Video summary
Gabrielle Lyon, a geriatrician and expert in palliative care, argues that skeletal muscle should be viewed as an essential endocrine organ rather than merely tissue for locomotion or aesthetics. Drawing from her experience at the bedside of dying patients, she asserts that maintaining high-quality muscle mass is the single most impactful lever for longevity, surpassing even dietary quality alone. While research often prioritizes resistance training to combat age-related decline, Lyon emphasizes in clinical practice that optimizing protein intake first yields immediate benefits by overcoming "anabolic resistance." This condition occurs as people age, causing their muscles to become less efficient at sensing and utilizing amino acids; therefore, older adults require higher doses of high-quality protein per meal—specifically 30 to 50 grams—to trigger the necessary nutrient sensors like mTOR. The quality of this protein is paramount because it depends on specific essential amino acid profiles, particularly branched-chain amino acids (BCAAs) such as leucine. Lyon explains that consuming less than approximately 2.5 grams of leucine per meal fails to activate muscle protein synthesis mechanisms, leading to a "skinny fat" phenotype where individuals appear thin but possess low metabolic function and are prone to pre-diabetes. She distinguishes between plant-based proteins, which often lack sufficient BCAAs without supplementation or massive caloric volume (e.g., six cups of quinoa for one chicken breast), and animal-derived proteins that have been consumed by humans for millions of years as a nutrient-dense source. While she respects moral desires to be vegan or vegetarian, she maintains from a cellular perspective that high-quality protein is non-negotiable for tissue health, noting that plant-based diets can be calorically devastating if one attempts to meet amino acid thresholds without significant adjustments. Muscle serves as the body's primary metabolic currency and organ of longevity because it regulates glucose disposal, fatty acid oxidation, and systemic inflammation through the secretion of myokines like interleukin-6 and BDNF (brain-derived neurotrophic factor). Lyon challenges the prevailing narrative that reducing protein intake extends life, pointing out that such advice often stems from flawed studies on fruit flies or ignores human data showing muscle protects against morbidity and mortality. She highlights that skeletal muscle is responsible for roughly 80% of glucose disposal in the body; without adequate muscle mass, individuals become insulin resistant regardless of their diet. Furthermore, she warns against "anti-animal dogma" which may obscure scientific transparency regarding protein quality, arguing that fear-mongering about animal products often leads to recommendations that inadvertently harm longevity by reducing essential amino acid intake during a time when the body needs them most for tissue repair and immune function. Lyon also addresses the balance between diet composition and exercise intensity, advocating for "carb back-loading" where carbohydrates are consumed around training sessions rather than at breakfast. This strategy allows the body to utilize muscle glycogen effectively while maintaining metabolic flexibility through gluconeogenesis from high protein intake. She notes that resistance training does not necessarily require lifting until failure; instead, a well-designed program is essential because as one ages and becomes more conditioned, it takes less effort to stimulate growth but also requires overcoming anabolic resistance with higher amino acid loads. Ultimately, her thesis posits that longevity depends on the delicate dance between what we eat, our insulin response, and how much muscle we carry and use; losing muscle due to inactivity or famine forces the body to break down its own tissue reserves to protect vital organs like the liver and kidneys, making the preservation of lean mass critical for surviving illness and aging gracefully.
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The body thrives under activity. And
whether you take a human, whether you
take an animal, if you essentially
domesticate them and they are not
training, they will lose muscle. You can
only pull one lever. So, if you you have
two levers, you have diet and you have
muscle mass. Which would you have
somebody pull for longevity? You can
have an amazing diet, but you have very
little muscle mass, you don't do a lot
of exercising, or you're like my swimmer
friend and you have in just incredible
output. You're exerting yourself
tremendously. You have a great amount of
lean body mass. We all know what
swimmers look like. They look fantastic.
Um
but your diet is a Twinkie diet, like
you called it. Which of those two levers
is going to be more impactful?
Okay, so I'm going to tell you what the
research shows and then I'm going to
tell you my personal experience. Word.
So, the research would say, "Hey, if you
had to prioritize one over the other,
prioritize resistance training."
Okay.
That being said, in clinical practice, I
have absolutely never seen that work.
If they prioritize dietary protein and
they get that first meal right,
by lunch they feel better. I'm not
asking them to wait 4 weeks. You nail
that first meal, by the second meal you
feel better. You want to deal with body
composition, you want to deal with
optimal aging, you want to overcome this
concept of anabolic resistance, which we
can talk about. The only and most
effective Now, again, this is my
personal opinion based on seeing
hundreds and I know I've been at the
bedside of hundreds of dying people.
Geriatrics is no joke.
And if I could pull the lever and go
back in time, what would I tell them?
You know, I would say you've got to do
both, but when you're young, you have
more flexibility
and you can out train a bad diet. But as
soon as those hormones begin to change,
if you have low-quality protein, and by
the way, protein is utilized in a dose
response. So, it's a a meal dosage. It's
really a 30 to 50 g
meal dosing. So, that's between 4 and,
you know, 5 to 6 oz of protein per meal.
And if you go under under that, you are
below what's called this leucine
threshold. And I I want to make this
very palatable for people. So,
basically, there's essential amino
acids. And out of these essential amino
acids, that's really what determines the
quality of a person's diet and the
quality of protein. So, when they are
sub-threshold of one particular amino
acid, which is leucine, if you eat food
that is sub-threshold to that 2 and 1/2
g of leucine,
you will be skinny fat. You will never
activate the proper mechanisms to turn
over muscle protein synthesis.
And this is a huge problem in our
society. You know, there's nutrient
sensors in the body.
So, hitting that particular amino acid
load, which is really 4 to 6 oz easy,
and it's easy for people to anchor their
meals in, you know, 4 to 6 oz of
protein, and then you stimulate your
muscle tissue,
which we know is an endocrine organ.
Let's talk about that. If you're not
trying to bodybuild, if you're not
trying to get bigger,
um so, I'm thinking I know somebody,
love her to death, she's amazing, but
her diet is ridiculous. But she's
skinny. Her whole family's skinny. It's
crazy. And so, I've always said, I
guarantee if you look at her biomarkers,
she's going to be skinny fat. She's
going to be probably pre-diabetic,
judging by how she eats. It's, you know,
pure insanity. Cuz I I want to
differentiate between busting your ass
in the gym and what you're going to get
from that, and then just like, "Hey,
even if you don't care about the gym,
even if you don't buy into that, uh
there's just a quality of tissue issue,
And if you think of it as an organ, it's
like saying the quality of the tissue of
your liver or your kidneys. It's like
this [ __ ] matters. So, if people could
do one thing
and leave this conversation with nothing
else other than muscle is the organ of
longevity and eat high-quality protein,
animal protein, and plant protein are
totally different. And if you have a
diet of plant protein, it is very hard
to sustain and calorically devastating
cuz you need between 25% and 40% more.
So, it's like six cups of quinoa for one
small chicken breast. If you really
wanted to think about the amino acids
necessary to stimulate that tissue. And
listen, that's not the only way to do
it. Could we add in branched-chain amino
acids to lower-quality protein?
Absolutely. But, why would you do that
when we have you know, cattle or a
ruminant that have that we've been
consuming for 2.5 million years and have
the capacity to take low-quality plant
nutrition and produce high-quality
nutrition with that is nutrient-dense
and highly bioavailable for humans. So,
I understand I've heard you say the same
thing. Like, I understand people have
they may have a, um,
a moral desire to eat plant-based food
and I get that, dude. As somebody who's
absolutely I just love animals and I
long for the day where we can lab grow
meat and that there was never an animal,
um, involved in that process. But, I'm
also just selfish enough to say I'm
going to protect my health. Yeah. Um,
you know, when you look at obviously
sustainable farming and things like
that, I'm all for it. I couldn't be more
behind that. Um, but wanting to
understand sort of at a mechanistic
cellular level what's happening and I
don't care what the answer is, vegan,
vegetarian, animal, a mix thereof. Um, I
just want to understand like at a
cellular level what's happening. Um, and
to get that, I think understanding the
what branched-chain amino acids are, why
they matter, and how the profiles differ
from plants to meat, I think it would be
really helpful. Yeah, I I couldn't agree
with you more. So, really the quality of
our diet, and this is globally, the
quality of our diet is largely dependent
on protein. So, there's 20 amino acids,
and nine of those are essential.
Of those essential amino acids, you have
the
meaning I I cannot produce it in my
body.
Exactly. So, the key branched-chain
amino acids, and when you think about
branched-chain, it's just the structure,
right? It's just a nomenclature. You've
got leucine, isoleucine, and valine. And
out of those three, which by the way
should all be consumed together, cuz
everything in life has its own balance.
Of those three amino acids, leucine is
the most relevant for protecting the
organ of longevity. And on a cellular
level, having the right amount at one
time, dosed appropriately, which is
where that 2 and 1/2 g, that's from the
That's just from research. But, you
know, it's really truthfully, it's
between 1.8 to 2.5 g of leucine, which
the majority of people are not going to
go,
"Hmm, how much leucine is in my food?"
right? It's not on the back of a label,
which just goes to show you how protein
has been the black sheep of the
macronutrient family for decades.
When you look at a label, all it simply
says is protein.
But, understanding on a cellular level
that really eating protein at a
meal-centric
dosing, meaning you at one time, you're
not drinking protein shakes over a
course of 2 hours, but at one meal, at a
bolus amount, you are getting
between 30 and 50 g of protein, which
would translate to between 4 and 6 oz of
high-quality protein would reach that
leucine threshold. So, once you reach
that leucine threshold, you trigger this
this complex called mTOR.
mTOR is a mechanistic target of
rapamycin, which then is actually a
nutrient sensor.
Anything below that, the body's like,
"Mhm, I don't care. I'm not going to put
on muscle." Or, "Mhm, I don't care. I'm
not going to really stimulate this very
expensive elaborate process for the
body."
It doesn't care.
So, that's where you get that skinny fat
because you're grazing all day at this
low threshold meal, especially important
in aging because you don't have that
flexibility.
And when I say aging, I'm talking about
40s.
You know, you've got to stay on top of
it, but once you reach that threshold of
arguably 2 and 1/2 g of leucine, which
you could have a 2 oz of fish and then a
scoop of branched chain and get up that
leucine level. But, mechanistically, you
need that branched chain, that essential
amino acid, to then trigger the rest of
what needs to happen for muscle protein
synthesis. And listen, the way that they
measure muscle protein synthesis, it's
not like you eat it and then you're
laying down protein. It truly I mean,
that's not an accurate assessment,
right? I would be
not being truthful if I said that, but
it really is a period of time. Over a
period of time as you continue to do
with anything correct, optimized habits,
you then can protect your tissue.
And protecting tissue is everything.
You know, and it's very dangerous
because when people do weight loss,
you know, you lose some fat, but you
also lose tissue.
And now we're in a situation where we're
not outside and we're not doing
resistance training,
and we're not actually moving that
endocrine organ.
So, you know, it becomes much more
difficult to maintain and recoup that
tissue. And the tissue is just one
aspect. It's truly the metabolic
aspects,
you know, of the of muscle. And if you
want to prevent diabetes, heart disease,
Alzheimer's,
cardiovascular, you know, cardiovascular
disease, that whole spectrum,
tiss- you know, muscle tissue will do
that for you. And then you put on
high-quality protein,
you're going to keep inflammation low,
you're going to keep calories in check,
you're going to upregulate your
thermoeffective feeding. These are all
really important. You're going to do
you're going to have lower blood
pressure because some of the amino
acids, one in particular, helps lower
blood pressure.
I mean, this is amazing stuff. It's a
muscle-centric approach to wellness, and
the paradigm is totally wrong.
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When I started working out, you can
actually feel just the difference in in
a lot of things. You can feel the
difference in mobility and strength and
just overall well-being. Um and then
some of the data in terms of how people
bounce back from long-term chronic
illness. I know in the cancer community,
one of the the things they look at is
when muscle mass gets too low, they're
just like they're they're one illness
away from demise. And same thing with
old people, it's like, "Hey, you might
be able to survive the flu if you've got
enough muscle to see you through." Um
but if not, then you could really be in
trouble. So, it's interesting to hear
that broken down. I I want to go back to
what you were saying about that first
meal, um which I think you're quite
careful not to necessarily refer to it
as breakfast, but your first meal, um
getting getting that right. Um I'd love
to hear what right is. Like in the real
world, am I eating eggs? Am I eating
chicken breast? Am I eating quinoa? Like
what am I eating?
You are not eating So, if you get that
first meal right, if your meal is bolus
with protein, you do a few things.
Number one, you stimulate your muscle
tissue, which is arguably the most
important organ, right? But number two,
there and there's really good data that
it actually helps with satiation
and blood sugar regulation. So you are
not going to be chasing 90 minutes later
your blood sugar. You are not going to
be obsessed in your mind and not able to
focus because you want to eat or you
feel like you have to take a nap. Yeah,
I I encourage people to try to overeat
steamed chicken breast. It's like good
luck. Like you will tap out long before
you get obese, that is for sure. So what
are Give me some ideal protein sources.
Am I eating is it chicken breast? Is it
red meat?
So we eat a lot of beef in our family,
beef, bison, eggs. We are not a low-fat
family. So you know, for breakfast for
us might be half a pound of bison each
with a little bit of olive oil and maybe
some avocado. But we're low-carb for
that first meal. We tend to do carb
back-loading or if we're going to have
carbohydrates, use carbohydrates around
a meal. Now my husband is a SEAL, so
they, you know, they kind of like go
crazy and train and then eat and train.
Navy SEAL for anybody wondering.
No, arguably he's probably an animal,
but it's okay.
Um so
that's how we but the first meal is
always the same. Why do you do carbs
later in the day? That's interesting.
Because you've been up and you've been
utilizing your tissue. So you depleted
your muscle glycogen essentially.
I mean listen, the the the data would
show in a 24-hour period. So I want to
be very careful to say this is my
experience because the data will say,
well, in a 24-hour period, how much
carbohydrates are you utilizing? And I
would say it's much easier to backload
your carbohydrates or utilize them
around training.
Perhaps post workout, so I do believe
that training low glycogen state is very
beneficial. Do you work out fasted or do
you work out or have your first meal?
I do. So, I work out fasted. And do you
have a strategy behind why you do that?
So, I think that training low, I like my
body to become very proficient and and
efficient on its own.
I like to be able to make all the
glucose I need.
Right? And because my diet is high in
protein,
there is what happens is it goes through
gluconeogenesis. So, truly for every 100
g of protein that I eat, my body
generates 60 g of carbohydrates itself.
So, I am not reliant on quinoa for
breakfast or carbohydrates. My body
becomes so good at making and generating
its own
that it allows me
any carbohydrates then?
You know, truthfully, I don't eat a
bunch of carbs. It when I work them in,
it would be, you know, possibly we had a
really busy day. We have a little
infant, you know, and we have no child
care, so we're just kind of, you know,
busy and we're training and, you know,
if I've gone for a lot of training that
day and I'm running around chasing her,
I might have, you know, and it's meal
specific. So, there's a carbohydrate
threshold, which is how I like to think
about carbohydrates. I might have, you
know, 20 g of some kind of carbohydrate
in the evening. And and truly, the carbs
that I love, and everybody says this,
are green leafy, you know, vegetables,
but I really like things like cilantro
and chives, things that maybe have more
medicinal purposes.
And that's really what we use.
So.
So, herbs as medicine, which ones, what
effect?
I am certainly not an expert on herbs,
but I will tell you one of the things
that we use is
this isn't an herb, but I'm just very
strategic. So, like in the morning, I'll
use something called Sunup green coffee.
And it's it's this one company that I
just really love and I have no
connection to them, but they have a
product that I think nobody knows about
that everybody should. And it's raw
green coffee. So, it looks like tea. I
don't make it. I get it
Clear like that.
It didn't look It tastes like tea.
And it really and it has a high amount
of polyphenols,
which I know that there's a lot of
debate in, but I believe in polyphenols.
And it has
does What do the polyphenols do for you?
So, they're antioxidants. They have
numerous effects, anti-cancer activity.
And I will tell you that I am able to
maintain my body composition
by doing these very strategic things and
just being very conscientious of
utilizing simple tools
that I have found incredibly helpful.
Like for example,
um jalapenos. Using raw jalapenos with
capsaicin, you know, the whole goal is
optimizing body composition.
And you utilize these in an you know,
over a period of time in enough amounts,
and the body generates its own effect.
And listen, this is totally subjective.
You do have to control for calories.
But there are things that we just as
scientists or as practitioners,
physicians don't necessarily understand.
But I can tell you that it works. So, I
use chlorogenic acid What is that? I've
never heard of that. What is it?
That's the green coffee. That's why I
use the green coffee.
Chlorogenic acid? Yeah. Has high amounts
of chlorogenic acid. You're going to try
it?
put together before. Chlorogenic acid,
okay. It's a compound that helps with
fatty acid metabolism. Hm.
Very interesting. Okay, so we have our
green coffee.
Um and then uh what else are we doing in
terms of um
herbs?
Um a lot of cilantro.
And they you know, there's some belief
and through what mechanism I don't know,
but very detoxifying.
You know, a lot of individuals with
quote heavy metals will utilize a
cilantro base kind of compound.
Cilantro, parsley, chives, garlic.
People are like, I'm not coming in your
house. It's all right.
But it it would be interesting because I
think that that's the You know, I think
we're all looking for ways to optimize
longevity at the not just at the end of
life. So, it doesn't really matter if
you live to 100 versus 105 or 95 to 100
if the last 5 years suck, right? So, how
do we live a way that
surpasses what we've seen for longevity,
but the quality
of our life is together. And that's the
question is not the length, right? So,
it's not quantity of life. It truly is
quality towards the end. So, really I'm
starting to experiment with these things
as it relates to longevity
and quality while keeping
Really fast, give people a bit of a
breakdown on your background in
geriatrics. One, I don't know that
everybody knows what a geriatrics is. Um
and then two, I know you spent a lot of
time in palliative care. So, what that
is and sort of the It's given you sort
of a tough edge and no-bullshit approach
to this that I really respect. So,
first, what is geriatrics and palliative
care and then what have you learned from
it? Yeah. And and I'm going to tell you
where muscle-centric medicine came from.
There was a turning point moment that
was during my fellowship. Um So,
geriatrics is really it's taking care of
aging and it's over the it's 65 and
older. And that's what's considered
geriatrics. And then palliative care is
the end of life. So, you are really at
the end of your life, whether it's a
month or so. And and that's really
transitioning to the other side,
whatever that other side is.
So, when I did my fellowship at WashU,
it was a 2-year fellowship and part of
the deal was I was going to get to do
nutritional sciences. So, I've trained 7
years in nutritional sciences. But the
deal the deal is in order to do clinical
research. So I did two years of clinical
research.
Part of the way that it worked was as a
physician, I also had to have clinical
duties.
Part of those clinical duties, the
agreement was, you know, there's always
a give and take.
The agreement was I got to do obesity
medicine and run a weight loss clinic
and and image people's brains and be
part of you glycemic clamps and do all
this really rad stuff.
But in order for me to do that, I had to
take care of people in nursing homes
at the end of life
in the hospital
and geriatrics, and I'm sure everybody,
many people have had aging parents. It
is not, I mean
diseases of aging are heart-crushing,
bone-sucking,
like it is so harsh. And that's why I
feel so passionate about this message
because I've actually done the work and
sat at the bedside
of these people.
You know, and at the end at that moment
in time, you can look back and you know,
people have a lot of regrets. And I will
never forget and the muscle-centric
medicine came from a very specific
moment. Part of the research I was doing
as I was imaging people's brains. It was
obese brains mid-life.
Incredible women, round, you know, late
40s, early 50s.
And I have to change the name of this
woman, so we'll call her Sarah. And
Sarah was the nicest woman and she had
three kids. She'd been overweight her
whole life.
And I had to sit with her, you know, we
did 24-hour you glycemic clamps, sit
with her and you really get to know
these people. You see them at multiple
points in the study. And
one of the parts of the study was
imaging her brain.
Just to see what her brain looked like.
And when
we imaged her brain, she had a lot of
like flattening of her matter.
And it came from midlife obesity. And we
knew that within, you know, really 10
years down the line, she's going to have
a Alzheimer's.
What is flattening of the matter? What
is that? So, the gray matter, right? So,
that the brains that the wider the
waistline, the lower the brain volume.
So, Alzheimer's, there are many there
are many multiple different aspects of
Alzheimer's, but Alzheimer's is type 3
diabetes of the brain.
It's a metabolic illness
that can be prevented just like
diabetes, just like cardiovascular
disease, just like hypertension. And
listen, I I want to say this with a
little bit of reserve because there are
genetic components. However, lifestyle
choices midlife, having access to the
right information changes the trajectory
of aging.
I was so heartbroken when we reviewed
her fMRI study. I was heartbroken
because all she told me was, you know,
I've emotionally eaten my whole life. I
have three children. I'm a stay-at-home
mom and I put everybody first.
And her habits were so deeply ingrained
and she was obese, her muscle tissue
wasn't there. She literally in the next
decade was going to have Alzheimer's.
And she had no idea what she's in store
for or what her family was in store for.
And at that moment, I knew that chasing
body fat was the wrong thing to do.
It was all about muscle as this
metabolic organ.
And if she had turned her attention to
protect against that?
Because it controls body composition.
So, metabolically The the bigger the
waistline, the smaller the brain. Why?
What mechanistically is happening?
Because it is very inflammatory. So,
there is insulin receptors in the brain.
You know, it can affect the blood the
blood brain barrier.
Insulin resistance in the body and
insulin resistance in the brain.
And one of the other things and and
we'll talk about muscle, but the
the the protein component affects
satiety. So that overeating, that
emotional eating
your body is going to feed until it gets
the protein that it needs.
And that's that's something
That's super interesting looking at
cravings from that perspective. Yeah,
and it's actually called the protein
protein leverage hypothesis. Where and
this is well maintained throughout
species where they will feed. So you'll
continue to eat and overeat and overeat
if you're eating a low protein diet
until you reach that protein need.
For these satiety mechanisms to shut
itself off.
Very troubling.
So now give me what does muscle do that
interrupts that
Why is it anti-inflammatory? Like if we
look at what I just laid out is how we
get too much insulin into the system,
what's muscle's role in?
So muscle is the largest site for
glucose disposal.
Glucose in and of itself is cytotoxic.
It is really critical to get glucose out
of the bloodstream and take it up.
One of the ways, the largest site for
disposal is actually muscle tissue.
The more muscle you have, the more
metabolically healthy it is, the more
that it's actually utilizing nutrients
appropriately.
The more carbohydrate flexibility you
actually have.
So it's in and of itself protective.
And we talked about when you when you
contract it by
secreting myokines
it is anti-inflammatory. So if fat is
the nemesis of muscle. Talk to me about
what the muscles is secreting. Um this
isn't uh interleukin 6 I'm familiar with
only because of what's going on with
coronavirus, so that sort of cytokine
storms and stuff is that's become more
um
people are talking about it more. Uh,
but the other stuff like what you just
said, which I I couldn't even tell you
what you just said. Um, what's that
called again and why is it
anti-inflammatory? So, the interleukin-6
is really the big one. That's what
muscle is famous for. But when you think
about muscle tissue as it relates to
inflammation and obesity and really
protecting Sarah, the story that I told
you, if she had been able to get her
tissue
under control just mechanistically from
getting her protein intake up,
right? And making sure that that tissue
was emptied.
But because she was largely inactive,
and you know, there's this this concept
where when the muscle is full,
everything starts filling back into the
tissue. Or it just can't
So, basically you have an increase.
Remember there was this whole big
discussion about branched-chain
branched-chain amino acids cause
diabetes. Because everyone with elevated
glucose also had elevated branched-chain
amino acids.
I've never heard that before. Tell me
more.
There was some research that had come
out where people had mistakenly
said, well, those with elevated levels
of branched-chain amino acids, it
correlates to high level, you know, it
correlates to diabetes.
Branched-chain amino acids in the
bloodstream.
correct. And actually, that's absolutely
true, but not for the reason people
think.
The reason it was true is because
branched-chain amino acids are utilized
by the muscle. Oh,
let me guess. So, you're this is that
backup mechanism, right? So, the
branched-chain amino acids should be
going into the muscle, but they're full
What are they full with? They're full
with glucose? No. Full of glucose,
they're full of fat, they're full
they're just full. They can't accept any
more substrate.
Because they're not being used. Exactly.
Now we're on to some Now we're on to it.
So, these diseases of obesity, these
diseases of being over fat, they're not
diseases of being over fat. They are
diseases of impaired muscle.
So, if you fix that muscle tissue,
and that's through lifestyle, keeping
inflammation low, keeping calories in
check, and truly we are domesticated as
a planet. Can we define fix? So, when we
say fix, cuz if you had stopped shy of
the word fixed, I would have said add
more muscle, which is where I always
expect you to go.
Um is this a
a game of quantity and quality?
Primarily quality? Um These are great
questions and I
I don't think anybody knows the answer.
And here's why. Because muscle is the
most underappreciated organ.
We have percentages of body fat that we
know are not great. But we don't know I
don't know what percent muscle mass you
should be.
You don't know what percent muscle mass
I should be.
And this is
so important to understand because if we
really truly want to help obesity,
Alzheimer's, cardiovascular disease,
it's really about optimizing muscle
tissue and and nobody knows that answer.
I would say from a professional opinion,
quality and quantity matter. Of course,
I'm not talking about in the extremes
of, you know, a bodybuilder in the
Olympia.
Although that's incredibly healthy
tissue, right? Can I tell you a secret?
Here's something I would love to know.
How does muscle mass correlate with um
surviving coronavirus?
I thought about that kind of early on
and I thought, "Ooh, I do wonder."
Well, if you think about it, the higher
the muscle mass, the better the
protection against all-cause mortality
and morbidity.
Just in general.
People need to let that one sink in
across all cause mortality.
I agree. So, listen, if someone goes in
they're on a vent or they're aging, I
mean, what are the things that are going
to be most important?
Muscle tissue.
You want to survive? You've got to be
able to support your system.
Yeah, man, it's crazy. Muscle, muscle,
muscle. So, now let's talk about how do
we get some muscle? So, obviously we
need to eat, we need to get our leucine
levels right, we need to eat a certain
amount of protein, which I think you
said roughly 1 g per lean body mass.
That's the recommended amount. I
actually that's what is would be
considered in the literature. 1 g per
pound lean muscle mass, and I would say
that's a great starting point.
I would say it should be 1 g per pound
ideal body weight. Okay.
So, lean lean muscle mass is very
variable.
bit of fat you're saying.
Mhm. Yeah, sure. Whatever you want, as
long as the calories are
take me. I'm 180 lbs. What should I
180
g of protein. 180?
Yes, sir. Okay. And then, you know,
what's your caloric target? We would,
you know, I would probably break up your
protein meals in 50 g or so. Could you
go over? Yeah. Would you have much
metabolic benefit? No.
So, 50 g of protein per meal, so 7 * you
know, 6 would be 32 g, so I mean,
brother, you're going to be eating a
lot.
Or if you didn't want to do that, you
would have a lower dose of protein and
then had to add in your branched-chain
amino acids.
So, that's one strategy. And then you
asked about fats. So, fat is more, you
know, for men I like to keep them a
minimum of 80 g for hormone production.
So, I would say a minimum of 80 g of
fat, but again, this is all based on
calories. And carbohydrates, take it or
leave it. And I'll tell you what is more
important is also as you age and we all
become more mature, hate to admit that
I'm aging, but we are. Is that you
actually have to get that meal threshold
right. So, you would be doing yourself a
service by getting 50 g of protein
per meal, because you're going to get a
robust
response for muscle protein synthesis
and anabolic resistance.
Mechanistically, the body becomes kind
of um immune or desensitized to amino
acids.
So, you require more amino acids at one
time
to get the sensing more robust. And
especially in aging, like in geriatric
population, you need that sensing
mechanism to be very robust, and that's
where your amino acids come in. And
getting that, you know, amount per meal
correct, so you overcome this anabolic
resistance. And to lead into resistance
exercise, right? That is essential.
And um there's a lot of questions or
someone, you know, if someone is aging,
there's some great work out there from
McMaster University, and they say, you
know, they've shown that it's not the
heavy weight, it's the two fatigability
and exhaustion. That's interesting. It
is interesting that they would get the
same benefit, because for a long time I
said, go out and work as hard as you
possibly can until you want to quit at
least twice or throw up.
And that may not be
the the that may not be a overarching
recommendation. So, really having a
well-designed trained program, you know,
planned out program is essential, and
you'll respond quicker if you're
under-trained or or de-trained, right?
And then the more advanced you get, the
less gains you're going to make, but
resistance training is key. I've heard
it said, and this makes a lot of sense
to me, that um
food are signaling molecules.
And that's what I heard you just say,
which is that
Muscle is a nutrient-sensing
organ.
Right. So, the muscle is listening for
the signal of the food that I eat to
say, "Ah, cool. There is adequate
amounts of protein available to me right
now." And that turns something on. Yes.
Exactly. Um
and that would be the branch chain amino
acids.
As we age, the ability for that skeletal
muscle to sense that decreases. Okay.
So, Ryan, I know I'm derailing us a
little bit here.
Um but now going back to incomplete
proteins like are found in cuz one of
the things you take the most heat for um
is, you know, saying, "Ah, some of the
protein that you're going to get in
vegetable matter isn't going to be as
complete." So,
which what you just said would predict,
which is that if the muscle is looking
it's sensing that signal and the signal
comes in the form of branch chain amino
acids and the branch chain amino acids
from the vegetable matter keep me in
some sub threshold where it doesn't
click over into this.
That It's not, you know, we use protein
as a blanket term, but it's complex.
You're looking at 20 different amino
acids. It's not the protein that we need
essentially, it's the amino acid
requirements that we have. And skeletal
muscle has very specific amino acid
requirements. To do the turnover
what is necessary. And to do turnover,
to be able to maintain its structure, to
be able to put on new muscle, to be able
to maintain its health.
This comes in the form of branch chain
amino acids. As we age, the sensing
mechanism of one of one of the branch
chain amino acids, which we've talked
about before, is leucine. That's sensing
mechanism decreases.
The way in which we which ultimately
leads a less efficient turnover, leads
to subsequent sarcopenia,
a decrease in muscle function, muscle
strength, muscle mass as we age
by optimizing for protein intake, you
know, specifically high quality protein,
then just like you said
High quality protein is typically what
we think about animal-based proteins.
Does it just have to be animal-based
proteins? No, but these are hard fast in
the literature. High quality protein is
defined by amino acid content.
It's not a negotiable nebulous concept.
These are hard fast biological numbers.
And each protein has very specific roles
in the body.
And specifically as we age and if you're
thinking about
famine and fasting, it's
specifically as we age the
branched-chain amino acids in particular
leucine is required by skeletal muscle
to begin that process.
As we age this concept of anabolic
resistance, meaning there's a decrease
in efficiency, the body becomes
know what's happening at the cellular
level? Well, yeah.
There's a decrease sensing of mTOR.
Okay. And mTOR,
um, which I understand vaguely enough to
be dangerous, is uh, basically what has
to happen for us to grow. Yes, it's
mechanistic target of rapamycin. There's
mTOR 1, mTOR 2.
And it's in all cells?
It's in all cells.
It's a
Will it happen differentially in
different cells?
And it's stimulated by different things
in different cells. And in muscle Like
what? Well, I'm going to tell you. Break
it down. Can't wait.
In muscle it's exquisitely sensitive to
leucine.
In areas like pancreas or liver, it's
exquisitely sensitive to energy, extra
calories. It's sensitive to insulin.
Regardless of macronutrient? Well,
arguably it would be more sensitive to
insulin and glucose in say the liver or
the pancreas.
But skeletal muscle is exquisitely
sensitive to amino acids. That's sensing
mechanism decreases as we age. So then
this brings me to this concept of
longevity, which is very hot right now.
People talk about longevity and there's
this conversation of decreasing protein
intake because that's going to help
longevity.
hypothesis?
I have no idea. It's because the
stimulation of mTOR.
So they're worried about cancer?
Yeah, they're worried about cancer. But
if you were worried about cancer,
and by the way, mTOR is signaled by
exercise in skeletal muscle as well.
So it's not an mTOR issue in muscle.
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right, I'll see you on the inside. But I
I just want to to stay on this longevity
topic of individuals saying you should
reduce your dietary protein because of
longevity, which that's probably the
worst piece of advice I could ever give
someone.
Let's define longevity.
What does that mean? Is it living from
to 95? Or is it living to 95 and a half?
And the question is do you want to be
mobile and healthy, or do you want to be
frail and sarcopenic?
If we believe in the hypothesis of
anabolic resistance, which arguably we
should, this is well documented in the
literature, you look at my mentor's
work, Dr. Donald Layman or Stu Phillips,
any of these guys, Van Loon,
you know, this is a well-documented
phenomenon that as we age, our capacity
to generate, heal,
keep muscle goes down.
So, I just told you about the sensing
mechanism, and that we actually require
more dietary protein. Really, we require
high-quality protein because we require
that amino acid stimulus.
So, if you now further reduce
dietary protein from aging individuals,
and aging can start in your 30s,
how are you going to then stimulate
tissue?
You have to be very careful about how
you want to age and this concept of
longevity. Longevity for a C. elegans or
a fruit fly
doesn't take into account the complexity
as a human human aging. Is that where
they're drawing that from?
these are not human studies. You're not
looking at randomized controlled trials,
you're not looking at good high-quality
data
to support a reduction in dietary
protein. And as a trained geriatrician,
no geriatrician says, "Hey, Study old
people. Yes. You You need to reduce your
dietary protein. We know that
skeletal muscle protects against
disease, it protects against morbidity,
it protects against mortality. Muscle is
an organ system. It's an endocrine organ
system. When you contract it, it
secretes myokines. These myokines, you
know, the the most studied myokine is
interleukin-6. Goes throughout the body.
It affects bone. It affects liver. It
affects nutrient partitioning. What
group do we put interleukin-6? Is that
considered
immune response?
It So, in it is an immune response when
it's released from macrophages. It is a
myokine when it's released from skeletal
muscle.
is. You You and I talked about this last
time. I don't I still don't have my head
myo So, this is This is actually a newer
science and this really comes from the
work of Patterson and she has
essentially paved the way. She's an
immunologist and internal medicine.
And what a myokine is, it's a protein
released from contracting skeletal
muscle.
And when we are deconditioned and when
we are not training, you don't secrete
interleukin. Interleukin-6.
do once it's in the bloodstream?
What does There's There's thousands of
them, which is interesting.
Of different kinds?
Interleukin-6, decorin, irisin. There's
thousands.
Again, this is new emerging science and
arguably what we should be studying. I'm
starting to look at blood levels
post-exercise in my patients.
Right? And this just goes back to a
broken obesity model, which we know
you're not over fat. We know everyone is
under muscled, right? When we are
talking about the general population,
you know, typically people don't have
a good solid founda- foundational
muscular base. They don't. And this idea
that we would further reduce dietary
protein is going to have a much more
negative effect and the
Here's another question. Do you think
there are problems with So, cuz I'm
trying to get to
Muscle, obviously hugely important. I
couldn't agree more with that. Just that
makes so much sense to me.
The question is what And maybe it
doesn't even matter, but which is more
important, the the muscle or the fat?
So, for instance, there is somebody in
my life who is
lovely, lovely human.
They're really [ __ ] strong, like
really strong, but they're also morbidly
obese.
And so, what is the muscle going to
protect them enough from the obesity?
And the story I've always told myself is
that
because he has such a massive surplus of
calories and so much of it is
insulin-secreting that he's in a growth
phase all the time. mTOR is just kicking
off like crazy. But he's also eating too
many calories.
The muscle can only do so much.
At some point
a point at which the muscle just can't
carry the burden of your diet.
Yeah. Yeah. You know, I and I when I
think about insulin, I think about when
I think about carbohydrates, I think
about it in a meal threshold, not in
this 24-hour period, but
carbohydrates are okay. Just got to make
sure that you are not overextending
yourself in terms of a meal per meal
basis.
Let's say someone has really, really
healthy muscle, but they're
over-consuming calories, they're not
going to have a chance.
There has to be some
you know, there has to be some balance.
But these issues start in skeletal
muscle first, and I think that that's
very misunderstood. Everybody is
focusing on adiposity, everybody is
focusing on insulin resistance, and if
you care about root causes, you have to
care about skeletal muscle.
So, that's where it feels like it's
maybe complicated. So,
um
if if this guy who has a ton of muscle
can still end up having the problem, it
feels like muscle is necessary but not
sufficient. You have to both have muscle
and a diet that isn't overwhelming your
system.
Yes, it is necessary but not sufficient.
I love the way you put that. And
wouldn't it be great to see this guy
lose some fat, adipose tissue?
And I think that that would make a lot
of sense. You say that he has a lot of
muscle,
but what individuals that we see when we
see MRIs or we see CAT scans, there's
fat infiltration into skeletal muscle.
Skeletal muscle becomes marbled.
You know, there's no free lunch or no
free pass.
If you struggle with obesity, it's not
just limited to visceral fat. It does
get into the organ. It does get into
skeletal muscle. This ultimately affects
this this cycle. It ultimately affects
your ability to manage, you know,
glucose. It affects your ability to
manage substrates. It affects the health
of the muscle. You know, we talked a
little bit about myokines and you know,
the big the biggest most famous myokine
is interleukin-6. And when you contract
skeletal muscle, it actually
does this whole body crosstalk where it
can lower some inflammation
throughout the whole body, right? So,
exercise is in and of itself, I don't
want to say anti-inflammatory because
oftentimes the process of exercise does
create free radicals. You know, there's
this you know, these these concepts like
you said are very complex. Yeah.
It's not just this way and that way and
I think that we try to over simplify it.
But to the best of our ability, there
are some fundamental things that are
important to understand.
And that is we have to address skeletal
muscle. You must.
Get your muscle.
And while I I understand that it makes
people afraid,
it doesn't mean that it's true.
Fear can be validated, but it doesn't
have to be true.
That's a really we could derail this
entire episode around that sentence.
But I I I I I
what's happening is that we're not
having transparent conversations. Mhm.
And this is really what I'm fighting
for.
Because of dogma, you're saying.
of dogma. It is Now, I've been I've been
in this space for 20 years. 10 years
ago, this was not a conversation. The
sort of ethical thing.
Animal cruelty, ethical kind of a a
conversation.
Bad the planet.
It wasn't it wasn't that way.
And what's happening is that at the very
heart is this
anti-animal
dogma.
And there's nothing wrong with not
wanting to eat animals and there's
nothing wrong with not wanting to harm
animals. Okay? I I can appreciate that.
But what's happened now is there's not
transparency around it. So this whole
conversation then goes to what
how can we get people to stop utilizing
animal products?
Well, we're going to scare them. We're
going to generate so much fear. We're
going to put out fake
educational documentaries. We're going
to completely obliterate the science.
or sinister? It's sinister. It's it's
totally conscious.
The people at the top, it's totally
conscious. And then what's happening is
then it's getting into
um
you know, it's then training physicians
and then it's affecting influencers that
are then going ahead and talking about
longevity and reducing protein. And they
believe they're saying the right thing.
They're not. They believe they're saying
the right thing for the body or for the
planet?
the body.
But they're not understanding that at
the very heart of that is is actually
coming from an anti-animal narrative.
And what's happening is there's no
transparency in the data. And
our expectation is now to lower
the quality of evidence to be able to
say, "Well, no. Plant and animal protein
are the same." No, they're not.
Last 20 years, this has not been a
conversation.
of branched-chain amino acids. Or any
amino acid. And there's this whole
argument about it. Now it's So now then
it's the longevity piece. Reduce protein
because it's going to affect your
longevity.
Longevity defined as what?
Six months? And also have you
that were the case, let's say that plant
uh based proteins actually did make you
live for an extra six months.
What kind of muscle mass would you have?
Would it Would it
Yeah, but if if it seems to me that if
it actually makes you live 6 months
longer, that's worth talking about. But
But we don't know that to be the case.
Right.
I mean, like I said, a fruit fly isn't
the same. And you know, I've taken care
of people more than I can count at end
of life. That last 6 months is brutal.
So, are you saying that what I'm trying
to understand cuz the analogy you always
use is that what? It gives you 6 more
months? If it does, I think we have to
talk about that. But is your hypothesis
that that data is flawed? You're looking
at the wrong animals. In humans, based
on
It's about the quality of life.
Okay. And
at the end of life
that like maybe it doesn't
It's possible.
live longer.
It's possible. I mean, again
even going to argue that. Who cares
about that? Now, let's talk about
quality.
You know, I'm never going to say, "Okay,
well, you know, these are things that
are highly complex. Is it possible?"
Maybe. But let's say let's say, "Okay,
that's possible."
Towards the end of life, you want to be
mobile. You don't want to have a broken
hip and be spend the last 6 months in a
nursing home bedridden. Or you don't
want to spend your time in an
Alzheimer's ward.
These things are related to skeletal
muscle.
Alzheimer's as well. There's a metabolic
component to Alzheimer's. It's type 2
diabetes of the brain. If you care about
Alzheimer's, you have to care about
Real fast, connect muscle to metabolic
disease for me. Exactly what's going on.
Okay. Skeletal muscle is your primary
site for glucose glucose disposal. And I
use the term disposal to get it out of
the bloodstream. Anything to get it out
of the bloodstream.
Or
So, right? So, when you think about
skeletal muscle, you have to think about
glucose utilization
or disposal.
You have to think about fatty acid
oxidation.
Skeletal muscle.
Healthy muscle stabilizing blood
glucose, which you've seen.
So, I don't get too much insulin
secreted, so I don't get insulin
resistant.
that's more of a dietary thing, right?
So when you have too high of a glucose
load, you're going to get a subsequent
insulin response.
Right? That that is what happens.
So
skeletal muscle for all these ways in
which it can help dispose of nutrients
is really what we're thinking about when
you think about metabolic syndrome.
Ultimately, it is a intake issue.
And I think that you
Meaning I could control it through my
diet.
You could, but you still want to have
healthy skeletal muscle for all the
other things.
No doubt, and it gives me a lot more
flexibility in my diet.
Gives you flexibility, gives you, you
know, there's mitochondria, gives you a
lot of positives.
Okay. So now coming back to the
longevity piece, we've got people and um
I'll be generous and say they really
really have amazing intentions. They
want to protect animals, they want to
protect the planet. So then you just say
that.
that it's better for us yet, right? Cuz
the science is
you can't now animal protection is
different than planet protection.
And I think that we just have to be
really clear.
Animal protection is animal protection.
All the other lines of narrative really
go back to animal protection because the
data doesn't support that, you know,
it's just that these cows are now
killing the environment, right? That's
not true. You know, if we look at the
US, it's
greenhouse gases, industry,
transportation, and electricity. 50% of
our fruits are flown in.
25% of our vegetables are flown in.
So that it can't be so convoluted. It
has to be I think there just has to be
transparent conversations. When you talk
about longevity, I think we have to
define longevity, and we have to have
these health conversations of what are
the end points that we're going to be
looking at.
And when you say define longevity, I
think it
your debate is
maybe longevity isn't the right
question, it's quality of life is the
right question.
and I agree with I yes. And I you know,
I was thinking before I was coming here,
you know, what is a different word that
we can use because people talk about
longevity, which is just the span of
life, you know, and then there's terms
thrown around like health span.
I think it really is about quality of
life and it can't necessarily be
And a big part and I agree with this,
but so if I'm putting inappropriate
words in your mouth, just tell me, but a
big part of quality of life for you is
really strength.
Yeah,
of course. And we know that to be true,
not just my personal opinion.
I think a lot of people don't really
think about strength.
They will when it starts to decrease.
When you can no longer lift something up
to put it in your overhead bin when
you're flying or you can
It's crazy how as you get older, that's
like the most dangerous thing you're
going to do is walk around.
But if you listen to the current
narrative, that is going to be
inevitable.
And that's very scary.
You know, this idea that we should not
focus on skeletal muscle and continue to
try to address obesity is a broken
paradigm. We are focusing on the wrong
tissue. Obesity is not the problem. It
is not the root cause. It's skeletal
muscle as a root cause.
And diet, yes? Well, yeah.
But they the two kind of go hand in
hand, right? Cuz because you can deal
with more bad diet if you have more
muscle. Yes, but you also have to nail
diet for
a quality of life going forward. Partly
because I have this um sensing organ
that is waiting for a certain amount and
kind of protein.
lot of energy. When I say energy, I mean
both physical, mental, and food-wise
energy to maintain.
It is not easy to put on muscle. You
know, Facts. I mean, I listen to Alan
Aragon, he's amazing. He would be
amazing to have a conversation with. You
know, I was asking him about how much
muscle could someone put on in a year.
And if you are totally untrained, you
might get 12 lb, maybe 12, maybe 24 lb.
That would be outrageous.
24 lb is astounding. You would look so
different.
But that would be outrageous, right?
This is like at the absolute upper level
that, you know, we don't really see
happen.
But the reality is it takes so much
energy and effort. Again, I use those
terms kind of interchangeably to
actually put on tissue.
What's so cool about this organ system
is that we can actually add to it.
And I like to think about it as we add
to it, we add to our life.
All right. This is so powerful. Give
people in like just one a quick couple
sentences
the thing they should be doing, whether
it's diet, working out, whatever. So
that
Let's start with resistance training.
You have to train hard.
Whether, you know, volume is what's what
is what is important, but you have to
get the volume in and you have to get
the stress in. The body thrives under
stress.
There's this concept of we should have
less stress, we should No. Your body
requires physical stress.
After you get that physical stress, you
know, whether you're doing
high-intensity interval training, you
need to you need to train, you know,
resistance training, you need to
strength train, and you need to do
aerobic training. You do.
And you probably need to work harder
than you think you're working.
I think you've said you need to feel
like giving up at least twice and about
to vomit.
And people will argue with me and say,
"Oh, no, that's not true." Well, okay,
but as you age, the tissue it becomes
more and more difficult to respond to.
And number two, you have to account for
your changing hormonal milieu. The body
is changing, whether we want to believe
it or not. When we are younger, we are
driven by hormones. When we are older,
older,
30s, 40s, we are now no longer driven by
hormones. We are now driven by dietary
sensing mechanisms.
You have to account for dietary protein.
You have to. Yes, you have to account
for carbohydrates. Yes, you worry about
insulin.
Yes, you worry about fat. Yes, I do
worry about total calories, but you have
to get the foundational piece
right up front. And that is high-quality
training is a non-negotiable. And number
two, high-quality proteins.
Right now, everybody focuses on
adiposity, being over fat. There's the
constant struggle against bulge. But
that's the wrong way of thinking. It's
not about being over fat. That is just
the
by-product of being under muscle. So,
the true way to fix everything is
optimizing muscle tissue and really
changing the paradigm of thinking. It's
not about being over fat, which is why
it hasn't worked. It truly is from a
metabolic perspective, about being under
muscle.
So, talk to me a little bit about um
when we look at what it means to be
optimized for muscle mass. I get why
being obese um is wildly problematic. Um
fat itself is an organ. It's a sign It
signals to the rest of the body. It's
pro-inflammatory.
Um it can hurt joints just in terms of
being too much weight.
One, why hasn't focusing on that worked?
And then two, why is muscle the answer
um to the problem?
Yeah, certainly. Well, it's kind of like
what you focus on, you get more of. And
by constantly focusing on the pathology
of adipose tissue, it's the wrong
perspective. And I think that that's
largely what's wrong with the Western
medicine approach. It's constantly
chasing the outside pathology as opposed
to really
Yeah, it's it's a And when you do that,
you're constantly chasing your tail.
But really, it's truly an issue of
muscle tissue. So, defects and issues
with the muscle actually happen first.
Adiposity is secondary. And how I really
like to think about it is it's like a
suitcase. Stuffing, you know, a whole
bunch of stuff into a suitcase, which
would be carbohydrates or glycogen, and
really overpacking it, and then having
things spill back out. And that's
exactly And then when it spills back
out, that's when you get fat. All right.
So, I had an employee who used to be an
Olympic-level swimmer, and when he
detailed what he ate, I was like, "Bro,
you are going to die so soon. This is
crazy. How are you not morbidly obese?"
He was like eating French fries and
chicken nuggets from McDonald's, and
eating something like 12,000 calories. I
could be a little off, but it was so
absurdly high that I was like, "This is
insane." And he was quite lean. So,
is the hypothesis, the reason that he
was lean, that he's using his muscles so
much, and he's in a state of burning the
carbohydrates at such a ridiculously
high level that he's sort of unable to
put on the fat because the muscles are
essentially taking care of it? And
that's a really good framework to think
about it. There That would be
multifactorial. Certainly, the amount of
output that he has with all that
activity, he's utilizing a ton of
carbohydrates. Because he's a
carbohydrate-adapted
athlete, as opposed to say someone who
eats less carbohydrates and more fat.
So, the reason he didn't get fat was
probably, number one, he was young.
His hormones were good.
Right? High testosterone. And he was
putting in so many hours that he was
utilizing everything.
So, people have, I think, a high-level
understanding of their three
macronutrients, and they probably have
heard things like um carbohydrates cause
you to store fat and water, um that the
muscles burn um glucose like at at that
level. Um
but my question is where it begins to
get fuzzy for people is like what's
happening when you use your muscle? Like
muscle mass, even just having it, is
going to be protective, is going to
allow you to consume more calories
without putting on adipose tissue. So, I
think explaining to people maybe the
function of muscle as an organ um would
be really helpful.
Oh, my pleasure. Probably my favorite
topic. So, muscle as your metabolic
currency, it is largely responsible for
your resting metabolic rate, which is
really essentially the calories that you
burn at rest.
It is one of the largest sites for
glucose disposal, which is exactly what
you were talking about. Whatever the
Twinkie diet he was on was being
utilized by the muscle tissue.
And another component of skeletal muscle
is that it's a site of fatty acid
oxidation. So, we hear a lot about high
cholesterol. Well, actually muscle is so
metabolically active, that's one of the
fuels that it uses. So, truly the three
components of muscle as a metabolic
organ are number one, resting metabolic
rate. It determines everything
about what you're doing. Muscle mass is
incredibly unique in multiple different
ways. You know, really not just as
locomotion, which I think in our 20s, we
all think about muscle as locomotion and
looking good in a bikini or mankini,
whatever you choose. But really the the
true essence and the true benefits of
muscle are far beyond that.
Just as its ability to utilize calories,
utilize energy. And you know, of course,
we have to get into the topic of the
importance of high-quality protein,
which I'm I'm that we'll talk about. But
muscle in and of itself is so
interesting. It's actually an endocrine
organ.
So, when you contract it, it secretes
things. It secretes proteins. One of
these proteins are called you know, this
group of proteins is essentially called
myokines.
So, it's responsible for all those
things that I mentioned, the resting
metabolic rate, the glucose disposal,
fatty acid oxidation, but also
interestingly, just as you had pointed
out
the fat adipose tissue being an organ,
which is the nemesis of muscle, right?
It's the nemesis of muscle. Muscle in
itself, when you contract it, also
secretes things. These myokines go
throughout the body and are
anti-inflammatory.
Things like interleukin 6, BDNF for
brain function.
It's just multi There's just There's
many, many.
So, BDNF is is something brain-derived
neurotrophic factor, if I'm getting that
right. So, that's the People have
referred to it as sort of a feel-good
chemical. So, you talked about muscle as
an endocrine system. For anybody that's
not familiar with endocrinology, that's
basically hormones. So, um is that what
triggers the release of BDNF is the
actual contraction of the muscle? I
mean, it's certainly part of it, yes.
And especially now, when you think about
that balance of inflammation, muscle
also releases interleukin 6, which
people always think of, you know, as the
cytokine storm as this interleukin that
causes all these damaging things down
the line, but truly muscle
as an organ secreting interleukin 6
actually has an anti-inflammatory
effect.
So,
walk me through then when my my tissues
are at rest, um the the metabolic rate
is that the tissues are what repairing
themselves? Like, how does that
They're just very active. They're
turning over, you know, they have
mitochondria. It's just an active
tissue. They break down protein,
you know, build new protein. It's just
this kind of balance between an anabolic
catabolic effect continuously turning
over. Okay, so anabolic being building
muscle, catabolic being tearing it down.
Um
talk to me cuz because this is one of
the things that ends up making muscles
so critical for people to understand as
they get older, more and more critical.
You've talked about how muscle is
basically a storage place for um
amino acids. Um and I know that like if
somebody gets severely burned, they
almost can't take in enough amino acids.
Um as you get older, if you get sick,
muscle, if I'm not mistaken, muscle is
one of the like most direct predictors
of mortality. Yes, and morbidity. If you
want to survive, the more muscle you
have, the more likely you will survive.
So what I'm assuming that's like a a
form of catabolic where the body's like,
"Yo, we've got a problem in in the
immune system. We've got a problem
within the case of burns trying to um
replenish the tissues." So what is the
body breaking the muscle down into?
So it typically breaks it down to amino
acids. So it's an amino acid reservoir.
And those amino acids are utilized for
fuels. And it's really a storage form
and also
uh you know, it goes there's other
proteins in the body that may require
it.
But typically it's that amino acid
reservoir.
It's really interesting. So I've always,
not always, but certainly in my once I
became aware of what's really going on
in nutrition in the body, um you
recognize that fat has this incredible
role to play, which as you can imagine
us out foraging, hunting, and there's a
period where you don't have any and it's
a battery. It's essentially like, "Hey,
mitochondria's going to need it for the
process of generating ATP, which is the
energy that actually keeps the cells
alive and allows them to function." And
then so you're like, "Whoa, it's
actually really powerful in a context
where we can't just overeat, overeat,
overeat." You get why the ability to
store fat is this incredibly powerful
thing. So, I'm going to store basically
potential energy. Um fantastic.
Literally, you're you're the first
person I'm aware of to talk about
musculature as a storage mechanism as
well and being able to store um
many different things that the body ends
up needing. Um
why
don't
Wait, you don't want to do that. So, you
don't want to rely on your store of
amino acids. You don't You want to keep
that muscle as healthy as you can for as
long as you can. And that's really where
this whole kind of question of dietary
protein comes in. Because as we age and
just really overall, there's only two
ways to stimulate muscle mass.
And that's I'm sure you know from the
Quest days is dietary protein, right?
That's essential. And then resistance
training. But in society right now, we
have we have really two fundamental
issues. We have this fixation on
obesity, and that is the pathology
versus the cure, which is under muscle.
So, that that's one venue.
And then you have this dietary component
where people are incredibly confused
about optimizing protein. Protein is
incredibly emotional for people.
And it's really the key macronutrient
for maintaining muscle mass and also
helping with obesity, diabetes,
Alzheimer's, cardiovascular disease.
These are pathologies.
These are metabolic pathologies that can
be corrected by having healthy muscle
tissue.
Modern diet has introduced just a
massive amount of glucose into the
system. Our body has mechanisms or
mechanism, we we will debate,
uh for dealing with that once it gets
inside the body.
Those mechanisms are evolutionarily
selected for, so they're advantageous,
but it is a very complicated dance.
I've recently um had uh a couple
different people on the show talking at
this the glucose issue and fat storage
issue and insulin resistance from a
really interesting angle.
Um so I feel like I'm beginning to
understand how by having these
constantly elevated levels, we end up
insulin resistant. We're not able to
Right. get the glucose out of our
bloodstream, which causes a whole host
of downstream effects, which we call
metabolic disease.
Um okay. So, now we introduce your idea
of muscle Yes. being the the organ of
longevity and and it being a
uh an organ that secretes hormones.
Myokines, yep. K. So,
the dance becomes I can control my
intake through glucose You can control
your insulin or you say just in general
got it.
through my diet.
I can also though control my insulin
response by you having muscle and using
the life out of it because it will suck
the glucose out of my bloodstream
and burn it for fuel. I'm not sure what
word.
uh muscle skeletal muscle is responsible
for 80 some percent of glucose disposal.
Okay. Yep. Now, the final capstone to my
thesis is it So, my thesis in a very um
simple sentence is you are existing in
this incredibly delicate balance between
what you eat, Mhm.
your insulin response to what you eat,
and you the muscle that you carry, and
how much you use it. Yes. And so,
when I was first going through the
things that you say about how critical
muscle is, it begs the question that in
a time of famine, muscle is actually
dangerous because muscle needs this
energy. It's going to burn energy, and
so if
my response to fructose
is to essentially become pre-diabetic,
and that's good because it causes me to
store a tiny bit of fat, to cling to the
fat that I have, and to store extra
glucose in my bloodstream,
and that's what get got us through the
winter famines, then I was like, "Well,
wait a second. If muscle is this hungry
organ, then it would be problematic."
And then I thought, "Well, that's
exactly why we lose muscle so rapidly if
we're not working out."
When you think about and there's some
interesting concepts here. So, the the
idea that in famine, the body tries to
protect itself, you're essentially
talking about a highly
Protect itself by staying alive. Yeah.
Highly catabolic
No fuel is coming in. There's basic
energy needs that we have. Skeletal
muscle is one. Turnover in skeletal
muscle is not great. Let's say it's a
couple grams a day. Meaning I can't use
it as quickly as I can use fat.
longer. Muscle turnover takes longer.
So, the body goes through a
And I want to push on that turnover.
That word doesn't immediately click for
me.
we're going to talk about it because it
also brings up this concept of
longevity. Is it gluconeogenesis?
Nope. It is the replacement of body
proteins. It is the regeneration, the
cleaning house, and the replacement of
body proteins like liver goes through
protein turnover. Intestines go through
protein turnover. Bone. You know, like
you said, there's a dance that's
happening.
was storing that in So, I'm let's stay
in the context of famine if we can for a
second.
So, I don't have incoming nutrients or
not very many. So, I'm breaking down my
muscle to provide, in essence, in part,
the body will use that those amino acids
to protect your organs. Okay. So, that
they can have their turnover of cells,
the cells can die and be replenished
with healthy healthy new cells. Right.
That is a non-negotiable.
And not for
gluconeogenesis at all? Well,
gluconeogenesis, the way in which I
think about gluconeogenesis is branch
chain amino acids or proteins in general
can be utilized by the liver to go
through a process of gluconeogenesis.
And would that be happening in a period
of famine or would I just completely
shift over to ketone production?
So over a period of time eventually you
would shift over to ketone production.
The body doesn't want to lose its
skeletal muscle.
Skeletal muscle is very important, but
I will say it's something that the body
would give up for the other organ
systems. Let me ask this. So as somebody
who
works out very consistently,
but if I even reduce my intensity, my
muscle and and don't change my diet, my
muscle mass will begin to dwindle. So my
body is is responding and my hypothesis
is that it's so afraid to carry more
muscle than it needs that the second I
don't need it, meaning I'm not putting
it under that level of strain, it goes,
"Cool, I'm getting rid of"
No. I would I would I I would say that
that is not a hypothesis I would go
with. Cool. So let's take a 21-year-old
since they are [ __ ] just primed, man.
So
on a Twinkie diet and they're just
jacked and tan. I get it.
So
if they stop working out,
can we not agree that they will lose
muscle? Maybe not as fast as I will in
my 40s, but they will lose muscle. I
would say yes. And why do you think the
body does that? I think that the body
thrives under activity.
And whether you take a human, whether
you take an animal, if you essentially
domesticate them and they are not
training, they will lose muscle.
And so I have a theory that that's the
body the body is giving you a signal,
which is these tissues are calorically
expensive
and it's dangerous to have anything
that's calorically expensive. So, with
some wiggle room, if I see nutrients or
demand
back off, then I'm going to shed those
muscle tissues. But muscle we know is
really, really important for longevity,
for morbidity and mortality.
Which is why you don't want to be in a
famine or not using it. The I I I think
uh
another way to think about it is that
yes, it is a metabolically expensive,
energy-driven tissue. It is. And it
takes a lot of effort and energy to
maintain that tissue.
But I don't think it's the body trying
to get rid of it. I think under
well-thought-out conditions training,
increase in energy, increase in dietary
protein, the body will do whatever it
can to maintain that tissue. I do think
it's interesting how you're phrasing it
and how you're thinking about it that
the body would be trying to get rid of
it. But I I don't
Because we have to I think we
I am almost certain that you and I agree
100% on how important muscle is. Like
I'll say my hypothesis includes the fact
that uh if you want to survive for a
long time, you better have good quality
muscle on your body. Because if you're
right that that's the store of these
building blocks, then I want to make
sure that I always have that and should
I ever lose it that I immediately when
that insult, whether it's the famine, a
great illness, or something like that is
gone, that I rebuild that muscle. So,
if the nutrients stop coming in, the
body goes, "Okay, whoa. Like this could
Now that I have these very expensive
tissues, I may need to prune them back."
Even though I know, like, "Oh god, I
don't want to do this. And I would
really appreciate if you would Or wait,
can I can I can I So or is it that
because you're not getting enough
nutrients the rest of your organs need
to function?
So having a high amount of skeletal
muscle that can be then utilized for the
protection and the utilization and
energy for all the other organ systems
is necessary.
Yes. Now let's
cuz without the brain, without the
heart, without the liver, without the
kidney it a problem in those tissues
will have an immediate effect.
Will the body pull from let's So we'll
come back to the famine in a second. Um
Which is not happening right now. It's
not and that's a big part of the
problem. But for people I think to
really wrap their head around what's
going on for a long time for a just an
unimaginably long period of time there
would be periods of massive food
scarcity. And so understanding the dance
becomes interesting to me. So stepping
out of the famine for a second and going
back into what you're saying. So organs
are critical and the body's going to do
whatever it needs to do to protect that.
So when the nutrients are coming in will
my I assume my body will preferentially
choose to take the proteins, the
whatever from what I eat versus from
skeletal muscle.
Yes. Yes. Okay. Right. So there are 20
amino acids, there are nine essential.
You are going to eat those for you know,
based on a lot of the current research.
There is some other data out there that
suggests that some of the gut microbiome
may be able to scavenge for some of
those essential amino acids, which is
incredibly interesting. And how does it
hand those off to us? As metabolites?
Um
well, these are proof-of-concepts right
now and they're in rodent models.
What is happening is what they believe
is that when an individual is eating a
very high fiber type more veget-
vegetarian vegan diet that the gut
microbiome can turn a bit into what like
a ruminant would be. So, that is one way
in which some people can be able to get
some essential amino acids, but I don't
want to go down that rabbit hole yet
because it is still proof of concept,
but I I do think it's very important.
But, going back to what you said about
muscle and going back to what you said
about famine, I think it's an
interesting concept in the way that in
my mind the fittest, most muscular
individual, the the people that have the
most muscle are going to be able to
survive.
Because they're going to have more of
let's talk about the myostatin gene.
Okay. So, the myostatin gene
And I have thought about this and I'm
not sure what to think about that, so I
have a guess. It's way less educated
than yours, but it's nonetheless a
guess. Uh so, for those that don't know
what the myostatin gene is, the
myostatin gene actually inhibits the
creation of muscle. And if you break the
myostatin gene, you get what they call
double muscling. Where if you've ever
seen a double muscled cow, it's crazy.
They look they look like a bodybuilder.
Yes.
It's insane.
Yes. And you get that some people
hypothesize that basically some
bodybuilders that get to like an elite
elite elite level have a way less active
myostatin gene. And
that to me is another signal that the
body is like, I want muscle, but I can't
just slather it on. Like it's it's
expensive tissue.
it's a difficult process and it is we
become forged by our training. We become
forged. And when you say it's difficult,
meaning meaning skeletal muscle is not
an easy process to put on, right? The
idea that we can just work out and put
on skeletal muscle, people are
different. This idea of being able to
put on muscle in general, it takes
effort and energy, meaning it takes
physical energy. It also is an
expensive nutrient process in the body,
right? It requires
a whole host of things to go right. It
requires being able to trigger mTOR,
subsequent muscle protein synthesis. You
have to have the building blocks. You
have to have the correct stimulation.
Then you have to have muscle damage.
Then you have to have rest. It's not
necessarily an easy process. And the
more well-trained you are, the more
difficult it becomes to put on muscle.
So, by, you know, for you to maintain
your muscle mass, you probably put a lot
of extra effort
into doing that. And it becomes more
difficult as we age because the skeletal
muscle, you know, aging is a process.
And when we age, things in general often
times become more difficult.
Building muscle is one of those things.
The efficiency of being able to build
muscle,
muscle as a nutrient sensor, goes down.
Its efficiency goes down.
Insulin resistance in skeletal muscle
goes up. Just part of normal aging,
whether you're training or not. These
are fundamental things that happen.
Talk to me about the anabolic
resistance. And and I'm looking at that
in the context of
um insulin resistance. Is it the same
where I've given it too much of
something and the body's like, "Yo, back
off." No, but it's a that's an
interesting thought process.
As we age, the muscle becomes less
efficient at utilizing protein.
Muscle utilizes protein, obviously, for
protein turnover and for muscle protein
synthesis, which is so valuable.
You know, and often times I talk about
muscle as the end point and eating for
muscle health. The reason, one of the
reasons I talk about it is exactly for
the reasons that you were talking about.
If you can optimize for skeletal muscle,
then the subsequent effects on the rest
of the body, like being able to have
proper tissue turnover for liver and
intestines, all happen. So, if you reach
that threshold for muscle, which you're
absolutely right is a highly energy
taking process, the rest of the body is
gets what it needs. So, if you eat for
high-quality muscle, you eat
high-quality protein, you create
high-quality muscle. So, are those two
things just correlated and it's really
the intake of the nutrients that
matters? The intake of the nutrients
absolutely matters.
Absolutely matters. And when we age,
anabolic resistance, which is really
defined as the efficiency of protein,
the efficiency of muscle to utilize and
sense protein goes down.
Skeletal muscle is a nutrient-sensing
organ.
When it gets enough of the amino acids,
it goes through a process of protein
turnover. I want you to to literally be
grateful and appreciative and and
nourish every good choice that you make
and let go of the bad ones, because when
we focus on that negative, when we just
keep
berating ourselves, we can't go
anywhere. We're stuck.