Title: Building Muscle in Menopause: Protein, Creatine and Strength Training with Dr. Gabrielle Lyon Channel: Dr. Mary Claire Haver, MD URL: https://www.youtube.com/watch?v=V7S8a_9d5Wo Views: 141,754 Upload date: 2026-09-25 Duration (sec): 3636 Transcript source: YouTube captions via yt-dlp (android client); VTT file: V7S8a_9d5Wo.en-orig.vtt Cue count (deduped): 3416 --- [0:02] In part one of my conversation with Dr. Gabrielle Lion, a board-certified family Gabrielle Lion, a board-certified family medicine physician and founder of the medicine physician and founder of the Institute for Muscle Centric Medicine, Institute for Muscle Centric Medicine, we challenged decades of conventional we challenged decades of conventional wisdom about women's health. We talked wisdom about women's health. We talked about why skeletal muscle is the about why skeletal muscle is the foundation of healthy aging, why so many foundation of healthy aging, why so many women are dramatically under consuming women are dramatically under consuming protein, and why building and preserving protein, and why building and preserving muscle must be at the center of every muscle must be at the center of every conversation about longevity. Now, it's conversation about longevity. Now, it's time to get practical. In this episode, time to get practical. In this episode, Dr. Lion breaks down exactly how much Dr. Lion breaks down exactly how much protein women really need. She explains protein women really need. She explains why anabolic resistance changes the why anabolic resistance changes the equation after midlife and how equation after midlife and how resistance training, hormone therapy, resistance training, hormone therapy, and even GLP-1 medications fit into the and even GLP-1 medications fit into the picture. She also gets into when you picture. She also gets into when you [0:47] picture. She also gets into when you should be eating protein throughout the should be eating protein throughout the day and why sleep matters just as much day and why sleep matters just as much as the workout itself. We also tackle as the workout itself. We also tackle one of the biggest questions I hear from one of the biggest questions I hear from women every day, which is how you women every day, which is how you actually build and keep muscle in your actually build and keep muscle in your 40s, 50s, 60s, and beyond. Part one 40s, 50s, 60s, and beyond. Part one explain why muscle matters, and this explain why muscle matters, and this conversation gives you the roadmap for conversation gives you the roadmap for protecting it. I'm Dr. Mary Cla Haver, a protecting it. I'm Dr. Mary Cla Haver, a boardcertified obstitrician and boardcertified obstitrician and gynecologist and certified menopause gynecologist and certified menopause practitioner and adjunct professor at practitioner and adjunct professor at the University of Texas Medical Branch. the University of Texas Medical Branch. Welcome to Unpaused, where we cut Welcome to Unpaused, where we cut through the silence and talk about what through the silence and talk about what it really takes for women to thrive in it really takes for women to thrive in the second half of life. the second half of life. The views and opinions expressed on The views and opinions expressed on Unpaused are those of the talent and Unpaused are those of the talent and [1:32] Unpaused are those of the talent and guests alone [music] and are provided guests alone [music] and are provided forformational and entertainment forformational and entertainment purposes only. No part of this podcast purposes only. No part of this podcast or any related materials are intended to or any related materials are intended to be a substitute for professional medical be a substitute for professional medical advice, diagnosis, or treatment. advice, diagnosis, or treatment. So, I hear a lot about when we should So, I hear a lot about when we should eat protein. You you talked about 30 to eat protein. You you talked about 30 to 50 grams. Like, is the amount per day 50 grams. Like, is the amount per day more important than when per day? And is more important than when per day? And is there a wrong time to eat protein or a there a wrong time to eat protein or a right time to eat protein? right time to eat protein? >> From a practical standpoint, that first >> From a practical standpoint, that first meal when you are coming out of an meal when you are coming out of an overnight fast is important. overnight fast is important. >> Okay? >> Okay? >> Okay? >> It doesn't matter when that is, but you >> It doesn't matter when that is, but you are in a catabolic state. Catabolic are in a catabolic state. Catabolic state is when you are in a breakdown state is when you are in a breakdown state. You're not feeding overnight. We state. You're not feeding overnight. We were meant to eat in discrete time were meant to eat in discrete time [2:17] were meant to eat in discrete time periods unlike rodents who are you know periods unlike rodents who are you know 24 hours ad limited feeding nocturnal 24 hours ad limited feeding nocturnal beings but humans we are meant to eat in beings but humans we are meant to eat in discrete meals. So that first meal of discrete meals. So that first meal of the day when you are coming out of an the day when you are coming out of an overnight fast is really important. overnight fast is really important. Doesn't matter when you eat it. Doesn't Doesn't matter when you eat it. Doesn't have to be eat in the morning or 6:00 in have to be eat in the morning or 6:00 in the morning. Doesn't have to be before the morning. Doesn't have to be before training or after training. But getting training or after training. But getting that first meal right at 30 to 50 grams that first meal right at 30 to 50 grams and closer probably to 50 to stimulate and closer probably to 50 to stimulate mTor which is in skeletal muscle is mTor which is in skeletal muscle is going to be critical. If the listener or going to be critical. If the listener or viewer only did that one thing viewer only did that one thing >> that is enough just based on those early >> that is enough just based on those early 2000 studies and they've been 2000 studies and they've been replicated. So now we have a large body replicated. So now we have a large body of evidence. This will change body of evidence. This will change body composition if they do nothing else. composition if they do nothing else. [3:03] composition if they do nothing else. >> Amazing. >> Amazing. >> Amazing. >> And there's there's more to address >> And there's there's more to address there. First meal is really important. there. First meal is really important. Also before you go to sleep, the last Also before you go to sleep, the last meal of the day and not necessarily an meal of the day and not necessarily an hour before you go to sleep, but that hour before you go to sleep, but that last meal of the day is also really last meal of the day is also really important. So you're bookending both important. So you're bookending both both days should both days should both days should >> or both times once a day. >> or both times once a day. >> We talked a little bit about protein >> We talked a little bit about protein timing around training. So you you're timing around training. So you you're saying just get the protein in. saying just get the protein in. >> I mean there's a little nuance here. >> I mean there's a little nuance here. Again, all studies to my knowledge are Again, all studies to my knowledge are done with that first meal of the day done with that first meal of the day because it's easier to have a kind of a because it's easier to have a kind of a clean slate from a measuring clean slate from a measuring perspective. perspective. perspective. >> But if you are eating a higher protein >> But if you are eating a higher protein diet, closer to 1.2 to 1.6, if you are diet, closer to 1.2 to 1.6, if you are plant-based, you have to be at the plant-based, you have to be at the higher end 1.6, then protein timing higher end 1.6, then protein timing doesn't matter as long as the totality doesn't matter as long as the totality [3:49] doesn't matter as long as the totality of protein you're getting in. Okay, of protein you're getting in. Okay, >> that being said, still we have great >> that being said, still we have great data that that first meal at 30 to 50 g data that that first meal at 30 to 50 g of protein affects satiety, affects body of protein affects satiety, affects body composition again for outcomes that we composition again for outcomes that we care about. care about. care about. >> Okay. >> Okay. >> Okay. >> And that becomes really important. >> And that becomes really important. >> How important is sleep? >> How important is sleep? >> I mean, unfortunately, it's very >> I mean, unfortunately, it's very important. Um, but it's hard for a lot important. Um, but it's hard for a lot of women to do the recovery and the of women to do the recovery and the training. You know, when I was in training. You know, when I was in residency, and I'm sure you experienced residency, and I'm sure you experienced the same thing, is that you were on call the same thing, is that you were on call and you didn't sleep. blood sugar and you didn't sleep. blood sugar regulation. I put on a continuous regulation. I put on a continuous glucose monitor one time. It was the glucose monitor one time. It was the worst decision I made, right? Because worst decision I made, right? Because the days that I didn't sleep, I saw my the days that I didn't sleep, I saw my my blood sugar was terrible. And you my blood sugar was terrible. And you know, we're recognizing that sleep is know, we're recognizing that sleep is very important for also recovery. very important for also recovery. [4:34] very important for also recovery. >> And is it true that's when we grow >> And is it true that's when we grow muscle? muscle? muscle? >> It is. It's in part of it. Yep. During >> It is. It's in part of it. Yep. During recovery, also the gal cells in the recovery, also the gal cells in the brain flush the the lymphatic system. brain flush the the lymphatic system. you know, one of the which is why I you know, one of the which is why I think it's a major design flaw because think it's a major design flaw because when you have little kids, my kids still when you have little kids, my kids still sleep in my bed. I cannot get them out sleep in my bed. I cannot get them out of my bed. I have not had a good night's of my bed. I have not had a good night's sleep. The only time I have a good sleep. The only time I have a good night's sleep is when I'm traveling. night's sleep is when I'm traveling. But, you know, we are designed to sleep. But, you know, we are designed to sleep. And um one of the things is having And um one of the things is having awareness as to your own habits. So, I awareness as to your own habits. So, I don't know about you, but once I miss a don't know about you, but once I miss a sleep window, I'm up. Does that happen sleep window, I'm up. Does that happen to you? to you? to you? >> Oh, yeah. Right. So you if you miss if I >> Oh, yeah. Right. So you if you miss if I miss by 9:30 and I didn't go to bed, I'm miss by 9:30 and I didn't go to bed, I'm up I'm up till like 11:30. up I'm up till like 11:30. >> Yeah. If I don't like hit my normal, >> Yeah. If I don't like hit my normal, then like I'll I always read when I go then like I'll I always read when I go [5:20] then like I'll I always read when I go to bed and I'll just keep reading and to bed and I'll just keep reading and reading and reading, you know, like I reading and reading, you know, like I that whatever happens with my circadian that whatever happens with my circadian rhythm, it's not good. And it's getting rhythm, it's not good. And it's getting worse with age, you know, and I'm fully worse with age, you know, and I'm fully replaced on HRT. It's not that. replaced on HRT. It's not that. >> So I have to protect my sleep with my >> So I have to protect my sleep with my life now. There's no it's life now. There's no it's non-negotiable. non-negotiable. non-negotiable. >> Well, I hope I get there. [laughter] I >> Well, I hope I get there. [laughter] I mean really I just yes I hope I get mean really I just yes I hope I get there but sleep is really important for there but sleep is really important for muscle health and it's also really muscle health and it's also really important for metabolic regulation. important for metabolic regulation. Something else that's really interesting Something else that's really interesting is if someone misses a night of sleep is if someone misses a night of sleep >> um number one it can actually suppress >> um number one it can actually suppress muscle protein synthesis muscle protein synthesis >> which makes perfect sense. Yeah. But >> which makes perfect sense. Yeah. But there's a ways to compensate for lower there's a ways to compensate for lower levels of sleep and that is there's some levels of sleep and that is there's some evidence to support highintensity evidence to support highintensity interval training interval training interval training >> really to offset a few nights of poor >> really to offset a few nights of poor [6:07] >> really to offset a few nights of poor and shortened sleep. and shortened sleep. and shortened sleep. >> So if I'm traveling and I'm jetlagged, >> So if I'm traveling and I'm jetlagged, >> yes, I always Yes, there is some data to >> yes, I always Yes, there is some data to support that it offsets the interesting support that it offsets the interesting >> outcomes of poor sleep. >> outcomes of poor sleep. >> So you you touched on amino acids. This >> So you you touched on amino acids. This is a supplement, right? This is not a is a supplement, right? This is not a food. Um, you talked about this, you food. Um, you talked about this, you know, complete amino acid. Where would know, complete amino acid. Where would you find that? Like I don't use that. you find that? Like I don't use that. Where would I find it if I wanted Where would I find it if I wanted >> what essential amino acids? I use body >> what essential amino acids? I use body health amazing product, very clean. And health amazing product, very clean. And I use perfect aminos. I use perfect I use perfect aminos. I use perfect aminos in tablets and in packets. It's aminos in tablets and in packets. It's extremely convenient extremely convenient extremely convenient >> because and especially for women who are >> because and especially for women who are number one looking to maintain their number one looking to maintain their muscle or even having a lower total muscle or even having a lower total calorie count. So if they want to lose calorie count. So if they want to lose weight, weight, weight, >> okay, >> okay, >> okay, >> if they want muscle recovery, this is >> if they want muscle recovery, this is [6:53] >> if they want muscle recovery, this is the way to do it. And the way to do it. And >> do you use it in conjunction with a GOP1 >> do you use it in conjunction with a GOP1 or do you think it's important? or do you think it's important? >> You can. Oh, it's it's critical. When we >> You can. Oh, it's it's critical. When we have patients that are on GOP1's, we have patients that are on GOP1's, we always give them uh perfect amino. always give them uh perfect amino. >> Okay. >> Okay. >> Okay. >> Because otherwise they're, you know, >> Because otherwise they're, you know, when you look at some of the data and when you look at some of the data and you see that as women age, their total you see that as women age, their total calorie intake goes down. And then you calorie intake goes down. And then you look at when you put them on a GLP1 now, look at when you put them on a GLP1 now, every bite matters. every bite matters. every bite matters. >> Mhm. You've got to get that nutrient >> Mhm. You've got to get that nutrient quality and nutrient density up. Okay. quality and nutrient density up. Okay. Which goes to creatine. Which goes to creatine. >> Yeah. My next question was creatine. >> Yeah. My next question was creatine. >> Creatine. Um, >> Creatine. Um, >> Creatine. Um, >> are you a fan? >> are you a fan? >> are you a fan? >> I am a huge fan. >> I am a huge fan. >> I am a huge fan. >> But let's just think about creatine and >> But let's just think about creatine and where it is found. Creatine is found in where it is found. Creatine is found in red meats. red meats. red meats. >> Yeah. >> Yeah. >> Yeah. >> You could not eat enough red meat to be >> You could not eat enough red meat to be able to get to five grams a day for able to get to five grams a day for [7:39] able to get to five grams a day for muscle. muscle. muscle. >> It is It's something like one It's >> It is It's something like one It's something like something like something like >> I thought it was 12 12 chicken breasts >> I thought it was 12 12 chicken breasts or something ridiculous. or something ridiculous. >> It's ridiculous. It's a pound of red >> It's ridiculous. It's a pound of red meat for half a gram of creatine. Don't meat for half a gram of creatine. Don't quote me on that, but something. It's quote me on that, but something. It's either a pound for half a gram or one either a pound for half a gram or one gram. gram. gram. >> If five grams is the minimum for muscle >> If five grams is the minimum for muscle and 10 to 12 for brain function, that's and 10 to 12 for brain function, that's no one is going to consume that much. no one is going to consume that much. Mhm. Mhm. Mhm. >> But what I think becomes really >> But what I think becomes really important is yes, we have a lot of important is yes, we have a lot of evidence for how it supports muscle and evidence for how it supports muscle and how it supports performance, but this how it supports performance, but this brain function aspect of creatine seems brain function aspect of creatine seems to be really promising and it seems to to be really promising and it seems to be most promising in the more mature be most promising in the more mature individual 60s and up. Again, I um individual 60s and up. Again, I um [8:24] individual 60s and up. Again, I um Darren Kandow, if you've not had him on, Darren Kandow, if you've not had him on, he is one of the world leading experts he is one of the world leading experts on creatine. And on creatine. And on creatine. And again, the most of the data that I've again, the most of the data that I've seen has been in older women in older seen has been in older women in older individuals, but potentially, individuals, but potentially, >> yeah, >> yeah, >> yeah, >> there's going to be more for younger. >> there's going to be more for younger. >> I love it. We recommend it. Um, >> I love it. We recommend it. Um, >> and it's good for mood, cognitive >> and it's good for mood, cognitive function, processing speed. function, processing speed. >> Awesome. >> Awesome. >> Awesome. >> So, what's one thing women are doing or >> So, what's one thing women are doing or being told to do that you want them to being told to do that you want them to stop? stop? stop? >> Well, that you should reduce your red >> Well, that you should reduce your red meat intake. That's probably the biggest meat intake. That's probably the biggest one. It is highly nutrient-dense and one. It is highly nutrient-dense and especially for young women. especially for young women. >> Is there ways to make it unhealthy >> Is there ways to make it unhealthy though? though? though? >> I mean, yeah, sure. If you want to go to >> I mean, yeah, sure. If you want to go to the gas station and eat un It's the same the gas station and eat un It's the same as eating a donut, as eating a donut, as eating a donut, >> processed. Yeah. >> processed. Yeah. [9:10] >> processed. Yeah. >> But that's probably one of the biggest >> But that's probably one of the biggest things. things. things. >> Okay. >> Okay. >> Okay. >> Most women have never heard of anabolic >> Most women have never heard of anabolic resistance. resistance. resistance. >> I know it's like a swear word, but >> I know it's like a swear word, but different. different. different. >> So, yeah. >> So, yeah. >> So, yeah. >> What is it? Anabolic resistance is what >> What is it? Anabolic resistance is what is considered a normal aging process of is considered a normal aging process of muscle. muscle. muscle. >> Okay? >> Okay? >> Okay? >> And it is less sensitive to the normal >> And it is less sensitive to the normal stimulus of skeletal muscle. So I go to stimulus of skeletal muscle. So I go to the gym at 20 and I eat x amount of the gym at 20 and I eat x amount of protein of healthy high quality protein protein of healthy high quality protein and I lift heavy. and I lift heavy. and I lift heavy. >> Mhm. >> Mhm. >> Mhm. >> I'm going to have a different response >> I'm going to have a different response than I am at 58. than I am at 58. than I am at 58. >> Yes ma'am. >> Yes ma'am. >> Yes ma'am. >> Next month with the exact same stimulus. >> Next month with the exact same stimulus. >> Yes ma'am. substrate in the stimulus and >> Yes ma'am. substrate in the stimulus and I'm going to have a different response. I'm going to have a different response. >> You are um you know this is like the >> You are um you know this is like the [9:55] >> You are um you know this is like the unfortunate part about aging. We get unfortunate part about aging. We get wiser. We get sage wisdom. We can now wiser. We get sage wisdom. We can now integrate our thinking and then all of a integrate our thinking and then all of a sudden it's like the body falls apart sudden it's like the body falls apart and I think it's a design flaw. and I think it's a design flaw. [laughter] But uh it can be [laughter] But uh it can be circumvented. I'm embraceing it. It can circumvented. I'm embraceing it. It can be circumvented. When you are young be circumvented. When you are young >> you're on the Twinkie diet. You go you >> you're on the Twinkie diet. You go you lift weights. Even the lighting makes lift weights. Even the lighting makes you look anabolic. I mean, you got the you look anabolic. I mean, you got the the lighting is making you look jacked the lighting is making you look jacked already. But as we age, already. But as we age, we think about the aging process of our we think about the aging process of our heart and our brain and our ovaries. heart and our brain and our ovaries. Muscle as an organ system follows the Muscle as an organ system follows the same trajectory, same trajectory, same trajectory, >> but it's manifested differently. How >> but it's manifested differently. How does aging muscle manifest? And I do does aging muscle manifest? And I do also want to point out that there are also want to point out that there are some nuances here because if you look in some nuances here because if you look in [10:41] some nuances here because if you look in the literature, it says healthy the literature, it says healthy sedentary people. That's it's not sedentary people. That's it's not possible. That's a diseased archetypes possible. That's a diseased archetypes wrong. It's in a diseased cohort that wrong. It's in a diseased cohort that represents something that is not a represents something that is not a healthy state, right? And I I say this healthy state, right? And I I say this because where does anabolic resistance because where does anabolic resistance flow through this conversation? Anabolic flow through this conversation? Anabolic resistance is what we think of as a resistance is what we think of as a normal process of aging. I'm not so normal process of aging. I'm not so convinced that it is a normal process of convinced that it is a normal process of aging. aging. aging. >> Really? >> Really? >> Really? >> Yes. I mean I believe that maybe when >> Yes. I mean I believe that maybe when you are 80 in your 80s and 90s you are 80 in your 80s and 90s potentially you know that there are some potentially you know that there are some of these fact and again this is of these fact and again this is controversial and I I would probably be controversial and I I would probably be fighting with my mentor because he would fighting with my mentor because he would say well no it is a normal process of say well no it is a normal process of aging but I would say that we don't have aging but I would say that we don't have [11:26] aging but I would say that we don't have highly physically active cohorts of a highly physically active cohorts of a normal population normal population normal population >> to be able to measure >> to be able to measure >> how can we say because elite athletes >> how can we say because elite athletes that's there's nothing normal about that's there's nothing normal about them. Mhm. them. Mhm. them. Mhm. >> These elite athletes that have been >> These elite athletes that have been training their whole life, their muscle training their whole life, their muscle will look different than, you know, a will look different than, you know, a normie like myself, it's it's going to normie like myself, it's it's going to look different. So, I I just want to look different. So, I I just want to point out that that little caveat point out that that little caveat because I do want to be fair in in the because I do want to be fair in in the literature. Anabolic resistance. Now, literature. Anabolic resistance. Now, I'm going to go back to the definition. I'm going to go back to the definition. It is the it is somewhat of an It is the it is somewhat of an insensitivity to a stimulus like protein insensitivity to a stimulus like protein or more specifically branch chain amino or more specifically branch chain amino acids. Even more specific to that, which acids. Even more specific to that, which is leucine. Okay. is leucine. Okay. is leucine. Okay. >> How do we overcome anabolic resistance >> How do we overcome anabolic resistance and why does it matter? Anabolic and why does it matter? Anabolic resistance manifests exactly what you resistance manifests exactly what you [12:12] resistance manifests exactly what you say. All of a sudden, I've eaten this say. All of a sudden, I've eaten this normal diet. Something has changed, but normal diet. Something has changed, but I'm doing exactly what I did since I was I'm doing exactly what I did since I was 20. And now all of a sudden, it's not 20. And now all of a sudden, it's not working. You will require working. You will require more protein for muscle to recognize more protein for muscle to recognize that signal. Amino acids are just that signal. Amino acids are just signaling molecules. signaling molecules. signaling molecules. If you have your two eggs in the If you have your two eggs in the morning, you're not going to stimulate morning, you're not going to stimulate muscle. It's going to be resistant. It's muscle. It's going to be resistant. It's not going to kick in that machinery. But not going to kick in that machinery. But if you hit that 30 to 50 grams, which is if you hit that 30 to 50 grams, which is again 4 and a half ounces of a meat of again 4 and a half ounces of a meat of your choice, or you know, we use this is your choice, or you know, we use this is where essential amino acids come in, where essential amino acids come in, which we should talk about, how if which we should talk about, how if someone is thinking about this, how they someone is thinking about this, how they could augment their nutrient density could augment their nutrient density without increasing total volume of food. without increasing total volume of food. [12:58] without increasing total volume of food. Yeah. uh cuz we're using this in our Yeah. uh cuz we're using this in our practice and it's transforming people's practice and it's transforming people's body composition without having to eat body composition without having to eat all this food. So um anabolic resistance all this food. So um anabolic resistance you can lower it. You can make old you can lower it. You can make old muscle act like young muscle by bumping muscle act like young muscle by bumping up the quality of the protein i.e. up the quality of the protein i.e. essential amino acids all essential essential amino acids all essential amino acids and doing resistance amino acids and doing resistance training. I know that that was a lot of training. I know that that was a lot of words. So, um, words. So, um, words. So, um, >> yeah, because I want our audience to >> yeah, because I want our audience to understand that you can grow muscle at understand that you can grow muscle at any age. At 70, at 80, at 90, it is any age. At 70, at 80, at 90, it is possible. possible. possible. >> And it's just harder. >> And it's just harder. >> It's harder. It just takes a little more >> It's harder. It just takes a little more diligence. And you can have older muscle diligence. And you can have older muscle respond like younger muscle. Anabolic respond like younger muscle. Anabolic resistance is not a static thing. You resistance is not a static thing. You [13:44] resistance is not a static thing. You can improve and lower the resistance by can improve and lower the resistance by doing the things necessary for doing the things necessary for stimulating muscle. For example, and stimulating muscle. For example, and there are some really good data. Um, I there are some really good data. Um, I think it was Cat Stan Kat Cat Stanos and think it was Cat Stan Kat Cat Stanos and and Simmons. They looked at and Simmons. They looked at a younger person having when I say a younger person having when I say younger in their 20s having 15 g of younger in their 20s having 15 g of protein and they get a maximum response protein and they get a maximum response of muscle and that the next cohort 60 of muscle and that the next cohort 60 plus had no response with that same 15 plus had no response with that same 15 g. But once you bumped up that protein g. But once you bumped up that protein intake to 30, the 60 plus responded just intake to 30, the 60 plus responded just like the 20-year-olds. Okay. And I do like the 20-year-olds. Okay. And I do think that we should segue into what are think that we should segue into what are the practical takeaways people need to the practical takeaways people need to do to understand muscle health. Okay. do to understand muscle health. Okay. [14:31] do to understand muscle health. Okay. And the reason I'm saying this is And the reason I'm saying this is because with the landscape of as we age, because with the landscape of as we age, our appetite reduces naturally and with our appetite reduces naturally and with the use of GLP1s, we're seeing a further the use of GLP1s, we're seeing a further suppression of overall food intake suppression of overall food intake >> that the quality of that food becomes >> that the quality of that food becomes critical. Now the dietary protein critical. Now the dietary protein recommendations are set at8 grams per recommendations are set at8 grams per kg. The RDA hasn't changed. The d the kg. The RDA hasn't changed. The d the new dietary guidelines recommend a new dietary guidelines recommend a higher amount, higher amount, higher amount, >> but the recommended dietary allowance >> but the recommended dietary allowance stays the same and it is set at the stays the same and it is set at the minimum and people that's um just a minimum and people that's um just a point of confusion for people. 08 grams point of confusion for people. 08 grams per kg of protein. per kg of protein. per kg of protein. So for some women that's 45 grams a day So for some women that's 45 grams a day >> is set at the minimum to prevent a >> is set at the minimum to prevent a deficiency. deficiency. [15:17] deficiency. Last time I checked, Mary Cla, you and I Last time I checked, Mary Cla, you and I are not looking for how not to be worse are not looking for how not to be worse than yesterday. Right. Right. We're not than yesterday. Right. Right. We're not looking for that. That is the minimum to looking for that. That is the minimum to prevent deficiency. prevent deficiency. prevent deficiency. >> How does >> How does >> How does >> different than optimal? >> different than optimal? >> How does muscle deficiency show up on a >> How does muscle deficiency show up on a daily basis? It doesn't. It takes 10 daily basis? It doesn't. It takes 10 years for us to begin to see problems. years for us to begin to see problems. >> Yeah. >> Yeah. >> Yeah. >> Overtly. Not in blood work, but overtly. >> Overtly. Not in blood work, but overtly. So, when we think about So, when we think about how much protein we need, the average how much protein we need, the average woman is getting 1.1 grams per kg, which woman is getting 1.1 grams per kg, which means people are like, "Oh, well, the means people are like, "Oh, well, the new recommendation is 1.2 to 1.6. new recommendation is 1.2 to 1.6. They're close." No, that means 50% of They're close." No, that means 50% of people are below that number. people are below that number. >> Yeah. >> Yeah. >> Yeah. >> For women in their 60s, anywhere from 20 >> For women in their 60s, anywhere from 20 [16:03] >> For women in their 60s, anywhere from 20 to 40% are below the RDA. to 40% are below the RDA. >> This I know. Yeah. They're having toast >> This I know. Yeah. They're having toast for breakfast for breakfast for breakfast >> and we and we know >> and we and we know >> almost no protein at lunch and they'll >> almost no protein at lunch and they'll stack a little bit more at dinner. stack a little bit more at dinner. >> Devastating. Not only the metabolic >> Devastating. Not only the metabolic consequences, but fracture risk consequences, but fracture risk increases. increases. increases. >> We know that protein is what makes bone. >> We know that protein is what makes bone. These are really important aspects that These are really important aspects that people have to understand because the people have to understand because the landscape changes in terms of how we landscape changes in terms of how we talk about protein because anyone talk about protein because anyone listening to your anyone listening to listening to your anyone listening to your podcast in their 50s has heard that your podcast in their 50s has heard that red meat is bad for you. that I should red meat is bad for you. that I should be concerned about saturated fat. be concerned about saturated fat. They've heard all of these things and we They've heard all of these things and we have to fight for the women in the have to fight for the women in the middle that are like okay well I've middle that are like okay well I've tried lowering my protein and now look tried lowering my protein and now look [16:48] tried lowering my protein and now look what has happened. So um again this is a what has happened. So um again this is a very long-winded way of saying how do we very long-winded way of saying how do we design a diet? Well we have to first design a diet? Well we have to first focus on protein total. You'd asked focus on protein total. You'd asked earlier is it the leng is it timing does earlier is it the leng is it timing does timing matter? Timing only matters if timing matter? Timing only matters if you are lower protein. Oh, you are lower protein. Oh, >> timing doesn't matter if you are a high >> timing doesn't matter if you are a high protein person. If you're getting closer protein person. If you're getting closer to 1.6 grams per kg, then timing doesn't to 1.6 grams per kg, then timing doesn't matter. But I will also say almost every matter. But I will also say almost every single study on protein is done with single study on protein is done with that first meal of the day. Easy to that first meal of the day. Easy to measure. You're highly catabolic. measure. You're highly catabolic. There's no reason why you wouldn't set There's no reason why you wouldn't set yourself up. And we do see data that it yourself up. And we do see data that it does transform body composition assuming does transform body composition assuming [17:33] does transform body composition assuming calories are within control. calories are within control. >> Okay. animal. You touched on this, but >> Okay. animal. You touched on this, but >> we have to clear this up. We have to >> we have to clear this up. We have to clear this up. clear this up. clear this up. >> Animal versus plant protein. What's your >> Animal versus plant protein. What's your position? You know, I today I had a position? You know, I today I had a comment on social media, but I'm a comment on social media, but I'm a vegetarian and you know, it was a vegetarian and you know, it was a protein post and protein post and protein post and and I I I was just okay. And I wanted to and I I I was just okay. And I wanted to say why because they think it's say why because they think it's healthier or they have problems with healthier or they have problems with killing animals and you know. killing animals and you know. >> Yeah. So this is a real challenge and I >> Yeah. So this is a real challenge and I think in the geriatrician landscape as think in the geriatrician landscape as well. well. well. >> Dietary protein is not just one thing. >> Dietary protein is not just one thing. It does come in those various qualities, It does come in those various qualities, the higher quality and the lower the higher quality and the lower quality. If someone is vegetarian or quality. If someone is vegetarian or [18:19] quality. If someone is vegetarian or vegan, could they build a healthy diet? vegan, could they build a healthy diet? They could. The statistics show us that They could. The statistics show us that it's unusual, right? It's hard. It's the it's unusual, right? It's hard. It's the statistics show us that people are statistics show us that people are struggling with obesity, people are struggling with obesity, people are struggling with menopause, people are struggling with menopause, people are struggling with osteoporosis and things struggling with osteoporosis and things that are really and movement. So we know that are really and movement. So we know that these struggles are well that these struggles are well documented. If someone wants to design a documented. If someone wants to design a diet, the first thing that they have to diet, the first thing that they have to determine is how much protein are they determine is how much protein are they going to get a day? No less than 100 going to get a day? No less than 100 grams. From my perspective, higher is grams. From my perspective, higher is better. In our clinic, you know, in the better. In our clinic, you know, in the playbook, we shoot for closer to one playbook, we shoot for closer to one gram per pound of target body weight. We gram per pound of target body weight. We also, and people are like, "Oh my gosh." also, and people are like, "Oh my gosh." [19:04] also, and people are like, "Oh my gosh." So, if there's 130 pound woman listening So, if there's 130 pound woman listening to this, she's like, "Oh, I have to eat to this, she's like, "Oh, I have to eat 130 grams of protein." No, you would be 130 grams of protein." No, you would be perfectly fine with 100 to 120 g. Could perfectly fine with 100 to 120 g. Could you go a little bit higher? Yes. Is you go a little bit higher? Yes. Is protein important for things other than protein important for things other than muscle? Yes. It's impro it's important muscle? Yes. It's impro it's important for every enzyatic reaction for m for for every enzyatic reaction for m for all you know like you listed it's there all you know like you listed it's there but how is she going to practically but how is she going to practically speaking design her diet she knows that speaking design her diet she knows that she needs 100 grams of protein if she she needs 100 grams of protein if she chooses to be vegan or vegetarian this chooses to be vegan or vegetarian this is where we use essential amino acids is where we use essential amino acids okay as an absolute non-negotiable in okay as an absolute non-negotiable in that first meal that first meal that first meal >> all right what are the or what is >> all right what are the or what is essential amino acid essential amino acid essential amino acid >> essential amino acids there's nine and >> essential amino acids there's nine and um if you are going to eat for For um if you are going to eat for For [19:51] um if you are going to eat for For example, two eggs. If you're going to example, two eggs. If you're going to eat two eggs, you're going to get 12 g eat two eggs, you're going to get 12 g of protein. We've already discussed that of protein. We've already discussed that as you age, that's not going to be as you age, that's not going to be enough to stimulate muscle. What you are enough to stimulate muscle. What you are going to do is you are going to augment going to do is you are going to augment that with a scoop of essential amino that with a scoop of essential amino acids so that your body recognizes that acids so that your body recognizes that as 30 grams of protein and it's going to as 30 grams of protein and it's going to start the machinery. For us, we use um I start the machinery. For us, we use um I only work with one company with only work with one company with essential amino acids and that's Body essential amino acids and that's Body Health. We use essential aminos with Health. We use essential aminos with those two eggs, one packet or two packet those two eggs, one packet or two packet raises that protein quality now to then raises that protein quality now to then stimulate muscle. So if a woman doesn't stimulate muscle. So if a woman doesn't want to eat between 30 to 50 grams of want to eat between 30 to 50 grams of protein, but still wants to maintain her protein, but still wants to maintain her muscle and maintain her lean tissue, muscle and maintain her lean tissue, [20:37] muscle and maintain her lean tissue, i.e. bone and everything else that's i.e. bone and everything else that's important, you have to get that those important, you have to get that those numbers right. numbers right. numbers right. >> Okay. >> Okay. >> Okay. >> Um and I'm sure you've got other >> Um and I'm sure you've got other questions as to how. So that is one way questions as to how. So that is one way a vegan or vegetarian which it's really a vegan or vegetarian which it's really important that they get that right. important that they get that right. >> Okay. Well, walk us through what does a >> Okay. Well, walk us through what does a 50 gram breakfast look like? 50 gram breakfast look like? >> Well, there's protein 50 grams of 50 >> Well, there's protein 50 grams of 50 grams of protein breakfast. You want to grams of protein breakfast. You want to know what I had this morning? know what I had this morning? >> Yep. >> Yep. >> Yep. >> Okay. Um I had two screaming kids. Uh >> Okay. Um I had two screaming kids. Uh one drew blood to the other, but you one drew blood to the other, but you know, it is fine. I had two eggs. I had know, it is fine. I had two eggs. I had some cottage cheese. Two eggs is 12 some cottage cheese. Two eggs is 12 grams. Um, a small serving of cottage grams. Um, a small serving of cottage cheese and I did a pack of essential cheese and I did a pack of essential aminos aminos aminos >> in orange. That was it. That raised my >> in orange. That was it. That raised my [21:24] >> in orange. That was it. That raised my quality up to 50 grams of protein. quality up to 50 grams of protein. That's not a ton of food. On a Saturday That's not a ton of food. On a Saturday or Sunday, I might have six eggs, which or Sunday, I might have six eggs, which people are like, "Oh, but that that's so people are like, "Oh, but that that's so much." You could also have um Greek much." You could also have um Greek yogurt. I know. I think that you you yogurt. I know. I think that you you >> I make a shake. >> I make a shake. >> I make a shake. >> So, you make three days a week for you >> So, you make three days a week for you make a shake. You make a protein shake. make a shake. You make a protein shake. >> Your protein shake. Um, without over >> Your protein shake. Um, without over complicating it, it could be 20 gram. complicating it, it could be 20 gram. You use whey protein, right? You use whey protein, right? >> Yeah, I use whey. I have also put Greek >> Yeah, I use whey. I have also put Greek yogurt in it, so three/4er cups. So, yogurt in it, so three/4er cups. So, you're hitting it. you're hitting it. you're hitting it. >> Yeah. So, it's about 40 grams of >> Yeah. So, it's about 40 grams of complete protein. And then I do add some complete protein. And then I do add some collagen, but not counting that as my collagen, but not counting that as my protein protein protein >> because we know collagen has a protein >> because we know collagen has a protein score of zero. score of zero. score of zero. >> Yeah. >> Yeah. >> Yeah. >> But the whey protein with the Greek >> But the whey protein with the Greek yogurt, that's perfect. That is a high yogurt, that's perfect. That is a high quality breakfast. Um, do you hear quality breakfast. Um, do you hear [22:10] quality breakfast. Um, do you hear people having push back on what does people having push back on what does that look like? It's too much. And that look like? It's too much. And that's if it's too much food. that's if it's too much food. >> I mean, it takes me a couple hours to >> I mean, it takes me a couple hours to get it down. Like half of it still in get it down. Like half of it still in the fridge. the fridge. the fridge. >> You can't do that. >> You can't do that. >> So, oh, >> So, oh, >> So, oh, >> you can't do that. If you don't have it >> you can't do that. If you don't have it at one time, the the leucine level, the at one time, the the leucine level, the the amino acids in the blood will never the amino acids in the blood will never reach peak. reach peak. reach peak. >> So, you have to have that shake at once. >> So, you have to have that shake at once. >> Okay. Okay. I just have to drink it >> Okay. Okay. I just have to drink it faster. What would a 50 gram dinner look faster. What would a 50 gram dinner look like? like? like? >> My favorite is um lean steak. >> My favorite is um lean steak. >> Mhm. >> Mhm. >> Mhm. >> Lean steak and vegetables. >> Lean steak and vegetables. >> Yeah. >> Yeah. >> Yeah. >> Plate. One/3 of your plate should be >> Plate. One/3 of your plate should be lean proteins. Onethird of your plates lean proteins. Onethird of your plates can be some kind of fibrous carb. And can be some kind of fibrous carb. And one/3 of your plate can be starchy carb. one/3 of your plate can be starchy carb. >> Okay, >> Okay, >> Okay, >> very simple. Uh, red meat gets a really >> very simple. Uh, red meat gets a really bad wrap for aging women. And a lot of bad wrap for aging women. And a lot of [22:56] bad wrap for aging women. And a lot of women feel that it's unhealthy for them. women feel that it's unhealthy for them. I would say it is very healthy. And I would say it is very healthy. And almost 50% of the fat in red meat is almost 50% of the fat in red meat is olive oil. It's monounsaturated fat. olive oil. It's monounsaturated fat. >> Wow. So, are you ProShakes or >> Wow. So, are you ProShakes or anti-shake? Proshake. Okay. anti-shake? Proshake. Okay. >> They are so convenient. >> They are so convenient. >> It's for me it's like I can hit because >> It's for me it's like I can hit because I put extra fiber in it, you know, add I put extra fiber in it, you know, add in I have my berries. So, like I can hit in I have my berries. So, like I can hit so many of my overall nutrition goals so many of my overall nutrition goals >> and it's convenient. I know exactly what >> and it's convenient. I know exactly what it tastes like. I don't have to measure it tastes like. I don't have to measure anymore. Like if if I can get that down, anymore. Like if if I can get that down, I am like halfway home, you know, for my I am like halfway home, you know, for my nutrition goals. nutrition goals. nutrition goals. >> I would agree. >> I would agree. >> I would agree. >> It's delicious. So, >> It's delicious. So, >> it's and it's easy. Yeah, >> it's and it's easy. Yeah, >> we're busy. >> we're busy. >> we're busy. >> It's easy. someone, you know, my kids >> It's easy. someone, you know, my kids are screaming, the other ones, you know, are screaming, the other ones, you know, like why are you drawing on the wall? like why are you drawing on the wall? [23:42] like why are you drawing on the wall? >> But you have to get that right because >> But you have to get that right because again, if we're talking about health again, if we're talking about health outcomes that matter, outcomes that matter, >> we want to have good metabolic health >> we want to have good metabolic health like again glucose, insulin, like again glucose, insulin, triglycerides, they all have to be in triglycerides, they all have to be in check. There's another thing that I check. There's another thing that I think is really important that um is think is really important that um is critical to understand as we think about critical to understand as we think about designing a diet. The dietary guidelines designing a diet. The dietary guidelines that have been set have had 10% that have been set have had 10% saturated fat since the smoking days. saturated fat since the smoking days. It's never changed. It's never changed. It's never changed. >> When we think about 10% saturated fat, >> When we think about 10% saturated fat, it allows us to either knowing or it allows us to either knowing or unknowingly demonize all animal unknowingly demonize all animal products. products. products. >> Eggs, steak, everything. Those foods >> Eggs, steak, everything. Those foods will almost never be considered a will almost never be considered a healthy food. Even if an egg has a gram healthy food. Even if an egg has a gram [24:28] healthy food. Even if an egg has a gram of saturated fat and a donut has more of saturated fat and a donut has more saturated fat than an 85% lean saturated fat than an 85% lean hamburger. hamburger. hamburger. >> Okay. >> Okay. >> Okay. >> Yeah. >> Yeah. >> Yeah. >> We have to shift away from thinking >> We have to shift away from thinking about foods as a number like this about foods as a number like this component of the food only saturated fat component of the food only saturated fat thinking and even protein but really thinking and even protein but really thinking about the whole food matrix. thinking about the whole food matrix. Because if we demonize saturated fat, Because if we demonize saturated fat, then you see people push towards then you see people push towards more plant-based foods. And plant-based more plant-based foods. And plant-based foods are important, but they're not foods are important, but they're not important at the expense of high quality important at the expense of high quality proteins and foods that are all proteins and foods that are all nutrient-dense. So, the best of both nutrient-dense. So, the best of both worlds is really a combination of the worlds is really a combination of the two. two. two. >> And I, you know, I just wanted to say >> And I, you know, I just wanted to say that because the dietary guidelines, we that because the dietary guidelines, we have to ask, are these guidelines to have to ask, are these guidelines to [25:13] have to ask, are these guidelines to inform the public or are they meant for inform the public or are they meant for medical interventions? And where is medical interventions? And where is reducing saturated fat potentially reducing saturated fat potentially helpful? Well, if you are someone that helpful? Well, if you are someone that has a high LDL level, has a high LDL level, >> what percentage people have an LDL >> what percentage people have an LDL cholesterol above 160? It's like 6% of cholesterol above 160? It's like 6% of people. people. people. >> 6%. >> 6%. >> 6%. >> So, we created dietary guidelines >> So, we created dietary guidelines >> that are potentially going to address >> that are potentially going to address LDL cholesterol. What is how is that LDL cholesterol. What is how is that going to help someone who already has going to help someone who already has healthy LDL cholesterol numbers? Does healthy LDL cholesterol numbers? Does that make sense? that make sense? that make sense? No, totally. We're No, totally. We're No, totally. We're >> designing something for such a small >> designing something for such a small percentage of the population percentage of the population >> where it would lead to less healthy >> where it would lead to less healthy behaviors for the majority behaviors for the majority >> but they are now designing or being >> but they are now designing or being [25:58] >> but they are now designing or being forced to design diets that then have to forced to design diets that then have to fall within that umbrella. And then the fall within that umbrella. And then the other thing for uh carbohydrates, if other thing for uh carbohydrates, if tri, you know, when I think about how do tri, you know, when I think about how do we know if your carbohydrates are in we know if your carbohydrates are in check, that's a triglyceride question. check, that's a triglyceride question. If your triglycerides are elevated, then If your triglycerides are elevated, then you should reduce your carbohydrates. you should reduce your carbohydrates. So, this now moves us into personalized So, this now moves us into personalized nutrition. nutrition. nutrition. >> If someone is like, I did the Forever >> If someone is like, I did the Forever Strong playbook, my triglycerides are Strong playbook, my triglycerides are elevated. What do I need to do? elevated. What do I need to do? >> Well, then you would reduce your >> Well, then you would reduce your carbohydrates. then you would reduce carbohydrates. then you would reduce your carbohydrates below 130 gram or your carbohydrates below 130 gram or below 140 gram. And we've seen that in below 140 gram. And we've seen that in the data. We'll see a 20% reduction in the data. We'll see a 20% reduction in tri triglyceride levels. And so we just tri triglyceride levels. And so we just have to ask ourselves, are we utilizing have to ask ourselves, are we utilizing dietary patterns and guidelines as dietary patterns and guidelines as [26:44] dietary patterns and guidelines as medical interventions? And if we are, medical interventions? And if we are, then they have to be specified as then they have to be specified as medical interventions. Or are we using medical interventions. Or are we using it for optimal health? it for optimal health? >> I love that. I mean, >> I love that. I mean, you know, I love that because we do the you know, I love that because we do the same thing in our clinic. You know, we same thing in our clinic. You know, we have generalized guidelines, but then I have generalized guidelines, but then I get to look at a very extensive lab get to look at a very extensive lab panel panel panel >> and look at the patient and be like, >> and look at the patient and be like, okay, for your nutrition, for your okay, for your nutrition, for your needs, for your maybe you don't your needs, for your maybe you don't your vitamin D levels are great. You're vitamin D levels are great. You're getting plenty. You know, we don't need getting plenty. You know, we don't need to supplement this, but your to supplement this, but your triglycerides are elevated. You've got triglycerides are elevated. You've got insulin resistance. Now, we need to like insulin resistance. Now, we need to like target your nutritional goals to meet target your nutritional goals to meet your health goals, your health goals, your health goals, >> right? And then that is how we then move >> right? And then that is how we then move into the era of personalized nutrition. into the era of personalized nutrition. >> Okay. Um let's talk about women >> Okay. Um let's talk about women specifically because there's just so specifically because there's just so [27:31] specifically because there's just so little data for us. Um but most of the little data for us. Um but most of the muscle and longevity research has been muscle and longevity research has been done on men. Am I correct in that done on men. Am I correct in that statement? Okay. statement? Okay. statement? Okay. >> You are. >> You are. >> You are. >> What changes when you apply this to your >> What changes when you apply this to your female patients to women? female patients to women? >> Um >> Um >> Um >> specifically to like our listening >> specifically to like our listening population which are usually somewhere population which are usually somewhere per menopause, menopause, postmenopause. per menopause, menopause, postmenopause. So 40 plus. So 40 plus. So 40 plus. >> Yeah. There's a few things. Um, number >> Yeah. There's a few things. Um, number one, what we see is with a good one, what we see is with a good resistance training program and calories resistance training program and calories controlled with higher protein, controlled with higher protein, regardless if they are on hormone regardless if they are on hormone replacement therapy or not, which is replacement therapy or not, which is really shocking because in my mind, I'm really shocking because in my mind, I'm thinking we're going to replace uh thinking we're going to replace uh people's hormones and their body people's hormones and their body composition is going to change. We don't composition is going to change. We don't always see that, right? And it's not a always see that, right? And it's not a >> we don't see it in clinic either unless >> we don't see it in clinic either unless they do the work. they do the work. [28:16] they do the work. >> And this is really important. what we >> And this is really important. what we >> it's a tool but it's not everything >> it's a tool but it's not everything >> and it's a tool that isn't going to work >> and it's a tool that isn't going to work if you do not have the fundamental if you do not have the fundamental principles in in check and so principles in in check and so >> I tell patients hormone therapy will not >> I tell patients hormone therapy will not keep you out of a nursing home keep you out of a nursing home >> it will not it will not the biggest >> it will not it will not the biggest needle mover is resistance training and needle mover is resistance training and people will say well what about zone 2 people will say well what about zone 2 zone 2 is great you've got different zone 2 is great you've got different fiber types type one type two type you fiber types type one type two type you know there's a hybrid type people say know there's a hybrid type people say well it's different in men and women and well it's different in men and women and is that through it's probably more is that through it's probably more dependent on your training dependent on your training >> because that's the reality is that we >> because that's the reality is that we have agency. So resistance training two have agency. So resistance training two days a week will be critical. Dietary days a week will be critical. Dietary protein is critical if you want to build protein is critical if you want to build [29:01] protein is critical if you want to build muscle and maintain muscle. Uh one of muscle and maintain muscle. Uh one of the things that we do see is that women the things that we do see is that women sometimes what becomes really important sometimes what becomes really important is that they have to increase their is that they have to increase their stimulus. So there's this idea of stimulus. So there's this idea of progressive overload. progressive overload. Uh we don't believe that it doesn't just Uh we don't believe that it doesn't just always have to be heavier. You can always have to be heavier. You can change Yeah. So you can change the change Yeah. So you can change the stimulus. It can be heavier. It can also stimulus. It can be heavier. It can also be be be >> be a different exercise. >> be a different exercise. >> It can be a different exercise. It can >> It can be a different exercise. It can be a change in tempo. It can be a change be a change in tempo. It can be a change in um Yeah. So speed, exercise, there in um Yeah. So speed, exercise, there are so many levers are so many levers are so many levers >> that you can change. It doesn't just >> that you can change. It doesn't just have to be heavier. And that is you can have to be heavier. And that is you can change volume. There are a handful of change volume. There are a handful of other things that you can change beyond other things that you can change beyond [29:47] other things that you can change beyond >> just going heavier and heavier >> just going heavier and heavier >> the weight. And so progressive overload >> the weight. And so progressive overload should now be termed progressive should now be termed progressive stimulus. stimulus. stimulus. >> I love that. >> I love that. >> I love that. >> That makes me feel better cuz I, you >> That makes me feel better cuz I, you know, I I'm human. I get injured. We know, I I'm human. I get injured. We travel. I'll, you know, and then I'm travel. I'll, you know, and then I'm like, oh. And I'll go back and look and like, oh. And I'll go back and look and I'm like, I'm not gaining, you know, I'm I'm like, I'm not gaining, you know, I'm my my weights are not increasing that my my weights are not increasing that much. Definitely I'm stronger than when much. Definitely I'm stronger than when I started or I can lift heavier, but I'm I started or I can lift heavier, but I'm like I think I'm plateauing a little like I think I'm plateauing a little bit. bit. bit. just because life gets in the way. But just because life gets in the way. But like I could switch it up, change it, do like I could switch it up, change it, do something different and still get enough something different and still get enough stimulus. stimulus. stimulus. >> You can. And again, we have to help. If >> You can. And again, we have to help. If there are all these narratives that there are all these narratives that create our limitations and that there's create our limitations and that there's one way to do to do something, then it one way to do to do something, then it creates a lot of limitations within the creates a lot of limitations within the person, within the listener who is person, within the listener who is [30:34] person, within the listener who is saying exactly the same thing that saying exactly the same thing that you're saying. Do I love lifting heavy you're saying. Do I love lifting heavy weights? I do. Do I get injured? Yeah. I weights? I do. Do I get injured? Yeah. I decided that I should be doing clean and decided that I should be doing clean and you know cleans at 100 pounds. I'mund I you know cleans at 100 pounds. I'mund I mean I'm a small person. I couldn't move mean I'm a small person. I couldn't move my left shoulder. I'm like out of the my left shoulder. I'm like out of the gym for a week. gym for a week. gym for a week. >> I know you had hamstring surgery. >> I know you had hamstring surgery. >> Okay. Yeah. I mean from hamstring to >> Okay. Yeah. I mean from hamstring to shoulder, you name it. shoulder, you name it. >> But the the real key is and there is a >> But the the real key is and there is a lot of information in this space that lot of information in this space that you know what is the impact of estrogen you know what is the impact of estrogen and muscle? What is the and muscle? What is the >> Yeah. Walk me through what do we know? >> Yeah. Walk me through what do we know? What do we know about a woman goes What do we know about a woman goes through the menopause transition? What through the menopause transition? What happens to her muscle? I'm going to tell happens to her muscle? I'm going to tell you my personal perspective because I you my personal perspective because I don't think that I think there's a lot don't think that I think there's a lot of mechanistic data. I don't think that of mechanistic data. I don't think that the mechanistic data is translating over the mechanistic data is translating over to uh women to uh women [31:20] to uh women >> yet that we can say in clinical >> yet that we can say in clinical practice. And here's what I will tell practice. And here's what I will tell you that you that you that does the s does the menopause transition does the s does the menopause transition change body distribution of fat because change body distribution of fat because of the change in estrogen and the change of the change in estrogen and the change in testosterone? You and I have seen it in testosterone? You and I have seen it in clinic. in clinic. in clinic. >> Every every cohort shows it. >> Every every cohort shows it. >> Okay. Yeah. Now, what does that mean for >> Okay. Yeah. Now, what does that mean for the quality of skeletal muscle? We see the quality of skeletal muscle? We see mechanistic data that there are estrogen mechanistic data that there are estrogen receptors on skeletal muscle, but if receptors on skeletal muscle, but if someone is taking estrogen, it doesn't someone is taking estrogen, it doesn't mean that they're building more muscle. mean that they're building more muscle. If someone is suppressing their uh If someone is suppressing their uh hormonal status or estrogen on birth hormonal status or estrogen on birth control, are we seeing that it's control, are we seeing that it's changing their musculature? We're not. changing their musculature? We're not. >> I mean, there might be outliers, but >> I mean, there might be outliers, but what I believe that it comes down to, I what I believe that it comes down to, I mean, again, this is my perspective. I I mean, again, this is my perspective. I I [32:06] mean, again, this is my perspective. I I I want to be fair. I don't think that I want to be fair. I don't think that that we're there with the data that we're there with the data >> right we need biopsies throughout the >> right we need biopsies throughout the transition thousands of people transition thousands of people >> I think that there is probably an >> I think that there is probably an influence which we know right um to what influence which we know right um to what extent if someone is training and is extent if someone is training and is highly physically active I'm not sure if highly physically active I'm not sure if it's relevant it's relevant it's relevant would I want to believe something else I would I want to believe something else I do is it possible is it plausible yes do is it possible is it plausible yes have we proven it yet maybe not yet Um, have we proven it yet maybe not yet Um, all that to say, I think that the jury all that to say, I think that the jury is still out. But what I will say is is still out. But what I will say is during the aging process, as hormones during the aging process, as hormones decline for both men and women, decline for both men and women, >> so testosterone declines in both >> so testosterone declines in both >> for both men and women, we do see >> for both men and women, we do see changes in body composition. changes in body composition. [32:52] changes in body composition. But is it because of that or is it But is it because of that or is it because of the activity? because of the activity? >> And I just think we have to be really >> And I just think we have to be really fair. fair. fair. It could be one, the other, or both. So, It could be one, the other, or both. So, I decided to start testosterone I decided to start testosterone um um um three years ago maybe and I didn't meet three years ago maybe and I didn't meet the qualifications for HSDD though I the qualifications for HSDD though I have seen an uptick in that area and I'm have seen an uptick in that area and I'm super happy with it and I would feel sad super happy with it and I would feel sad if that went away. Um, but I didn't like if that went away. Um, but I didn't like have distress with, you know, frequency have distress with, you know, frequency or whatever. But I but I'm a naturally or whatever. But I but I'm a naturally very thin person and I'd been lifting very thin person and I'd been lifting and I knew the studies had shown that and I knew the studies had shown that women who naturally had higher women who naturally had higher testosterone levels as they aged. You testosterone levels as they aged. You know, when they looked at cortiles, the know, when they looked at cortiles, the [33:37] know, when they looked at cortiles, the women with the highest testosterone women with the highest testosterone levels had more muscle mass. And I was levels had more muscle mass. And I was like, well, if I supplement a little like, well, if I supplement a little bit, maybe that'll help in my efforts to bit, maybe that'll help in my efforts to hold on and grow some muscle for my hold on and grow some muscle for my aging process. And one of the side aging process. And one of the side benefits was, you know, an increase in benefits was, you know, an increase in libido, which was amazing. So, um, was I libido, which was amazing. So, um, was I was I ridiculous to think that or to use was I ridiculous to think that or to use that, you know, because we don't have that, you know, because we don't have studies. We're not looking at that data, studies. We're not looking at that data, you know, other than just looking at you know, other than just looking at what woman happens to naturally by luck what woman happens to naturally by luck or whatever have a higher testosterone or whatever have a higher testosterone level, you know, where what cortile does level, you know, where what cortile does she land in at 50, 60, 70, and what's she land in at 50, 60, 70, and what's her muscle mass? her muscle mass? her muscle mass? >> I believe that obviously I believe in >> I believe that obviously I believe in hormone replacement. Um and you you guys hormone replacement. Um and you you guys call it in the menopausey group. call it in the menopausey group. >> Oh god. Yeah. Yeah. PET. >> Oh god. Yeah. Yeah. PET. >> I want to just say it right because >> I want to just say it right because [34:23] >> I want to just say it right because >> PET progesterone, estrogen, >> PET progesterone, estrogen, testosterone. testosterone. testosterone. >> Um I have seen the benefits in my >> Um I have seen the benefits in my clinical practice. I believe in it. clinical practice. I believe in it. >> Did it improve muscle mass for you? >> Did it improve muscle mass for you? Testosterone? Testosterone? Testosterone? >> I don't know. It's hard to measure. >> I don't know. It's hard to measure. >> It's hard to measure. Uh we don't >> It's hard to measure. Uh we don't measure muscle mass. measure muscle mass. measure muscle mass. >> I'm eating protein. I'm lifting weights >> I'm eating protein. I'm lifting weights and I'm growing muscle. So, I don't have and I'm growing muscle. So, I don't have it's my end of one, it's my end of one, it's my end of one, >> right? >> right? >> right? >> You know, >> You know, >> You know, >> I think that it's possible if you're >> I think that it's possible if you're doing all the other things, right? Um, doing all the other things, right? Um, again, we see great benefits for the again, we see great benefits for the reasons that you mentioned, sex drive, reasons that you mentioned, sex drive, libido, maybe energy, all for all of the libido, maybe energy, all for all of the other things. You also have to recognize other things. You also have to recognize that um muscle mass changes are really that um muscle mass changes are really hard to detect. And one of the things hard to detect. And one of the things [35:08] hard to detect. And one of the things that you will see in the literature is that you will see in the literature is for example um protein doesn't matter for example um protein doesn't matter because if you're not doing resistance because if you're not doing resistance training you're not going to see a training you're not going to see a change in in muscle change in in muscle change in in muscle muscle is very difficult to detect. I muscle is very difficult to detect. I mean it in 10 years you might see an 8% mean it in 10 years you might see an 8% change. change. change. >> How much is that per year? 1% a 1% >> How much is that per year? 1% a 1% change in muscle mass per year again change in muscle mass per year again because I think that the it's the because I think that the it's the quality of that tissue that we're not quality of that tissue that we're not addressing. It's again this big gaping addressing. It's again this big gaping hole. Will testosterone help it? I mean hole. Will testosterone help it? I mean hopefully. But also the levels that hopefully. But also the levels that women are getting are different than the women are getting are different than the more robust dosing of men. more robust dosing of men. >> A men for sure. >> A men for sure. >> A men for sure. >> Um >> Um >> Um >> but also we know testosterone is >> but also we know testosterone is [35:54] >> but also we know testosterone is important for so much more. important for so much more. >> There's a lot of debate right now. >> There's a lot of debate right now. >> Is there really? Oh, in in my world you >> Is there really? Oh, in in my world you probably don't see a lot of it. So probably don't see a lot of it. So there's there's researchers um who have there's there's researchers um who have studied testoster like really smart good studied testoster like really smart good researchers who are coming out very researchers who are coming out very strongly saying and they're very strongly saying and they're very academic minded. I don't think they academic minded. I don't think they actually see patients um that you know actually see patients um that you know we're overselling testosterone like we we're overselling testosterone like we need to hold back. Don't be talking need to hold back. Don't be talking about brain or mood or cognition like about brain or mood or cognition like like testosterone has no place in this like testosterone has no place in this conversation or we don't have enough conversation or we don't have enough data so we shouldn't be talking about data so we shouldn't be talking about this this this >> but we know about androgen deprivation >> but we know about androgen deprivation therapy don't we therapy don't we therapy don't we >> we know a lot about men you know and um >> we know a lot about men you know and um yeah when we block estrogen androgen yeah when we block estrogen androgen receptors what happens receptors what happens >> changes in brain function all kinds of >> changes in brain function all kinds of things things [36:39] things >> so you know I I think there's some >> so you know I I think there's some gatekeeping of data I think that a lot gatekeeping of data I think that a lot of people want to control the narrative of people want to control the narrative Um but I just know clinically in my Um but I just know clinically in my patient population I'm seeing very patient population I'm seeing very positive results in multiple organ positive results in multiple organ systems. systems. systems. >> Yeah, we are too. And that is the >> Yeah, we are too. And that is the challenge of academic medicine and challenge of academic medicine and research research research >> oftent times unless you're like the guys >> oftent times unless you're like the guys at Baylor like our friend Mohead Cara at Baylor like our friend Mohead Cara who are doing the research and seeing who are doing the research and seeing patients. You have one group that are patients. You have one group that are PhDs that are looking at, you know, what PhDs that are looking at, you know, what is the hardcore data? And then while is the hardcore data? And then while hardcore data is important, we might not hardcore data is important, we might not just be there yet in the randomized just be there yet in the randomized control trials saying that testosterone control trials saying that testosterone for women, say vaginally, will improve for women, say vaginally, will improve [37:25] for women, say vaginally, will improve sex drive or X, Y, and Z or any of these sex drive or X, Y, and Z or any of these other things. Um, other things. Um, other things. Um, >> but I think that we're going to get >> but I think that we're going to get there. And I think in the next 10 years, there. And I think in the next 10 years, if someone goes to their physician and if someone goes to their physician and they're caring about aging and they're they're caring about aging and they're not on hormone replacement, that that not on hormone replacement, that that physician is going to be out of out of physician is going to be out of out of date. date. date. >> Yeah. And it needs to be a part of the >> Yeah. And it needs to be a part of the conversation. conversation. conversation. >> Well, also, which kind of segus nicely >> Well, also, which kind of segus nicely into GLP1's. into GLP1's. into GLP1's. >> We talked about the beginning of the >> We talked about the beginning of the obesity epidemic. Food guide pyramid obesity epidemic. Food guide pyramid happened. the late 80s, early 90s, all happened. the late 80s, early 90s, all of a sudden people became uh obese with of a sudden people became uh obese with diabetes, diabetes, diabetes, but they were trying to address heart but they were trying to address heart disease and then they increased heart disease and then they increased heart disease and metabolic syndrome [38:14] disease and metabolic syndrome underneath the umbrella of trying to underneath the umbrella of trying to correct for cardiovascular disease. correct for cardiovascular disease. Remember, so this was just a whole Remember, so this was just a whole >> big human experiment mistake. >> big human experiment mistake. >> We are at that precipice again >> We are at that precipice again >> with JLP1. >> with JLP1. >> with JLP1. >> We are. Yeah, >> We are. Yeah, >> We are. Yeah, >> we are. And >> we are. And >> we are. And >> what do you think we're doing wrong? >> what do you think we're doing wrong? What do you think we're getting wrong? What do you think we're getting wrong? >> We Okay, my prediction, and I really >> We Okay, my prediction, and I really hope that I'm wrong. In the next 10 hope that I'm wrong. In the next 10 years, we are going to see an years, we are going to see an accelerated rate of sarcopenic obesity, accelerated rate of sarcopenic obesity, sarcopenia, and osteoporosis that no one sarcopenia, and osteoporosis that no one is ready to manage. is ready to manage. is ready to manage. >> Is there a way to safely give a GLP1 >> Is there a way to safely give a GLP1 without that risk? we do in our clinic without that risk? we do in our clinic and we manage nutrition and resistance and we manage nutrition and resistance training and lower dosing of these training and lower dosing of these [39:00] training and lower dosing of these medications. It there it doesn't have to medications. It there it doesn't have to be very high doses. I think it's a be very high doses. I think it's a double-edged sword. The data I believe double-edged sword. The data I believe that is coming out and will continue to that is coming out and will continue to come out improves muscle quality come out improves muscle quality lowering the fat within the muscle. I lowering the fat within the muscle. I think, you know, there's some data to think, you know, there's some data to support that it improves strength and, support that it improves strength and, you know, a whole host of promises, but you know, a whole host of promises, but that could be because healthy muscle is that could be because healthy muscle is stronger muscle as opposed to connective stronger muscle as opposed to connective tissue and fat. You know, there's tissue and fat. You know, there's various infiltrating various infiltrating various infiltrating >> infiltrating underneath the fascia >> infiltrating underneath the fascia around muscle groups, within the muscle around muscle groups, within the muscle tissue itself, within the muscle tissue itself, within the muscle bellies. There's various places for it. bellies. There's various places for it. But I think GLP1s are improving that. But I think GLP1s are improving that. We're going to see more data lowering We're going to see more data lowering inflammation. However, if someone goes inflammation. However, if someone goes on a GLP one, and by the way, they don't on a GLP one, and by the way, they don't magically cause muscle loss, right? They magically cause muscle loss, right? They [39:47] magically cause muscle loss, right? They track in line with when an individual track in line with when an individual loses weight, we see it's the same loses weight, we see it's the same percentage. percentage. percentage. >> It It's not something magical. >> It It's not something magical. The problem is if individuals are The problem is if individuals are abusing GP1s, not training, seeing the abusing GP1s, not training, seeing the celebrity sphere become very skinny, celebrity sphere become very skinny, sarcopenic, sarcopenic, sarcopenic, I believe that we're going to have an I believe that we're going to have an epidemic of sarcopenia that we defined epidemic of sarcopenia that we defined as an aging change in muscle accelerated as an aging change in muscle accelerated years earlier right underneath our years earlier right underneath our noses. noses. noses. >> How are you monitoring body composition >> How are you monitoring body composition in your clinic? Well, like I mentioned in your clinic? Well, like I mentioned before, we don't have great ways of before, we don't have great ways of measuring skeletal muscle because MRI is measuring skeletal muscle because MRI is not feasible for most people, but we use not feasible for most people, but we use [40:33] not feasible for most people, but we use bio impedance and we use a DEXA and we bio impedance and we use a DEXA and we always measure and keep strength always measure and keep strength metrics. metrics. metrics. >> Oh wow. How do you do that? We're not >> Oh wow. How do you do that? We're not doing that. doing that. doing that. >> We just report I mean we usually are in >> We just report I mean we usually are in contact with their trainers and we contact with their trainers and we whatever it is that their programs are whatever it is that their programs are and their lifts, are they evolving? and their lifts, are they evolving? Where are they from a strength Where are they from a strength standpoint? So you are 100% of your standpoint? So you are 100% of your patients are doing strength training. patients are doing strength training. >> Yes, they are. So you're not coming to >> Yes, they are. So you're not coming to me. Yeah. Okay. Because it's nothing me. Yeah. Okay. Because it's nothing moves the needle more than exercise. And moves the needle more than exercise. And we were talking about the fat that we were talking about the fat that infiltrates into the tissue. The fat infiltrates into the tissue. The fat that infiltrates into that tissue. The that infiltrates into that tissue. The most effective way to get rid of that is most effective way to get rid of that is not diet, it's movement. You have to get not diet, it's movement. You have to get a flux. If you think about your muscle a flux. If you think about your muscle like a pond, when a pond is stagnant, it like a pond, when a pond is stagnant, it gets bugs and all all kinds of things. gets bugs and all all kinds of things. [41:19] gets bugs and all all kinds of things. muscle is the same. Even if you then muscle is the same. Even if you then revert to a healthy eating behavior, if revert to a healthy eating behavior, if your muscle is full, muscle glycogen, your muscle is full, muscle glycogen, fatty acids, and you're not leveraging fatty acids, and you're not leveraging this turnover through activity, this turnover through activity, >> then your muscle doesn't >> then your muscle doesn't >> I mean it it will improve obviously >> I mean it it will improve obviously because the quality of your diet because the quality of your diet improves, but the most effective way to improves, but the most effective way to improve that muscle quality is through improve that muscle quality is through movement. movement. movement. >> All right, so let's talk about the >> All right, so let's talk about the training prescription, which is I love. training prescription, which is I love. So you have two books. Let's talk about So you have two books. Let's talk about these real quick. So, I love the these real quick. So, I love the playbook. You know what's the difference playbook. You know what's the difference between the two books? between the two books? >> This is this one book. This book has >> This is this one book. This book has pictures. This book is written for now pictures. This book is written for now who people don't want all the heavy who people don't want all the heavy science. science. science. >> The heavy science is all in forever >> The heavy science is all in forever strong. But this is how to do what to strong. But this is how to do what to [42:04] strong. But this is how to do what to do. do. do. >> So, >> So, >> So, and you know what? We're going to do a and you know what? We're going to do a challenge and maybe you will pop on the challenge and maybe you will pop on the challenge challenge challenge >> and talk about your own lots of recipes >> and talk about your own lots of recipes and Yes. and protocols and Yes. and protocols >> and it tells you exactly how to design a >> and it tells you exactly how to design a diet to support muscle health. diet to support muscle health. >> So that's why this is how >> So that's why this is how >> that's right. >> that's right. >> that's right. >> Okay. Protein without resistance does >> Okay. Protein without resistance does not build muscle. not build muscle. not build muscle. >> It does not. But >> It does not. But >> It does not. But >> resistance without protein doesn't build >> resistance without protein doesn't build muscle. muscle. muscle. >> Right. >> Right. >> Right. >> You need both. Okay. >> You need both. Okay. >> But both are valuable without the other. >> But both are valuable without the other. Meaning okay if you are eat if you must Meaning okay if you are eat if you must consume calories consume calories consume calories >> you still need beyond building muscle >> you still need beyond building muscle again skin repair hormones brain again skin repair hormones brain function precursors function precursors [42:49] function precursors >> okay >> okay >> okay >> methionine for glutathione production >> methionine for glutathione production the Manchester antioxidant but yes the Manchester antioxidant but yes >> so define resistance training for Maddie >> so define resistance training for Maddie who she is lifting weights now but like who she is lifting weights now but like forever Pilates Pilates um for the woman forever Pilates Pilates um for the woman who's doing Pilates and walking and who's doing Pilates and walking and thinks she's covered thinks she's covered thinks she's covered >> [sighs and gasps] >> [sighs and gasps] >> [sighs and gasps] >> This hurts my heart a little bit because >> This hurts my heart a little bit because all activity is good activity. all activity is good activity. >> Yes. >> Yes. >> Yes. >> And I believe we should hold people to a >> And I believe we should hold people to a higher standard if they want to age higher standard if they want to age well. well. well. >> Okay. >> Okay. >> Okay. >> When individuals age, again, we had >> When individuals age, again, we had touched on these uh fiber types. touched on these uh fiber types. >> Mhm. >> Mhm. >> Mhm. >> When our parents age, and we've watched >> When our parents age, and we've watched them age, they become thinner and more them age, they become thinner and more frail. Typically, there's a transition frail. Typically, there's a transition of fiber types to those bigger, bulkier of fiber types to those bigger, bulkier fiber types to the more thin, what we fiber types to the more thin, what we would consider more endurance would consider more endurance [43:34] would consider more endurance >> muscle fibers. >> muscle fibers. >> muscle fibers. >> Muscle fibers. The only way to protect >> Muscle fibers. The only way to protect those muscle fibers to maintain that those muscle fibers to maintain that size is to do resistance training. size is to do resistance training. There's no other way. Is Pilates great? There's no other way. Is Pilates great? Pilates is great. Is it going to be Pilates is great. Is it going to be enough stimulus? If Pilates was the end enough stimulus? If Pilates was the end all be and Pilates is great and people all be and Pilates is great and people get very offended. But if Pilates was get very offended. But if Pilates was going to build the most amount of going to build the most amount of muscle, then you would think the Navy muscle, then you would think the Navy Seals and the football players, that's Seals and the football players, that's all they would be doing. They wouldn't all they would be doing. They wouldn't be at the weight room. They would be be at the weight room. They would be doing Pilates. doing Pilates. doing Pilates. >> And I would say it's a great place to >> And I would say it's a great place to start and it's a great adjunct and it's start and it's a great adjunct and it's very hard. And I would like people to very hard. And I would like people to lift weights. resistance again it's lift weights. resistance again it's lifting up against something that is lifting up against something that is [44:19] lifting up against something that is heavy heavy heavy >> right >> right >> right >> that's hard for you >> that's hard for you >> and women will say I have never lifted >> and women will say I have never lifted weights is it too late and you know what weights is it too late and you know what I will say I will say I will say >> it's never too late >> it's never too late >> I will say lady you have been lifting >> I will say lady you have been lifting weights your entire life weights your entire life >> whether you have kids my kids are 40 50 >> whether you have kids my kids are 40 50 lbs whether you have groceries you have lbs whether you have groceries you have been lifting weights your entire life been lifting weights your entire life you are so much less fragile than you you are so much less fragile than you think you are so um if you are mature. think you are so um if you are mature. The one thing I would say is there's a The one thing I would say is there's a lot of discussion around power and force lot of discussion around power and force production. production. production. >> I think that mudd muddies the water. You >> I think that mudd muddies the water. You know, I talk to me. Talk to the woman know, I talk to me. Talk to the woman who's listening who's 50 and she's the who's listening who's 50 and she's the first woman in her entire bloodline who first woman in her entire bloodline who is going to try to do this and she's is going to try to do this and she's [45:04] is going to try to do this and she's never lifted in her life. Where does she never lifted in her life. Where does she start? start? start? >> She Well, number one, she's amazing and >> She Well, number one, she's amazing and there's a ton of typically she's not there's a ton of typically she's not ready to go to a gym. She's like, "I'm ready to go to a gym. She's like, "I'm embarrassed. I don't want to go to the embarrassed. I don't want to go to the gym. gym. gym. >> It's overwhelming. >> It's overwhelming. >> It's overwhelming." I said, "You know >> It's overwhelming." I said, "You know what? We're going to start with either what? We're going to start with either body weight or we're going to start with body weight or we're going to start with bands." And you are going to recognize bands." And you are going to recognize that everything that we start is always that everything that we start is always hard at first. hard at first. hard at first. And then after she feels comfortable, And then after she feels comfortable, she will then progress to machines. She she will then progress to machines. She doesn't have to do free weights. She doesn't have to do free weights. She doesn't have to do complex movements. doesn't have to do complex movements. And then she's going to say to me, "Doc, And then she's going to say to me, "Doc, I don't have time." And you know what I don't have time." And you know what I'm going to say to her? If you don't I'm going to say to her? If you don't have time for strength, how are you have time for strength, how are you gonna have time for sickness? And then gonna have time for sickness? And then she's gonna go, "Oh, yeah, okay. I she's gonna go, "Oh, yeah, okay. I thought about that." Then she's gonna go thought about that." Then she's gonna go [45:49] thought about that." Then she's gonna go to the gym. to the gym. to the gym. >> And we're gonna start her with machines. >> And we're gonna start her with machines. There's a low injury rate with machines There's a low injury rate with machines because there's not a ton of because there's not a ton of variability. variability. variability. >> You're not getting under a barbell, >> You're not getting under a barbell, doing a squat, you're not doing broad doing a squat, you're not doing broad jumps, jumps, jumps, >> you're not doing any of those things. >> you're not doing any of those things. And then eventually you maybe progress And then eventually you maybe progress with a trainer or someone online to with a trainer or someone online to begin to see how to explore different begin to see how to explore different movements because I'm going to give you movements because I'm going to give you another prediction. another prediction. another prediction. The first prediction is we're going to The first prediction is we're going to talk about muscle in totality. When we talk about muscle in totality. When we think about muscle, we think about body think about muscle, we think about body parts, biceps, back, legs, improving parts, biceps, back, legs, improving insulin resistance, improving strength. insulin resistance, improving strength. Once we move a little further, what I Once we move a little further, what I believe is next is the movement believe is next is the movement patterns. patterns. patterns. So it's now no longer thinking again So it's now no longer thinking again [46:36] So it's now no longer thinking again this is not for the beginner but this is this is not for the beginner but this is for the people that have been following for the people that have been following you and have been doing what you're you and have been doing what you're doing. It's [snorts] now we have to doing. It's [snorts] now we have to begin to think about how are we moving begin to think about how are we moving what are the patterns that we are moving what are the patterns that we are moving in and I think that that's the next in and I think that that's the next thing rather than bicep curls and leg thing rather than bicep curls and leg extensions which is perfect and you will extensions which is perfect and you will be perfectly healthy if you always do be perfectly healthy if you always do that. But when we think about injury that. But when we think about injury prevention over time, we have Yeah, we prevention over time, we have Yeah, we have to begin to think about what are have to begin to think about what are the patterns and how we're moving. the patterns and how we're moving. >> Okay. How about the woman who's been >> Okay. How about the woman who's been doing cardio her whole life and she's doing cardio her whole life and she's fit by, you know, our usual definition fit by, you know, our usual definition of fitness. of fitness. of fitness. >> She's running, she's spinning, she's in >> She's running, she's spinning, she's in great cardiovascular shape. great cardiovascular shape. >> Um, but she's still losing muscle. >> Um, but she's still losing muscle. >> First thing I would say, >> First thing I would say, >> these are my runners, you know, my >> these are my runners, you know, my competitive runners. They are very competitive runners. They are very [47:22] competitive runners. They are very frustrated by this. Um, I have a frustrated by this. Um, I have a patient, her name is Sharon, she's 60. patient, her name is Sharon, she's 60. When I inherited her as a patient, she When I inherited her as a patient, she was running ultras. She's running 50 to was running ultras. She's running 50 to 100 miles. 100 miles. 100 miles. >> And um, she wanted to be able to run for >> And um, she wanted to be able to run for the rest of her life. Instead of having the rest of her life. Instead of having her run more, we pulled off two days a her run more, we pulled off two days a week of running and adding and added in week of running and adding and added in compound movements and weights and sled compound movements and weights and sled poles. And she's 60. This woman puts me poles. And she's 60. This woman puts me to shame in the gym. Shame. And you know to shame in the gym. Shame. And you know what? She's gotten faster and stronger what? She's gotten faster and stronger >> because she's diversified her program. >> because she's diversified her program. >> Awesome. What does heavy enough mean for >> Awesome. What does heavy enough mean for women our age? women our age? women our age? >> Yeah. Um, you know, I was chatting with >> Yeah. Um, you know, I was chatting with your team and and there was the lift your team and and there was the lift [48:07] your team and and there was the lift more trial. Yeah. more trial. Yeah. more trial. Yeah. >> Yeah. And basically the lift more trial, >> Yeah. And basically the lift more trial, >> 80% of max. >> 80% of max. >> 80% of max. >> Exactly. >> Exactly. >> Exactly. >> I don't think that people really >> I don't think that people really understand their one rep max. I think understand their one rep max. I think it's unrealistic. it's unrealistic. it's unrealistic. >> So one rep max for our listeners is the >> So one rep max for our listeners is the heaviest you can lift and do one heaviest you can lift and do one repetition, one one bicep curl. repetition, one one bicep curl. before you cannot do a second one. So before you cannot do a second one. So that's your max, that's your max, that's your max, >> right? Most people are not testing that >> right? Most people are not testing that out or doing that. Um, you know, but out or doing that. Um, you know, but basically what this showed it was this basically what this showed it was this like you had said 85% of one rep max and like you had said 85% of one rep max and heavy enough meant two to three reps of heavy enough meant two to three reps of a set should be very very challenging. a set should be very very challenging. >> Mh. >> Mh. >> Mh. >> What we also see, and this says twice >> What we also see, and this says twice weekly 30 minutes, but what we also see weekly 30 minutes, but what we also see is that the volume is just about the is that the volume is just about the stimulus. And there's a million stimulus. And there's a million different ways to get to the stimulus. different ways to get to the stimulus. >> Should you be challenging yourself? Does >> Should you be challenging yourself? Does [48:52] >> Should you be challenging yourself? Does it have to be heavy? It doesn't have to it have to be heavy? It doesn't have to be heavy as long as the volume is there. be heavy as long as the volume is there. It depends. It depends. It depends. >> You just have to fail, right? >> You just have to fail, right? >> Just depends. And is that 25 reps or is >> Just depends. And is that 25 reps or is that, you know, 10 reps? And and I that, you know, 10 reps? And and I understand that this is very contentious understand that this is very contentious in the exercise space. But we are not in the exercise space. But we are not talking about elite athletes. And it is talking about elite athletes. And it is unfair that we take our perception and unfair that we take our perception and the data of elite athletes and sport the data of elite athletes and sport performance and we push that on to our performance and we push that on to our general population. It's unfair and it's general population. It's unfair and it's not right. You know, there's all this not right. You know, there's all this talk about zone 2 training. Well, zone 2 talk about zone 2 training. Well, zone 2 is different for you than it is for me is different for you than it is for me than it is for my husband who runs 100 than it is for my husband who runs 100 miles. miles. miles. >> So, what she needs to do is she needs to >> So, what she needs to do is she needs to get enough stimulus where things are get enough stimulus where things are challenging. challenging. [49:38] challenging. >> Yeah. to improve. You know, as doctors, >> Yeah. to improve. You know, as doctors, we're thinking about health outcomes. we're thinking about health outcomes. What are the health outcomes? I want you What are the health outcomes? I want you to have lower blood pressure. I want you to have lower blood pressure. I want you to have better metabolic control. I want to have better metabolic control. I want you to be able to live long and well and you to be able to live long and well and be able to stay independent. I don't be able to stay independent. I don't need you to do a one rep max and risk need you to do a one rep max and risk injuring your back or be an idiot like injuring your back or be an idiot like myself doing cleans cleaning jerks. I myself doing cleans cleaning jerks. I mean, what am I doing because it's fun? mean, what am I doing because it's fun? Okay. Well, I have to be a little um Okay. Well, I have to be a little um more disciplined in that because then more disciplined in that because then you're out for a week. Again, this is you're out for a week. Again, this is the long game. the long game. the long game. >> Yeah. I'm like in my mind when I'm in >> Yeah. I'm like in my mind when I'm in the gym and my gym's in my garage. I've the gym and my gym's in my garage. I've been there. Convenience. Yes. been there. Convenience. Yes. >> I am thinking about that BDNF. I'm like >> I am thinking about that BDNF. I'm like whenever I'm like getting tired or whenever I'm like getting tired or [50:24] whenever I'm like getting tired or frustrated or like this is taking so frustrated or like this is taking so long or whatever, I'm like no, no, no. long or whatever, I'm like no, no, no. You're making those important, you know, You're making those important, you know, messengers in your brain that are going messengers in your brain that are going to decrease your risk of dementia. And to decrease your risk of dementia. And at the end of every workout, I'm like, at the end of every workout, I'm like, "One less day in the nursing home." "One less day in the nursing home." >> Oh, I love that. I mean, that's very >> Oh, I love that. I mean, that's very positive reinforcement. positive reinforcement. >> Yeah. Like, I'm down here to This is my >> Yeah. Like, I'm down here to This is my nursing nursing home prevention program. nursing nursing home prevention program. >> You know, this is um this might sound a >> You know, this is um this might sound a little negative because nobody wins the little negative because nobody wins the war, right? war, right? war, right? >> Yeah. We all die. >> Yeah. We all die. >> Yeah. We all die. >> We all die. >> We all die. >> We all die. >> But not today. And we can win the >> But not today. And we can win the battle. And it's just not today. battle. And it's just not today. >> You know, >> You know, >> You know, >> I just want to decrease >> I just want to decrease the time that I lose my independence. I the time that I lose my independence. I know I'm going to lose my independence know I'm going to lose my independence one day. one day. one day. >> You must not. >> You must not. >> You must not. >> Maybe not. But like the trajectory of >> Maybe not. But like the trajectory of the women in my family who beat cancer, the women in my family who beat cancer, you know, who run the cancer gauntlet you know, who run the cancer gauntlet [51:10] you know, who run the cancer gauntlet and and make it past 70, okay, and and make it past 70, okay, >> is not great. It is over a decade of >> is not great. It is over a decade of loss of independence and requiring loss of independence and requiring others to care for you in your daily others to care for you in your daily needs. My mom's in it right now. Both needs. My mom's in it right now. Both frailty and dementia. So that's my frailty and dementia. So that's my motivation. And like I'm I want the motivation. And like I'm I want the science to say, okay, there's no science to say, okay, there's no promises in life, but like how can I promises in life, but like how can I stack the cards in my favor? And I just stack the cards in my favor? And I just was never taught and learned in med was never taught and learned in med school that I have more control over school that I have more control over this than I ever imagined. And it has this than I ever imagined. And it has everything to do with what I put on my everything to do with what I put on my plate, you know, and how I move my body. plate, you know, and how I move my body. >> It's all >> It's all >> It's all your agency. It's your choice. And your agency. It's your choice. And that's really important that muscle and that's really important that muscle and [51:56] that's really important that muscle and strength is a choice, weakness is a strength is a choice, weakness is a different choice. You know different choice. You know >> what do you think the longevity movement >> what do you think the longevity movement is getting wrong for women is getting wrong for women >> in the longevity space? The idea of >> in the longevity space? The idea of stimulating mTor stimulating mTor stimulating mTor >> is a problem and that those that >> is a problem and that those that suppress mTor which mTor is in every suppress mTor which mTor is in every cell. It's for muscle protein synthesis. cell. It's for muscle protein synthesis. It's, you know, it's [snorts] apparent It's, you know, it's [snorts] apparent in all things. It's kind of this growth. in all things. It's kind of this growth. It it's a switch. It's a switch. And one It it's a switch. It's a switch. And one of the things that they were saying is of the things that they were saying is that when you are fasted or you are that when you are fasted or you are calorie restricted, mTor levels are low, calorie restricted, mTor levels are low, which is true. AMPK is up. which is true. AMPK is up. >> But one of the things is mtorc1 is one >> But one of the things is mtorc1 is one complex and that's the building complex. complex and that's the building complex. [52:42] complex and that's the building complex. And then there's mtorc2 which is another And then there's mtorc2 which is another complex. and they kind of ride along the complex. and they kind of ride along the same lines, right? Nothing in the body same lines, right? Nothing in the body is completely separate. You and I would is completely separate. You and I would agree with this. agree with this. agree with this. >> And there's this big headline that >> And there's this big headline that when you inhibit mTor, you extend life. when you inhibit mTor, you extend life. And that's kind of the premise as to And that's kind of the premise as to where it comes from. And I will say what where it comes from. And I will say what it doesn't tell you is that when you it doesn't tell you is that when you chronically suppress mTor, which again chronically suppress mTor, which again there's a ton of different a ton of there's a ton of different a ton of problems with even the framework of this problems with even the framework of this is you also affect glucose. You become is you also affect glucose. You become glucose intolerant. You change your glucose intolerant. You change your lipid profile. There's all these whole lipid profile. There's all these whole host of other problems with it. So it's host of other problems with it. So it's not just muscle insulin resistance, not just muscle insulin resistance, [53:29] not just muscle insulin resistance, weakened immune system. A lot of the weakened immune system. A lot of the data in the longevity space is rodent data in the longevity space is rodent clinical clinical clinical >> was also right. So it's rodents. >> was also right. So it's rodents. >> And here's the thing that people will >> And here's the thing that people will say, well um mice are not people. say, well um mice are not people. >> The rodents used are obese model >> The rodents used are obese model rodents. They're not quote normal human rodents. They're not quote normal human subjects. subjects. subjects. >> They are feeding all day 24 hours. They >> They are feeding all day 24 hours. They are in essence a diseased model. are in essence a diseased model. >> Um so that's that's one part. And by the >> Um so that's that's one part. And by the way, mice don't die from the same things way, mice don't die from the same things we do. And I was reading, we do. And I was reading, >> they don't die of dementia. >> they don't die of dementia. >> No. Um, so mice in these landmark >> No. Um, so mice in these landmark studies of longevity, they die mostly of studies of longevity, they die mostly of lymphoma and connective tissue tumors. lymphoma and connective tissue tumors. They don't get aththeroscerosis. They They don't get aththeroscerosis. They [54:15] They don't get aththeroscerosis. They don't get Alzheimer's. And um there, you don't get Alzheimer's. And um there, you know, without getting too technical, know, without getting too technical, this is really in the scope of rapomy. this is really in the scope of rapomy. I'm sure you've heard I'm sure you've heard >> heard of it of course talking about it. >> heard of it of course talking about it. But basically they did this analysis But basically they did this analysis again this was a landmark study 2013 again this was a landmark study 2013 found that rapomyin barely touched the found that rapomyin barely touched the markers of aging in those mice but what markers of aging in those mice but what it did it was explained by suppressing it did it was explained by suppressing those specific cancers that kill lab those specific cancers that kill lab mice. mice. mice. >> I've read the >> I've read the >> I've read the two biggest longevity books that have two biggest longevity books that have come out in the last fiveish years. Um come out in the last fiveish years. Um but I don't want to name names. but I don't want to name names. >> I'm going to be offended. I've also read >> I'm going to be offended. I've also read yours and Vonda's and so what do you yours and Vonda's and so what do you think those blockbusters think those blockbusters [55:01] think those blockbusters got wrong about women? got wrong about women? >> I mean, well, first of all, the whole >> I mean, well, first of all, the whole premise that mTor suppression is going premise that mTor suppression is going to help with longevity, they've never to help with longevity, they've never worked in a nursing home. MTOR is worked in a nursing home. MTOR is necessary. This idea that we're going to necessary. This idea that we're going to suppress this one pathway and that that suppress this one pathway and that that is what's going to make us live longer is what's going to make us live longer is foolish. It is the same pathway that is foolish. It is the same pathway that is stimulated with resistance training. is stimulated with resistance training. By default, if you believed that By default, if you believed that suppressing mTor was going to extend suppressing mTor was going to extend lifespan, then you would also have to lifespan, then you would also have to believe that resistance training is believe that resistance training is going to decrease lifespan. going to decrease lifespan. >> My gosh. >> My gosh. >> My gosh. >> And the just the core fundamental >> And the just the core fundamental arguments are wrong. And ideally, it arguments are wrong. And ideally, it would just be better if someone says, would just be better if someone says, [55:47] would just be better if someone says, "Okay, I made a mistake." And perhaps "Okay, I made a mistake." And perhaps I'm looking at this wrong, but that is I I'm looking at this wrong, but that is I mean that is one of the biggest biggest mean that is one of the biggest biggest problems. And then when the data was problems. And then when the data was analyzed, there was a big 2014 study analyzed, there was a big 2014 study that talked about lowering dietary that talked about lowering dietary protein, but it was very self- selected protein, but it was very self- selected data. And when they expanded the full data. And when they expanded the full data set, it actually showed that those data set, it actually showed that those with lower protein intakes died earlier. with lower protein intakes died earlier. >> Yeah. Yeah. >> Yeah. Yeah. >> Yeah. Yeah. >> So, what are your top five, top three, >> So, what are your top five, top three, you know, things you want a woman to you know, things you want a woman to take away from this conversation? Like, take away from this conversation? Like, what would be what are things she can what would be what are things she can change in her life right now that will change in her life right now that will change the trajectory of how she's going change the trajectory of how she's going to age? to age? to age? >> Yeah. The most important thing is that >> Yeah. The most important thing is that she's strong. she's strong. she's strong. >> Okay. I don't care how you get there. I >> Okay. I don't care how you get there. I [56:32] >> Okay. I don't care how you get there. I don't care if it's um carrying your don't care if it's um carrying your children around the house and doing children around the house and doing push-ups in between, but you do not have push-ups in between, but you do not have time to waste. You must get strong and time to waste. You must get strong and you will not get bulky. you will not get bulky. The greater risk is becoming frail. The greater risk is becoming frail. Becoming bulky is not a real risk. It's Becoming bulky is not a real risk. It's like going to medical school and going, like going to medical school and going, "God, I don't want to go to medical "God, I don't want to go to medical school cuz I might get too smart." It's school cuz I might get too smart." It's never going to happen. Yeah. And neither never going to happen. Yeah. And neither is getting bulky. Right. How many women is getting bulky. Right. How many women do we know that are too bulky because do we know that are too bulky because they've been lifting? they've been lifting? >> It's just not It's a It's a inherited >> It's just not It's a It's a inherited scientific belief just like you should scientific belief just like you should wait an hour before you go swimming wait an hour before you go swimming >> after [clears throat] eating a meal. >> after [clears throat] eating a meal. That killed me as a kid. I think our That killed me as a kid. I think our parents made that up. Give themselves a parents made that up. Give themselves a break. break. break. >> The idea that women are going to lift >> The idea that women are going to lift and become too bulky is is in line with and become too bulky is is in line with that. Um, so they have to do that. They that. Um, so they have to do that. They [57:17] that. Um, so they have to do that. They have to eat their dietary protein. High have to eat their dietary protein. High quality protein, fine. If you want to quality protein, fine. If you want to choose plant-based, that is your choose plant-based, that is your prerogative. You should be then prerogative. You should be then utilizing essential amino acids if that utilizing essential amino acids if that is going to be the deal and how you are is going to be the deal and how you are going to do it. But high quality protein going to do it. But high quality protein and nutrient density are everything and and nutrient density are everything and doing it over the long haul. And the doing it over the long haul. And the third is again this could be is it going third is again this could be is it going to be hormones? Is it going to be sleep? to be hormones? Is it going to be sleep? I think the third thing is knowing what I think the third thing is knowing what you stand for and when you know what you you stand for and when you know what you stand for and you have standards then stand for and you have standards then everything else allows you to make a everything else allows you to make a good decision and be very discerning. good decision and be very discerning. >> So what do you mean by that? >> So what do you mean by that? >> I mean that with our evolving landscape >> I mean that with our evolving landscape there is so much information. People there is so much information. People have access to other people more than have access to other people more than ever before. It is noisy and if you [58:05] ever before. It is noisy and if you don't know what you stand for and if you don't know what you stand for and if you don't know what your standards are then don't know what your standards are then you will go off course and you will fall you will go off course and you will fall for anything. And as a geriatrician I for anything. And as a geriatrician I saw people at the end of their life and saw people at the end of their life and there was nothing more profound than there was nothing more profound than regret. regret. regret. >> Mhm. >> Mhm. >> Mhm. >> Not cancer, not Alzheimer's. It was the >> Not cancer, not Alzheimer's. It was the regret at the things that they didn't do regret at the things that they didn't do or the chances that they didn't take. or the chances that they didn't take. And that's why the third thing has And that's why the third thing has nothing to do with um nothing to do with um protein or muscle. I think that, you protein or muscle. I think that, you know, and why I'm writing the third know, and why I'm writing the third book, my third book on strong women is I book, my third book on strong women is I think women become whatever they've been think women become whatever they've been told to become. told to become. told to become. >> Mhm. >> Mhm. >> Mhm. >> And I don't want that for my daughter. I >> And I don't want that for my daughter. I don't want that for your daughter. don't want that for your daughter. We can get rid of the labels and you can We can get rid of the labels and you can [58:52] We can get rid of the labels and you can be relentless and you can be ambitious be relentless and you can be ambitious and you can be kind and you can be all and you can be kind and you can be all the things. I feel like in in clinic I'm the things. I feel like in in clinic I'm often often often writing a prescription for a patient to writing a prescription for a patient to put herself first put herself first put herself first to really focus on her to be to be and to really focus on her to be to be and she thinks she's selfish because she's she thinks she's selfish because she's not putting everyone else's needs. not putting everyone else's needs. >> That's like the oldest story tale that >> That's like the oldest story tale that needs to stop, right? It's like the needs to stop, right? It's like the self-sacrificing of self-sacrificing of self-sacrificing of >> like I don't have time. I'm like you >> like I don't have time. I'm like you don't have time not to do it. don't have time not to do it. >> And we >> And we >> And we >> who's gonna take care of you. >> who's gonna take care of you. >> I agree. I agree. And that starts with >> I agree. I agree. And that starts with being able to unwind that way of being able to unwind that way of thinking because it's not useful. It's thinking because it's not useful. It's dangerous. And it creates a setup for dangerous. And it creates a setup for the downfall of families. It's not it's the downfall of families. It's not it's [59:38] the downfall of families. It's not it's not selfish to be doing the things that not selfish to be doing the things that you put the standards for that you would you put the standards for that you would want your children to do. want your children to do. >> Okay. How can our listeners find you? >> Okay. How can our listeners find you? >> They can go to my website, >> They can go to my website, drgabrielion.com. drgabrielion.com. drgabrielion.com. Uh also on Instagram and our YouTube, Uh also on Instagram and our YouTube, both Dr. both Dr. both Dr. Lion, we see patients at Strong Medical Lion, we see patients at Strong Medical and um anywhere. Again, we have a and um anywhere. Again, we have a podcast which you've been on, podcast which you've been on, newsletter, the whole thing. newsletter, the whole thing. >> Okay. Awesome. Well, Dr. Gabriel Lion, >> Okay. Awesome. Well, Dr. Gabriel Lion, thank you so much for joining us on thank you so much for joining us on Unpaused. You've been an incredible Unpaused. You've been an incredible guest and I can't wait to share this guest and I can't wait to share this with our listeners. Thank you for having with our listeners. Thank you for having me. me. me. You can find full episodes of Unpaused You can find full episodes of Unpaused on YouTube at Dr. Mary Cla. Also, you on YouTube at Dr. Mary Cla. Also, you can find me on Instagram at Dr. Mary can find me on Instagram at Dr. Mary Claire and get honest and accurate Claire and get honest and accurate [1:00:23] Claire and get honest and accurate information on health, fitness, and information on health, fitness, and navigating midlife at the pausedife.com. navigating midlife at the pausedife.com. Unpaused is presented by Odyssey in Unpaused is presented by Odyssey in conjunction with Good Roommate Media and conjunction with Good Roommate Media and Longwave Digital.