WHOOP Podcast - Protein and Skeletal Muscle: The Keys to Longevity with Dr. Gabrielle Lyon

Episode Date: May 31, 2023

On this week’s episode, WHOOP VP of Performance Science, Principal Scientist, Kristen Holmes is joined by health expert Dr. Gabrielle Lyon. Dr. Lyon is the founder of the Institute for Muscle-Centric Medicine and is a nationally recognized speaker and media contributor specializing in brain and thyroid health, lean body mass support, and longevity. Kristen and Dr. Lyon will discuss a patient’s story that unlocked Dr. Lyon’s research (3:15), where things start to go wrong for people’s health (6:35), what skeletal muscle does and the behaviors needed to build it up (11:35), the relationship between protein and skeletal muscle (13:50), how to find the right amino acids (17:20), Dr. Lyon working with patients to get proteins (21:45), fasting and eating throughout the day (26:50), getting adequate levels of protein as a vegetarian (31:25), protein and resistance training helping to prevent disease (34:25), having tough conversations about health (37:25), Dr. Lyon’s journey in writing her book (43:30), Dr. Lyon’s ideologies and practice (47:15), dealing with doubters and skeptics (53:55), talking with loved ones about health (57:40), and tips on improving muscle tissue health (1:01:25).Resources:Dr. Lyon's Website Dr. Lyon’s TEDx TalkEPISODE 45 The Science of Recovery: How to be More Resilient | Kristen Holmes Support the showFollow WHOOP: www.whoop.com Trial WHOOP for Free Instagram TikTok YouTube X Facebook LinkedIn Follow Will Ahmed: Instagram X LinkedIn Follow Kristen Holmes: Instagram LinkedIn Follow Emily Capodilupo: LinkedIn

Hello, folks. Welcome back to the Whoop podcast, where we sit down with the best of the best. I'm your host, Will Ahmed, founder and CEO of Whoop. We're on a mission to unlock human performance. This week's episode, Whoop VP of Performance Science, our fearless principal scientist, Kristen Holmes, is joined by health expert Dr. Gabriel Lyon. Dr. Lyon is the founder of the Institute for Muscle Centric Medicine and is a nationally recognized speaker and media contributor specializing in brain and thyroid health, lean body mass support, and longevity. Dr. Lyon's clinical practice services the leaders,

innovators, mavericks, and executives in their respective fields. Dr. Lyon works closely with special operations military and has a private practice that services patients worldwide. Kristen and Gabrielle discuss the connection between proteins and skeletal muscle tissue. Dr. Lina gives her recommendations on dietary proteins. How to find the right amino acids and proteins for different diets. Spoiler, you don't always need to have meat. There are other solutions.

Fasting in the best times to consume proteins. how resistance training can help prevent skeletal muscle diseases, and the importance of having tough conversations with loved ones about their health. Are you constantly in the pool, taking cold plunges, or ready to hit the beach this summer? The all-new hydronet band, that's right. Our fastest drying, most advanced fabrication yet. It dries twice as fast as supernet and retains 30% level. less water. I'm wearing it. It's amazing. You got to check it out. It's really good for water sports,

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Call us 508-443-4952, and we'll answer your question on a future episode. Without further ado, here are Kristen Holmes and Dr. Gabrielle Lyon. Dr. Gabrielle Lyon, welcome. Thank you so much for having me. so pumped to talk to you. You know, I think for the conversation today, I really want our listeners to come away with a very, very clear understanding of the link between protein, muscle tissue health, and longevity. And I'd love for us to start with Betsy's story. Yeah. Well, Betsy is actually a real person. And I was doing my fellowship in nutritional sciences, geriatrics. and obesity medicine at Washu. And part of the responsibility of a fellow is you work on a project.

And I was looking at the interface between obesity and brain function. And it's a very in-depth study. It was an arm of a very, very detailed study, which included euglycemic clamps, muscle biopsies, fat biopsies, all the things, which I had to do those biopsies. The section that I also worked on was brain imaging. And Betsy was a woman in her 50s, right? And she had three children.

She had always struggled to lose the same 20 pounds, right? She'd been on this cyclical yo-yo dieting. And in the process of that, she had really destroyed her metabolism and lost a ton of muscle mass. When I went to image her brain, her brain looked like the beginning of an Alzheimer brain. And I thought to myself, we've totally failed this person. We have totally failed with the information that we've been giving out. And when I think back, how did she get there? How did this 50-year-old woman with three kids, the nicest woman in the world? She had big brown eyes, was so full of life.

You know, how did we get to the place where I knew eventually she was going to potentially forget her kids' names, not able to, you know, use a microwave. And I realized that for decades, she and we as a medical community had always been focused on fat, obesity. Fat is the primary problem. And I had this aha moment that it wasn't fat, that the one thing in common all of my patients had was they had unhealthy muscle. Yeah.

It was all about muscle and it wasn't about fat. And that's really where this concept of muscle-centric medicine came from, which is muscle as the organ of longevity. And how do we bring that now to the forefront as the pinnacle instead of pushing it to the periphery? Because we've already been trying to fight this obesity epidemic for the last 50 years. People are more overweight than ever before. You know, 73% of adults are either overweight or obese.

24% are meeting their physical activity requirements. We have a real problem. But it's not a fat problem. It's a muscle problem. God. All right. And you just rattled off some statistics. So I just want to kind of go back to that for a second. So how many Bessies are there out there? What a great question. Way too many to count. Way too many to count. And, you know, my guess is 73%. So this metabolic crisis that we're in, that impacts the brain. It impacts every organ tissue cell in the body. It starts with our muscle. It does. So what is that, maybe start from the beginning. You know, you kind of outlined this beautiful story, Betsy,

which it gives us, I think, an incredible framework to start from. Where do things start to go wrong for someone? Yeah, that's a great question. You know, in the literature, we talk about healthy sedentary individuals. And these healthy sedentary individuals could be 18 years old. You know, they could be older. And if someone were listening to do a quick PubMed search, you would find these studies that have healthy sedentary individuals. There's no such thing.

A sedentary lifestyle is in and of itself a disease state. Period. End of story. There's evidence to support that the muscle issues, and let's just say, and I'm going to highlight to you all the things that muscle does, but muscle illness, muscle sickness, dysfunctional muscle can start at any age. and it starts with inactivity, and it starts with low-quality diet. And this, you know, again, can begin at 18 years old or younger. Because muscle, I'm going to tell you something that's so fascinating. Up until recently, we have not been able to measure skeletal muscle directly. Wait a second.

But everyone says lean body mass is how we're looking at skeletal muscle. Lean body mass includes bone. It includes all the body mass. the other organ tissues, it includes everything else other than adiposity. So for the longest time and still in the literature, people say it's all about strength, not lean body mass that matters. Doesn't matter how much muscle you have as long as you're strong. Well, actually, that's not true. And I think that we're now entering a new era because there's been a new development in a way to actually measure skeletal muscle mass directly, which is called D3 creatine, which has been,

which has been in the literature for a very long time and now recently is being used in studies. But prior to that, it's been DEXA, CT, and MRI. Right. How do you go about measuring D3 creating? Like, what's the process? Well, it's just very easy. It's a capsule. It's not available to the public yet, but I believe that it will be.

And now we're going to be, for the first time ever, able to directly measure skeletal muscle mass. So, Kristen, the big thing here is we're at the forefront of a new era. We are at the forefront of a new era because we've been able to measure fat mass forever. And because of the ease of measurement, we believe that, you know, that's what we should focus on. But there was a recent paper that came out. It was a really good paper. And Bill Evans was one of the authors. And what they looked at was they looked at sarcopenic obesity. And for the listener, sarcopenic obesity is really the decrease in skeletal muscle mass and the increase in body fat. So you're both sarcopenic and obese. And what does that mean? It means that you have two things happening, which suck. You're putting

on body fat and you're destroying muscle. But now being able to directly measure skeletal muscle, they found that the fat didn't matter, that the changes, the increase or decrease in fat didn't really matter, it was all the changes in skeletal muscle that actually impacted metabolism and impacted mortality. And now that we're able to measure skeletal muscle, it's going to change everything that we thought about lean body mass, the importance of muscle mass in and of itself above and beyond strength. Gosh. And so in terms of knowing that skeletal muscle muscle tissue kind of the, it's the canary in the coal line. How do we, what, what is the, what are the behaviors that, you know, lead to improved skeletal, you know, tissue? Like, how do we, how do we, how do we

get there? And we're going to, I think that will come to that practical aspect, but let me outline to you what skeletal muscle does. So I'm going to do what skeletal muscle does. And then amazing. I'm going to explain to you what we need to do to maintain it. So skeletal muscle is the organ of longevity. Skelital muscle is an organ system. It's not just about athletic performance. It's not just about looking good naked. All those things are a plus. Skeletal muscle is the primary site for glucose metabolism, meaning everything that you eat. 80% is disposed in skeletal muscle first. It is an amino acid reservoir. Your body doesn't readily store protein. The largest protein stores are in skeletal muscle. If someone were to become injured, if someone would have to go on

bed rest, which is the number one treatment that, you know, you go into the hospital, you write for bed rest. If someone is going through periods of fasting, long periods of fasting, the body requires these amino acids to continuously turn over. Skeletal muscle is that reservoir. If an individual falls, skeletal muscle is what is going to protect you. I mean, yes, and fat, I can appreciate that, but healthy, strong skeletal muscle is going to help with mobility. And obviously, strength. The other really interesting aspect of skeletal muscle, it functions as an endocrine system. When you train it and you contract this tissue, it releases myokines. And myokines interface, there's, you know, hundreds, if not thousands of myokines that are yet to be discovered.

But what we know is that it changes the way that nutrients are utilized. It interfaces with the immune system. It affects the brain and the bone, all of these different things. So skeletal muscle in and of itself is the input that we can put in, we can use our cognitive processes to contract your bicep, to do some squats, to go for a run. We can influence the endocrine system, the skeletal muscle system, as an endocrine organ directly. We can't, I mean, you're pretty good. You might be able to control your heart right at will to say go to 90 beats a minute. But for the majority of any other tissue, you can't tell the liver to work harder. You can't tell any other system to do what it does, but there's a direct input into skeletal muscle, obviously starts in the brain, but to actually

execute. So that it's like the gatekeeper. So it's the gatekeeper. And it's the tissue that we have direct control over. As it relates to how do we keep skeletal muscle healthy, there's two primary ways. Number one, resistance exercise and exercise in general. And number two, dietary protein. Those are the two main drivers and two main inputs that we can do to influence skeletal muscle health. Amazing. So let's talk a little bit about protein because this is a big piece of the equation. All right. So why don't you just break down what is protein in the context of skeletal muscle tissue? And, you know, just just give us honest, you just a deep dive masterclass on all things protein. And then we'll kind of, yeah, and then we can, yeah, so wherever you want to take that.

You got it. Okay. There are 20 different amino acids in, you know, for humans, just say for humans. And nine of those are essential and the rest our body can make. Of those nine essential amino acids, that means that you have to get them from the diet. And they're not all equally essential, which is an interesting concept. Lysine and Lusine, they're not all equally essential. And what else is so interesting, you know, of these different amino acids is they all have different metabolic pathways. They all do different things. They're all metabolized differently. They all play a different role in the human body. Yet, if you look at the back of a protein bar, you'll just

see protein 10 grams. Yeah. Well, that tells me nothing because it is highly complex. The protein in a hemp protein bar is going to be different than the protein in a way protein bar in different amino acid ratios, which means while we look at the back of a label, it says protein, but the input into the body is different, which is really, really fascinating, and I think underappreciated because when we think about protein as a macronutrient, we solely just think about protein. But again, protein is 20 different amino acids, and we're really eating for those amino acids, and we're eating for those essential amino acids that do very different things.

So that is number one. Number two is that we have to understand that when we're talking about muscle health, the way in which we really drive muscle health is through kind of the gatekeeper amino acid, which is called lucid. Lusine is an essential amino acid that is required in a certain amount at one time to get into the bloodstream to trigger what's called mTOR, which is mechanistic target of rapamycin this complex, which then goes down and creates the input for muscle protein synthesis, and then you require all the amino acids to then lay down new tissue.

So what does that mean from a dietary perspective? From a dietary perspective, we have to think about high-quality proteins. And there's a lot of confusion in the space and a lot of discussion about what that means. So I'll give you the current recommendation. The current dietary protein recommendation is 0.8 grams per kilogram, which is not very much, and that's the minimum to prevent deficiency. 0.8 grams per kilogram is the minimum to prevent deficiencies, yet individuals take that as the maximum amount, right? The average American female might be getting 64 grams of protein

and the average male might be getting 90 grams of protein. Yeah, so that's like half of what you need at best. Exactly. That is, you know, if we are thinking about longevity and we are thinking about aging well, then there's nothing more important than dietary protein. Right. I think you make a really good point that, again, not all protein is created equal and not all amino acids are as essential as others. So maybe just a quick kind of one, two on, you know, which of these amino acids, you know, how do we find them? What foods are they most associated with? Like, you know, I try to get three to five, you know, three to six grams of lucid, for example, you know, make sure that my meat is has these essential amino acids because then it gives me a trigger of like, okay, this is quality. Totally. Yeah. The current RDA also, if we're at 0.8 grams per KG, the leucing recommendation is between two and three grams a day, a day. And let me... Oh my God. I try to get that per meal. Is that too much? Okay. Now you're talking about how do we improve skeletal muscle health over the long haul and what does that mean? High quality protein and low quality protein. This is not an emotional

discussion. This is purely based on the amino acid profile. And I think that people have to understand And high quality protein is typically protein from animal-based sources. That would be egg, chicken, fish, red meats, way protein. You know, these are the, that is the definition of a high-quality protein. Those amino acid ratios are similar to the amino acid ratio needed for a human. But low quality protein based on an amino acid ratio would be considered plant-based proteins. It is lower in the essential amino acids. Now, that's not to say that you can't overcompensate by increasing the amount of plant

protein that you're getting to overcome those lower amounts of amino acids. But there was a really good recent study that came out and it talked about that the higher your protein content in the diet, you have more flexibility, right? You could get half more metabolic. Yeah, you have more, well, you have more ability in terms of eating. So you could get. Oh, sure, right. You could get some of your protein from animal-based products.

You can get some of your protein from plant-based products. You know, as long as the protein ingestion overall is higher. However, the lower your protein intake is, then 50% of that should come from animal-based sources because it's not just the macronutrient need, you know, that we're thinking about, but it's also what are the other physiological nutrients that we need, like B12, zinc, selenium. What are the other bioavailable things that, you know, the other bioavailable nutrients that we have to meet? So the quality of protein, again, you know, we're talking about just the macronutrient

aspect, but we have to understand that food is, should be thought of as a matrix, highly involved in multiple things, not just broken down as macronutrients. So when we think about designing a diet, the evidence would support a diet with the first meal of the day hitting between, you know, 30 to 50 grams of high quality protein and probably at the higher end, probably between 40 and 50 grams of high quality protein. And again, for the listener, what does that look like? That would be, it could be a weight protein shake. It could be eggs and something else.

It could be a lean steak. I know it sounds crazy, but easily if you did a six-ounce steak or six-ounce chicken breast, you would be getting 42 grams of high-quality protein. And that would be easy. Now, if you were to do a plant-based protein or a plant source of protein, you may need, depending on the source, 25% more of that actual food, which ultimately, typically the carbohydrate, the plant-based sources right along with carbohydrates, and unless an individual is highly physically active, you're going to get too much carbohydrates to

offset that. So it's not perhaps the best choice. And I think that that's really important to understand. You know, it's funny because ever since I started working with you and just being more aware of just the role of protein and how critical it is and how I really was, I just simply wasn't getting enough protein. know, so I talked to all my friends, and I'm just like, ah, you got to get your protein in. And they're so sick of hearing me talk about protein. But, but I think they, their initial reaction always is like, oh my God, I could never get that. You know, like, so how do you, how do you work with your patients? Like, what are some of the strategies that you deploy with, with your patients on just, you know, how do you get enough protein? And is, you know, quality

obviously really matters. Like, what if I get some, you know, if I have a tortilla that has, has nine grams of protein. And, you know, how does that mix? And you kind of just answered that with just the thinking about the different amino acids. But maybe just from a real practical standpoint, like, how do you think about that? These are really great questions. And I, that is the example of a combination meal. And I think that that's great. Just because it comes from, just because the protein comes from plant sources, doesn't mean you throw it out, right? You do count it towards protein. And adding in a high quality protein source is critical to that plant-based protein. And now you're talking about likely the best of both worlds. And that's like a tuna wrap. Exactly.

Two cans of tuna inside a wrap, spinach, celery, whatever, onions, you're good to go. So now you're talking about the best of both worlds. And I try to simplify it by just focusing on the high quality protein because that way you're never going to underfeed it. That is the most critical thing to understand. And the next question I would ask you is when people say I can never eat that much protein, I hear it all the time. Right. I do have a full clinic. We do We talk about protein all the time. And the thing is, is I say, why? And one reason is they say, well, I don't want to eat too much of it.

And then the other thing they'd say is they get too full. Now, when an individual gets sick. So you've gotten sick before, I know. And let's say, you know, we were working on, we met actually at the triple seven expedition when these guys were folds for honor jumping out of airplanes. Now, if someone were to get sick, the RDA for, vitamin C is 60, it's like 60 milligrams. It's nothing. But if an individual were to get sick, you might say, okay, well, I'm going to take one gram of vitamin C. Or if I want to get the best

of my performance, I'm going to take one gram of vitamin C. Nobody looks at the RDA for vitamin C or some of these nutrients is the maximum, right? Nobody. Everybody we know gets sick and they want vitamin C and they want zinc. But we fail to think about protein like that. But we should. So true. Because protein, dietary protein, not only does it feed and support muscle, but your body goes through 250 grams of protein turnover easy a day, depending on the size even more. Protein turnover is exactly.

How do we keep up with that? You're only eating 64 grams of protein or 90 grams of protein. You're not going to be able to keep up with protein turnover. Over a period of time, the body becomes less efficient at that protein turnover. Protein turnover is really the replacement and the renewal and regeneration of all tissues, whether it's liver, gut, skin, all of it. It's not just muscle. And that's why dietary protein becomes so important. And when we think about what too much is, well, there really is no evidence for what too much is. And I think getting the languaging around what high protein is

is important. So if the RDA is 0.8 grams per kilogram, everybody feels that that's a maximum. And so to eat more than that, people think, oh, man, that's just too much. Totally off the table, totally not true, right? And it's just we have to start rethinking what does that mean. So when we think about how to actually tactically implement dietary protein, start with that first meal of the day and start with the last meal a day. And actually, I learned this from you. I would often tell people before I learned all about circadian rhythm from you, I had people

push their meal to 11 or 12 so they eat from noon to 8 that's not as effective right so again I learned this from you yeah people this all the time um starting at that first meal and that should be you know I don't know how how soon after they wake up within 90 minutes or so yeah within 90 minutes it just I think to your point like it's really hard to get in if you're only eating two meals a day it's actually really hard to meet your protein targets because you do simply get And that's what I tell my friends. Like, I just like, if you're only eating two meals a day, like, it's just, it's going to be, you are going to get full. Like when you're not going to, you're only going to end up with 80 grams of protein and not 130, you know.

So, yeah, so I think, you know, and men and women, I think are probably a little bit different. But I think for women, like, three meals a day is probably what you need in order to get the protein that you need. And indeed, you know, I know, I know we talked about this, but from a circadian perspective, you know, you have, there was a really good study. It was an excellent controlled study with 30. to young lean women, and they found that after one week of eating late, so lunch at 4.30, and then dinner at 8.30, those women suffered metabolic alterations that, you know, you know, basically blunted variations in cortisol and body temperature, decreased blood sugar tolerance, decreased resting energy expenditure, and decreased carbohydrate utilization. So, I mean,

there's just like some profound effects. And this is like, it was a really good study. But just again, this concept of late eaters versus earlier eaters. And I really, you know, the more I'm inside this literature. And I used to be that person who I literally, my first meal is at 11, I would fast, regardless, you know, I would fast until 11. And I just think that's probably not the path forward if we're actually really trying to meet these protein requirements. Absolutely. I couldn't agree with you more. And when you're waking up out of an overnight fast, you're in essentially a catabolic state. And again, catabolic state is your body. is, you know, breaking down. It's not really breaking down, but you are in a fasted catabolic

state. And what does that mean? That means the longer you push it, then how are you able to protect skeletal muscle? And as we age, you know, and I think I will likely begin to rethink this now, but let's say a normal aging person, there is a decrease in hormones, there is, you know, a decrease in movement and potentially it doesn't have to be that way because now we have hormone replacement and there's all these kinds of things that we can do. But traditionally in the literature, the efficiency of protein utilization goes down. And protein utilization goes down as we age muscle mass and strength also decline. Again, do I think that there is going to be a change in literature as we start to see what optimal fitness will look like. And if the load

of physical activity can actually counterbalance that. But again, in the literature right now, as it stands, the belief is that as you age, there's increase in insulin resistance of skeletal muscle. There are all these changes. There's a blunted muscle protein synthesis effect in skeletal muscle. And even with those with insulin resistance, insulin resistance is, you know, the pancreas makes insulin. Insulin is required to help get glucose into the cell. Skeletal muscle as the primary source of glucose disposal, primary site of glucose disposal, skeletal muscle and skeletal muscle becomes insulin resistant, you see alterations in blood sugar,

insulin levels, all of those things. And we do believe that as individuals age, there is a increase in insulin resistance in skeletal muscle. So the way in which you can prevent that is keeping the tissue healthy through dietary protein. The best thing that you can do is to preserve what you have. You can always get stronger. You can always add mass, but preserve what you have, and then create flux within that tissue. Flux is the increase in utilization through exercise. Flux within that tissue. You know, we do see that there are fatty infiltrations within the tissue, in the muscle cell, all of these, there's so, you know, there's a lot of controversy in the

literature. Is it intramiocelular fat? Is it intra, you know, is it intramuscular fat? There's a whole host of things that happen to skeletal muscle, unhealthy skeletal muscle. And the way in which we know one way to keep that healthy is to increase the flux. So it doesn't become stagnant. And flux means increased utilization through exercise. right and that's just resistance training obviously yeah easy and then you know mitochondrial health is endurance training but i before i move into that for the listener that first protein meal is critical that first protein meal when you are coming out of an overnight fast you're primed to metabolize yes if the listener could take away one thing get 40 grams of protein it will change your life

it will change the way in which your next meal is it will change your hunger you're hungry It will change your blood sugar regulation, you stimulate tissue. These are very free and doable things, 40 grams of dietary protein at the first meal. And if they could hit that threshold at the last meal, say 40 grams of protein at that last meal or even 50, great. You're getting close. I mean, it doesn't have to be perfect, and my protein recommendations are probably higher. I typically recommend one gram per pound ideal body weight.

The literature right now really supports one point. to 1.6 or 1.8 grams per KG. I do think that, again, we're at the precipice of change in studies and literature that are going to be coming out. So amazing. So this is going to be potentially a little controversial this question. Vegetarians, how do you adequately get, like, can vegetarians get enough adequate levels of protein to protect their muscle tissue? Is that even possible? Yes. Could they get adequate amounts of protein? Yes, absolutely. They're going to need to be on the higher end of protein consumption, whether that would be double the RDA. But the higher,

the more vegetarian, the more plant-based individual is the more protein they're going to need to over, you know, to compensate for those amino acid ratios. Now, the question becomes really important. So that's for the total protein need. But again, this study that was so interesting, I'll have to send it to you, but it really discussed that, you know, it's not just about the macronutrient protein. It is, there's other things that ride alongside with a more well-rounded diet that include muscle-based stuff, especially red meat like creatine, and serene, torrentine, all these other

things. But the bigger challenge with a vegetarian diet is as you age, the amount of calories that you require become less, and the choice of those calories as far as high nutrient density becomes critical. Because again, the goal is how do we live optimally? How do we protect ourselves against disease? And in order to do that, we have to think globally. the most dangerous thing is to become metabolically unhealthy, destroy skeletal muscle, and start putting on a lot of body fat, especially visceral body fat. And it's not just the body fat, it's the fat that infiltrates into the muscle tissue, which then increases the quality of the tissue. Can you change that?

Yes, but again, as we age, it becomes much more difficult. It's so hard. Maybe just explain the difference between, you know, visceral fat, you know, if you just give it. So visceral fat is the fat, the belly fat, and that's the fat around organs. It's more inflammatory. It's more metabolically active. It creates a lot of issues. It is the fat, again, around the viscera.

And in, you know, there's also ectopic fat and fat within liver. Fatty liver is an issue. And it's interesting. You think about fatty liver. I just, I just have this kind of insight as I'm talking to you. Everyone talks about Nash, right? Non-alcoholic fatty liver. Alcoholics, yeah.

Nobody talks about myose. steatotosis, which is fat infiltration into the muscle, which is probably just equally as critical. Again, this is highlighting the fact that we're not imaging skeletal muscle appropriately or consistently. Everybody talks about Nash, as if liver is the most important organ. Yeah, it's critical, but what about skeletal muscle? The fat that you see in liver, you see that same kind of fat and muscle. Yeah.

And there's a muscle liver cross talk. So the way to improve your or kind of decrease the visceral fat is through protein and resistance training. Those are like the two things that you can do. And what diseases do you prevent by targeting, like by really paying attention to the protein and the resistance training? Yeah. This is really great.

I was just here. this was, I was looking at this study for you, which is so good, and I'm going to send it. Well, let's go back to Betsy. Okay. Betsy was on her way for Alzheimer's, diabetes, cardiovascular disease, all these diseases that we feel ride along with obesity. It's the primary mover. these I believe are diseases of skeletal muscle first yeah it's not about it's losing weight is not betsy's path to fixing or to paying down her risk right she did it so the reality was

for her and for what I believe as 73% of the population it's really about skeletal muscle if you want to prevent cardiovascular disease and I'm not talking about the genetic you know we are not talking about, you know, someone who is a genetic, someone who is going to genetically get Alzheimer's at 30. We are not talking about the individuals that, you know, have massive issues with genetics. We are talking about diabetes, cardiovascular disease, even low levels of inflammation. These things can be largely prevented and corrected through skeletal muscle. Wow. And that becomes really, really critical. I mean, you just don't hear this. You don't hear it framed that way. I mean, I've never heard

one doctor. I don't know. It just seems as though like you're really starting kind of a revolution here. I hope so. I hope so. Yeah. You know, and I love, like, in your TED talk, I thought it was just, it was so brilliant how you, you ended that, that, that conversation about this is, we're all kind of in this together and that you need to find a Betsy in your life and help them understand this path, you know, and so what, maybe, maybe, what does that conversation look like? You know, if I, I have someone in my life who just, I know that they kind of fit that profile and they're going down this path, you know, how do you recommend, what does, that conversation look like, you know, because it's such a tender, it's such a hard thing.

It's such a hard conversation to have with someone, you know, like, and it's just like you love them so much and you just want them to be, have the energy and be able to maximize their time on this planet. And it's like you could want that for someone, but they have to kind of want it for themselves too. Like I just am curious, how do we have these conversations with the Betsy's in our life? Now, this is, for some might sound really harsh and somewhat negative. And, you know, I have a medical practice that takes care of war fighters, mavericks innovators, the people that are at the pinnacle of what they are doing, people that want to move the needle, that want to change the world.

And one of the things that you see with every practice, and you actually see it all the time, is that there are archetypes, archetypes of people, patterns that are predictable, and understanding those patterns and not being surprised by them is critical. Now, I'm going to get to your question about Betsy. The progressive decline and ultimate death and end of life is predictable for the majority of people. understanding that the choices an individual makes in the moment will change the trajectory of their

life. Those that excel and those that remove physical limitations in their life, you don't have to be a Navy SEAL, you don't have to be an elite entrepreneur. What can we learn from people that have exemplified a way of doing things that everybody can take into their own life. And that is 100% being aware of the weaknesses of the individual. We all have weaknesses. And if that weakness is not wanting to eat a good diet, if that weakness is drinking at night, if that weakness is skipping a workout, if that weakness is eating pizza on the weekend, whatever it is, bringing that weakness to the forefront, having it be present, and thinking every time you indulge in that weakness, which by the way is a complete

distraction, and if you do that over a lifetime, what is the outcome of that going to be? And fast forward, what is that, are you willing to trade the immediate gratification for a later life decision? And if you can close the gap of your future, your future self and your current self, got to close that gap. And every decision you make and you just practice it, is this moving me forward or is this moving me back? And that's where I think that the conversation starts. It's not, you know, we could say, oh, if you keep doing this, you're going to get Alzheimer's, all that stuff. Yeah. But the reality is, do you want to be the best version of yourself or not? It's going to take work. And if you do not change this habit,

Where are you going to be in the next six months and in the next six months after that? And then you're going to get into the season of regret. Now, I'm going to tell you something else very powerful. And this took me quite a number of years to work through. I'm a trained geriatrician, which means I take care of people 65 and above. That was my fellowship training. I have sat at the bedside of a lot of dying individuals. And the biggest thing at the end of life is this regret of not having lived or have put in the effort of what it would mean for them to have a meaningful life.

And for a lot of people, it was a meaningful life free of physical illness. illness. So that is the thing that I would say. Yeah. Is that what drove you to write your book? That and my mentor, Dr. Donald Lehman, who's mentored me for 20 years, you know, he's getting older. And I know he's never going to listen to this because he doesn't listen to any of my podcast. But he is my best friend and mentor. And, The work, you know, he discovered this, this leucine threshold. This was his discovery where all this stuff that we totally take for granted, oh, this has been around forever, eat this much more than it.

It didn't exist before. Yeah. And he's getting older and he's very academic. And we have been working on these concepts of muscle-centric medicine for two decades. And this book is dedicated to him. And there's going to be a time where he's not alive anymore. and I know that this work, because I've seen it work, I've seen thousands of patients, this will change the trajectory of aging.

So that's why I wrote the book. I love it. I love it. Well, I think it's, you know, in terms of, and you said it, you know, I think people need to get really micro, you know, with choices. That's just the reality of it, you know, and there is some effort that's involved in and being micro about your choices and um but the the opportunity though you know if you can get into that routine and you understand what those choices need to be and that's why i think this book is

going to be such a game changer for so many people is because they're just going to have a little bit of a playbook and they're going to understand the the why certainly which should be the their inspiration and then okay how how do i actually do this and you know i think i think that's where I know there's a lot of folks out there who want to be healthy and, you know, want to have quality life, you know, into the later years and, but don't necessarily understand where they need to focus their attention, you know, and I think that's, that's, I'm like really excited about this book and maybe just talk a little bit about just that journey in general. You know, we have, just writing a book is just this colossal effort.

It's like giving birth to a child. This book took two years to write. It is evidence-based. It really talks about what it means for longevity, just in general, right? You know, there's a lot of longevity experts that are spreading the word to reduce your dietary protein, do all the stuff. And nothing could be further from the truth, quite frankly. And the evidence is there. It's a lot of discussion about how bad red meat is.

There's just numerous things that are incorrect. And I do think that people are well-meaning and everybody has different specialties. You know, I'm trained in nutritional sciences, fellowship trained in nutritional sciences, and mentored by one of the world-leading experts in this area, and I'm a clinician. So I've seen it. I'm a geriatrician. I'm a training. So this book is a guidebook, number one, for understanding.

How did we get to this place? There's history in this book. history of the nutritional guidelines, history of how we got to the place that we are. And there's also a reframing of skeletal muscle as this organ of longevity, which, again, is so fascinating. And the truth is, we've never been able to measure it directly until recently. You know, I'm talking about, you know, like 2019, they're starting to measure it directly. I'm not talking about, you know, I mean, it's been building up in the literature, but it starts with the rodent models, all these things. You know, and then there's also a mindset component to it because many people have

tried everything and failed. And again, I work with a Maritime Navy SEAL. I work with some of the most tough individuals on the planet. And you learn a lot from them and you see a lot. So there is a mindset component of the book. And there's very practical application, everything you need to get started three tracks. Do you want to lose weight? Do you want to maintain health and longevity? Or do you want to build muscle? And how are you going to do it? This exercise, it's very well laid out and took a lot of work and a lot of effort. And I think that there is much to be said. The only regret I have is I don't have Woop data in there, but that'll be. I know. Yes, yes. That's book number two for sure. And actually it's available now. So it's available now for

pre-sale. People can go to my website. It's called Forever Strong. This is amazing. Go to my website, which is Dr. Gabriel Lyon. They can get it off Amazon. There's a million places that it can be pre-ordered. We're doing all the stuff where we're creating stuff for people that pre-order the book. Oh, cool. Recipe book, a whole thing. So it's like it's sort of in the way. They don't have to wait until October. Nice. I love it. How do you, So we recently launched a feature in our app. It's called strength trainer. And it's pretty epic.

You can finally, finally, you know, we're able to quantify the toll that strength training takes on your body. So it's really kind of quite an innovative feature, I suppose, and we're really excited about it. How do you think about strength training in your practice? And, you know, I know you have, you've got world class coaches, you know, at your, you know, inside your practice, kind of helping inform training. But, you know, where, what's the kind of crawl walk run scenario for, you know, someone who's coming into your practice and wants to leverage your expertise, you know, where do you maybe start? And maybe we can end with strength training and maybe we actually start, just talk about blood work real quick and just get, you know, just a high level understanding

of how you utilize blood work in your practice, you know, what are really the core markers. And how does that inform the programming that you lay out across, you know, nutrition and, you know, lifestyle and training. Yes. Well, all my patients cringe when they have their blood on, which you will also cringe when you get your blood drawn. And we look at the typical CBC, CMP, but we also look at a full hormone panel. We look at fasting insulin, fasting glucose, and a pretty in-depth cardiovascular screening.

That's just kind of the start. You look at inflammatory markers, it all just depends. it is very, very helpful as it relates to how healthy is skeletal muscle tissue, which you think, well, how can you tell that? There are some markers that we look at, for example, triglycerides, fasting insulin, fasting blood glucose. These are some core markers that we look at to see, okay, well, where are they at in terms of metabolic health?

So, would the inflammation, yeah, I'm just, I'm kind of wondering if, like, H.SCRP, if that would point to your muscle tissue health? Good question. Well, what we do know is it would point to it indirectly. H.SCRP is high sensitivity C-reactive protein, which is made in the liver. Right. And for those individuals, there's a whole host of reasons why it can be elevated. but we do know that exercise and correcting body composition will lower HSCRP. Healthy lifestyle will lower HSCRP. There's also something called an ESR, which is a sed rate, and that is another inflammatory marker that can be lowered that we'll see, again, depending on what drives it, is it an autoimmune,

is it, you know, why is this being driven up, but certainly lower levels of or increased physical activity can lower a lot of these markers. I will say, however, it all depends on how close in proximity that you're taking the blood work. So, for example, if we have someone who is training really hard and then, you know, someone who's very athletic, and then they get their blood work done and their liver enzymes are elevated, we see that all the time. We see that all the time. Yeah, creatinease and like you see all these elevations.

Right. So we see that all the time in operators. We see that all the time in athletes. So, you know, utilizing the whoop, there's a, you know, we have patients that are, you know, most of our patients, which are coming out with an app, we're like, gosh, we should gift everybody a whoop. Yeah. That's a good context. As we see that their recovery is solid, that's the time, you know, for somebody who's highly physically active, that would be the time that we would implement that. And then, you know, also, unfortunately, getting a DEXA, I say unfortunately, because right now that's the best that we have asked to. That's all I have.

Right? That's the best. And it doesn't measure skeletal muscle mass directly, except lean body mass, the correlations are not great, but the good news is it will track body fat does the best that we can at the moment because people are not going to be doing routine CTs MRIs. They're not going to be doing routine MRIs. And those two aren't necessarily correlated for muscle mass. So there's issues with utilizing that, but hopefully eventually we'll be able to measure skeletal muscle mass directly in practice, which I believe we'll move in there through this D3 creatine. So yeah, so that's that's where we start. And then of course, we do a lot of gut health because digestion, it doesn't matter if you're eating all the protein in the world, if you can't

digest things. And then sleep, we test nearly everybody for sleep apnea. It's all kinds of things. Good. I wonder if there's like a potential for like an algorithm until until we actually get the, what was that call that is not, hasn't been approved yet to measure D3 creatine? D-3-Krington. Until that comes on online, I'm wondering if there's like an algorithm with HSCRP, trigoslides. I don't know. I feel like if we could kind of come up with an approximation of your muscle tissue health, kind of looking at all these different components. Maybe you already do that. Do you have like some map running in the background? We've been trying. Yeah. You know, it would be so interesting, you know, so interesting.

You need to get our data scientists on it. Yeah. It's so interesting to also look at myokines like interleukin 6. Myokines. Yes. Inolucin 15. The question is, how long do they stay elevated? It's challenging. It's definitely in the literature. We can order it. It's just, you know, what does that mean right now? I think it's not quite ready for prime time yet. And then we were measuring adiponectin and leptin and all that stuff. But none of that is, it's not super helpful, you know, it's in first cost. So we don't measure that anymore. Okay. Yeah. It's interesting. Just the amount. of data that you must have, you know, and you can are really starting to put together a, a picture of what is actually indicative of, of kind of actual health trends and trajectory and what isn't, so yeah. And I can't state this enough. You know, we all take for granted that we all know that muscle mass is, is important, but the literature doesn't support that up until now.

The literature says it doesn't matter about muscle mass. It's all about muscle strength and we don't care about masks, but that's not true. And it also, I'm telling you, we are at the precipice of seeing a whole change. And now, you know, for example, I was thinking about these rates of sarcopenia where they'll say that, you know, the sarcopenia rates is annually, you'll change between three and eight percent, you know, per decade. But the reality is, is we're now saying sarcopenia has those rates, but we haven't ever been measuring skeletal muscle mass directly. Right. So my guess is those rates of sarcopenia are totally wrong totally wrong that's like a little frightening yeah totally wrong um how how hard is it to kind of shift that uh you know there's just you know

there's a gazillion examples of just outdated thinking how to i i guess it's just like what you're doing you're just pounding the pavement and just just trying to just put it out there over and over and over again in all sorts of different media. You know, it's writing a book on a TEDx like a podcast, like just pounding the pavement with with these ideas and concepts and this kind of new science. What, maybe just talk briefly just about what does that look like for you as a leader in this field, you know, doing innovative work. You know, there's people must come at you with pitchforks all the time. How do you deal with that? I mean, I think that if you have the desire to do something great, it's never going to be without getting bloody.

It's just the way that it is and that's okay because the other option is to do nothing and say nothing and that's not, you know, after going through my geriatric training, once you see something and if you are the kind of person that feels responsible for other people, really feels that they're in your life is a servant leadership trait, which our family is all about servant leadership, then you can't feel good about yourself not doing anything. Yeah. I've been talking about this for years. There is, you know, how do we really empower people? You know, how do we change the end of life, how do we, how do we change what we thought the narrative was, right? It's not obesity. This whole obesity up and down, I mean, okay, fine. But what is the, how are really going

to move the needle to fix things? How many obesity drugs do you think there are? By the way, a zillion. I mean. How many drugs do you think there are to treat sarcopenia or frailty? Yeah. How many? Maybe five, maybe. I mean, like what? Testosterone, which isn't even FDA approved yet for it. You realize that I can go and write drugs for obesity medicine all day long. You fall under this criteria here, I can give you this drug. We don't have good healthy muscle mass, sorry, which is arguably way more of a problem than obesity. We have to change the way we are thinking about this problem. When a problem, when a paradigm is promoted enough, when a paradigm is discussed enough, it becomes truth, it becomes fact. This now is our operational domain. But

that operational domain, I believe, is incorrect. So, yeah, you know, it's, I think a lot, I think a lot about how society in general does not do us like much service in terms of just like kind of letting folks off the hook, kind of. I want to just kind of hear your point of view on, on, you know, it's a little bit of a leading question because I know that we have kind of a similar mindset around this, but I feel like we sometimes overindex and normalize a lot of these unhealthy, behaviors, frankly, because, you know, kind of choosing health sometimes is hard and we don't want to make people feel bad. And I understand all that. But at the same time, being unhealthy

puts a huge burden on society. Everybody. You know, so, you know, so I guess I've just, I have this like internal tension all the time about how to how to talk about this in a way that is, that feels inclusive, but that also gets to the truth of what's happening. Because I think we can avoid, you know, the truth and avoid reality, but that doesn't do, doesn't do me or my loved ones any good. So I guess I'm just am curious, like, how do you think about that whole dynamic and what is your recommendation in terms of how do we kind of tread this reality versus kind of still being, you know, tender? I don't know. There is nothing more real. reassuring than the truth. There is nothing more reassuring than the truth.

That's why I love whoop data. Guess what? I just want to know. The truth is if an individual needs to execute a plan so that they maintain metabolic health and they need to build muscle and lose weight, that's the truth. And everything else is irresponsible. It's irresponsible. If you walk through, the airport and you see someone sitting there eating fries and you can see that they are unhealthy, it's completely irresponsible. And it's not a short-term win or I just want it. And listen, the stuff shouldn't even be sold, right? The food industry shouldn't even be able to sell half the stuff that it sells, but it does. Yeah. So that it's a carcinogen, right? Like a whole bunch of,

you know, who knows, eating a bunch of french fries. Who knows where that oil is coming from? You probably, it's probably not even in someone's caloric domain. What's the point? You know, it's nutrient poor, calorically dense, highly palatable. The question becomes, when you see that, is that responsible? No, it is a distraction. And then it becomes this mind-numbing thing where if you do not surround yourself with people who want to become the best version of themselves, and that does include diet,

exercise, you know, mental fortitude, negative thinking, all of those things, you know, these diseases are not, you know, we say they're non-communicable, meaning you can't get it. You absolutely can get it. These are communicable choices, communicable diseases. And so when an individual, if you have to have a hard conversation, you have to have the hard conversation. And the other thing is you have to be the example. Yeah. You have, but sometimes hearing the truth doesn't feel good, but there's nothing more reassuring than hearing the truth and getting to the bottom of it because it allows you to take action.

Everything else is irresponsible or distraction. I think in terms of being a role model, you are an exceptional one. And I think one of the many reasons why I love you and, you know, is just that you walk the talk. you know you uh and and i think that that's just so powerful uh you know you've got a daughter and a husband and you know like i and a son don't forget that and a son shit yes i know yeah you got too little i know i always see your daughter i don't see your son on on on video as much yeah yeah that's because he's too busy he's he's only yeah he's just do like like he poop everywhere I don't know what he's doing.

Peen on the wall. But I do think modeling behaviors obviously is so critical and, yeah, and appreciate just everything that you do to get this good word out and live the life yourself. I think it's really inspiring. I'd love to end on and just talk a little bit about just strength. And I know I'm sensitive to time here. But I would love to kind of get. that, you know, when a patient comes in, you know, what are the top three things that you

recommend to really get them thinking about their muscle tissue health and, you know, via protein or via strength, however you kind of want to frame that? Yeah. Another great question. The people coming in, the first thing, now there's multiple inputs to get an outcome. Really, we're looking for an outcome. We're looking for muscle mass, which is critical and muscle strength. Again, multiple different ways to get the job done. something easy. Everyone should be training three to four days a week of resistance exercise. Again, the literature is, there's a continuum. Could you do lower reps, higher weights? Yes, you can do all of those things. Three to four days a week of strength training that is meaningful. You know, it matters.

You can't just be on there, you know, talking on your phone. Quality. Yeah, I was at the gym this morning. Someone's, you know, on the phone doing lateral raises, whatever. I don't I'm not, although if that's what you have to do, fine. Three to four days a week of focused, meaningful resistance exercise. If there is a place for high-intensity interval training, it could be one day, a week, let's say someone's coming in to start that one-day week. Do 20 minutes. Do 20-minute cycles of high-intensity interval training, right?

We're not talking about max effort. Sprint interval training is great. You might not be there yet. Tanks you, you know, it's like the hardest four minutes of your life. So there's that. So, yeah, so add in three to four days of resistance. You can tack that on with one or two days of high-intensity interval training. And then I do think that there is something to be said for steady-state cardio.

It's not a ton. Even if it's just without moving, there's something to be said for mitochondrial health. You know, we can't throw out cardiovascular. Everyone says, oh, cardiovascular activity doesn't matter. It does. I do cardio. Yeah. I mean, yesterday I just did 10 minutes.

I did strength training. I did a high-intensity interval around every minute on the minute. But there is, if someone wants to include 30 minutes of some kind of cardiovascular activity five days a week, I think it's great. It's very difficult to do too much. And again, there are people that do too much, but the majority of us are not. The other easy trick is, after you eat, go for a walk. Get your activity in because you can leverage skeletal muscle to dispose of that meal. Get up, go for a walk.

Go do some air squats. go do some push-ups. It's easy. Yeah. Yeah. That's such good advice. I think, too, like those little, like, you know, micro, like just working out. I forget, oh, exercise snacks. Exercise snacks. I feel like it's like such a good, you know, like just literally between, you know, this and this podcast of my next call, like I can just do 10 air squats, you know, and like, or five rupees because you know that I have, I don't pants. Oh, I mean, I have pants. I have shorts. I have like workout shorts. I have like work out. shorts on right now. We both are so good.

Also, do I ever wear? I never wear. I usually wear a black blazer. I know. I'd save. I don't even know how this beige blazer got into my wardrobe. Yeah, we didn't plan it, folks. Those of you who are watching on YouTube, awesome.

Well, Dr. Lyne, this has been such a fabulous conversation. You are just a wealth of knowledge and insight. And, you know, where can folks? I know you mentioned your website. where folks can learn more about your practice and pre-order your book. And then you're also so active on Instagram. You have a massive, massive following. What's your handle?

Dr. Gabriel Lyon. Easy day. It's so funny. I can't get verified because my legal last name is Kronstadt now since I got married. But whatever. Oh, my gosh. Are you serious? Yeah.

It's crazy, right? So I'd have to change it to Lyon. in Cronstadt or Cronstadt, but whatever. So you guys can find me. It's Dr. Gabriel Lyon. At Dr.gallel Lion.com. I have a YouTube as well under the same. I have a great newsletter.

I encourage everybody to sign up for it. It's totally free. And it is exceptional. I read it religiously. It's so good. And we're going to be doing a special 30 Gs, which is 30 grams of protein recipes. So we have created recipes. easy to follow recipes, which is separate than the newsletter.

But if you go to my website, you'll be able to see it and sign up for it. It'll be awesome. And it's all free, all easy to implement. It would be great. Love it. Well, thank you for everything you're doing to make the world a better place. And if you guys have not listened to my podcast episode with Kristen, then you should. That was so fun.

Yeah, thanks for having me on. And thanks for being here today. Of course, anything for you. I love being able to chat. you're just such a superstar so thank you so much oh of course thanks again to dr gabriel lyon for joining the show to discuss her insights on building muscle and strength training if you enjoyed this episode of the whoop podcast please subscribe leave a rating or review check us out on social at whoop at will ahmed if you have a question you want to see answered on the podcast email us

podcast at whoop dot com call us 508 443 4952 and we'll answer your question on a future new members can use the code will W ILL to get a $60 credit on WOOP accessories when you enter the code at checkout and that's a wrap folks thank you all for listening we'll catch you next week on the WOOP podcast as always stay healthy and stay in the green