#163 - Layne Norton, Ph.D.: Building muscle, losing fat, and the importance of resistance training

1. 0:00 – 0:09

   Intro

   1. PAPeter Attia0:00

      [upbeat music] Hey, everyone. Welcome to "The Drive Podcast." I'm your host, Peter Attia. [upbeat music]

2. 0:09 – 10:25

   Layne’s childhood and why he gravitated towards weightlifting and bodybuilding

   1. PAPeter Attia0:10

      Hey, Layne. Awesome to, uh, be sitting down with you today, at least virtually. Uh, been looking forward to speaking with you for actually about two and a half years. I know Dom introduced us a long time ago. We were trying to do this in person at some point, and then one thing led to another. It became COVID, and then all of a sudden I realized you don't have to be in person to do a podcast. Though I do wish we were in person, 'cause I, I suspect this will be a really long discussion, um, and a great one. Um, you know, first off, I just wanna say o-one thing that, um, I, I think people sometimes assume is that people like you and I have m- so much i-in terms of, you know, uh, viewpoints that are vastly different. And, uh, you know, I spent a lot of time reading your material and watching your videos, and I followed your work for quite some time. And I would actually say that, that, um, I-- there are very few things that I think you and I don't-- that don't, don't see eye to eye on. And, and, and maybe some of those things will come up today. I think they'd be very interesting. Um, but I also think the level of nuance and sophistication you bring to the subject matter is exciting, which is why I wanna talk with you about so many things. Um, but I kinda wanna start by letting listeners understand a little bit about who you are and, and why I think you're qualified to speak on so-so many subject matters. So I mean, let's just talk about, you know, you, you grew up in outside of Chicago, if I recall.

   2. LNLayne Norton1:29

      Actually, in Southern Indiana.

   3. PAPeter Attia1:30

      Okay.

   4. LNLayne Norton1:30

      So I'm from, uh, Evansville originally.

   5. PAPeter Attia1:32

      Okay.

   6. LNLayne Norton1:32

      So 20 minutes from Illinois and five minutes from Kentucky.

   7. PAPeter Attia1:35

      Oh, impressive. Wow. Um, [chuckles] that, that's not often you can straddle that many, uh, borders, right? Um, what kind of sports did you play growing up?

   8. LNLayne Norton1:44

      So, uh, baseball was my primary one. I, um, I played since I was five, and I lettered in high school. Um, but it was, it was-- I would never say that sports came naturally to me. It was definitely something I really had to work at. Um, and, uh, that may be apparent for my baseball aficionados out there. I was a five-foot-ten right-handed first baseman, so that's not your prototypical, uh, first [chuckles] baseman. Um, but I really enjoyed baseball, and it kinda stoked my competitive fire. Um, and then, uh, I also did run, uh, cross country in high school as well, um, which definitely not the sport that you would pick as the precursor to, uh, strength sports and bodybuilding. But, uh, those were, at the time, kind of like the ones that I sucked the least at, I guess [chuckles] is the way I'll put it, in terms of, uh, natural ability. And, um, yeah, the baseball was my real passion, though, growing up. That's what I, I really enjoyed.

   9. PAPeter Attia2:48

      Was it during baseball and, and, you know, learning to get conditioned for baseball that you kinda discovered the weight room and your talents in the weight room?

   10. LNLayne Norton2:57

       So I would actually say no. That was more so, um, I was very, very much, uh, picked on and I would say, like, borderline, like, emotionally abused by my peers growing up. Uh, I was a nerdy kid. I had ADHD. I was talkative. Um, I was goofy. And so when you're... You know, all that stuff can help you when you get older, because being different is good when you're older. But when you're young, uh, being different is not so much fun. So, um, I got picked on a lot, didn't really get much attention from girls. And, uh, just to be quite frank, I started lifting weights just to hopefully have people stop picking on me and, uh, and get some dates. And lifting weights didn't do either of those things, but, um, I developed a, a passion, uh, for weight training. And I wouldn't say it was something that, like, really, really came naturally. I was never, like, a hyper-responder or anything like that. Um, but I just, I really, really enjoyed it, and I'd always been somebody who, um, in my scholastics, I wouldn't say things really came that easy to me either because, probably a little bit because of my ADHD. Um, but I was able-- I did find at a young age that through sheer volume of work, I could overcome a lot of that stuff. And so I really appreciated lifting weights, I guess, from the perspective of the work investment to the payoff compared to how much talent was needed seemed to be a lower threshold. So it didn't... You know, if you're five foot ten, right-handed, and you're trying to pitch in the big leagues, I mean, you're gonna be pretty limited. You know? Now, certainly there are, are limitations in terms of, like, hypertrophy and, and strength building. But for me, it just, it felt more fair, I guess, in terms of the level of work you get in versus what you see. And then in terms of... I think the other thing is it's very measurable. If you go-- If you, if you lifted a certain amount today, and in two months you go in and you're lifting, you know, 10% more than that, that's a very hard outcome. There's no, there's no, "Oh, I think I'm getting better." It's like, no, I am getting better. And so I think, you know, I appreciated kind of that black and white, um, to weightlifting.

   11. PAPeter Attia5:21

       Um, you know, I can sort of, uh, appreciate so many of the things that you just said. Um, and among them is sort of an early discovery for training. Um, for me, it was, um, more boxing that was the thing that kinda drew me in young. But, but in parallel to that, strength training and endurance training both became supportive pillars to boxing. Um, I was fortunate, I think, in that I found great mentors that, you know, introduced me to powerlifting when I was young. They were older men that trained in a gym at the university that I trained at when I was 13 and 14 years old. Did you find mentors like that who kind of took you under their wing to keep you safe and also explain the sport and, you know, give you some common sense around training?

   12. LNLayne Norton6:04

       I would say the first few years, no. Actually, when I, you know, I, um, I always joke that, you know, I didn't, I didn't, we didn't have a lot of money growing up and, um, [smacks lips] you know, I didn't really have... You know, Southern Indiana wasn't really a hotbed of fitness in- information. And I, I'll go ahead and date myself. I'm, I'm 39 years old, so when I started was, you know, you know, in the late '90s. And so, I mean, basically what you had was, was bodybuilding magazines. [smacks lips] And, uh, I really couldn't afford a subscription to those either. So I actually, the first thing I ever did when I got into weightlifting was I walked down to my local library, literally walked down to my local library and checked out books on weight training. [laughs]

   13. PAPeter Attia6:44

       What... Do you remember some of the books you checked out?

   14. LNLayne Norton6:48

       Oh, man. I wish I did, but I, I don't. And actually, I would say, like, l- the, what I do remember, especially for one particular book, which was, it's kinda like basics of strength training or something like that. It wasn't that bad, actually. Um, you know, uh, we have really advanced our understanding of, of weight training, but, you know, the basics, progressive overload, that sort of stuff is, is still, still relatively similar. And I remember the book did talk about periodization, which at that time kind of was not a new concept in athletics, but for weightlifting was a new concept. And, um, [smacks lips] so anyways, like that, that was kind of like my first few years was a little bit self-guided or when I had, uh, lifting classes, they did offer a, a class on lifting in high school. It was kinda just doing what- whatever the football team was doing, basically. Uh, but obviously I still got stronger, just 'cause if you're consistent, you will get stronger regardless of, of what you're doing. Um, and then at 19, I entered my first bodybuilding competition, uh, as a teenager, and just by pure serendipity, uh, I was... I wanted to compete in drug-tested bodybuilding. Now I don't have any-- I always have to give this caveat. You know, I've always been drug-free in terms of anabolic steroids, growth hormones, you know, all that kind of stuff. Um, no performance-enhancing drugs. I don't have any problem with anybody who does it, as long as they compete in untested organizations. That's my, my caveat. I always just chose to compete drug-tested because I just never felt called to be Mr. Olympia or anything like that. And I, you know, again, I don't... This is my own personal ethos. I'm not judging anybody who's ever done performance-enhancing drugs. Um, I just wouldn't have felt good about myself. That, that's, that's the only thing I can say. And I'm not saying that anybody who's done that shouldn't feel good about themselves. I just knew I wouldn't feel good about myself. So with that out of the way, um, I was doing a drug-tested bodybuilding show, and pretty much the only natural bodybuilding, evidence-based natural bodybuilding coach lived in my hometown, and his name was Dr. Joe Klemczewski. And, uh, I reached out to him 'cause he wrote for the natural bodybuilding magazines, and, uh, he helped prep me for the show. Uh, I won the teenage division and the, the novice division, and I was hooked, of course. But also, um, he... I mean, Dr. Joe wasn't right about everything, obviously, but the, the crux of his information and being r- you know, being so focused on being evidence-based and, um, you know, not necessarily buying into dogma, that sort of thing, that definitely did help me. And just listening to him talk about, you know, the physiology of... You know, for example, uh, water depletion is something very common amongst bodybuilders. And, you know, the first meeting we ever had, he's like, "Yeah, I don't do that because, uh, I don't think it's a good idea." And he listed out all the physiological reasons why he didn't think it was a good idea. [smacks lips] And, uh, it made a lot of sense. So I... But I remember listening to that thinking, "Man, I don't know any of this stuff. Like, I would love to, to know more about this." And so I think meeting Joe, that was part of the reason that I really wanted to learn more about, uh, uh, the human body and push more in academics. And he had a PhD. And I think that was kind of like the first seed of maybe I wanna go even further than just, like, an undergraduate

3. 10:25 – 21:35

   Layne’s academic path, overcoming ADHD, and kicking Adderall

   1. LNLayne Norton10:25

      degree or something like that.

   2. PAPeter Attia10:26

      So there are actually several things in there that I wanna go back and revisit. Um, I'll start with the latter. Y- y- you mentioned ADHD. Were you s- uh, was, was school kinda hard for you? And, um, was this a big step forward to think, "Hey, not only am I gonna go to college, but I'm probably gonna wanna do a PhD to follow in this guy's footsteps"? Not, or not necessarily to follow in his footsteps, but to really go deep into something scientific?

   3. LNLayne Norton10:50

      Uh, I think by the time I got to college, I had developed really good study habits. And so let me back up. Yeah, school was difficult for me. It was very difficult for me to stay focused. But, [smacks lips] um, I, I think just through sheer effect of my parents basically beating into my head from a young age, "You are going to college, and you are going to get an education," you know, that sort of thing. And, uh, you know, not... I don't wanna sell it like it was an overbearing parent sort of thing. It was just they were very committed to my education. But it was never like, "Oh, you need to go be a doctor," or, "You need to go do this," or, "You need to go that." It was just, "We want you to get educated." And I wanted to get educated, too. I was the first person in my family, even, like, my extended family, ever to even go to college. And, um, [smacks lips] so I think the ADHD made it tough at first. And I never got bad grades in school, but I struggled in terms of the teachers would really complain about, you know, how my lack of attention, my lack of focus, uh, those sorts of things. And I, um [smacks lips] So I, I found for me, when I had to study, I really had to spend a lot more time than most of the students my age were doing. So I took, for example, um, uh, advanced chemistry in high school, and I'll never forget this conversation. We had a test coming up, and I had studied for probably a total of, like, 15 hours, I'd say, for this test, which in high school is a lot for a test, at least for me seemed like a lot. Um, and I remember talking to, uh, a friend of mine who got the same grade I did on the test, and he was like, "Yeah, you know, I studied a little bit that last night." Um, and I was thinking, "Man, if I studied just last night, I would've failed this test," you know? So it, it did seem like I had to do more work, and, and it might not even have been more work. I just... If I tried to sit down for, like, eight hours-- I remember my, my roommate my freshman year in college, great guy. He's now a, a, um, um, um, head-- He was the head of medicine at Naples General, uh, for several years. Uh, but he could sit down for eight hours straight, have complete silence, and just study the whole time. If I tried to do that, I'd get about 30 minutes of productive studying in. So I had to learn to kind of break things up, and I'm not saying this works for everybody with ADHD, but for me it worked. So I, I would get distracted so easily that I just stopped trying to fight that, and I allowed myself to get distracted, but I would always come back. So I would do 30 but no more than 45 minutes at a block. I would do that, and then I would take 15 minutes, and I would let myself, you know, browse the internet or, or read something else or watch some TV or something like that. But I would always put a timer on, and I would, I would go back when it was time, and that seemed to really work personally for me. Um, so by the time I got to college, I had, I kinda had figured out what worked for me studying-wise. And I went to a college called, um, Eckerd College, which is a private school, uh, in St. Petersburg, Florida, which was, um, you know, on the, on the, the ranking it was very selective and a high-quality school, all this kind of stuff. And so I was petrified because I'm this kid from Southern Indiana. I've never been anywhere really, and I have no idea how I'm gonna stack up against, you know, students from other places like, you know, the Northeast and that sort of thing. So I was so petrified. I studied so hard, I, I got, uh, As. I still remember this. I got As on my first 11 tests I ever had in college [chuckles] 'cause I was so petrified about, uh, failing. So I think by that point I had already had good study habits. You know, I did take, like, Ritalin and Adderall growing up, and I do think those helped a little bit. Um, the only-- [chuckles] I always joked, like, the only problem with, like, Adderall, um, is whatever I was doing when it kicked in was what I was gonna be doing for the next eight hours, you know? So if I-- [chuckles] I remember one day I was, I was looking up fantasy football rankings. Uh, it was the first year I ever played fantasy football, and that, I did that all day.

   4. PAPeter Attia15:13

      [chuckles]

   5. LNLayne Norton15:13

      Uh, all day when it kicked in. And, um, I went from worst to first [chuckles] in fantasy football that year. And, uh, so anyways, but by the time I got to grad school, I was kinda able to wean myself off that. I think the last time I ever took any medication was 15 years ago, and I think a lot of it w- you know, I don't judge anybody who takes medication for it because, like I said, I, I think it did help. But I think I just got to the point with my study habits where I didn't really feel like I needed it. And, um, yeah, so I th- I just think the fact that I had to struggle a little bit when I was young actually really helped me and kind of, like, cauterized me in terms of, like, being able to deal with some adversity. And, uh, uh, I, I think that's what really helped me when I went to college and then grad school.

   6. PAPeter Attia16:00

      So, um, I'm gonna put on the back burner for a moment some of the stuff I wanna come back to with respect to your training history and, and continue down this sort of academic thread. Um, i-i- talk to me a little bit about the decisions you made to then pursue higher education beyond, uh, a bachelor's degree and how you decided to, for example, pick a Ph.D. and then further decide what, what, what area you wanted to study.

   7. LNLayne Norton16:23

      So this is just, like, one of those things where you look back and you go, "Wow, I really stumbled into doing some of the right things," having no freaking concept of what I was doing at the time. [chuckles] So, uh, when I originally went to school, I went for-- I, I went to Eckerd because I wanted to study marine science. When I was growing up, I wanted to be a shark biologist. Like, I, like, that was my passion was sharks. Um, I still love fishing, and I still love going out and, and, and, uh, being in the wild with sharks and that sort of thing. In fact, one of my, uh, goals is to dive with a great white shark at some point.

   8. PAPeter Attia16:56

      Did you see that, uh, did you see that Nat Geo special, um, that tracked or that, that i-i- it was based on something that happened in Hawaii, I think two years ago, where that whale came ashore? They took it-- This was off, uh, Honolu- or off Oahu. They took it five miles out, and they went out there to study the tiger sharks that would be feeding off it.

   9. LNLayne Norton17:16

      Ooh.

   10. PAPeter Attia17:16

       And lo and behold, like, the largest great white ever came up upon it.

   11. LNLayne Norton17:20

       Oh, I didn't see that.

   12. PAPeter Attia17:20

       Oh, the-- You must see this. We'll link to it in the show notes. I-- This is one of those things where one day I was walking through the playroom, and my kids were fixated on it, and I sat down for two minutes to watch it, and then an hour later I'm still watching it.

   13. LNLayne Norton17:33

       [laughs]

   14. PAPeter Attia17:33

       Um, couldn't stop, but it-- I won't spoil it for you then. I'll just, I'll just leave it at that and say you will go bananas watching this thing, and it's, it's... Yeah.

   15. LNLayne Norton17:44

       Cool. Yeah, I think I watched Jaws about 8,000 times-

   16. PAPeter Attia17:47

       [chuckles]

   17. LNLayne Norton17:47

       ... when I was a kid. So, um, I probably will enjoy it. I still get excited for Shark Week whenever it comes up. So anyway, I went to Eckerd for that, and, um, I remember I interviewed at Florida Institute of Technology as well, and one of the professors there actually studied great white sharks. And, you know, he-- I'm, I'm very thankful for this guy. I can't remember his name, but he said, "Look, I'm not telling you not to do this. I'm just gonna be honest with you about-" ... what I do." He said, "I've got a job that maybe one in 10 people in the entire world have. I don't get paid great for it, and it was really hard to get. Now, I'm not saying you can't get that, but what I would recommend to you is if you're truly passionate about this, go do a degree in a more general science and then go specialize when you get to graduate school." He said, "Because if you start general, you'll still have the base that you need for grad school. Um, and if you're still really passionate about this, you're gonna need the grad school education anyway." And I thought, "Okay, well, may- that's not a bad idea." Um, and so I actually went, instead of marine science, I started in biology, and then my first year I had a general chemistry professor named, uh, Chris Schnabel, and I actually still keep in touch with him to this day, um, here and there. Um, and we were in lab one day, and I, I think he really liked me, like, just my attitude, and he said, "Layne, come here." He's like, "I, I know you're doing biology." He's like, "What you need to do is biochemistry." And I was like, "Well, why do I... I, I'm, you know, I'm a freshman. I have no idea what I'm doing. Like, why do, why do I wanna do biochemistry?" He said, "Well, let me put it to you this way." He's like, "If you decide that you don't want to go to grad school and you have a biology degree, you look like a pre-med who didn't get into med school when you go get a j- when you go to get a job." He said, "But if you get a degree in biochemistry, the world is your oyster. You can get any job that you'd be able to get in biology, you can get with biochemistry and then some. And if you want to go to grad school, you have that option," this and that. By the way, I'm not slamming on biology students out there. If you love biology and that's what you wanna do, no worries. This is just what he said. Uh, so anyways, I was like, "Okay." So I switched to biochemistry, and, um, my second year I took organic chemistry, and I had a great professor for organic chemistry. It was very hard. He was not easy, but he was firm but fair, and I, I... my... if I look back, my best mentors were always firm but fair. Um, and I got a B in the class, but at the end of the semester, he asked if I wanted to come do research with him over the summer. And I was kinda like, "Well, why do you want me? I, you know, I got a B." He's like, "You asked a lot of questions. You were engaged." He said, "Grades matter, but at the end of the day, I want students who are passionate and work hard, and I saw how hard you worked." So I went and did research with him over the summer. Um, that was my first kind of foray into research. Didn't get anything done because, you know, it, it's 10 weeks, and it's my first experience in research, so I got to deal with a lot of frustration and stuff not working. Um, but I got to do research with him, uh, for two years over the next two summers, and when I got to my junior year of college, I think having that idea of, "Okay, what happens next?" I had, I had started writing articles for bodybuilding.com. Again, that's another, whole nother conversation of serendipity. Um, and I knew I was really passionate about bodybuilding because during that time, like I said, I'd, I'd gotten into competing and whatnot. And, um,

4. 21:35 – 33:05

   Paradoxical observations about expertise, and Layne’s career transition to health and fitness

   1. LNLayne Norton21:35

      but I was thinking, "Well, I don't feel like I'm gonna be a professional. I don't feel like I really know anything." Um, I, I had just, I had crested the, uh, Dunning-Kruger and I was down in the valley, you know? [laughs]

   2. PAPeter Attia21:49

      By the way, that, that's such a great, that's such a great point to make. Why don't you explain to people who don't understand what the Dunning-Kruger curve looks like and what it means?

   3. LNLayne Norton21:57

      Yeah. So if you look at any subject, um... and I'm, I'm generalizing very much. Um, so if Dunning or Kruger listens to this, I apologize if I butcher it. But essentially, um, so the Dunning-Kruger curve is basically perceived knowledge versus actual knowledge, and the really interesting thing is when we start in a subject, since we are aware that we have no knowledge, our perceived knowledge pretty much aligns with how much knowledge we have, which is none. But pretty quickly, our perceived knowledge skyrockets. It, it goes very, very high, usually after about 6 to 12 months of, you know, being involved in a particular subject. And we get to this... Some people never get to this inflection point where it starts to come back down. But, um, eventually, if you keep learning and keep learning and keep learning, you realize, "Oh, wow, I, I, I didn't know as much as I thought I did because I thought I knew that, but then this contradicts it." And so you start having this, like, downward turn. Even though you're learning more, your actual knowledge is going up, your perception of your knowledge starts going down. Um, and I would say my third year of graduate school was where it got to the very bottom. [laughs] It's, it's where it got to the very bottom. And interestingly, if you look at the Dunning-Kruger effect, you... I have a friend named Jeremy Lindsey, he's a professor at Ole Miss, and he always says, um, [lips smack] "Once you drink from the fountain of knowledge, you will thirst for the ignorance you once had."

   4. PAPeter Attia23:28

      Mm-hmm.

   5. LNLayne Norton23:28

      And, um, you never... Your perception of your knowledge, if you continue learning, will never reach that initial crest that you had that first 6 to 12 months where you thought you had kinda everything figured out, so-

   6. PAPeter Attia23:40

      I, I just can't agree with that more. Um, Bob Caplan, uh, uh, often says, and, and I'm sure he's paraphrasing somebody, that the, the further you get from shore, the deeper the water gets. And, um-

   7. LNLayne Norton23:53

      Yeah

   8. PAPeter Attia23:53

      ... a- again, it's a, it's a slightly different way of saying basically the same idea. And, and I, I, again, I... What I thought I knew about nutrition 10 years ago relative to what I know today, in absolute terms, I know infinitely more today. But in relative terms, i.e. the perceived terms, it's basically to the point where [lips smack] I pretty much think I know nothing. Now, I know that's not true, but there are days when I think I actually don't know nothing. Because to your point, you're constantly looking for the example that contradicts your belief system. And so you have a belief system, which is, well, you know, under this condition or this condition or these set of conditions, this must be true There's always going to be an exception to that. Um, there is something else though. I, I think, I, I, I mean, I think unfortunately social media, um, has, has created a lot of people who shout really loudly from the top of the Dunning-Kruger, that, that initial peak of the Dunning-Kruger curve. And I'm not sure if it's just blind stupidity, willful ignorance, or what, but I think there are a lot of people who have no interest in moving forward, right? Um, and that's unfortunate, but, um, I think that makes it very difficult for people who want to learn because it makes the signal noise problem very difficult, you know? Um, for example, um, nobody really wants to hear uncertainty. Like, if, if, if, if someone's in the market for knowledge, do you wanna hear it from that person whose absolute knowledge is high, their perceived knowledge is perhaps low, and they caveat things that they talk about? Or do you wanna hear that person who's nine months into their, you know, resurrection of knowledge and speaks like they know everything? You know, you- you- we tend to gravitate more towards that person. So I find this phenomenon very interesting, and I just had to make sure we spent a moment on that based on your, your reference.

   9. LNLayne Norton25:49

      We had a guy named Alan Levinovitz on our podcast who's a professor of religious studies. But, um, not to get too far down the rabbit hole on that, but he, he's done a few books about naturalism and how we kind of even without evidence default to believing that something that's natural, even though he talks about how we can't really define that, um, is better. And one of the things he talked about was if you want to look for people who know what they're talking about, and it is difficult, as you said, because there's this sea of information out there, um, look for people who seem unsure. He's like, it's... He's like, it's a complete paradox, right? Because what another friend of mine, Greg Knuckles, said, he said, "What we're... What... If a..." People are really good at when they talk to somebody, quickly they can determine whether or not that person knows more about a subject than they do. What we're really bad at is if two people have more knowledge on a subject than we do and they're in disagreement, we have a lot of problem picking out who is more knowledgeable of the two, and we tend to just default to whatever our bias is. Um-

   10. PAPeter Attia26:57

       Which, by the way, is why debates tend to be a very unhelpful forum.

   11. LNLayne Norton27:02

       Yeah, I, I don't... I, I always tell people debates favor people who can speak well. Debates, debates tend to favor people who can speak well. And at the end of the day, I mean, y- well, it doesn't matter what it's talking about, religion, politics, nutrition, um, 95% of the people are going to go with whatever their perception was before the debate, and then that little 5% of the independents are, are gonna make their decision usually based not necessarily off evidence. 'Cause I mean, if you don't have a PhD in something or an advanced degree, you know, if two people are citing studies, who do, who's, who's, who, who do you go with?

   12. PAPeter Attia27:42

       Right.

   13. LNLayne Norton27:42

       You know? It's very, very difficult. So, um, yeah, so just all that to say, you know, I didn't feel like I really knew anything. It's three years into my biochemistry degree, even though I was getting good grades and didn't know what I wanted to do with my life. I knew I wanted to be in the fitness industry, like I was very passionate about bodybuilding, but I had no idea how I was gonna make a living doing that because at that time, you know, this is circa 2003, you know, the, the people who made money in the fitness industry, either you owned a supplement company, you owned a gym, you were a personal trainer, or, you know, you, you wrote for a publication or, or something like that, you know? Um, and I didn't have the capital to start a supplement company or, or the, the wherewithal to do that, and I didn't really wanna be a personal trainer. Um, and so I, I, I just kind of was like, "Well, if I go to graduate school, I'll learn more. Uh, maybe I won't feel so stupid, [chuckles] and, uh, and I can delay the real world a little bit longer, figure out what the heck I actually wanna do, um, and hopefully I won't be in the unemployment line if I have a, a master's or PhD." And that was, that was literally my logic.

   14. PAPeter Attia28:53

       Now, how did you, how did you toggle between... 'Cause I could see at that moment in time you choosing between two paths, right? You could have gone very deep down the exercise physiology path, and you could have gone very deep down the nutrition path. You chose the latter-

   15. LNLayne Norton29:07

       Yeah

   16. PAPeter Attia29:07

       ... of course. Curious as to how you thought about it at the time.

   17. LNLayne Norton29:11

       Yeah, I think probably the magazine shaped some of my bias. There was a lot of focus on nutrition as opposed to training. And even to this day, you know, this could be a little bit of selection bias, but I get a lot more questions about nutrition than I ever do about training. And even, like me, like people are like, I hear, "Well, it's 80% nutrition, 20% training." And I'm like, "Listen, I have a PhD in nutrition. I will tell you, training is the most powerful thing for your health and body composition that you can possibly do." You can eat all the protein you want. You can do all these modifications with your diet you want. If you don't train, the changes to body comp are gonna be, eh, pretty minimal. You know, in terms of you can lose fat, but you're also gonna lose a little bit of lean body mass with it when you, when you diet. Um, and you can gain lean body mass, but you're also gonna gain body fat with it. You know, resistance training specifically is the most powerful tool you have to change your body composition, and I would actually argue your overall health as well. But, um, at the time, I was very focused on nutrition, and specifically had just started kind of reading studies on muscle protein synthesis. Just, I was always a skinny kid growing up. You know, I wasn't a fat kid. I was, I was a skinny kid growing up. And so I was mostly focused on how do I build more muscle? How do I maximize muscle building? I wasn't really focused on how do I get super lean.

   18. PAPeter Attia30:32

       Wait, let me... That, that goes back to a question I wanted to ask you earlier, Layne. We kind of glossed over the fact that at 19 you win a drug-free amateur bodybuilding contest, which happened to be your first. Um, when did you start lifting weights seriously? How old were you?

   19. LNLayne Norton30:47

       [lip smack] So I started and stopped because I got my first girlfriend. [chuckles] So I started when I was, like, 15 years old, stopped when I was 16 'cause I got my first girlfriend, [lip smack] and then I picked it back up when I was 17, almost 18, and then never dropped it a- after that.

   20. PAPeter Attia31:04

       Okay, so when you go to that second pickup, give me a sense of your, your, your height, your weight, your body comp, and then contrast that with what you looked at... what you looked like at 19.

   21. LNLayne Norton31:15

       [lip smack] So [chuckles] I actually remember exactly how much I weighed. Um, I was about... I was right under 5'10". I'm now 5'10" and a half, so I essentially was pretty much stopped growing. Uh, and I was 152 pounds. And I remember that because the day I picked back up weight, weight training was in November of, I wanna say 1998. No, 1999. And it was at a Bigger, Faster, Stronger seminar that came to my school because I had decided to get back into strength training because my girlfriend had dumped me. [laughs] Very shallow reasoning.

   22. PAPeter Attia31:53

       [chuckles]

   23. LNLayne Norton31:53

       Um, and, uh, they weighed us at the Bigger, Faster, Stronger seminar. And for whatever reason, I always remember that. Now, when I started originally, I was 140 pounds. As a freshman I started lifting some weights. But at this... When I picked it up and never dropped it, I was 152 pounds. And then for my first show, [lip smack] I, I had peaked in the off-season, uh, I guess it would've been two or three years later. Would it be two, three? Been two years, two years later, uh, at 200 pounds. Um, and I competed at 175 pounds, probably something like that. Uh, and I was s- th... By that time I had grown an extra half inch and was 5'10" and a half. And yeah, so I guess it would've been about two and a half years later when I, when I hit that, hit that mark. Um, [lip smack] and, uh, you know, I did, by the end of my high school career, had gotten to be, like, one of the, I don't wanna say bigger guys in the class, but a l- a little more muscular than other people. Other people had started to notice. Uh, but specifically my upper body because my legs were still terrible. Because for the first year I didn't really train them because, you know,

5. 33:05 – 45:00

   The power of persistence and resilience in the face of setbacks

   1. LNLayne Norton33:05

      leg training sucks.

   2. PAPeter Attia33:06

      Was there a point when you just discovered you had a gift of strength? You know, I, I remember, um, talking to Mark and Chris Bell, um, and, uh, on the podcast with them I talked about these brothers that were around when I grew up. They were, they were, uh, uh, an age above me, so they weren't my peers, but by the time I was a teenager, they were in their 20s and they were always in the gym when I was there. And, um, there were four of them, and they were freaks of nature. Now, they were also all of them taking herculean doses of anabolic steroids, but I saw them-

   3. LNLayne Norton33:40

      Right

   4. PAPeter Attia33:40

      ... both on and off steroids, and the steroids simply took their God-given abilities and made them out of this world. But, uh, I, I mean, I'll never forget, one of the brothers, who at the time was in residency, he was doing his residency in emerg- i-in emergency medicine. Um, so he was very... He was... His training volume was a fraction of what it was when he was in college. He would still come into the gym between shifts, narrow grip 315 for 12 cold like it was nothing, you know-

   5. LNLayne Norton34:13

      Yeah

   6. PAPeter Attia34:13

      ... on his way to squatting 505 for twel- like, [lip smack] unwrapped, by the way. And, like, there was just a genetic gift that these guys had, and I sort of assumed, like, yes, they train very hard, but pretty early on they knew that they were strong. And it was clear just based on the hereditary nature. Did you... I mean, your, your, your, your best total's nearly 1,800 pounds, correct?

   7. LNLayne Norton34:37

      Yeah.

   8. PAPeter Attia34:38

      So again, I don't want to for a moment take away from how hard you work, because I know how hard you work, but was there something that clicked in and said, "I'm way better at this naturally than I will be at baseball"?

   9. LNLayne Norton34:52

      [lip smack] Um, so I would say actually no.

   10. PAPeter Attia34:59

       Okay.

   11. LNLayne Norton34:59

       It never, it nev- never clicked at that time. Um, there was... Because I, I never had, like, I never had a period of time where my gains were just crazy. I, I never really had that. Um, [lip smack] what happened was I saw that when I was very consistent and very steady, I had very steady increases. And so it was never like, oh, you know, we... I put, you know, 50 pounds on my bench press in six months, and it's like, "Oh, this is the thing I'm, I'm doing now." Um, it was just a very steady progression, and I think that was actually good for me, honestly, uh, because I think if I'd had a lot of success right out of the gate, I might not have pushed as hard or been as consistent because it's kind of this weird paradox with me. The harder something is, the more [chuckles] I wanna do it. Um, [lip smack] so... And I, I do see this as it comes naturally to people, and they don't have those ki- that kind of resistance early on in terms of having to overcome, like, plateaus and frustration and setbacks, and I encountered all those pretty early on. And I think having a little taste of that enabled me to push through much bigger setbacks in the future. So honestly, I can't think of a time when I ever was like, "Wow, this is..." Now, I will tell you, when I got to college and was training consistently and able to really eat consistently, 'cause even though, you know, it's calorically dense food, I was trying to build muscle. Like, that, I wasn't really concerned about the fact that, you know, um, I'm eating more calories because, one, I was using them And two, um, I just wanted to be bigger. Like, I didn't care if I put on a little bit of body fat. Um, so there was a point when I got to college where I was like, "You know what? Maybe, maybe I can do this." 'Cause I would look at, you know, some of the other, uh, the f- I'd search online to try and find any, like, teenage bodybuilders, you know? And I'd, I'd look at it, and come to find out, partly delusionally, because people on stage photos always look way less impressive than they actually look in person. Uh, but I would look at them and I-

   12. PAPeter Attia37:13

       Way, way less or way more?

   13. LNLayne Norton37:14

       Oh, way less. So if you see an actual, like, you know, competitive bodybuilder in person compared to how they look on stage in the photos, usually way more impressive in person.

   14. PAPeter Attia37:25

       In terms of their girth? Or ...

   15. LNLayne Norton37:28

       Uh, definition, muscle size, muscularity, everything.

   16. PAPeter Attia37:33

       Oh, that's so, that's counterintuitive to me. I don't really follow ... I mean-

   17. LNLayne Norton37:36

       Yeah

   18. PAPeter Attia37:36

       ... basically, I, I think the last bodybuilder I sort of paid any attention to was, um, God, well, let's see. Maybe Lee Haney. When I was a kid growing up, right?

   19. LNLayne Norton37:46

       Yeah.

   20. PAPeter Attia37:46

       I mean, I paid attention to Lee Haney.

   21. LNLayne Norton37:47

       Yeah.

   22. PAPeter Attia37:47

       And Dorian Yates. Probably after Dorian Yates I stopped paying attention-

   23. LNLayne Norton37:50

       Yeah

   24. PAPeter Attia37:50

       ... to bodybuilding. So I di- I, I, and I've never seen, uh, someone of that stature in person.

   25. LNLayne Norton37:55

       Yeah. It, it'll blow your mind. [laughs]

   26. PAPeter Attia37:57

       Wow.

   27. LNLayne Norton37:57

       It really, it really does. Um, like, obviously it's extremely impressive in magazines, and some of the gym photos that they take where the lighting is set up really well, you can look at that and go, "Okay, that's crazy"-

   28. PAPeter Attia38:11

       Mm

   29. LNLayne Norton38:11

       ... compared to even the stage photos. But yeah. So anyway, I, I had this, um ... I, I'm looking at these other guys that are about my age, and I'm like, "You know what? I'm, I ... He's a little bit better than me, but I'm, I'm kinda there. You know? I'm kinda, kinda right there." Now, again, take my legs out of the equation 'cause my legs were awful at the time. Uh, but my upper body was there, basically. And so I was like, "Okay, well maybe this thing, maybe I could be good at this," right? And, you know, come to find out, I'm sure genetics are just as important in hypertrophy as they are with hitting a baseball or shooting a basketball, whatever have you. But at the time, my mentality was this is more about work ethic and translates better. And so I was more committed to putting that energy into it. And as far as, like, strength goes and where I felt like I might have a gift, honestly, I think that a lot of my gift was ... And again, this could be just hyperbole on my part. Uh, I think a lot of the gift was I'm just really stubborn, and I could tolerate a lot of training volume. I actually today went back and looked at, uh, what I was doing before I went to the IPF World Championships, which is essentially like the Super Bowl for powerlifting. Um, and, uh, that was in 2015. And I, uh, I, I was able to get a gold medal in the squat and actually set a, a world squat record at the time, which was, uh, 668 pounds, and I weighed in at 201 and a half pounds when I hit it. And, like, I tallied up how many sets I did that week with over 500 pounds between squat and deadlift, and it was 34 sets.

   30. PAPeter Attia39:56

       The week you hit that lift?
6. 45:00 – 1:01:20

   Battling injuries, managing back pain, and setting lifting records

   1. PAPeter Attia45:00

      g- g- let's go back to when you were 19. How much could you squat, deadlift, and bench, uh, with clear... I mean, under, you know, and I don't mean bench where you're bouncing it off your chest. I mean under c- clear guidance and rules.

   2. LNLayne Norton45:13

      So the interesting thing was I was a really good bench presser in high school, and as a competitive powerlifter 15 years later, bench press was my worst lift. So I peaked early. [chuckles]

   3. PAPeter Attia45:25

      Yeah.

   4. LNLayne Norton45:25

      Um, I hit a 300-pound bench press, uh, in high school. Now, that was not with a pause. Um, if I'm thinking about what I could pause, probably would've been, like, 285 or something like that, 280.

   5. PAPeter Attia45:38

      Okay.

   6. LNLayne Norton45:39

      Um, my squat I managed... So I didn't really train squat that much because legs hurt.

   7. PAPeter Attia45:46

      [chuckles]

   8. LNLayne Norton45:47

      Um, and I, I'm l- I have... So my body type, I have a very long femur to shin ratio, as well as a shorter torso, and essentially what that's going to mean is when you squat, the bar must stay over your midfoot if you're going to not fall forwards or backwards. And so that means that I have to lean forward quite a bit when I squat. [lips smack] And so it's not a, it's not a pretty squat when I was in, when, especially when I was in high school and didn't know how to use, um, you know, hinge correctly and use my hips and whatnot. So I mean, basically I was able to squat 315 folded over, [laughs]

   9. PAPeter Attia46:24

      Mm-hmm

   10. LNLayne Norton46:25

       ... um, as a, as a, as a high schooler. So I mean, that's pretty strong for a high schooler, but it wasn't... It was barely to depth, if that, and, uh, definitely not the way you would teach it to somebody. Um, [lips smack] and as far as deadlift, I didn't really deadlift in high school. I don't think I... I'm trying to think about if I ever actually deadlifted. I think maybe sporadically, maybe I could've hit three plates, but I'm not sure. Uh, I do know that I kinda started doing it in college, and I think I hit, like, a 405-pound deadlift, you know, um, before I left college. Um, and I think when I... I want to say that I hit, like, a 385-pound squat when I finished college. So there's no... Again, you can see, like, it's not like, okay-

   11. PAPeter Attia47:14

       That's amazing

   12. LNLayne Norton47:15

       ... but-

   13. PAPeter Attia47:15

       Yeah. That's, those are very mortal numbers, right?

   14. LNLayne Norton47:20

       Right.

   15. PAPeter Attia47:20

       That's a, that's a-

   16. LNLayne Norton47:20

       Right

   17. PAPeter Attia47:20

       ... very slow and steady trajectory, um, to, to, to obviously where you are now. And it, and it, it probably reflects, um, uh, kind of muscle maturity and also technique maturity. You mentioned earlier in passing that you had a couple of herniations, both cervical and lumbar. Did any of them require surgery?

   18. LNLayne Norton47:39

       [lips smack] No. And actually I, you know, uh, I- I'm... Full disclosure, I'm not a, uh, a pain expert or a, um, you know, an orthopedist. Um, [lips smack] I think I got some really good advice to not get surgery, um, by the initial person I saw for my neck. Uh, and actually, so Dr. Joe, my coach, he was, um, also a physical therapist, and he said, "Listen..." [lips smack] 'Cause so the first doctor I went to when I had my disc herniation, I played rugby in college, and that's what I got it from. Um, I had two disc herniations, and I had lost... I remember, uh, basically I had a stinger. Um, and I couldn't even pick up a chair with my left hand in my dorm room without it slipping out of my hand. I lost about 40% of my strength on this left side. And I mean, uh, the first doctor I went to was like, "Yeah, you, you, you know, you probably won't get back all the strength that you, you had." And I remember thinking, "Why don't you just stab me in the heart instead?"

   19. PAPeter Attia48:38

       [chuckles]

   20. LNLayne Norton48:38

       You know? Like, it'd been easier. Um, [lips smack] but you know, I, I talked to Dr. Joe, and Joe was like, "Listen," you know, "you have to understand, these doctors are used to dealing with your average person who's not gonna do the rehab, who's not gonna do the work, who's not gonna push themselves." He said, "That's not you. You will get back. You will hit PRs in the future. You know, this is, this is not a death sentence for your lifting career." I said, "Okay." And sure enough, six months later I was, you know, I did the rehab and I was, I was hitting PRs again. Um, and then my lumbar herniations, I actually saw, um, uh, Stu McGill, um, who's one of the f- more well-known experts on, on lower back pain. And, uh, you know, he did a in-person assessment of me, and he basically said, "Listen, you know, you've ... Yeah, you've got, you've got some herniations, but so do about 60% of Amer- of all people who are over the age of 30."

   21. PAPeter Attia49:36

       Did you have any loss of strength going down your legs? Did you have any true sciatic pain or-

   22. LNLayne Norton49:41

       I never had radiating pain.

   23. PAPeter Attia49:43

       Okay.

   24. LNLayne Norton49:43

       I was very localized.

   25. PAPeter Attia49:44

       Mm.

   26. LNLayne Norton49:44

       But I mean, when it flared up, it was like 10 out of 10, could not get up off my floor. I mean, I, I, I tell people at my lowest point, I went from literally not being able to move off my side on my floor to squatting 668 pounds, you know, a- at a point later in time.

   27. PAPeter Attia50:03

       What was the, what was the delta between those time periods?

   28. LNLayne Norton50:06

       Uh, so with my lower back, it's ki- it has kinda been a little bit of an ongoing issue. Um, so the first time it really hit me was in 2015. Um, the first really bad incident I had was actually a week out from the Arnold Pro, and, uh, I had been crushing weights in training. I mean, I was, I was very convinced I was gonna squat like 680 or 690. I had hit 600 for five, uh, in training on squat. I had hit, uh, 675 deadlift for four. I mean, I was smashing weights. And, uh, the last heavy training session before the Arnold, so I was gonna compete on the Friday of the Arnold Classic, and the Friday before was my last heavy training session. And I finished my squats, I went to go do bench press, and I still remember, like I laid down, I was like, "Mm, I feel a little tight. That's weird." Um, and it kinda progressively got worse through the day to the point when I woke up the next day, I couldn't move. And I was like, "Oh my God, I have to pull all this meet," you know, this and that. And, uh, once the initial kind of inflammation went down, you know, a few days later I went in, I was like, all right, basically three days before the meet, I said, "I'm gonna go in and try to hit my openers, and if I can't hit 'em, then we're just gonna call it." And I hit 'em. I went and did the meet. I actually won. Um-

   29. PAPeter Attia51:30

       Uh, just so people know what we're talking about, this was a bodybuilding meet, not a powerlifting meet, correct?

   30. LNLayne Norton51:36

       No, this was powerlifting.
7. 1:01:20 – 1:10:45

   Bodybuilding vs. powerlifting: comparing and contrasting the training approaches

   1. PAPeter Attia1:01:20

      the root problem was. I guess the last question I have for you on this very specific topic before I get into a whole bunch of other things that [clears throat] we're gonna talk about, um, is the overlap and/or detraction between powerlifting and bodybuilding. So you've competed at such a high level in these two sports that have a very clear overlap, but also have a pretty different point of optimization. I mean, bodybuilding is a very subjective sport where it's about how you look, and at the end of the day, nobody cares how strong you are when you're standing on that stage. Conversely, powerlifting, which of course requires a lot of strength, um, nobody really cares how you look. So both of those athletes pay unbelievable attention to how much weight they lift, um, but they're serving a very different purpose. Um, you're one of the people who has excelled at both. I've met people who are excellent at one or the other, uh, more on the power side, I should say, than the bodybuilding side. Um, so I'm curious as to what some of the, the trade-offs are that you have to make, and, [clears throat] and sort of a hypothetical, Layne. If you... What would be the closest length of time you could have between the two if you wanted to be at your best in each?

   2. LNLayne Norton1:02:36

      Great, great, great question. Um, [sighs] so I think the overlap is that the obvious one is that to look muscular, you have to have a lot of muscle. And, um, contractile tissue is what's needed to move weight, right? So the more... There is a little bit of debate about this, but the, the consensus is, is that hypertrophy does matter for strength training, so the, the more muscle you have, the more weight you're gonna be able to lift. Um, I think that the trade-off is that bodybuilding is a much more forgiving sport insofar as exer- I mean, you can, you can skin the cat a thousand different ways. If you don't wanna squat, you can half squat. If you don't wanna half squat, you can split squat. If you don't... It is simply about creating tension on that muscle, getting the requisite volume in, uh, and progressive overload. Now, people hear progressive overload [smacks lips] and they think weight, but progressive overload takes many forms a- and the major one of which is [clears throat] volume, uh, in particular volume load, which is basically, for all intents and purposes, number of, of hard sets, number of sets that approach failure. Um, so you can do that many different ways. If you, if you're hurting on a certain exercise, hey, change it up. Try something different. Find something that you can do without pain, or find something that you really enjoy, right? There's a lot of different ways to skin a cat. When it comes to powerlifting, you can do some accessory movements and whatnot, but you still have to do the major lifts. You still have to be very well-trained at the major lifts. Otherwise, you're not gonna perform your best on meet day. [smacks lips] And so I think that bodybuilding, in a way, is a little bit more demanding mentally because the hug- Like, if you've never... If people out there listening, if you've never been, like, insanely shredded, you cannot imagine the levels of hunger and low energy that these people go through, and that I have been through. I'm talking about so hungry that you literally think about it from the moment you wake up to the moment you go to sleep, and then it wakes you up at night. Um, [smacks lips] I'm talking about such low energy that I can remember one time I was like... I had finished my training session. I was probably a few weeks out from a show. [smacks lips] I was sitting on my couch, and the remote control was probably five feet away from me, and I... There was a terrible show on-

   3. PAPeter Attia1:05:22

      [chuckles]

   4. LNLayne Norton1:05:22

      ... that I did not wanna watch, and I watched the entire thing because I did not feel like getting up to get the remote. Um, and that, that kind of serves into, like, metabolic adaptation and, and reductions in non-exercise activity th- uh, thermogenesis.

   5. PAPeter Attia1:05:38

      A- and just give people a sense, Layne, of how many calories a day you might be ingesting during that period of your training cycle, and for how long that would last.

   6. LNLayne Norton1:05:48

      Yeah. So I, you know, my last p- my last show I did, um, I competed as a pro natural bodybuilder in 2010, so it's been a while. Um, and I won the IFPA International, uh, the heavyweight division, and then I, um, I ended up doing the IFPA World Championships and placed top five in the heavyweight division. Um, and [sighs] it's, it's difficult because it's like the amount of calories you start on is not gonna be what you end up finishing on. [chuckles] Um, [smacks lips] I think the lowest my calories got was a ch- just around 1,900. Now, that may not sound that bad, but keep in mind, you know, we're talking about somebody who is, you know, probably over 185 pounds of lean body mass. You know, quite a bit of lean body mass.

   7. PAPeter Attia1:06:39

      And training how many hours per day?

   8. LNLayne Norton1:06:41

      Two hours a day, you know, minimum. Um, so I mean, that was pretty much all I had energy for. You know, I'd go in, in the gym and train for two hours, and that would be all she wrote, you know? And I, I, I'd, I'd muster up... I can remember going in and doing a cardio session one night. [chuckles] I got on the elliptical, and I started going, and the only way I can describe this is it felt soul-sucking. Um, and I went for what I felt like must have been 40 minutes, and I looked down at the clock, and it said three min- three minutes.

   9. PAPeter Attia1:07:14

      [laughs]

   10. LNLayne Norton1:07:15

       And I just remember thinking Ha, how can I do this? [laughs] Um, I mean, like so tired that like, um... Or even like I would stand up and I would get lightheaded because my blood pressure was so low, you know? It, it's a very... So I think bodybuilding's very difficult in that, that, that doesn't leave you, right? Powerlifting's difficult in that it beats your body up y- but once you're done at the gym, other than your like rehab work and some other stuff, I mean, you can kind of leave it at the gym, you know? Um, so they're really difficult sports, but for, for slightly different reasons. You know, again, bodybuilding's more forgiving in that it doesn't really matter what exercises you do as long as you get in enough, right? Um, and, and you can kind of skin that cat multiple different ways. I mean, we've, we've seen bodybuilders be successful through every different methodology. You know, Dorian Yates never squatted. I mean, he talked about it.

   11. PAPeter Attia1:08:09

       Yeah.

   12. LNLayne Norton1:08:09

       He only did leg press, right? Leg press and leg extensions. Um, whereas Ronnie Coleman, you know, squatted, you know, tons of weight. So, um, I, I, I think that the, the appeal for me for bodybuilding was that mental challenge, you know, basically how much could you suffer? Um, and then the appeal in powerlifting was this is not subjective. I mean, it is a little bit subjective 'cause you can argue squat depth is subjective.

   13. PAPeter Attia1:08:39

       Yeah.

   14. LNLayne Norton1:08:39

       You can argue that deadlift lockouts are subjective.

   15. PAPeter Attia1:08:41

       Right, but far, far less subjective.

   16. LNLayne Norton1:08:44

       Far less subjective. And I mean, I've had that, you know, the order of the, the competition is you get three attempts on each lift, and it goes squat, bench press, deadlift, and it's progressive, meaning if you pick a weight and you miss it, you can't go down, so you can only go up. Um, but I've been, I've been in those big meets where it comes down to the very last deadlift, and it's like either you pull it or you don't, and that determines if you win or not. I mean, I've had that experience. It's unbelievable. Um, and so to me, I probably prefer that only because I'm, I'm doing what I trained to do, right? Like in bodybuilding, I'm doing something different than I trained to do. What I needed to do to get to that bodybuilding stage is way different than what I'm gonna do on stage, whereas powerlifting, I'm just doing what I've done, right?

   17. PAPeter Attia1:09:38

       Yep.

   18. LNLayne Norton1:09:38

       Like this is just a showcase. So now to your question, how far apart could you do well in them?

   19. PAPeter Attia1:09:45

       And, and let me add one more question, which is what order would you pick? [laughs] You get to pick the order of which you do the two contests and what the minimum space is to optimize both.

   20. LNLayne Norton1:09:56

       So that's gonna be so individually dependent, right? Because, um, you know, for me, um, at my weight class in powerlifting, 93 kilograms or 205 pounds, I'm pretty lean at that body weight. So what I would say is that I would probably, if I was going to do this, I would do a meet... I, I maintain this body weight with some level of effort, but mostly pretty easily. Um, I would do the meet, and then I would start prepping for a show. [laughs]

   21. PAPeter Attia1:10:26

       And how much longer would you need? After that meet, how long would it take for you to be stage ready?

   22. LNLayne Norton1:10:33

       It, it depends on how hard I wanted to push it and, and what level... I- if I was wanting to really maximize lean body mass retention, I'd probably want six months-

8. 1:10:45 – 1:31:35

   Cutting weight without losing muscle mass: exercise and dietary protocols, fasting, and a look at the literature

   1. PAPeter Attia1:10:45

      Okay. Wow

   2. LNLayne Norton1:10:45

      ... I would say. Um, because what people don't realize is we look at like, we look at these diet studies, and we see how much lean body mass gets lost versus fat mass, and people don't realize that a lot of this depends on how much body fat you're starting with, and then it changes. The curve changes. So if you're somebody who's overweight or obese, you don't really need to worry about losing too much lean body mass because you have such a reservoir of energy to pull from that your body doesn't really see the need to start pulling from lean body mass. But if you're somebody who's at... And I, I'll use my caliper measurements. For all the internet experts out there, I realize that the numbers I'm gonna give you are not the true numbers, but I don't care. It's what I'm refer- It's, I'm just using it as a reference point. I always have to qualify this when I give body fat numbers. Um, so I can go from 15% body fat to 7% body fat, and it's extremely easy. No problems. I lose very minimal lean body mass. From 7% to 5%, now I'm probably losing, you know, 20% to 30% of that weight is lean body mass. When you get down to the, like, shredded area where you're just, where you're literally trying to squeeze off that last little bit of body fat, you might be losing just as much lean body mass as you are fat mass. So for me, what, what, what I would do, and I ha- I didn't do this years ago 'cause I didn't even, didn't even know about this tool, is I actually implement a lot of what's called diet breaks. So those, those would be periods of eating at maintenance. Um, so basically a, a, a level of calories where you're not going to add back fat tissue, uh, but you can eat more than you did previously. Um, so I had pretty good success with this the past year 'cause I, I dropped 30 pounds. I went up a weight class in powerlifting and then came back down. Um, and so basically I would diet for two or three weeks pretty aggressively, um, try to lose like a pound and a half, two pounds each week, and then I would take one or two or three weeks and eat just at a maintenance level of calories, which for me is about 32, 33, 3,400. Um, and that worked extremely well for me, extremely well for keeping my strength. And so if I was getting ready for a bodybuilding show, I probably wouldn't use those too much if I was, like, coming down from a higher body fat. But as I approach, as I would be approaching, um, that lower level of body fat, I would be starting to put these in more and more frequently. So that's why I would give myself so much time, even though I'd only need to drop about- maybe 12, 15 pounds from where I'm at right now, um, I would s- probably spend more time at maintenance than I did in a deficit because when you get to those low levels of body fat, the best way I can describe it is like if you have a wet towel. When you start squeezing, water comes out very easily. This is, uh, this is actually almost a perfect example of adipose tissue because if you take somebody who's overweight, obese, what do you have? You have a lot of, uh, free fatty acids getting released into the bloodstream. You have, um, very, very expanded fat tissue. So when you start, you start wringing that rag out, it, it comes off very easily. But then when you get down to the ends and you're just trying to get that last little bit of water out, to get the same amount of water out, you have to put in monumental levels of effort compared to what you did at the beginning. So I guess that's kind of a huge qualifier of why I want so much time to be at maintenance.

   3. PAPeter Attia1:14:28

      I mean, the one thing that you said, Layne, that actually surprised me, and, and I want to think about this through the lens of some examples 'cause I, I thought we could use examples of people like, you know, kind of people that y- hypotheticals or patients of mine. I, I was surprised that you said going from 15% to 7% body fat could be done without much loss of lean tissue. That is really impressive.

   4. LNLayne Norton1:14:54

      For me. Yeah, for me. Um, uh, and I think-

   5. PAPeter Attia1:14:56

      And is that, is that just a function of how hard you're training at the same time? Um, is that just something that you would attribute to your genetics? 'Cause it's, you know, it's not due to exogenous testosterone, which would obviously be one tool that would enable that kind of lean mass retention.

   6. LNLayne Norton1:15:12

      Yeah, so I think the first thing is, uh, um, it probably depends a lot on what your body fat set point is, uh, or settling point. So for those who aren't familiar, body fat set point theory is essentially that you kind of have this r- sh- relatively tight range of, of homeostatic body fat that your body will defend. Um, and once you start to drop below that range, uh, it's when you, you really start to feel the, the negative effects of caloric restriction in terms of, um, your hunger goes up, your BMR drops, your non-exercise activity thermogenesis drops, your libido drops. You start to have those negative side effects. For me, um, you know, I would say that my, again, on calipers, that the low end of my body fat set point is probably around 7% and the high end is probably around 11.

   7. PAPeter Attia1:16:09

      And how does that correlate with DEXA for you? Do you, do you know how the caliper numbers correlate with DEXA?

   8. LNLayne Norton1:16:15

      Probably about 3% more on a DEXA, I would say.

   9. PAPeter Attia1:16:18

      So kind of 10 to 14% is your DEXA sweet spot.

   10. LNLayne Norton1:16:21

       So-

   11. PAPeter Attia1:16:22

       Yep.

   12. LNLayne Norton1:16:23

       Yeah, something like that.

   13. PAPeter Attia1:16:24

       And, and in a show, by the way, you're below 4%? Is that what I would infer from what you said earlier?

   14. LNLayne Norton1:16:31

       On calipers, uh, the, the lowest I've calipered, it was like just over 2% body fat. Um, so-

   15. PAPeter Attia1:16:38

       So call it 4%, 5% by DEXA potentially

   16. LNLayne Norton1:16:41

       ... probably, probably around s- eh, probably s- maybe five or six. Yeah, something like that. Uh, and again, that's something I don't really... I let the internet worry about that because at the end of the day, it's just about the, the visual aspect, right?

   17. PAPeter Attia1:16:52

       Although I would guess, I would guess below that, Layne, because, uh, as recently as 10 years ago, I was 7.1% on DEXA. I mean, repeatedly, like 7.1 to 7.8 by DEXA, and I still remember what I looked like then. Nothing like what a bodybuilder looks like. So I would easily believe that by DEXA a bodybuilder could be 4%.

   18. LNLayne Norton1:17:12

       Possible. Uh, I, I just, I remember, uh, so there was a guy, he's another natural bodybuilder named Alberto Nunez, and if you ever saw pictures of this guy, like I'm talking like veins, visible vascularity in his glutes, right?

   19. PAPeter Attia1:17:27

       Yeah.

   20. LNLayne Norton1:17:27

       So like that, that level of leanness.

   21. PAPeter Attia1:17:29

       Yeah, yeah, yeah. That's crazy.

   22. LNLayne Norton1:17:29

       Um, and he was going... He went and got a DEXA done, and I remember he was asking people, he's like, "What do you think I'm gonna be?" And people were like, "Oh, 2%, 3%."

   23. PAPeter Attia1:17:37

       Yeah, yeah.

   24. LNLayne Norton1:17:37

       And he, and he was 6, you know, on a DEXA.

   25. PAPeter Attia1:17:39

       So the question is then I'd have to ask how much of that was visceral versus subcutaneous.

   26. LNLayne Norton1:17:44

       Possible. Uh, the, the other thing is people don't-- people need to r- appreciate is the level of error that's in those measurements.

   27. PAPeter Attia1:17:50

       Yeah.

   28. LNLayne Norton1:17:50

       You know? There, there is an inherent level of error in those measurements.

   29. PAPeter Attia1:17:53

       But yeah, that's, that's, that's counterintuitive for that level of what you describe in terms of vascularity.

   30. LNLayne Norton1:17:57

       Yeah. Yeah. So, so who knows? Um, uh, the... But I think if you are somebody who your body naturally likes to be at a little bit of a higher body fat percentage, you may see some lean body mass loss, you know, a- at a similar body fat to what I am able to retain more at, right? So, um, now this is me just completely speculating because there's so little data on this, uh, because studies are just so restrictive in terms of what you can actually measure. And I think that this is, this is another point that people don't fully appreciate is that, you know, scientific studies are really big, blunt instruments. Like you, you, you can... Y- you are really, if you're doing a scientific study, you're only supposed to modify a couple of variables, if that, because otherwise you just have no idea if what you're observing is due to the, the, the variables that you want to test. Um, otherwise you might as well just go do observational data. And so they're just... When it comes to this kind of stuff, there's so little data out there and, and, and so this kind of is pulling from my opinions based on some randomized control trials I've seen, some case studies I've seen, and some mechanistic data, some animal data. You know, and I'm, I've, I always like to tell people when I'm, when I'm kind of going out on a limb, because I don't want to state it as fact if I, if I'm not sure if it's fact. But I would say that, you know, the differences we see in how much people can retain with lean body mass Um, I think part of it's due to what their natural body fat set point level is. Um, because as we exit that lower end of our body fat set point, if the body likes to keep a certain level of body fat, um, then it makes sense that it might start pulling a little bit more energy from lean tissue compared to fat tissue if it's starting to defend, uh, that body fat. Now, there are quite a few things we could do to overcome this, like resistance training, right? Like, that's a big one. Um, and I think, uh, some of the decrements we see in, in, uh, lean body mass with dieting is, one, a lot of these studies don't, don't do, um, resistance training, or when people are dieting and they're starting to feel worse because they're lower energy, their training volume drops, their training intensity drops, and that, that's probably part of it. And I think the other thing is too, like, I will say going from, like, 15% to 7 on calipers, I did lose some lean body mass, but, you know, my relative strength didn't really change. So what's likely is, you know, a lot of... People don't realize lean body mass is not the same thing as muscle mass. L- lean body mass is all non-fat tissues. That's skin, bone, organ weight, all that stuff, and including your body water. And, uh, a lot of, I think, what we see with lean body mass loss is, um, water, um, gut tissue, liver. Um, those, those tissues shrink in response to caloric restriction. Uh, a- and so-
9. 1:31:35 – 1:44:12

   Muscle protein synthesis and the importance of leucine

   1. PAPeter Attia1:31:35

      The other thing I would say, going back to protein, that I've always struggled with, and I, I want to actually get your opinion on this, 'cause this is something that I'm, I want to know h- how much this matters both personally and also professionally for my patients. ... is I have to suspect, at least when it comes to leucine, timing must matter. And I, and I'll... in a moment, I'll come back to why I've been curious about this just based on what we now understand about how leucine and sestrin two work in triggering mTORC1. So there becomes this whole other variable, which is when we talk about plant versus animal, does it matter where in relation to training we're taking that? Does it matter, um, y- you know, meal timing specifically, training timing and, and all of those other things? Um, so, so, so let's actually maybe use this as an opportunity to now talk about kind of your work in graduate school and, and, and, and what it's taught you about muscle protein synthesis and the importance of leucine. Because I think even the most, [clears throat] you know, sort of casual observer of bro science has heard of a branched-chain amino acid. And, you know, if you click one level below a branched-chain amino acid, you'll know that there are three of them, and one of them happens to be called leucine. Um, and people, I think, would gather that somehow taking those things is good for muscle. Uh, but I-- my guess is that's about the level at which most people stop understanding it. So let's talk about what is muscle protein synthesis, what is the role of leucine, and l- and I also wanna even dive deeper into that, which is how does the body preserve leucine? What do leucine levels look like during the course of a day in response to a meal, a fast, et cetera?

   2. LNLayne Norton1:33:12

      Great question. So, um, muscle protein synthesis is basically what it sounds like. It is the, the synthesis of muscle proteins, um, from amino acid substrates. And, uh, s- you know, you can separate it in terms of, like, what you look at in research. You can, you can do what's called mixed muscle protein synthesis, which is what we did, which is where you're literally taking the entirety of a muscle, and you're grinding it up, and you're homogenizing it, and then you're, you're basically using... In the studies, we used stable isotopes to assess this. We used, uh, D5 phenylalanine, which is basically a, a deuterated, uh, one of the hydrogens on the phenylalanine is deuterated, and you can... Basically, you're looking at how much of that label gets incorporated into the m- the mixed muscle of the, of the... or, sorry, the mixed muscle, um, versus how much is in the precursor pool, which is the intracellular fluid. Um, and that rate divided by a time factor will tell you what the rate of muscle protein synthesis is. Um, and on a kind of a more broad level, protein synthesis starts in your DNA because your DNA codes for those proteins that are going to be synthesized. So for example, let's say you go and you would do a resistance training session. We know that in the response to resistance training, you have an increase in muscle protein synthesis. That resistance training is triggering something, uh, it's probably a cascade of things, that are telling your DNA, "We need to adapt to this stressor, so we are going to increase the transcription of these, you know, specific DNA sequences to the messenger R..." I'm, I'm... and I'm really, really abbreviating this, um, because you can get into introns, extrons, mRNA degradation, all this kind of stuff. But it gets trans- uh, transcribed to an mRNA sequence, which is then read by a ribosome, and that ribosome, based on the mRNA, is going to bring amino acids in and hook them together to build these new proteins. So in the case of, you know, let's say you go and you, you do resistance training. You know, myosin, actin, these contractile proteins, you're going to need those as part of your, um, adaptation to that stressor. And so those are gonna be some of the things that are gonna be built during muscle protein synthesis. Now, my work specifically was, uh, in, in animals, and I, and I'll tell you why, and you kind of alluded to it earlier. So we actually-- I have a, um, a research review that's gonna be coming out on my website. One of the things I'm very proud of is we have a 50-page guide on how to read research. And we have a Venn diagram in there. And in the Venn diagram, we have highly controlled, high subject number, long duration. And what you find is the only way you can get all those to overlap is if you do animal studies. So if you want, if you want tightly controlled and a high subject number, it's gonna be really short i- in humans. If you want, um, long duration, uh, uh, and, and tightly controlled, it's gonna be very few subjects. If you want, you know-

   3. PAPeter Attia1:36:34

      Yeah

   4. LNLayne Norton1:36:34

      ... and y- you can kinda get the gist of it. So for-- I decided I wanted to do animals because I was more kind of interested in, in s- finding out the mechanisms of this stuff. Um, and so, you know, you can do... One of the reasons I liked using rats was, one, they're a good model for human protein metabolism. A lot of the stuff in rats has then been validated in humans. There are some differences. Um, but I can teach a, a rat, I can teach a rat to meal feed, meaning they, they eat discrete meals. Um, I can get them to eat what I want them to eat, and then I can measure what I want to measure, and I can poke and prod them and do all that stu- kind of stuff as long as it's okay with the IACUC, which is basically the IRB for, for animals. Um, and so what, what we were interested in was what you kind of talked about, like how important is leucine? Because at that time, the, you know, the mid-2000s, um, there had been quite a bit of, of work done by my advisor, Dr. Don Layman, as well as the Penn State group, which was, uh, Leonard Jefferson and Scott Kimball, uh, looking at, okay, we know if we give purified solutions of leucine, they increase mTOR activity, and we see an increase in muscle protein synthesis. But one, what does that mean for complete meals where you have protein, carbohydrate, and fat What does it mean in the context of different protein sources? And then what does it actually even matter for, uh, tissue weights, right? Like, do you actually, actually see differences in, in, in, in actual tissue? And so o- one of the-- some of the work we did was, one, we looked at the duration of muscle protein synthesis in response to, uh, a complete meal. Um, and that was really interesting. Actually, that was one of the things I was dead wrong about, what I thought I was gonna see versus what I actually saw. Um, and so we saw, like even with whey, so whey protein, which is thought of as a fast protein, um, basically we saw an increase in muscle protein synthesis that peaked at ninety minutes post-meal, and then by a hundred and eighty minutes or three hours, had gone back down to baseline, which has since been validated in humans. That, that's about what we see in humans as well. Um-

   5. PAPeter Attia1:38:46

      Now, now Layne, let me just ask you a question there for a sec before you go further. Um, [lips smack] do we have a sense of after the training stimulus ends, how long that transcriptional stress is in place to continue muscle protein synthesis, provided enough substrate is available? In other words, when do we become substrate available? Uh, s-substrate limited, I'm sorry.

   6. LNLayne Norton1:39:10

      So this is really interesting because it's so hard to assess. Because so part of the reason that this stuff is so hard to measure is in humans, you basically have to have a steady state in order to measure muscle protein synthesis, because there are certain assumptions you have to make about the isotope that you're, you're using to assess it, the precursor pool, and the, the actual protein bound, um, label. And so that requires what we call a nutritional steady state. So if you want to assess, like muscle protein synthesis in response to exercise, you're gonna confound that-

   7. PAPeter Attia1:39:49

      Well, yeah, but let's-- Yeah, but let's say you could give somebody an intravenous infusion of all amino acids. So I guess there'd be two questions, right? We start with one question which says we don't care which amino acid it is, but we'll give you enough of all of them so that you're not gonna be limited by a given amino acid. And then we're just gonna give you an IV infusion, so the second you finish the highest stress workout, we just keep running it out, and then we're tracking over time muscle protein synthesis. That would be one experiment that would be interesting. And then the second one would be playing with which amino acids, um, are, are the most important there. Does that kinda make sense?

   8. LNLayne Norton1:40:25

      So w-we kinda have a pretty good idea of, like the time course of muscle protein synthesis in response to an exercise bout.

   9. PAPeter Attia1:40:32

      Okay.

   10. LNLayne Norton1:40:33

       When it comes to mixed muscle protein synthesis.

   11. PAPeter Attia1:40:35

       Okay.

   12. LNLayne Norton1:40:36

       Okay? So, so I'm, I'm gonna make a very important caveat here in a second. And it appears to be pretty similar for, uh, or sorry. So the peak, so the, the change percentage is about, it increases... Uh, it's different from study to study, but um, about 100 to 150% increase in muscle protein synthesis, that p- that, that peak is about the same for trained versus untrained, but the untrained duration lasts much longer. So it, it's still not back to baseline in studies by 48-- Well, some studies, it's back to baseline in 48 hours. In other studies, there's still a statistical difference at 48 hours. So we think basically in untrained people, it's about 48 to 72 hour response. The interesting thing is in trained people, that r- initial robust response comes back down about 10 to 12 hours, and at 24 hours is basically not different from baseline. So this is-- Now, that's for mixed muscle protein synthesis. Now, here's the rub. For myofibrillar protein synthesis, because you can separate that out during your analysis. So we're talking about actual contractile muscle proteins, because mixed muscle protein synthesis include, includes all cytoplasmic-

   13. PAPeter Attia1:42:02

       Mm-hmm

   14. LNLayne Norton1:42:02

       ... proteins, mitochondrial proteins, all these sorts of things. Mi- uh, the myofibrillar protein synthesis, they actually don't know how long it lasts because they've only assessed it up to 16 hours post, and so far neither group has returned to baseline, although they have assessed the area under the curve, and it's ac- it's greater area under the curve for untrained versus trained. Now, the rub on that is if we look at... I know you're asking about nutrient availability, and I promise we'll tie it all back in here.

   15. PAPeter Attia1:42:34

       No, no, we'll... Yeah, we'll keep, keep going with this point, though.

   16. LNLayne Norton1:42:37

       [lips smack] Um, the rub on that is none of these are addressing the other side of protein balance, which is protein degradation. Now, what's really interesting is during the first approximately six weeks of resistance training, you don't see much hypertrophy in people who are training. You see strength improvements, but you don't really see hypertrophy. And what's really interesting is in the initial kind of phases of training, you have an increase, a robust increase in muscle protein synthesis, but you also have a very robust increase in protein degradation. And so the thought process is because this is such a big stressor, a massive stressor, if you've never resistance trained before, I mean, everybody knows, like the first time they went and did a leg workout, you couldn't walk for like a, you know, few days after that. You have to completely... It's almost like your muscle's doing a complete overhaul of those, of those proteins. And so you have such a robust degradatory response because there are so many damaged proteins or, or proteins that need to be, I guess, improved, that it's almost like you're, you're doing this protein turnover futile cycle, um, kind of remodeling, and then what we see is after six weeks, that, at the end of six weeks, that increase in degradation goes way down And that's actually, I mean, again, I can't say for certain, but that coincides with when we start seeing the big improvements in hypertrophy.

10. 1:44:12 – 1:54:13

    Nitrogen balance and muscle protein synthesis, and the regulatory role of hormones for fat flux and muscle growth

    1. LNLayne Norton1:44:12

       And actually-

    2. PAPeter Attia1:44:12

       So, Layne, all things equal, sorry to interrupt, all things equal, if a person is consuming roughly the same amount of protein during that phase and their training volume and intensity is roughly the same, is it safe to say during that first period you described they are going to be in a negative nitrogen balance, uh, versus a neutral potentially nitrogen balance? Like if you were evaluating them with a nitrogen cart, like how are you... Would that show up as, uh, nitrogen excretion in that first phase? Or are they recycling it?

    3. LNLayne Norton1:44:41

       So prob- probably not. Probably not. It's probably gonna be pretty... They're probably gonna be nitrogen positive a little bit.

    4. PAPeter Attia1:44:48

       Okay.

    5. LNLayne Norton1:44:49

       Um, but here, here's where this stuff gets so, so complicated because we know that in muscle protein synthesis, about seven out of every eight amino acids used to create a new protein are recycled from degraded proteins. So when we look at, okay, exogenous amino acids or exogenous dietary protein, and we think about it as muscle build- building, I think most people think about, "Okay, I'm eating this protein and this is going to get incorporated into my tissue, and that's what's gonna make me big and strong." Eh, [chuckles] it's a lot more complicated than that. In fact, about the most amino acids you can deposit in muscle tissue, if you... Let me back up. If you look at somebody who added 50 pounds of muscle tissue in a year, right? That's a ton of muscle.

    6. PAPeter Attia1:45:46

       Yeah.

    7. LNLayne Norton1:45:46

       Even for somebody on steroids, I think we can agree that's a ton of muscle. When you account for the fact that muscle tissue is about 70% water and about 30% protein, you're basically looking at about 10 grams of amino acids deposited in muscle per day. It's very underwhelming. Oh, I'm sorry, sorry. That'd be for about 25 pounds of muscle a year, I think. Um, still extremely impressive.

    8. PAPeter Attia1:46:08

       Sure. But, but there are two different points there that I want to get at. The f- the first point is the one you're making, which is no matter how much muscle mass you put on, you're... it's never gonna be impressive relative to the amount of amino acids you took in. There's a second point you're making, which I find even more interesting potentially, which is the actual fate of the ingested amino acid and how much is being recycled versus not. So the analog here, but you're gonna love this, Layne. I didn't even think this would come up, and I know you're gonna love it. You want to know my favorite thing that drives me nuts about people when they just rave about a ketogenic diet? Is the differentiation between re-esterification, lipolysis, and fat oxidation. So here's the example, right? If you're on a ketogenic diet and you're mainlining fat, you can very easily gain weight because if you're ingesting so much fat that it exceeds your ability to oxidize fat, regardless of where that fat source is being oxidized, meaning endogenous versus exogenous, it doesn't really matter. And in fact, a ketogenic diet can still produce a ton of fat oxidation without oxidizing the endogenous source that you want to oxidize in the first place. And by the way, a lot of the triglyceride con- con- contained within the adipocyte gets recycled, so it can be liberated as free fatty acid and then be re-esterified with glycerol back into it. So actually it, it becomes kind of a nice analogy here.

    9. LNLayne Norton1:47:45

       It 100%-

    10. PAPeter Attia1:47:46

        I just don't think I knew it was true on the amino acid side as well.

    11. LNLayne Norton1:47:50

        Yeah. So you're, you're making an analogy that is, I don't know if I've ever used it before, but it's, it's b- it's bang on. I mean, there, there's differences of course.

    12. PAPeter Attia1:47:58

        Yeah.

    13. LNLayne Norton1:47:58

        But, um, I think a lot of this boils down to people think of metabolism as like on and off switches, and it's like that's... think about like dimmer switches, like nothing... People think like when you're losing fat, that means that fat burning is ramped up and, you know, fat storage is all the way down at zero. No. [chuckles] You are always burning and storing fat simultaneously. Um, same thing. You are always synthesizing protein and degrading it at the same time. Now, it's the relative rates of each that are going to determine if you deposit versus, uh, lose fat or protein.

    14. PAPeter Attia1:48:42

        So, so let me then bring it back to that analogy, 'cause I just did a podcast on this with Bob, uh, Kaplan recently, and we talked about it in terms of fat flux. So we talked about three states, a person who is in neutral fat flux, so they are neither gaining nor losing fat tissue, negative fat flux, and positive fat flux. So you're either gaining fat mass, losing fat mass, or maintaining the same. And we talked about it through the lens of, um, de novo lipogenesis, re-esterification, lipolysis. Note, none of that says anything about oxidation. That's happening outside and that can feed into substrate pools. What we then talked about was how many hormones are regulating these different steps. So what happens when insulin goes up and down? What happens when epinephrine goes up and down, when norepinephrine goes up and down, when hormone-sensitive lipase goes up and down, when cortisol goes up and down, testosterone, lipoprotein lipase, et cetera? So in other words, these are all regulated hormonally, some of them outside the cell. So insulin obviously is acting outside the cell. Uh, you know, LPL is outside the cell, HSL inside the cell, et cetera. Tell me about the hormonal regulation on the same unit of muscle. Um, the most obvious difference, of course, is that testosterone works inside the cell, right? So let's start with testosterone, but then I want to, uh, I want to talk about all of the hormones that impact this. Specifically, I want to make sure we at least touch on cortisol and estradiol at some point, but let's start with testosterone because it, it plays such an important role in that transcriptive drive.

    15. LNLayne Norton1:50:18

        Yeah. So I think the, the one thing I want to say before we, before we start on this is keep in mind that when we're talking about all these hormones, and this goes for fat tissue or muscle tissue, what you are seeing on the surface in terms of the actual outcome is the result of the summation of all of those signals, right? So people get hung up on, say, insulin, or they get hung up on, uh, leucine, or they get hung up on, you know, one particular thing, and then they get confused when they see a paradoxical outcome, right? So a, a great example of that is, uh, you know, Kevin Hall's study on, uh, uh, fat loss looking at, um, you know, where they showed that insulin was 26% higher, but those people actually ended up losing a, like an... I would s- call it a non-significant, uh, greater amount of actual fat mass than people who are on a ketogenic diet. [smacks lips] And people say, "Well, how can that be true?" Right? And it's like, okay, well, you got to remember that insulin is just one input. It's, it's not the only input, and the same thing goes for building muscle and muscle tissue. So with regards to testosterone, what's interesting about testosterone is, uh... I actually reviewed a study recently where-

    16. PAPeter Attia1:51:30

        Yeah, the study by Stu Phillips that looked at androgen receptor density.

    17. LNLayne Norton1:51:34

        Yeah. So that's-

    18. PAPeter Attia1:51:35

        Which by the way-

    19. LNLayne Norton1:51:36

        Again, we-

    20. PAPeter Attia1:51:36

        ... I still don't understand something, which I'm hoping you can explain. Why would androgen receptor density be higher in someone getting exogenous testosterone? You would think that someone taking exogenous testosterone would have a paradoxically negative response in that they would down-regulate androgen receptors. I'll let you [smacks lips] maybe go back and explain it from the beginning because m- the listener might not be familiar with the, the thesis of the work.

    21. LNLayne Norton1:52:01

        Yeah. So essentially, you know, when you have, um [smacks lips] uh, w- when testosterone gets into the cell, it's converted and then that, uh, end product binds with the androgen receptor, [smacks lips] and then it can attach to the DNA, increasing transcription of, of different proteins, right? So, so basically you're ramping up your capacity for, uh, amongst other things, increasing muscle proteins. Um, that's different than how leucine acts nutritionally because leucine is a signal also that happens inside the cell, but it's more of a short-term signal. Um, [smacks lips] now w- to answer your question specifically, the... What I've seen proposed is that when you have enough testosterone available, what tends to happen is the androgen receptors upregulate to meet the demand for metabolizing that testosterone, m- and that the conv- the regulation of the excess testosterone, think about the negative feedback loop, functions more so on like luteinizing hormone and, and, and the gonads-

    22. PAPeter Attia1:53:12

        Yeah. Yeah

    23. LNLayne Norton1:53:12

        ... and that sort of thing, right?

    24. PAPeter Attia1:53:13

        Yeah.

    25. LNLayne Norton1:53:14

        So I, I... If I had to hazard a guess, that would be my guess, that the, that the regulation in terms of trying to tamp that down... Because think about if you're not getting exogenous testosterone. If you're not getting exogenous testosterone, then there's probably not that same negative feedback regulation loop. And so I always hate it when people go, "Well, it makes sense," because there's tons of stuff in metabolism. They say, "Well, it makes sense," and then it ends up not working out in the study. But to me it would make sense that the muscle might increase its androgen receptor density to meet that testosterone load or that free testosterone load, so long as you're not having so much testosterone that's not negatively feeding back to the gonads and luteinize, uh, or reducing luteinizing hormone or increas- increasing aromatization, those sorts of things. And I will straight up say I am not a testosterone expert, so I could be getting this stuff

11. 1:54:13 – 2:03:45

    What’s really driving muscle growth: intrinsic vs. systemic factors, IGF, and hormone signaling

    1. LNLayne Norton1:54:13

       dead wrong. But I think the more to the point of Stu Phillips' work is that [smacks lips] muscle growth appears to be mostly intrinsically regulated. And I think in the late '90s, early 2000s, what people were really focused on was systemic, what they thought was systemic regulation of muscle growth, right? Your, your systemic levels of testosterone, IGF-1, and even like the acute responses, like we know, for example, resistance exercise will increase testosterone, you know, f- for 30 or 60 minutes. And it used to be thought, well, that is what's, that is what's driving these responses of hypertrophy. And through a few elegantly designed studies, a lot of them by Stu Phillips, uh, we know that that's probably not the case, that this is probably an effect of tension. Now, what's interesting about muscle growth is if we're going to have that tension that's driving muscle growth, there has to be a translation of that contractile force into a chemical signal. So we call that, um, me- mechanotransduction, right? [smacks lips] And so this is where I know you, we had talked about it a little bit earlier, mechano growth factor probably comes in. So IGF-1, systemic IGF-1, and growth hormone are not anabolic to skeletal muscle. People don't realize this.

    2. PAPeter Attia1:55:35

       Let's, let's pause here 'cause this is... I want to make sure people understand what we're talking about, and this is such an important topic. I don't want to rush it. So let's, let's go back to the beginning and assume that the listener here doesn't fully understand where growth hormone comes from, right? And where it-

    3. LNLayne Norton1:55:51

       Yeah

    4. PAPeter Attia1:55:51

       ... what it does in the liver, what IGF does. So, so let's, um, let's go back and explain the, you know, the endocrine versus... Well, we'll get to the endocrine versus autocrine function of IGF but, but, uh, just back up two steps with where you are, Layne, and, um-

    5. LNLayne Norton1:56:06

       Sure.

    6. PAPeter Attia1:56:07

       Yeah.

    7. LNLayne Norton1:56:07

       So we know that, like, growth hormone increases in response to certain things like fasting, um, [smacks lips] uh, uh, resistance training, exercise in general, um-

    8. PAPeter Attia1:56:18

       Sleep potentially.

    9. LNLayne Norton1:56:19

       Sure, sure. All those things, right? And people kind of looked at that as, "Okay, well we should be aiming to increase gr- growth hormone for these things." And we know that growth hormone increases the liver production of IGF-1. And IGF-1 has always been thought of as kind of like the master hormone that is increasing muscle mass. When they look at studies, even where they give exogenous growth hormone, what you see is you see an increase in lean body mass, but not an increase in skeletal muscle mass. So the increase in lean body mass is completely accounted for by an increase in, in body water and connective tissue. So now you can argue there might be some benefits to connective tissue and that sort of a thing.

    10. PAPeter Attia1:56:58

        And, and I would argue organ weight as well, right? I mean, we see, we see-

    11. LNLayne Norton1:57:02

        Uh, possibly. Yeah

    12. PAPeter Attia1:57:02

        ... yeah, we see, we see liver hypertrophy and other, other things like that as well.

    13. LNLayne Norton1:57:07

        So when it comes to growth hormone, I actually had a article about this years ago on my site about how growth hormone wasn't anabolic, and I got a lot of bodybuilding dogma people getting, uh, really upset about that, um, because they don't understand, and this is pervasive even amongst scientists, people who don't understand the concept of a localized response versus a systemic response, or people who don't understand an acute response versus a chronic response.

    14. PAPeter Attia1:57:33

        We're gonna talk about this with respect to cortisol as well.

    15. LNLayne Norton1:57:36

        And mTOR signaling, I'm, I'm sure.

    16. PAPeter Attia1:57:38

        Yeah.

    17. LNLayne Norton1:57:38

        So growth hormone, not anabolic to skeletal muscle, uh, and the growth hormone response to exercise appears to be mostly substrate driven, that it's, that growth hormone probably increases as a response to exercise to increase lipolysis to liberate free fatty acids for use, uh, uh, as an energy substrate. Now, here's where people get confused. The IGF-1, the autocrine IGF-1 that is released by the muscle tissue itself in response to mechanical tension is very anabolic.

    18. PAPeter Attia1:58:19

        So let, let me just explain for a moment to people the difference between endocrine, paracrine, and autocrine. So the endocrine function of something is when a hormone gets released and its effect is all throughout the body. So, you know, uh, insulin is a great example, right? So the pancreas, the beta cell releases insulin, insulin goes and acts on all sorts of cells in the body. Paracrine is when something, when a hormone gets released and it only impacts the cells right next to it. And autocrine is on itself, as you would guess. Now, going back to what you said earlier, the, uh, I- the one way we explain this to patients is IGF-1 is the integral of growth hormone. So if you wanna get a sense of how much growth hormone is floating around, eh, to a first order approximation, you get a sense of how much IGF somebody has. You get a sense of how much IGF is being produced by the liver. And to your point, that's all systemic or what we would really think of as an endogrin, an endocrine IGF. Now what you're about to talk about is something that, you know, frankly never really gets talked about.

    19. LNLayne Norton1:59:25

        Yeah. So IGF-1, autocrine or paracrine IGF-1 that gets released by the muscle tissue itself is also called mechano growth factor, and that is very anabolic to muscle tissue. But again, it's a very localized intrinsic response. And it makes sense from, to me, again, here we go-

    20. PAPeter Attia1:59:48

        [laughs]

    21. LNLayne Norton1:59:48

        ... it makes sense. From a teleological perspective, if you place a stress on a particular muscle tissue like your, your legs, it does not make sense to me that your arms will grow. Because you may not need your arms. [laughs] Like if you're, if you are a, I don't know, if you're a tribe and you're having to climb something in the, whatever, you know, and you're using your legs much more than your arms, muscle tissue is an energetically expensive tissue to maintain. It takes more energy, more ATP, more calories. It is a futile cycle, meaning that to maintain it, you actually have to increase synthesis and breakdown because you're having more proteins that are misfolded and whatnot that need to be broken down. That whole thing takes more energy. And so that's why we tell people, "If you wanna be able to eat more calories, hey, build some more muscle, because to maintain that takes more." Um, so it does not make sense from a evolutionary perspective, because evolution doesn't care if you're jacked. It cares if you can live long enough to pass on your genetic material. Um, it does not make sense that you would build a different tissue in response to a localized effect of training. A- and that, we, we, we see that. We see that if you train your legs, your arms don't get bigger. Uh, we, we know that. Um, and if you train one leg, the other one doesn't get bigger, right? In fact, some of the best resistance training studies are where they use unilateral training and the person's non-trained leg serves as the own individual's control, because you're accounting for genetic variations by doing that. Um, so yeah. And then we have, uh, another probably component of mechanotransduction is probably phos- uh, phosphatidic acid. So phosphatidic acid is stored in the Z-disc of the skeletal muscle, which if you look at a... All right, let's back up. [laughs]

    22. PAPeter Attia2:01:41

        Yeah, let's remind people how actin, myosin work, and then where the Z-disc-

    23. LNLayne Norton2:01:45

        Yeah

    24. PAPeter Attia2:01:45

        ... fits in. 'Cause I, I, I forgot.

    25. LNLayne Norton2:01:46

        Right.

    26. PAPeter Attia2:01:47

        You and I got so into the weeds, I, I, I sh- it was my bad. I should have reminded us-

    27. LNLayne Norton2:01:50

        Yeah

    28. PAPeter Attia2:01:50

        ... that we should go back and-

    29. LNLayne Norton2:01:51

        That's okay. That's okay. This is fun for me.

    30. PAPeter Attia2:01:53

        [laughs]
12. 2:03:45 – 2:16:53

    The role of protein, carbohydrates and insulin on muscle growth and preservation, and the importance of context when interpreting study results

    1. LNLayne Norton2:03:45

       side of things. Uh, in fact, there ... If you look at studies looking at carbohydrate ingestion, we don't really see increases in muscle protein synthesis. So if you just give pure carbohydrate, even up to, like, 100 grams of glucose, even though you get a, a pretty good rise in insulin, it, it doesn't seem to affect muscle protein synthesis. But it does seem to, uh, inhibit protein degradation. In fact, there was a study in resistance training, I think out of Bob Wolfe's lab in, like, 2004.

    2. PAPeter Attia2:04:14

       Hmm.

    3. LNLayne Norton2:04:15

       And they did what's called AV balance. So arteriovenous balance is where basically you're infusing a stable isotope, and you're looking at essentially how much of that label is going into the muscle and then how much is coming out, right? And so you can determine the net balance. And if you take a biopsy as well, you can determine the fractional rate of protein synthesis, and then by basically subtraction can determine what breakdown is. So what they saw was when they gave a large amount of carbohydrate to people who had resistance trained, they went from a negative protein balance to almost, uh, to, to ba- or, sorry. They went from having, uh, an increase in muscle protein breakdown to basically back to baseline in muscle protein breakdown, and synthesis didn't change.

    4. PAPeter Attia2:05:02

       Now, now Layne, if you did that in combination with protein, would that be a better strategy to hit it at both ends, where you would reduce degradation and increase synthesis? And is that an argument for combining carbohydrate and protein after a resistance training as opposed to just protein?

    5. LNLayne Norton2:05:20

       [sighs] So here's where it gets very complicated, because there probably is some degradation that is needed in order to remodel and actually-

    6. PAPeter Attia2:05:29

       Hmm

    7. LNLayne Norton2:05:29

       ... make things better. Um, however, really we need to go to kind of the hard outcome studies. So there's only really two studies I know of that examined, like, a protein and calorie equated, um, low carbohydrate diet versus a protein calorie equated non low carbohydrate diet. And it was a k- it was ketogenic, so they measured blood ketones and, and saw they went up. Um, and this was I think 12 weeks. It was by, uh, uh, somebody, um, uh, Vargas was the author.

    8. PAPeter Attia2:06:02

       Okay.

    9. LNLayne Norton2:06:03

       And they did see less lean body mass accrual in the ketogenic diet group. Now, they still increased lean body mass. That's important to note. Um, but the group that was getting carbohydrate or more carbohydrates had more lean body mass. Now, the caveat to that is carbohydrates have, make you store glycogen. So was it just water, or was it contractile tissue? Now, in the second study, they did see a difference in, uh, like one rep max squat and I think bench press as well. So that kind of suggests that perhaps there is something different in terms of actual contractile tissue, but this is an area that's gonna be, need to be studied a lot more. And again, I don't want anybody to straw man what I'm saying. I'm not saying you can't build muscle on a ketogenic diet. You absolutely can. You can probably build a really good amount of muscle. But can you build as much as if you're including carbohydrate? Possibly not, and it may have something to do with carbohydrates' effect or insulin's effect on blunting muscle protein breakdown.

    10. PAPeter Attia2:07:07

        The other thing I- I'll add to that, again, based on my experience, and, and you've probably talked about this with Dom, is I think one of the challenges of studying ketogenic diets is the length of time it takes to adapt to them. Um, I, I went on a ketogenic diet in May of 2011 as an experiment, and I was committed to doing it for 12 weeks. And, uh, I mean, five weeks in, I had... I was so miserable. My wife was like, "What are you doing and why?" And you know, you know, all the standard mistakes I was making, and, and the first being I made no reduction in training volume, and I was already training at the level of a maniac, right? So I mean, ridiculous training volume, and I made zero reduction in it. And I was, I mean, just staggeringly and upsettingly miserable. And at 12 [laughs] weeks, I finally crested the first hill, which was the aerobic hill. So at the time it was cycling and swimming were the two sports. And I, at 12 weeks, I just got to the point where I could get my aerobic base back to where it was 12 weeks earlier. But anaerobically, I was nowhere near what I was 12 weeks earlier. Um, I won't put you on the spot and make you guess, but if I were gonna make you guess, how long do you... Well, first of all, I decided to stay with the diet because I became so interested in the physiology of it. Um, and I wanted to see, like, what is it gonna take to return back to my previous level of anaerobic fitness. It took 18 months. And I wanna be clear, this is 18 months without one day of deviation Um, I would end up staying on this diet for three years with one day of deviation. My, my wife's birthday, I ended up having a bunch of cake. But, um, for three years to stay on this one in, you know, incredibly restrictive diet, um, it took half of that period of time just to get back to where I was anaerobically. Um, so it speaks to how difficult I think it is to study any of this stuff. And, and by the way, was I perfectly controlling my exercise during that period of time? No. It's quite possible that some of those changes had to do with other variables. So, um, I don't know. I... Sometimes I just think this, this stuff is so complicated, we should, we should focus on the biggest picture questions and, and try to get at them. But then there's times when we get into discussions like this and I'm like, "No, these details are the most interesting part of this," right? Um, especially on this side of the equation 'cause this is, this is an area I know so little about. That's why I was very excited to dis- discuss it with you.

    11. LNLayne Norton2:09:47

        Yeah, so I, I think that, you know, for, for the majority of the audience, I think that... And that's why I try to provide so much context when I talk about this stuff, and I, I don't talk about the ketogenic diet study and also not say, "Hey, you can still build muscle on it," right? Because I don't want people to take away, "Layne said you can't build muscle on a ketogenic diet," and then they go out and they see somebody who built a bunch of muscle and they go, "Okay, well this doesn't make sense," right? So I think that's why the, the, the nuance is very important. Like you said, we're, we're in the details, right? Because that's what's interesting to us because we kind of hopefully know some of the, like, the major things, right?

    12. PAPeter Attia2:10:19

        It's the same as testosterone, right?

    13. LNLayne Norton2:10:20

        Yeah.

    14. PAPeter Attia2:10:20

        You could say the same thing. You'd be like, "Do you need to take exogenous test- testosterone to be a bodybuilder?" Nope. Look at all the examples. But if your goal is to be the biggest, the strongest, I have news for you. Go and get yourself test- some testosterone cypionate and get ready to start smacking 1,000 milligrams every single week.

    15. LNLayne Norton2:10:40

        [laughs]

    16. PAPeter Attia2:10:40

        I mean, that's the reality of it, you know? So, um-

    17. LNLayne Norton2:10:42

        Yeah

    18. PAPeter Attia2:10:42

        ... a- and again, that- that's spoken without prejudice. It's simply biochemistry.

    19. LNLayne Norton2:10:47

        Yeah. And, and anecdote plays into this, and anecdote is important and, and I'm about to discuss yours a little bit, but I always tell people, like, be- just be, be cautious with anecdote. I'm not saying that your anecdote doesn't matter, but what I am saying is everyone knows somebody who smoked every single day of their life till they were 90, right?

    20. PAPeter Attia2:11:03

        Right.

    21. LNLayne Norton2:11:03

        And lived to a ripe old age. Does that mean that it's okay to smoke, or do we think that's the best thing for longevity? We certainly do not.

    22. PAPeter Attia2:11:11

        Right.

    23. LNLayne Norton2:11:11

        Right? So when we're, when we're making broad recommendations, we're doing that based on the consensus of the evidence. But we un- we also need to understand that there will be outliers that fall outside that, and that's where, you know, individualization comes in. So I think one of the things that we really are struggling with right now, and I've, I kinda challenged the low carb community on this a while back because one of my pet peeves is I'm not saying that there's not such a thing as a ketogenic adaptation or fat adaptation that may take longer. What I'm saying is we need a, a hard metric for it. We, we really need some kind of hard metric to explain this because if we look at things like, okay, let's look at blood ketones.

    24. PAPeter Attia2:11:50

        Yeah, it's clearly not that.

    25. LNLayne Norton2:11:52

        Well, a couple days really.

    26. PAPeter Attia2:11:52

        Yeah, yeah. It's clearly not blood ketones.

    27. LNLayne Norton2:11:54

        Right.

    28. PAPeter Attia2:11:54

        It's not lipolysis. It's not... I mean, my only regret-

    29. LNLayne Norton2:11:57

        Right. 'Cause and we see fat oxidation. Fat oxidation within six days-

    30. PAPeter Attia2:12:00

        Yeah. No, no
13. 2:16:53 – 2:24:30

    Clarifying the role of cortisol—a misunderstood hormone

    1. PAPeter Attia2:16:53

       and look at that. I wanna change gears for a second and come back to this cortisol thing 'cause I think this is a very misunderstood hormone. Um, and I know you've written-

    2. LNLayne Norton2:17:02

       For sure

    3. PAPeter Attia2:17:02

       ... about this, and I think it's worth getting the listener up to speed on cortisol. Um, we tend to look at this very black and white. Um, so let's give the extremes. So there's something called an Addisonian crisis, right? Someone gets a bad infection. They have an injury to their adrenal gland. They can't make cortisol acutely. They're going to die. They are hands down going to die. The only way to rescue that patient is to give them massive doses of hydrocortisone or hydrocortisone equivalent, um, and that very much speaks to the medical necessity of cortisol. Let's look at the other extreme. Uh, let's look at Cushing's disease. Uh, so you can have Cushing's disease or Cushing's syndrome, where either at the pituitary gland or at the adrenal gland, rampant amounts of cortisol are made, and nobody would dispute the pathology of that state. This is a person who develops, um, uh, basically a ball of fat on the back of their neck that's basically the size of a basketball, excessive fat accumulation, um, all sorts of metabolic dysregulation. Again, nobody would dispute that, that that is a problem. Um, fortunately, very few people are in either of those states. So-

    4. LNLayne Norton2:18:16

       Right

    5. PAPeter Attia2:18:16

       ... let's now talk about physiologic levels of cortisol and their impact on muscle protein synthesis and something you said earlier, which I found very interesting, which was, uh, tolerating pain, pain threshold, training resilience, and things like that.

    6. LNLayne Norton2:18:33

       Yeah. So we have to think about the function of cortisol at its root, which is a stress hormone, right? So you're, you're secreting hormo- so cortisol in response to some kind of stressor. Um, when it comes... Again, so this is, this is a great example of acute versus chronic, okay? When it comes to somebody who's getting very low sleep, um, overall unhealthy lifestyle, you know, smoke, whatever, they're gonna have high levels of cortisol and, and that can be problematic from the... or very, like, high levels of stress because now, like think about what stress used to mean. Stress used to mean, "Oh, crap, there's that thing that's gonna kill me. I need to run." And so your body would produce cortisol for a myriad of different reasons. A part of that was just a fuel mobilization response. It, it mobilizes glucose, free fatty acids, those sorts of things. Um, it's just trying to get as much fuel in the bloodstream as it can. Now, when you, when it comes to, uh, Cushing's, for example, because, or at least my best guess is, and there may be studies on this, I haven't looked super in detail on it, my best guess is it's not necessarily that you're accumulating fat. You're redistributing it, right? Like, it's going to weird places.

    7. PAPeter Attia2:19:48

       That's right. The legs become incredibly thin. The abdomen and the upper back become incredibly full.

    8. LNLayne Norton2:19:55

       Right. So you actually see this in like, um, people who have, uh, oh God, what do you call it? Um, why can't I think of the name? Um-

    9. PAPeter Attia2:20:05

       Lipodystrophy

    10. LNLayne Norton2:20:05

        ... liposuction.

    11. PAPeter Attia2:20:06

        Oh, liposuction. Okay. Yeah.

    12. LNLayne Norton2:20:07

        So your adipose doesn't just sit on nothing. It sits on the extracellular matrix. Um, if you do liposuction, it destroys that matrix, and so people go, "Oh, well, you can't gain fat back." But you can't gain it back there. [laughs] But you start... If you regain it, you start gaining it in very odd places. And so what you're looking at is a redistribution because cortisol, going back to cortisol, if you have high cortisol because you're stressed constantly, and your, your body is still operating on genes from, you know, a million years ago that's telling you, "We're stressed. Must be something coming to kill us. [laughs] So we're gonna liberate a bunch of energy into the bloodstream," well, well, then it's still got... If you're not gonna use it, if it doesn't get used, it's gotta be put back somewhere, right? And so now you can have it started to be deposited in, in strange places possibly. Now, when it comes to exercise specifically, it's a stressor. Exercise is a stressor. Makes sense that it would increase your cortisol. Um, but people have kind of taken this, say, "Well, we need to limit cortisol as much as possible." So remember there used to be the old... I don't know if you remember this, but it was like, "Don't train more than an hour because at that point, cortisol starts to go up, starts to spike."

    13. PAPeter Attia2:21:22

        I, I missed that entire memo and school of thought fortunately. [laughs]

    14. LNLayne Norton2:21:28

        [laughs] So interestingly, so we've, we've referenced Stu Phillips a few times now. He did a study, I wanna say 10 years ago, and looked at, uh, different hormones and how they associated with actual hypertrophy. So he looked at, uh, s- uh, sorry. So the post-exercise increases in systemic hormones. So he looked at testosterone, IGF-1, growth hormone, cortisol, um, and I think that was it. Guess which hormone was most closely associated-

    15. PAPeter Attia2:22:01

        Cortisol

    16. LNLayne Norton2:22:01

        ... with hypertrophy?

    17. PAPeter Attia2:22:01

        Absolutely cortisol, hands down. But of course-

    18. LNLayne Norton2:22:03

        Cortisol

    19. PAPeter Attia2:22:03

        ... I'm, I'm familiar with the paper, but yes. Uh-

    20. LNLayne Norton2:22:05

        Right

    21. PAPeter Attia2:22:06

        ... and, and yeah. The interpretation is, again, is it that cortisol is producing hypertrophy or is it cortisol is in response to the stress that is producing hypertrophy?

    22. LNLayne Norton2:22:17

        So that's... Again, this seems paradoxical because people see an association, they automatically think, "Well, there must be a cause there." Not necessarily at all. These two things are happening in parallel. So what it means is the resistance training, uh, session that is going to produce the most amount of stress, the most amount of adaptation, is probably gonna produce the most cortisol and possibly the most hypertrophy if it's repeated, right? So cortisol, like we know that it will impede muscle protein synthesis, but again, that is... Cortisol acts transcriptionally, like testosterone. It is actually a steroid hormone. In fact, people get confused 'cause they're like, "Well, he got a steroid, a steroid injection before his, you know, tennis match," and people are like... They're not test- test- They're not injecting him with testosterone. They're giving him cortisol so he can go out and play because it reduces, uh, inflammation in that particular area. Well, um, cortisol is more of a long-term hormone. It's acting transcriptionally. So it's... What you need to be worried about are long-term low-level elevations in cortisol. And people make this mistake with anything. They make it with mTOR. A lot of the, the vegan doctors get all up in arms about mTOR, you know, getting stimulated by leucine, and that's gonna give you cancer. You don't understand s- tissue specifics, and you don't understand acute versus chronic.

    23. PAPeter Attia2:23:46

        I just wanna make a funny comment there. I, I was at a, at a meeting, and a very famous vegan doctor, who I obviously won't name, um, came up to me and chastised me for the idea that I would ever suggest someone ingest five grams of leucine during a workout because of its negative effect on mTOR and how that could be bad for a person's health, and I just had to sit there and smile and... See, I, I, I just don't have it in me sometimes to tell people to shut up, but-

    24. LNLayne Norton2:24:21

        Yeah. A lot of this is really reductionist thinking. You know what I mean? Um, a- and this happens for all different, all different... If I can

14. 2:24:30 – 2:29:05

    The problem with studies trying to isolate one nutrient

    1. LNLayne Norton2:24:30

       switch gears just a little bit because I think this is really important for people to hear. People want to isolate out nutrients as being good or bad, and I would really implore people that nutrients are not necessarily good or bad. Context matters, and what really matters is lifestyle and overall eating patterns. That is what matters. You cannot possibly think that in a diet where there are thousands of different nutrients that we ingest, that it's one thing is causing all the problems that we're having, right? And this, whether it's leucine or sugar or whatever. Um, because when you isolate out these things, you can find mechanistic data to support almost anything you want. But even things that we th- we think we know... Like I remember when I got to grad school, and I was like, "High-fructose corn syrup, independently fattening. It doesn't matter the calories, anything like that." And again, do I think high-fructose corn syrup is good? Absolutely not. I think it's hyperpalatable. I think people overeat it, but if you look at the studies pretty closely, it seems to mostly be an energy thing, that it just provides too much energy. Now, people hear that, and they think it's a dismissal of it, you know, like that it's I'm condoning it or something like that, and I'm not condoning it. I'm just saying that if you isolate it out and you keep people's calories the same, it doesn't seem to have the same effect. But do people who eat a lot of high-fructose corn syrup keep their calories the same? Of course not. They eat more calories than other people. They also usually eat more, um, you know, processed foods, more fats, you know, all that sort of thing. So a great study that, um, I think came out a couple years ago that I think really highlights this point was a study where they looked at, um, all c- I think it was, um, cancer incidents from any form of cancer, and it was in, uh, it was in Canada, 100,000 people cohort. And they looked at low meat intake versus high meat intake, and I think it was in quartiles, so four different levels. And I mean, we know this. If you do that, what you tend to find is that meat is as- meat intake's associated with cancer. Now, the problem is people who eat high amounts of meat tend to have an overall unhealthy lifestyle in general. They're less likely to exercise. They're more likely to smoke. They're more likely to eat processed foods because most of the meat is coming from fast food, that sort of thing But what was cool about this was they also compared it with the lowest to highest quartiles of fruit and vegetable intake. And what they found was that at the highest level of meat intake, but also... that also consumed the highest level of fruit and vegetable intake, they had the same risk for cancer as the lowest level of meat intake with, with a high level of fruit and vegetable intake. So basically what that tends to suggest is that to me, we need to look at eating patterns much more so than we look at individual nutrients. And that if you're looking for one nutrient to explain, you know, disease incidents, this sort of stuff, you really need to look at the whole diet. And people who eat... I, I- is sugar... Like, when I say that sugar isn't inherently bad for you, I mean from a purely mechanical, if I take 50 grams out of somebody's diet of, you know, starchy carbohydrate, and I just put sugar into it, or, you know, the same equal calories from fats and I just put sugar in there, do I think anything bad's gonna happen? Probably not, but that's not how people eat. So I'm talking mechanistically, and people think I'm making a recommendation. So all that to say, it's really important to understand how limited nutritional studies are, and you mentioned it. When you're talking about trying to pick out these really granular details, you're talking about a study that's so restrictive, it's really hard to generalize the results to the average person. So when you look at studies that are generalizable to the average population, you can't control that many variables because it has to be free living. And if it has to be free living, I mean, it's very hard to pick out differences because dietary adherence tends to be so

15. 2:29:05 – 2:33:47

    The important role of inflammation from exercise

    1. LNLayne Norton2:29:05

       low. So I know I went off on a really big divergent rant, but, uh, you know, cr- acute versus chronic, localized versus systemic, you know, people just don't understand the, the, the differences, and these are... And this includes scientists. I mean, even, like, inflammation. God, I... Um, a great example of this is, um, on the Joe Rogan Game Changers debate where John Wilkes was talking about inflammation. He said, [lips smack] um, you know, "If you're training for exercise, you know, and you're having higher levels of inflammation from that, and then you go and eat meat afterwards, like, now you're compounding that inflammation." And I just remember thinking, "You just don't understand the difference between acute versus chronic. These aren't even the same types of inflammation." R- right? Like, y- your, your acute inflammatory response from exercise means nothing. Well, it actually doesn't mean nothing. It-

    2. PAPeter Attia2:29:59

       It's beneficial, actually

    3. LNLayne Norton2:30:00

       ... exercise it... Yeah, yeah. So here's the crazy thing about exercise. If you were an alien and you didn't know anything about exercise but you knew about human physiology, and I told you, "Hey, I'm gonna make you do something that increases your blood pressure, increases your heart rate, uh, increases your free radical production, increases your inf- inflammation, you know, all these different things," you would go, "That's horrible. Don't do it." But what is exercise? It's, it's like... It's almost like a vaccine, right? You give a small... You give a g- give a controlled dose of a stressor, and your body adapts to that stressor by getting better at handling it. So what do we see in people who exercise regularly? They have lower resting heart rate. They have lower blood pressure. They have, um, [lips smack] lower levels of inflammation, you know, those sorts of things. Um, and, uh, you know, nutritionally, I question, like, these studies that look at inflammatory response in respon- in, in terms of post-meal injection. I really go, "How much does that actually mean?"

    4. PAPeter Attia2:31:05

       I, I... Yeah, I th- I think this stuff means absolutely nothing. I, I think that, you know, when you think about the time course of something and you tell me that you measured somebody's IGF-1 or IGF-6 an hour after a meal and in two hours, I, I, I... Yeah, I agree with you completely. It's totally nonsense. And, and by the way, your point about exercise I think comes back to what you said when you were making that decision between nutrition science and exercise science, which was, look, exercise probably is the best drug we have. I, I agree emphatically with that. I think that when you think about the, um, the hormesis that comes from exercise, like, uh, I, I just... I don't believe we will ever be able to develop a drug that is that remarkable. It is simply unbelievable what it can do.

    5. LNLayne Norton2:31:53

       No, I mean, l- look at e- like, almost any dietary intervention, unless you're t- unless you're okay with just small improvements, to see big improvements, you pretty much gotta lose body fat. Like, that, that, that's, that's, that's what the crux of it is. With exercise, you get massive improvements with zero loss of weight. You, you can see big improvements. Um, [lips smack] and so, you know, I, I just implore people, one of the, one of the... And this goes for, like, kind of the two opposing ends, like, like plant-based, kind of really emphatic supporters and then, like, low-carb supporters. I'll hear a lot of people s- they'll spend so much time, you know, on these granular details of diet, and they say, "Well, I, I don't, I don't resistance exercise. I don't have time for it."

    6. PAPeter Attia2:32:38

       [laughs]

    7. LNLayne Norton2:32:38

       And I'm like, "You got time to stress over your diet on Twit- on Twitter for two hours, but you don't have time to go into the gym or just do some push-ups at home? Like, you are missing out on the most powerful tool you have to improve your health and body composition." And even, like, um, there was a, a study by Wolf looking at, uh, longevity over age 65 and found a direct association. The most powerful predictor of longevity after age 65 was how much lean body mass you had That was the most powerful predictor of who lived the longest after age 65, was your level of lean body mass

    8. PAPeter Attia2:33:18

       Yeah, and there are lots of studies that go beyond just the sarcopenia and look at, like, grip strength, um, and so-

    9. LNLayne Norton2:33:24

       Yes

    10. PAPeter Attia2:33:24

        ... a- and, and, and, and, and things like that. So yeah, I, I completely agree. And I love the idea, by the way, of in between Twitter feuds over your nutritional views, you have to do some pushups. That's... That could be the solution here to, to this problem. Um, I wanna talk a little bit about, uh, uh, I'm sorry, we're just g- I, I, I keep saying we're gonna wrap this up, and we're not, but I'm sorry. We're gonna wrap this up at some point.

    11. LNLayne Norton2:33:46

        Oh, you're fine.

16. 2:33:47 – 2:45:56

    Keys to preserving muscle, and the value of habits, consistency, and resilience

    1. PAPeter Attia2:33:47

       Um, one thing that I've been really impressed with in following you, Layne, is the, uh... What's the right word I wanna use? Um, the, the deliberate nature with which you approach things. So I've seen pictures of you where I think, like, "He doesn't even look like a human being, he's so ripped and shredded." And I've seen pictures of you where you look kinda chubby, and you've been very clear and said, "I'm going through different phases. I'm very deliberate about what I do. This is a phase where I am adding a ton of lean mass, and with it comes some body fat. And right now I'm taking it off." But, um, one, you're very deliberate, so nothing's haphazard, and two, you really emphasize the importance of consistency. So how do I stay consistent? Because it's... It doesn't take nearly as much work to preserve muscle mass once you have it, but you... And I talked about this with Alex Hutchinson on a previous podcast. One of the things I fear the most for my patients as they age is any sort of injury or illness that takes them out of exercise. Because the deconditioning that occurs when someone doesn't do anything for a month is devastating. So can you, can you put some numbers to that? 'Cause I, I believe you've spoken about this, which is what is the effort required to maintain, uh... And I, I'm not talking about show, you know, like, 4% body fat on a stage. I'm talking about... And again, we'll use your numbers as an example. You happen to be, you know, great to begin with, but, you know, for you to stay at 13, 14% body fat, um, is not the end of the world. It's not a huge sacrifice. But it requires being diligent still. What does that mean to you, and how do you advise your clients around that?

    2. LNLayne Norton2:35:31

       So there's a few layers to this. Um, when it comes to resistance training, I mean, this is really just anything in life. Resistance training taught me so much about just life overall, right? So the same people who come up with bio hacks of how you can, like, get to your goal in 12 weeks or whatever, uh, i- in the financial world, th- the, they're the same people who are like, "Hey, join my pyramid scheme and earn six figures from home doing one hour of work a week." Most reasonable people know that that's not how you acquire wealth, right? You acquire wealth through... If, if you're, you know, Thomas J. Stanley's... I, I use fiscal examples because I just find it's easier for people. Um, but 80% of millionaires are first generation, self-made. Um, and most of them got there not through getting lucky, but the fact that they saved more money than they earned, they were consistent, and they did that for a long period of time. Now that is the granular, mechanistic way of doing it, kind of like how we talk about calories in, calories out, right? But what it takes to get that consistency is modification to behavior, right? Because for the same reason that somebody binges on whatever, donuts, chocolate, cakes, cookies, whatever, uh, is the same reason that somebody who also knows, "Hey, in order for me to save money, I need to earn more than I spend," still goes out and blows 1,500 bucks on a shopping spree after a stressful week, right? Because they have a habit and an association with something. And so I think people need to understand that consistency is the most important thing. But to create that consistency, you have to change your habits. Um, you have to create habits. I read a, a, a review, systematic review by a, a gal named Marie Spreckley, and I'm gonna give myself a pat on the back here for a second because she actually said that she went back to school after reading my book Fat Loss Forever, and it's what inspired her to do her Ph.D. work, which is pretty awesome. Um, and she did a systematic review of looking at people who lost weight and kept it off, so some of the commonalities of that. And a lot of it was what you expected: consistency, um, a, ability to embrace challenges rather than, um, rather than running from them, or viewing challenges as part of the process. I think a lot of people, when setbacks occur or challenges occur, they feel that that's abnormal as opposed to embracing it as part of this process. But then something that was in the paper that I hadn't thought about before that I think is so critical to developing that consistency and making a change: forming a new identity. So the people who lost weight and kept it off said that they had to form a new identity. And I really chewed on this for a while. And, and, and do you know Ethan Suplee?

    3. PAPeter Attia2:38:36

       No, but I was, I was just about to say James Clear is the first person who made that point clear to me, no pun intended. And it, it... Of all the things in James' book, that one actually appealed to me the most, which was it's not about dis- well, I always knew it wasn't about discipline and willpower, 'cause those things are gonna fade over time. But this piece around... And let's use exercise as the example. It's going from, "Oh, I have to do this thing. I have to do this thing," to, "I'm a person who exercises. I'm a fit person That's the transition that makes it easier to do day in and day out. And that's probably why I've never struggled with exercise. I struggle with the opposite. I really struggle to take a day off. I think to be completely transparent, I'm always gonna struggle with food a little bit. I haven't had the full identity switch in food, but I was, I think I was born with, or at least it was etched in my brain when I was so young due to my insecurities around exercise.

    4. LNLayne Norton2:39:41

       So I think you said something very poignant there. That's, you just put in your mind, this is what I do. This is what I do. This is part of who I am. And so Ethan Suplee, he's an actor, um, and he was in, you probably, if you've seen the movie Remember the Titans.

    5. PAPeter Attia2:39:56

       Yeah, yeah, yeah.

    6. LNLayne Norton2:39:57

       Um-

    7. PAPeter Attia2:39:57

       Oh, yes, yes, yes. I know, I know who you're talking about now. He lost a staggering amount of weight. Like a, almost an unrecognizable-

    8. LNLayne Norton2:40:02

       Yeah, he lost-

    9. PAPeter Attia2:40:03

       ... amount of weight

    10. LNLayne Norton2:40:03

        ... He's jacked now.

    11. PAPeter Attia2:40:05

        Yeah.

    12. LNLayne Norton2:40:05

        Right?

    13. PAPeter Attia2:40:05

        Yep.

    14. LNLayne Norton2:40:06

        Um, so I, I talk to him pretty frequently and, uh, he has a thing he puts on his Instagram. He s- he, he say, "I killed my clone today." And I asked him about that because I read Marie's paper, and then I made this connection 'cause I always wondered what he meant by, "I killed my clone today." And I said, "Is this what you mean? That you formed a new identity, that, that you killed the old person that you were?"

    15. PAPeter Attia2:40:28

        Mm.

    16. LNLayne Norton2:40:28

        And he said, "That is exactly what I mean." Because you cannot create a new life, a new identity, or you cannot create a new life and you cannot have a physical and overall change in your life without funda- while still dragging those behaviors behind you, right? Let's ta- let's take a basic example. An alcoholic, right? If you decide, if an alcoholic decides tomorrow, "I don't wanna be this anymore," you have to change everything. You can't just, "Okay, I wanna stop drinking." No, no, your entire identity has been around, I go to a bar, I hang out with my friends after work, they probably drink, my family probably drank growing up. That's where I learned it from. Now you've gotta change everything. You are not gonna be able to be, you know, this new person while still dragging your old behaviors behind you. And I think a lot of people try to do that when it comes to nutrition and maybe even exercise. It's, it's, "Well, I, I want things to change, but I don't wanna give up my, you know, three glasses of wine a night," or, "I don't wanna give up this," or, "I don't wanna give up that." What I always tell people is like, "Listen, the great thing about nutrition is you get to pick what you sacrifice, okay?" So for me, what made it easy for me, and I always tell people, "You should pick the form of restriction that feel, feels easiest to you. I don't care what anybody else feels like." For me, if I'm able to eat whatever foods I want as long as I control portion size and track my calories and macros and whatnot, that feels easy. That is not difficult for me to maintain like a lean physique and, and athletic. Um, but for other people, that may be extremely tedious, difficult. It may feel labor-intensive. To me, it doesn't. What feels labor-intensive to me is saying, "Okay, Layne, you can't have, you know, processed food ever again," or, "You can't have carbs," or, "You can't have fats," or whatever. But for other people, some people, I hear it all the time, say, "I did X diet, ketogenic diet, and it felt easy. I did intermittent fasting. I was never hungry. I f- it felt easy." Cool. Great. Just don't assume that what was easy for you is gonna be easy for everybody else because this... You know, I thought flexible dieting was gonna be the solution for everybody 'cause it was easy for me, so I arrogantly assumed that it'd be that way for everybody else. And I think everybody goes through that, that sort of like, you know, you seek out your own echo chamber sort of thing, right? And you find these people who had the same f- had the same experience as you, and you just assume everybody's like that. It turns out, no, no, people are quite different. So find the, the... You get to pick the type of restriction. Find what feels easiest, and try not to get too caught up in, "Well, this diet increases fat oxidation and insulin," and like all these little things we talk about. 'Cause at the end of the day, if you've ever lost weight and then regained it, why did it happen? It didn't happen because you didn't get your macronutrient ratio perfect or your nutrient timing wasn't down. It happened because you stopped being consistent with the behaviors that you implemented. That's what happened. And the same thing goes with exercise. People tell me all the time like, "Man, Layne, I wish I was motivated like you." I'm like, "Ha." [laughs]

    17. PAPeter Attia2:43:51

        [laughs]

    18. LNLayne Norton2:43:53

        Uh, I, I, I, I would say that I, I love lifting weights and that makes it easier to be motivated. I acquired that love through years. Um, but I don't always love it, just like I'm not always happy with my spouse, right? Like some days we fight. Doesn't mean I don't love her overall. It just means some days we get annoyed at each other. Some days I'm unhappy with weightlifting. I don't wanna do it. However, I always tell people, and I'm not saying you can never take a day off. Of course. You know, if you need a day off to reset, whatever, that's fine. You just gotta be careful that that doesn't turn into weeks and months and years, right? And here's the comparison I use. I don't have to be motivated to go into train. It's part of what I do. Just like I don't have to be motivated and pump myself up to brush my teeth. Do you know why? Because it's a very simple equation. If I don't brush my teeth, they're gonna go to crap. Just like if I don't exercise, my body's gonna go to crap. So it doesn't, it is not, for me, it is not a question of motivation. It is a question of what do I want and what are the actions that are required to get what I want? And if my actions do not line up with what is needed and the amount of work that is needed, it's very simple. I'm not gonna get what I want, and it's on a fundamental level, it's that simple. But getting people to, one, buy in And two, you know, get past the stage where you start and you've got that honeymoon phase and everything feels good. You're like, "Yeah, I'm gonna do this." And then you hit your first challenge or your first setback, or y- your scale fluctu- actually, during the, the, the systematic review, uh, participants talked about how, um, seeing the scale fluctuate wa- w- was a difficult thing to get over, and some people would quit because they would gain three pounds, when in reality they probably just had a, a bad weigh-in day. That's why, that's why I actually tell people, "Weigh in every single day and take the average," because the average is not gonna fluctuate that much. Um, so anyways

Episode duration: 2:51:54