Sarcopenia Is Preventable And Reversible! Don't Let Muscle Loss Get The Best Of You

Welcome to the Dr. Gundry podcast. Today, we're going to talk about something I know you've been stressing on sarcopenia. And you're going, "I'm not stressing on it. I've never even heard the word." Well, pay attention because sarcopenia is probably happening you right now without you even knowing. Around the age of 30, you started losing muscle mass. And you might not have felt it. Uh you might not have even noticed that your clothes look differently. In fact, uh I used to do a fun thing with my patients and I would show them a CT scan of a thigh of a 30-year-old and a CT scan of the thigh looks very much like a piece of round steak, which, believe it or not, a round steak is a thigh of a cow. And there's a round bone in the middle and then there's muscle and and obviously a little bit of fat. And you look at that same thigh in a 70-year-old, and the thing that you notice is that even though the outside diameter looks to be exactly the same, now a great deal of all that red muscle mass has been replaced by fat. And that little big hunks of muscle are just kind of islands of muscle and mostly fat. So that you could wear the exact same pant size, and yet most of you in that thigh is now fat rather than muscle. And that's why many of us are unaware of this process of losing muscle as we age. And it's got a fancy name called sarcopenia. And here's the bad news. The amount of sarcopenia really correlates extremely well with how you're going to live or not live well for the last oh, 20 years of your life. Now, we've thought that losing muscle mass is just a normal part of aging like getting gray hair. But in fact, it's absolutely not. So today I want to break down what's happening and what you can do about it to prevent it. And quite frankly, it's preventable. Muscles if most of you know, are the customer that the hormone insulin sells the proteins and the sugars, the carbohydrates that you eat to. They buy whatever insulin is selling. And quite frankly, the more customers that insulin has to sell to the easier it is to unload the sugars and the proteins that you're eating to these customers. Sadly, as anyone who's followed me knows that about 88% of overweight individuals are insulin resistant. That means their muscles are not interested in buying what insulin is selling. By the way, if you're smirking and say, well, I'm normal weight 50% of normal weight individuals are insulin resistant. So there's a 50/50 chance even if you're normal weight that your muscles still aren't interested in buying. Now, this is getting more and more important as GLP-1 drugs are becoming more and more ubiquitous. Why? Sadly, most of the studies show that the weight loss that these GLP-1 drugs induce, about 40% of all the weight loss is actually muscle. Now, think about that for a minute. If muscle is the customer that insulin sells sugars and proteins to, and you've lost 40% of those customers, one of two things happens. Number one, insulin has to work a whole lot harder to make the sale, to push sugars and proteins into the muscles. And sadly, the muscles push back. They basically say, "Hey, we're full. And there's 40% less of us than there were before. And we don't want any more. We're insulin resistant." Number two, if you keep eating exactly the same as you're eating once you stop these GLP-1 drugs, then again, you've got 40% less places to unload the sugar and proteins that you eat. So, what happens? Well, insulin says, "Well, the muscles aren't interested in buying this stuff, and you keep packing it in, I've got to unload this stuff someplace. I know, I'll sell it to the fat cells. They're stupid. They'll always buy from me. And in fact, that's exactly what happens. And sadly, every study that's been done on GLP-1 users shows that when you stop, and you will stop, your weight comes screaming back because there was no place to sell it to in the muscles, so you stored it as fat. So, maintaining muscle mass, maintaining customers, as you grow older, is really one of the main ways that you can maintain a low insulin level, maintain metabolic flexibility, that is having no insulin resistance, and aging properly. So, all of this, however we do it, just plain old aging, {quote} reduces our muscle mass. GLP-1s dramatically reduce our muscle mass. And that's sarcopenia. Now, you probably heard that once you reach the age of 60 or 65, you need more protein in your diet because somehow, magically, mystically, studies show that yeah, it looks like older adults should get more protein in their diet because of sarcopenia. I've found, now, following my patients for 25 years, that actually nothing could be further from the truth. And that's because we don't need more protein as we age. What we need is two things. Number one, we need a bigger surface area in our gut to absorb protein in the first place. And number two, we need more customers for that protein. And really, the only reason we need protein is for wear and repair of our muscles, of our bones, of our ligaments, and for making enzymes. That's it. Those are our only needs for protein. And it's really not much. Now, if you've read my books or listened to me, you know that the surface area of our intestinal lining is at least one or two tennis courts in surface area if we laid them all out. It's a huge surface area. But what I and others have found is that through the years, that surface area gets damaged by all the mechanisms that I talk about in the book, whether it's lectins, whether it's antibiotics, whether it's NSAIDs that we're swallowing. But that surface area of a tennis court literally shrinks to the surface area of a ping-pong table. So that the ability to absorb nutrients like proteins becomes less and less. So even though it appears that you need more protein as you get older, that's not what I find with my patients. When I put my patients on a lower protein diet, but a diet that repairs the wall of their intestines, So, imagine their surprise when we look at their total protein in their blood, and we look at albumin, which is about 80% of the protein in you. And in case you're wondering, albumin is what egg white is composed of. So, albumin goes up, even though they're eating lower protein. Why? Because we can measure on their intestinal permeability tests that the wall of their gut is being repaired. So, it wasn't a lack of protein in their diet, or it wasn't a need for more protein. It was the fact that they just didn't have the surface area to absorb whatever protein they're eating. So, that's number one. Now, number two. Going along with this, Hippocrates, the father of medicine, 2,500 years ago, said that all diseases begin in the gut. And sarcopenia is a disease of aging. Would it surprise you, if you follow me, to realize that leaky gut is a major driver of sarcopenia, of muscle loss. Well, in fact, it is. And now, many, many studies are confirming that there is a gut muscle access, just like there's a gut brain access, just like there's a gut skin access. In fact, there's a gut bone access. There's a gut joint access. All of which was predicted by Hippocrates. So, one of the things that contributes to muscle loss are compounds that are called myostatin. You probably heard the word statin before. We use statins to lower your LDL cholesterol. But myostatin actually promote muscles not growing. Now, we can hypothesize that if you're a bad example of an animal and you might be taking more than your fair share of food compared to what you're contributing then there might be a mechanism that you should induce your muscles to stop growing. Since muscles are one of the major eaters of food. And if you don't have much muscle you don't need to eat much food. And so you would naturally in this mechanism hopefully eat less food as you are voted off the island as I like to say. So myostatin actively prevent muscle growth. Now, it's exciting to know that there are compounds, peptides that actually block myostatin. But one of the easiest ways to block myostatin production is to seal leaky gut. And amazingly, you can build muscle at any age by blocking myostatin and preventing their release in the first place by sealing leaky gut. And the other good news is you get back to having a big absorptive area to absorb proteins in the first place. How do you do that? Well, if you follow my books, I can pretty much guarantee you you will seal leaky gut. Number two. And that gets to strength training. Now, there's aerobic training where you get your heart rate up and you can do that, believe it or not, by brisk walking. You can do that by running. You can do that by swimming. And you get your heart rate up. Nothing wrong with that. I'm big fan of getting your heart rate up. But when we talk about strength training, the problem with strength training is people think that strength training is lifting heavy weights, primarily with their arms. And pump iron. Here's the problem. Most of your muscle mass that counts is in your butt and your thighs. And that's [clears throat] where the money is. And unfortunately, working on your butt and thighs at the gym is just not sexy. And everybody wants guns. The problem with guns is that's not big muscle groups. So, you want big muscle groups to sell the food you're eating to. And those big muscle groups are in your butt and thighs. The Godfather of fitness, Jack LaLanne, who I got to know in his later years, always said that there are only two exercises for perfect health. And number one was deep knee bends, squats. Number two was either planks or push-ups. And what he meant by that is that those two exercises usually use all of the big muscle groups. And he knew, you know, back in the '40s and '50s how important those muscle groups were. Now, the great news is you don't have to go to the gym to do this. You can do it at home. First of all, if you're brushing your teeth twice a day, like I do, and you do it for 2 minutes, while you're sitting there at the sink staring at your mirror, just do deep knee bends while you're brushing your teeth. That's kind of like walking and chewing gum at the same time. Let's see if you can do it. That's 4 minutes a day free exercise snacking using big muscle groups. If that's not enough for you, buy yourself a couple of milk cartons or water cartons. Get 2-gallon ones, and then do deep knee bends. Fill it up quarter of the way full first, halfway up, all the way up, and then do the deep knee bends. You don't need to go to the gym. If you're going to the gym, make sure if you've got a personal trainer or you're just learning how, make sure the personal trainer teaches you the leg machines, the leg lifts, the hamstring curls, the push away on the big plate. That's where the money is. Now, having said that, you can do all of those, but if you're not absorbing nutrients from your gut, you've got nothing to work with while you're working. Now, here's the good news. Evidence shows that you can build substantial muscle mass at any age. I've seen it in people in their 70s. I've seen it in their 80s. And study after study shows that it's never too late to add muscle mass. But, please don't think getting a couple of 2-lb or 5-lb little dumbbells and doing bicep curls is really going to do you any good. It's not working the muscle mass that you need. So, sarcopenia is a real thing. It's not a part of aging. It's a part of your gut wall being destroyed and becoming permeable, leaky gut. And it sets up a process of literally destroying your muscles, preventing muscles from growing, because you're being voted off the island. So, when you think about fragility as we get older, and believe me, fragility is one of the biggest predictors of a shortened, bad end of life span. The way to prevent that fragility is sealing the gut and working on the large muscle groups. And that can be started at any age. It is never too late. And that's the take-home message today. Never too late to seal your gut. Never too late to rebuild muscle mass where it counts the most. And that's in your butt and thighs. May not be sexy, but that's the key to a healthy, long life span.