 4% or more of muscle mass. That's a very slow decline, if you think about it. Can you imagine trying to look at these 12-week studies and try to get a sense of the input of 1.2.2.000.

to 1.6 grams per KG, it's, this stuff is not very sensitive with the tools we have. We're not taking someone's muscle and then stripping it down, right? So we have to understand that low protein intake is over a lifetime, right? These effects are over the lifetime. So the protein decision is the older you get, the more you need. Number one, your age. Number two, activity. The less active you are, the more protein you need. Because if there's two main ways to stimulate muscle as you age and becomes less sensitive. It's the mechanical input as resistance training, and then it's the protein input. And then your metabolic health, right?

So the next choice would be, how do you determine how much protein? Well, you know, you want to begin to limit carbohydrates if you're metabolically unhealthy, and you want to increase dietary protein. Because ultimately, if we match our diet to our muscle health, then we will be able to live a long healthy life. What does it look like? Because people go like, God, it's a lot of protein. But why do they think that? Because we've been taught. Right. But what does it look like to eat it? Like breakfast, lunch dinner. So very simple. This morning I had a protein shake, which was 50 grams. Great.

Weight protein. Amazing. And put in 10 grams of creatine. You're like rock star. Your brain function is amazing and you threw a little urolithine in there and look at you. I did. You're like, you're doing amazing. So there's a couple ways to do it. The first, meal when you're coming out of an overnight fast is the most important. People talk a lot about fasting and at some point, if we believe that muscles the organ of longevity, I don't really care when you have breakfast, but recognize that after an overnight fast, you are in a catabolic state, right? And you're not just your muscles, but you've got enzymes and everything else is repairing and rebuilding in your body. That first meal, your body is primed for nutrients.

It doesn't have to be at 8 a.m. It could be at 10 a.m. Between 30 and 50 grams of protein is ideal. Okay? What does that look like? It could be a 15 gram, a 50 gram protein shake. It could be. It actually double what the says on the label says.

It says two scoops is 25. I put in four scoops. Well, I love that. But it's a lot of smoothie. Correct. I mean, I have a big guy going to have it, but it's a lot of. So let's talk about another, let's talk about something that I do. Right.

So for me, I might have a. scoop of a weight protein shake, which has about 20 grams of protein, two and a half grams of lucene. But that's not enough for me because, you know, I'm burning the candle at both ends and I'm training hard. So I'll add in a scoop of essential amino acids. You supplement with amino acids. I do. But I do it very strategically and for a very important meaning. So I know that you use body health. So do I. Perfect aminos. It was a big part of my recovery too. Yes. And so there's great evidence for recovery and also for people who say want to control their calories. You have a base of protein and maybe it's 20 grams and then you add in a scoop of essential amino

acids and now you bump up what your body sees. Just like jacked up a little bit. Yes. And there's a lot of data out there on this, especially looking at the aging population, which I think is really impressive. When you're young, you can get a max muscle stimulation at, you know, 14 grams of protein. But 14 grams of protein for you and 14 grams of protein for me won't, it won't stimulate our muscle. But by doubling that amount or by adding these essential amino acids, you now can create a robust response that's critical for aging well. So you have a protein shake with some extra amino acids. What if you don't want a protein shake, what's breakfast look like? Eggs.

You need six eggs to get 30 grams of protein. That's right. So do three eggs plus essential amino acids. I've just solved it. Also, what about Greek yogurt? Greek yogurt is easy. The minimum you want to hit is 30 grams. And what is that?

Six ounces, eight ounces? Yeah, so it's a cup of yogurt. We'll have like 20. And then you could have turkey sausage, chicken sausage. If you are vegan or vegetarian, then I highly recommend essential amino acids. And then some kind of multivitamin. So what do you do? Again, if you're vegan and vegetarian, it could be tofu.

You know, the majority of plant protein comes from wheat in the U.S. diet. Yes. And wheat is a very poor source of these essential amino acids. So we're really talking about improving protein. We're talking about improving nutrient density. Protein quality. Protein quality. So it would be lunch.

So for me, actually, and also from a dosing perspective, lunch doesn't matter from a protein amount. Yes. And why? Because we don't have a ton of data. Does it have to be 30 grams of protein or is your muscle still primed? The way I think about lunch is that that's the place where you just get your extra protein. The most important part about also these meals is balancing carbohydrates.

So for lunch for me is so lunch today is going to be I prep all my food on a Tuesday, by the way, prep all my food on Tuesday. Lunch for me, you might laugh at me, is going to be protein waffles. made with cottage cheese, almond flour, and some blueberry compound. Blueberries, you're reading blueberries now? Of course. I couldn't even let you eat weird. I know.

Yeah, see, I've evolved. So the protein waffles are amazing. So that is one of, it's a recipe that I put in the book. So all the recipes in the playbook are easy. Yeah, there's some great recipes in this book. And there's great images of exercise. You've got a little avatar cartoon of you that was really great. And it's like, wow, this is something I actually could follow.

Because I was like, all right, well, I want to vary something. I don't want to do something I travel. I don't always have my trainer. Like, what do I do? And this is really, really great. And then let's talk about dinner. Dinner is the next. I often will have like a couple of cans of sardines.

That's like almost 50 grams. Yes. But if I need 180 grams of protein today, that's a lot of protein. But for who? Well, I'm saying like if I have 50 grams for lunch for breakfast and then I have a couple of cans that's 50 grams, I need another 80 for dinner. Yes. And so, but here's the other part is the more active you are.

So protein decisions, it's a U-shaped curve. And if you think about a U, at the top is the worst of all worlds is if you are an older person who is sedentary. This is the worst of all worlds for muscle health and metabolic health. But as you become more active than, you know, say like you're moderately active, your protein need goes down. So you offset the amount of protein you're eating with your physical muscle activity. And then as you move into the more elite activity, which I'm not doing and you're not doing, the more protein you need. So dinner would be what? For me, it's a lean steak, six ounces.

Why lean? Why low fat? Because I actually do better with carbohydrates. If I were to allocate how I want my food to be, I do much better on a higher carbohydrate diet than on a higher fat diet. And it's just personal choice. Carbohydrates and fats are interchangeable as fuel sources. I mean, you mean, you don't mean like, like, flour or sugar. I mean, you mean like a sweet potato or?

No, I just eat ice cream for dinner. I'm just kidding. No, I don't. I mean, no, I don't. Let's be sensitive because I think people hear that and they're like, oh, carbs are interchial. But I, but also, how do we think about carbohydrates? That doesn't mean like a big bowl of pasta or. We talk about how much protein someone needs in a day in a 24-hour period, close to 0.7 to 1 gram per pound.

But carbohydrates should be thought of as a meal threshold. we never talk about that. People do not talk about that. Just like protein has a meal threshold, carbohydrates should be thought of as a meal threshold. Are you ready for this? The average American is eating 300 grams of carbohydrates a day. That's three glucose tolerance tests a day. Okay?

But how do we recreate? About four. It's 75 grams in a glucose tolerance test. How do we re? That's really funny. How do we recreate that? So for me, dinner is around 40 grams of carbs. Yeah.

40 to 50. Okay. Anything above that for someone who's listening who is sedentary begins to distort metabolism. And I cover this in the book. Yeah. It's something called a carbohydrate threshold. Carbohydrate threshold is how many grams of carbohydrates can you have at a meal before you begin to distort metabolism?

What the choices are, again, one third is protein. One third is fruits or vegetables, fibrous carbs. one third is more complex carbs. Is there a place for pasta? There is, if you're training hard, right? There's a place for pasta. But for me, you know, I like potato. I like white potato.

Yeah. I like resistant starch. I might make the rice. I mean, I eat rice. Yeah. But again, I eat. I also train. Yeah.

And I am not grazing all day long. The thing is, you know, what people don't realize is there's this concept of metabolic flexibility. Correct. If you're a diabetic and you have a can of Coke, your blood sugar are 300. If you or I have a can of Coke, our blood sugar won't go above normal because we're metabolically able to handle the same sugar load because we're trained and where our muscles and our tissues are more sensitive to insulin and we can actually regulate our blood sugar

in ways that people can't give in the same exact dose of carbohydrate or the form of carbohydrate. Yes. That's really important. I want to kind of shift gears a little bit. I think this is fascinating. I think, you know, we covered a lot, but I want to talk about some of the sort of added things that I do and I know you do. I mentioned creatine, and I think there's a lot of increasing data on creatine. Oh, yeah.

For using it for a long time. For cognition. Beyond muscle. For muscle welding. It's a mitochondrial cofactor. And I use a lot of mitochondrial therapies from my own health because I've had mitochondrial issues. And one of the things that I've started using is something called urolithine, which for those of you don't know, we've talked about a little. on the podcast, but essentially it's a, it's a molecule that's what we call a postbiotic,

as opposed to a prebiotic or a probiotic. It's a molecule that's made from using microbiome converting certain plant chemicals, ledge gas and others from pomegranate and walnuts berries into this molecule. The problem is most of us have taken antibiotics. Most of us, I mean, I do, I do talks and I have a thousand people. I'm like, who here has never taken anybody? Like maybe one personal raise their hand or maybe nobody. And so we've all kind of messed up our gut and have trouble making this.

But this molecule is found out to have some really extraordinary properties around muscle quality, strength, longevity, muscle function, inflammation, immune health, mitochondrial function. So can you kind of walk us through what the research is on this compound? I mean, they're talking about grip strength and things like the thing that kind of blows my mind about the research on this is that even without exercise, it seems to improve your fitness and strength, which seems a little bit weird. to me, but it seems to be true based on the data, including VO2 max, grip strength, things that are highly correlated with longevity. Now, urolithinae is a postbiotic that the majority of people cannot make. And this comes from these alagetanins, from walnut, pomegranate, and let's say you could make it. It would be, I don't know, six, four cups of pomegranate juice.

It's a lot of sugar. But the reality is, is this urolithinate compound is so fascinating. And the company that we are both talking about is timeline, because I don't recommend actually other forms of urolithinae because I think it should really be tested. Yeah, they spend like $100 million researching these stuff. It's crazy. And it's published in JAMA and major medical journals. It is.

It is. Like there's a lot of crappy supplements out there. And there's a lot of hype and promotion. This is one of those things where, you know, you and I focus on where's the data, Where's the evidence? How good is it? You know, where is it? I mean, I'm a huge fan. And we had Honorog Singh, which is one of their immunologist scientists on the podcast.

And there's some really cool stuff that urolithinae is responsible for. What does it do? Its primary role is in mitophagy. And that is the removal and degradation of old mitochondria. Yeah. And, you know, when you think about muscle and you think about urolithinae, the house of our mitochondria, the majority, of our mitochondria is in our muscle. And one of the things that your allithin A does is it really

helps with this turnover process. And the other fascinating thing about your lithon A that... It cleans up old damage mitochondria and helps build new ones. Yes, it does. And the other aspect in terms of energy and metabolism, I think that we're going to start to see emerging data. So we know that it helps improve strength and endurance. Again, grip strength. I think there's also evidence for its use in individuals that are going through chemotherapy. Because it helps with this muscle metabolism component. And it's a really extraordinary compound. One of the things that we hear in our clinic is that people's energy improves.

I think that there's also going to be some emerging data on cognitive function. It's also, I think a paper just came out in, was it in JAMA on immune function and urolithinae. They just published another recent paper. And we typically recommend 1,000 milligrams a day. That's what I take, yeah. And you can take it in gummies, you can take it in powder, you can take it in pills. Yeah. It's pretty extraordinary.

It's a pretty extraordinary compound that we definitely recommend. And I think, you know, what I like about it is that, you know, it's sort of a phytochemical. It comes in nature or sort of if your microbiome mix it. But it works on the mitochondria. And the mitochondria are tricky because they're very delicate little organelles inside our cells that convert food and oxygen into energy or ATP that runs everything in our body. And it's sort of the foundation of our health. And most age-related conditions are mitochondrial disease.

In fact, sort of aging itself is a decline in mitochondria. See a two-year-old running around like a jackrabbit and a 92-year-old sitting on the couch doing nothing. Yeah. The difference is their mitochondria. And our ability to improve our mitochondrial health as we get older is partly related to exercise, strength training, muscle quality, you know, cardiovascular fitness, both muscle, strength training, and also to, you know, things that we can actually influence by reducing our level of inflammation and toxins and infections and all the things that potentially affect it.

But there are a lot of mitochondrial therapies, and it's something that has not been, really well utilized in medicine at all. And what happens is that, you know, as we think about chronic illness, whether it's dementia or Parkinson's or obesity or diabetes or even cancer, you know, autism, you know, mental illness, depression, bipolar, schizophrenia, the list goes on. These are all mitochondrial diseases. And you and I went to medical school. And I think we had our first year.

we learned biochemistry and we learned about some mitochondria and histology and like that was kind of it. Yeah. There's no like, how do you evaluate mitochondria? How do you test them? How do you treat them? How do you optimize their function? And as someone who at 36 years old got walloped with chronic fatigue syndrome as a

result of mercury poisoning, my mitochondria like, were in bad shape. Like my CPK, my muscle enzyme for 600. Really? Yes. For years and years and years. It's a sign of mitochondrial injury, basically muscle damage. Yeah. And I could feel it.

Rabdo, not at 600, but. What's that? Rabdo, you know, as I was just thinking. It wasn't from rhabdomyalysis, but it was like it was some degree of muscle dysfunction. I mean, when you get on a statin, that causes muscle injury. It's a mitochondrial toxin. And it actually leads to these muscle pain syndromes and also elevations in this muscle enzyme that I had.

But what I'm saying is that I got to really learn, okay, what are my mitochondrial? How do they work? And I started applying this in medicine. And so uralithinae is a really powerful mitochondrial nutrient. But there's many others, Kocutan, carnitine, creatine, ribos, and an acetyne, all the B vitamins and magnesium. There's a lot of things you need to actually produce energy. So it's important to really understand how do they take care of their mitochondria.

And so this is one incredible tool. And I think it's of all the sort of longevity. I agree with you. Well, in the supplements, it's quite unique. and it's part of my daily staple, actually. Same. I'm very careful about the, it's actually in this book, by the way. Yeah, I know.

You wrote about it in the book. I was going to say that. I did. Because it is something that with all the velocity at which information spreads, how do we begin to make choices that actually can move the needle? And I think that eurylithanae is a great one. Absolutely. And I think we're going to start to see it be more involved.

in what I would love to see is how it actually helps those with chronic illness that are going through therapies like chemotherapy. Well, it was so much more to talk about. Is there anything else before I hit the quickfire questions at the end here that you want to share about what you're doing, what's important, what's in the book? I think the big takeaway is what many of the diseases that we're seeing now are a mismatch for muscle health. And if we don't become careful, we're going to trade an obesity epidemic for an epidemic

of sarcopenia, and we have an opportunity to not recreate history. And it's happening right now in a way that we've never seen before with the use of gLP ones. And then also with now the more liberal discussions on hormone replacement and specifically the anabolic agents, this is, this is the time. And we're learning a lot. Yeah. Yeah. Yeah. Yeah. The GLP one thing is interesting. I mean, it's not black or white. They're not good or bad. They're like any other tool and when they're applied properly, they can be helpful. When they're applied improperly, they can be extremely armed. And they can help with the intramuscular adipose tissue. Yeah. And again, the next conversation that I would love to see as we begin on this journey,

just in general, on reorienting ourselves to muscle health, is that anabolic agents, beyond testosterone or these myostatin inhibitors, what else do we need to do that affects muscle health? And I will say one last thing regarding this is that a patient can go to their doctor and say, I want a medication that's going to help me lose fat. And the doctor probably doesn't think twice about it. But if a patient goes to their doctor and says, I want a medication that's going to help me build healthy muscle, it's a completely different story. Two organ systems, yet two completely different biases.

Well, what's the answer to that question? Which part? What drug can I take to build muscle? There are anabolic agents that are FDA-approved, that we have to have more conversation about, that have to be more involved in the conversations, just in general. And that is... We're using testosterone more. Yes, and this is the path forward.

Yeah. As a mother and a woman, what are the top three things that you do personally to support, longevity? I spend time with the people I love. Oh, that's a good one. Just like you, I'm very community-oriented. I care about relationships. And so I do that.

It's true. You reach out to me and I really appreciate that and stay connected. I think that's an important part that we neglect. You know, we can eat well and exercise and take all our supplements. But if you don't build community connection relationships, the quality of your life is less. Your longevity is shorter. And consistently, it's not transactional for me. I'm a relationship person.

So that's one thing. What are the other two? I always train. And you mean strength training. I do. Three times a week. Yes. And if I train hard enough that if I miss a training session, let's say it's impossible.

Let's say, and it's usually not, but let's say it was. Let's say my flight was delayed or I was in the airport and the best that I could do is push-ups in the airport, which I will do. And on the plane, I did go to Australia and did push-ups in that. Yeah, but whatever. People are like, that's a crazy person. I make it count when I'm in there. The crazy people are the other ones that changed the world. So I'm with you on that.

Okay, great. I train hard enough that I'm not dependent on the next workout. If for some reason I'm traveling. Yeah. But resistance training is a non-negotiable, and people will say I don't have time, but you don't have time not to. Yeah. I train with my kids. There's a slide that I was using my talk.

And this guy was like, you have a choice. You want to be, you want to exercise one hour a day or be dead 24 hours a day. That's funny. That is awesome. And we make training a family affair. You know, I walk down. I see that in your video. I walked downstairs and my son was on the treadmill sprinting.

I'm like, Leonidas, it's 8 p.m. This is way bad time. It's like, Mom, I got to get my training in. It's my second training session today. I got to get it done. I love that. I mean, and so it's not, I'd rather have them decide on the good habits

rather than try to break bad ones. Yeah. And what's the third thing? The third thing that I do for longevity. this is a toss-up. Obviously, the obvious answer is my nutrition. Yeah. But I think the not-so-obvious answer would be spending time with my husband

and really talking about the family and the landscape of how we want to go through life. So spending time on the standards of how we're raising our kids. Your values. Yeah. That's beautiful. Your mindset and values of how you approach life. That's beautiful. Amazing. All right. Quick fire questions. Fasting for women. Sure. When does it help? When does it hurt?

If you're trying to get pregnant, I typically don't recommend fasting. Again, there's nothing magical to fasting. It's calorie control. It allows for gut rest. But, you know, if you're more mature and older and want to maintain muscle, don't recommend it. If you decide you want to do it, I train fasted. It's totally your own choice. Choose your own inventor. And, you know, 12 hours is minimum. Like, people think that's a fast, but it's not, it's normal. But people eat all night and then they wake up and eat, I'm telling you, you eat in a middle of the night. So yeah, just at least 12 hours. Artificial sweeteners, good or bad? I'm not going to like this. Eh, not dead yet.

Not dead yet. Because what is the evidence that they're actually okay for your health? I mean. The evidence that they're not. Because I think it's controversial. So I would say things like Splenda might not be great for the gut microbiome. And there's sugar alcohols. Right.

So Suzanne Defkoda is someone who I look to to answer those questions. I'm certainly not a microbiome expert. But I think, for example, artificial sweeteners, when used in moderate doses, you know, not abusing it is, you know, the data doesn't say that it's terrible for you. But again. Does it publish what? Because they're not all crazy. That's right. Like, is it monk food?

Or like, you know, or allulose or stevia. Or alulis is no problem. Aspartame or breathitol or xylitol or other sugar alcohols, melaton, those can be problematic. It depends on the kind and it depends on the dose and it depends on the person. For sure. A little bit of CB or monk fruit or. I have no. So I don't have problems with those.

So this is, again, this is just my personal opinion. I'm okay with it. I think one of the things that we have to understand is the way it affects the brain. Because it does, it does keep you lit in the areas where you don't want to be lit. Which one? All of them may increase, you know, your sweet perception, which causes your brain to light up and to crave more. And so it's, I think there's probably a craving cycle that it activates, but who knows? How about caffeine?

Good, bad. All of it. So I, the people that should not use caffeine is if you're pregnant, they don't recommend 200 milligrams or more. And, you know, listen, if you have a genetic. perhaps you're a slow metabolizer, then maybe it's not great for you. But otherwise, I think caffeine has been around for a long time, studied for a long time,

and can be used well. And I drink a lot of caffeine. People make fun of me, they're like, you're 5'1, 110 pounds, and you drink more caffeine. You drink enough caffeine to kill a draft horse. And I would say that this is true. And doesn't affect your sleep? No.

That's amazing. You're fast metabolizer. Yes. How about menopause? What's the number one thing women going through that need to know? Be strong. Be strong like forever strong? Yes. Strength is a responsibility.

Strength will take you through that time. Physical strength. Begets mental strength. It's a lever that you can pull that you have control over. You have to be strong. No amount of hormone replacement is going to be a solution for being strong. It does help balance your hormones. It helps balance blood sugar and insulin.

It helps balance. It's a non-negotiable. It's the new frontier of longevity. It's just, It has to happen. What about cold exposure? Good or bad for women? Cold plunges.

I love it. I do it every day. No downside? Nope. No, and that's, I have protocols in the book. I've been hearing in the, you know, the misinformation internet cybersphere. But mechanistic, there's the mechanistic data. So when I told you that we just published this paper on sexual function muscle mass,

there has to be a mechanism that then is related in humans. So there can be mechanism. but the mechanism doesn't necessarily translate or hold up. You know, for example, we like uralithine, because we know that there's a proven mechanism translates over to humans. We like essential amino acids because there is a mechanism. We know how this works translates over to human. The idea of cold exposure being different for men or women at this point,

there might be mechanistic ideas, but I have not seen that translate over at all. and I think that cold exposure has been used for lifetimes. I have cold exposure protocols in this book. We are very acclimated to our perfect environment. It's not ideal. We want hormesis. It's a way of stress.

Same with heat. Okay, we've got a cold plunge out back. I can't wait. I would do it in a heartbeat. You give me a bathing suit. I'm not wearing yours. I will do it in a heartbeat. All right.

Creatine. Is something everybody should take or overreact? Yes. No. I think that it's, again, is there something that everyone should take? No, but creatine is, it's been around for a long time. I think there's a lot of positives. The other thing that I think is really valuable, too, we didn't talk about, is ketones.

Exogenous ketones? Yes. And you're taking ketones that are preformed, then you can take this supplement. Bidohydroxybutary, yes. Tell us about why. Because there's just more and more evidence from a brain perspective, cognitive perspective, you name it. It just seems to improve performance. I think there's a ton of benefits.

I talk about that in the book as well. If I could just make a product myself, I would definitely. That would be. Amazing. Not being in ketosis from a diet, but adding supplemental ketones. No, for brain function, right? For the ability of neurons and cells.

I mean, from a, because again, we talk about brain fog all the time and mitochondrial health. Amazing. Ketones are another one. Gabriel, you know, we've known each other a long time. I've seen you grow of all. develop your career, be a spokesperson for a new kind of thinking about muscle health. And I mean, the whole idea of muscle-centric medicine, I think is brilliant.

And your new book, Forever Strong Playbook is out. Everybody needs to get a copy. It's the playbook for you, if you want to stay healthy, long time, and be functional and feel good. Where can people learn more about your work and what you're doing? Well, you can go to my Instagram, Dr. Gabriel Lyon, my website, Dr. GabrielLine.com. We have a medical practice called Strong Medical. And we have been around for a while,

and we just have tremendous, tremendous patients and results. Also, my podcast, which you'll be coming on, The Dr. Gabriel Line Show. I have a newsletter. I have a YouTube, Twitter. I miss anything. I'm also a part-time travel agent for my kids. Amazing.

Well, yeah, we all keep up the good work. Make sure you take care yourself. And thank you for all the way. you've given us. Thank you. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman.

Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the Dr. Hyman show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show.

This podcast is separate from my clinical practice at the Ultra Wellness Center. My work at Cleveland Clinic and Function Health, where I am chief medical officer. This podcast represents my opinions and my guest's opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services.

If you're looking for help in your journey, please seek out a qualified medical practitioner. and if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultraweilnesscenter.com, and request to become a patient. It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health.

This podcast is free as part of my mission to bring practical ways of improving health to the public, so I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.