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Dr Rangan ChatterjeeDr Rangan Chatterjee

The Surprising Truth About Protein & Why You Need More For Longevity! | Dr. Gabrielle Lyon

My guest today believes that the single biggest problem with our health these days is not that we carry too much fat but that we don’t carry enough muscle.

Dr. Gabrielle LyonguestDr. Rangan Chatterjeehost
Sep 21, 20221h 46mWatch on YouTube

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Transcript

  1. 0:00 – 2:10

    Reframing the health crisis: “overfat” vs “under-muscled”

    1. GL

      The reality is, is we are not overfat. We are under-muscled. The healthier your muscle mass is, the greater your survivability across nearly all disease states: cancer, cardiovascular disease, dementia, obesity. If the people listening execute on the following advice that I'm going to give, they will change the trajectory of the way in which they age. [upbeat music]

    2. RC

      Have we as a society overly focused on losing weight and under-focused on gaining muscle?

    3. GL

      Absolutely. [coughs] In fact, I believe that that's one of our biggest flaws, and one of the reasons why we have such a health epidemic across the world. You know, everybody is focused on obesity, and that makes sense because you can see it, it can really affect people's lives, yet we haven't been successful at dealing with it. We are talking about decades later. The reality is, in medicine, in health, in root cause thinking, you would think that we would get better. We would get better at treating a disease. We have gotten worse, and as you know, of course, the point of change comes from asking the correct questions, and I believe that we've been asking the wrong question and trying to solve for the wrong problem. The reality is, is we are not overfat, and people could argue and say, "Okay, yeah, we are." But actually, we are under-muscled, and when we think about insulin resistance, obesity, all these metabolic diseases, even Alzheimer's, right? Or dementia, type three diabetes of the brain. These diseases, they start in skeletal muscle first. Insulin resistance, glucose disposal, issues with metabolism, the primary site is skeletal muscle, yet we've been obsessed as a culture, as a society, on, just obsessed with obesity. It has been the biggest oversight in medicine to date.

  2. 2:10 – 5:29

    Skeletal muscle as a root-cause “keystone” for metabolic disease

    1. RC

      You mentioned the term root cause medicine.

    2. GL

      Yeah.

    3. RC

      Right? What is the root cause of what is going on with our patients? I think it's a very powerful, uh, phrase, one that I think Western medicine has not fully embraced yet. Uh-

    4. GL

      Yeah

    5. RC

      ... although I, I, I'm very optimistic. I do think it's changing. On this podcast a lot we talk about what is the root cause of a variety of different health conditions, and we-

    6. GL

      Yeah

    7. RC

      ... sometimes speak about things like chronic inflammation, which of course lies at the heart of all kinds of different conditions.

    8. GL

      Absolutely.

    9. RC

      But what I've heard you speak before, and what you're incredibly passionate about, is that skeletal muscle or a lack of skeletal muscle-

    10. GL

      Yeah

    11. RC

      ... also is one of those big keystone areas that actually when we don't have enough, it can also lie at the heart of all kinds of different problems, right?

    12. GL

      Yeah, totally. I mean, think about it. Physical movement is optional now. It ne- the machine, the human machine was designed for physical activity. Not just physical activity. I'm not just talking about walking. I'm talking about bouts of high-intensity movement, lifting heavy things, really being physically active. And what's happened is because our society is so domesticated, it is no longer a prerequisite to living healthy. And if you think about muscle as the pinnacle, right, the pinnacle of health and wellness, it, it makes up, depending on the person, 40% or more of the individual, right? Of our individual tissue. It is the largest endocrine organ, and yes, skeletal muscle is an endocrine organ. But what's so fascinating is it's now become optional to use it or not. You know, when I think... So I did my training in geri- I mean, I did my training in nutritional sciences. So I did seven years of nutritional sciences, and I did a fellowship in geriatrics and obesity medicine, and what is so profound is that there is an interface between the two. Obesity, sarcopenia, uh, you know, Alzheimer's, and if we can address skeletal muscle early, and we are seeing issues with skeletal muscle in lean, quote, "healthy" individuals, young populations, because insulin resistance in skeletal muscle, which, you know, insulin resistance is this concept of requiring more insulin to move glucose out of the bloodstream. So glucose is toxic. We need it, but it's toxic. And these issues start, they could easily start a decade before, before we are even seeing abnormalities in the bloodstream, before we are even seeing elevated levels of insulin, and that's an issue. So what's happening is we are missing the mark. These diseases are starting in your 20s and 30s.

    13. RC

      Yeah. You mentioned a few terms there. Um, sarcopenia, which we're definitely gonna get to.

    14. GL

      Yeah.

    15. RC

      You also mentioned, though, which I, I wanna go here, I think, which is we're seeing issues with skeletal muscle early, right?

    16. GL

      Yeah.

    17. RC

      That is, I think that sentence alone-

  3. 5:29 – 7:19

    What skeletal muscle is—and why “optional movement” is a modern problem

    1. GL

      Yeah

    2. RC

      ... leads to so many thoughts in my mind. First of all, what is skeletal muscle, for people-

    3. GL

      Yeah

    4. RC

      ... who are not familiar with that term?

    5. GL

      Of course.

    6. RC

      And then when you say early, what do you mean? How early are we seeing these things, and how worried, I guess, do we need to be in terms of motivating us to change our behavior?

    7. GL

      Yeah. And these are fantastic questions. Let's start by thinking about skeletal muscle. Skeletal muscle is really the tissue that you have voluntary control over. When you think about your biceps or, you know, your quadriceps, that, it is the muscle you have voluntary control over.

    8. RC

      As opposed to, let's say in your gut-

    9. GL

      Smooth muscle

    10. RC

      ... you've got smooth muscle, which-

    11. GL

      Right

    12. RC

      ... you know, you can't control. Your food goes-

    13. GL

      No

    14. RC

      ... d- you know, through the digestive-

    15. GL

      Exactly

    16. RC

      ... tract. Okay, so when people hear skeletal muscle-

    17. GL

      Yeah

    18. RC

      ... I think a lot of people think of, uh, strength training and, um, if I, you know, work out in the gym and lift heavy weights, I will grow bigger muscles. Now, uh, of course, not everyone's gonna think of that, but I think a lot of people think of that when they, when they hear these terms. Now, I think we've undervalued the importance of strength and skeletal muscle in health as you do, for sure. And when I'm talking to groups of people, one of the things I often say to them is, "Hey guys, listen, once you hit the age of 30," right? And I might-

    19. GL

      Yeah

    20. RC

      ... I might crack a joke there sometimes-

    21. GL

      [laughs]

    22. RC

      ... depending on who the audience is, but once you hit the age of 30-

    23. GL

      Yeah

    24. RC

      ... unless you do something about it, you are losing muscle mass every single year.

    25. GL

      Yeah.

    26. RC

      So first of all, is that consistent with the latest research? And at what age do we start losing this really important commodity in our body, which is skeletal muscle?

  4. 7:19 – 15:05

    Aging, anabolic resistance, and “marbled steak” muscle quality

    1. GL

      Yeah. Th- these are, this is... First of all, thank you so much for providing a platform to talk about it. It is... If we can get this message out there, this will change the world. Now, you said a couple really important i- things here. Number one, when do we lose it? And I would argue, how do we grow it? How do we maintain its health? From a very young age, your body has the, this potential, potential for muscle growth. You are very anabolic, meaning your capacity to put on muscle really starts very young. When I say very young, I am talking about, you know, I have two very little children. The more active they are, the better that's going to be for their muscle mass potential. Now, it's very important from a young age to train, and people are like, "Well, you can't tell kids to train." No, children must be physically active. They were designed to do that. The worst, one of the worst things that we can see is childhood obesity, and the reason is, is because skeletal muscle is definitely affected by obesity. The potency of skeletal muscle to have that hypertrophy mechanism, which we, you were talking about, you go to the gym and you build muscle, it becomes blunted. The ability to respond, the ability for the muscle to respond to dietary protein, which is really important for stimulating, it's a, a key, a key component to stimulating skeletal muscle, becomes blunted. The age in which an individual begins to lose muscle can really depend on their physical activity, if they have a chronic illness. You pointed out that low levels of inflammation create all kinds of diseases. Low levels of inflammation impact skeletal muscle.

    2. RC

      Wow.

    3. GL

      It blunts skeletal muscle activity. And can some of these things arguably be overcome with exercise and diet? Yes. Exercise is going to be a much more potent stimulus than diet, which is wild, because of the physiological pressure that an individual can put on its tissue. As we age, there's a natural phenomenon that happens, and this is called anabolic resistance. And, and you know, and I say this cautiously because all of the majority of the models that we've been looking at for aging are oftentimes sedentary or only moderately active individuals. We don't have a huge body of evidence to actually see if anabolic resistance can be pushed off for highly, highly active individuals. So I'm gonna explain what anabolic resistance is. Anabolic resistance is a decrease in the efficiency of the skeletal muscle to, number one, recognize and utilize dietary protein. So the mechanism of actually stimulating the tissue becomes less. Now, that typically happens, gosh, that could happen in your 40s. And what that means is that, so if you eat the way that you did in your 20s, and let's say you wake up and you have two eggs in the morning and a piece of toast or maybe a little bit of yogurt, you will be at a sub-threshold protein amount. You'll never stimulate that tissue. That's a problem. And we'll, we'll ta- obviously talk about nutrition. The question of when does this start is very variable on the way in which a person has taken care of themselves up to that point. Inevitably, anabolic resistance does happen, and r- that makes it much more difficult for individuals to build muscle, to stimulate the tissue, and that really, you know, I believe that can happen at any age. In an aging population, it can happen with destruction of skeletal muscle. You know, as individuals age and they don't take care of skeletal muscle, you get... We've all seen a marbled steak. Well, what do you think happens to our tissue?

    4. RC

      Mm.

    5. GL

      We could be walking around with skeletal muscle that look like a marbled steak, and that decreases its ability metabolically for glucose disposal. It decreases its contractile potential. It decreases its ability or efficiency to turn over and repair. There are all kinds of problems, and again, that can start in your 30s, that can start in your 40s. It depends on your physical activity, and when it begins, it is much more difficult to recover from periods of inactivity than ever before.

    6. RC

      Yeah There is just so much there, and I really want this to be an empowering episode. My goal is at the end of this conversation, people understand, "Man, I need to be looking after my skeletal muscle. I need to be prioritizing that." And we're hopefully gonna go through all kinds of different areas around this topic to persuade people, hopefully inspire them to think, "No, no, this is really important."

    7. GL

      They can do it.

    8. RC

      But-

    9. GL

      They can do it

    10. RC

      ... yeah, and, and there's the first thing you said that really, um, really made me reflect and think was what you said about children.

    11. GL

      Yeah.

    12. RC

      And you were talking about if we're not active enough, if we're not stimulating the growth of enough skeletal muscle, then we become less responsive to the protein in our diet. Less responsive in terms of that protein then stimulating muscle growth. Is that a correct, uh, summary of what you said in that particular area?

    13. GL

      Well, um, there's a, a couple things to unpack here. In terms of youth and kids, they are very anabolic. They are anabolic. They don't require a meal threshold of protein. They are primed for activity. They are primed for growth. They are incredibly resilient. Fast-forward, so their muscle is not anabolically resistant. They are primed for it. After growth happens, when we're no longer in a prime growth phase, say, you know, we're not growing bigger, we're only growing wider, there is that potential where anabolic resistance ... And again, anabolic resistance setting in early is somewhat unlikely, but really in your 30s is, 30s and 40s is where I believe anabolic resistance can begin, depending on the individual. And what that means is in midlife ... And by the way, you can overcome anabolic resistance.

    14. RC

      Mm-hmm.

    15. GL

      You can definitely overcome anabolic resistance. There is great data that supports that in the literature. Um, and it is not a hopeless kind of experience. So individuals can become anabolic resistant in their 30s and 40s, which for sure can be overcome. So I, I hope that answered your question.

    16. RC

      Yeah, it does. So let's just go there just for a second. Let's say there's someone at the moment, um, I don't know, in their 30s or 40s who are, who are listening to this-

    17. GL

      Yeah

    18. RC

      ... and are thinking, "Well, I don't know, I've not really thought about muscle before, but, you know, I'm in pretty good shape. I walk regularly. I look after my diet. Uh, I sleep well." You know, and they, and they think, "Well, I don't really have any problems with energy or anything like that."

    19. GL

      Right.

    20. RC

      Why should they be concerned about what you just said?

  5. 15:05 – 17:37

    The exercise blueprint: HIIT, strength training, and cardio for muscle-as-medicine

    1. GL

      Yeah. Well, unfortunately, if a stimulus, an intensive stimulus is not provided, there is a natural trajectory of aging which we see. As individuals age, we've all seen it in our parents, they get skinnier, they get tinier. We believe that that is the endpoint, right? I think oftentimes we believe, "Well, I'm just getting older. I, I don't need to do things that really stress out my muscle, or I don't necessarily need to change my nutrition targeted to skeletal muscle aging." And I would say that is the prime time to execute and implement the strategies that I'm about to tell you. Number one, just because you can't see the changes doesn't mean they're not happening. Individuals should definitely be involved in some kind of high int- high-intensity interval training one day a week. You must create flux in that tissue. You must utilize substrates. You want to create a stimulus that changes the metabolism of the muscle, you know, in the moment, right? And that could be easily three bouts of 20 seconds all-out effort. Not much, right? It could take you 10 minutes. Uh, you know, three, uh, three bouts of 20 seconds high-intensity training, rest, right? You do a bout, you rest for three minutes, you do another bout, you can rest for three minutes. Incredibly valuable. Walking is wonderful. Walking is just movement. I don't consider it training. The other thing that we have to understand is strength decreases as we age. An individual should definitely be doing strength training three to four days a week just to begin to build a foundation. Hopefully we started earlier, but if you didn't, the body is incredibly resilient, and it wants to have muscle. It's not like it doesn't want to. We, it is part of our makeup. It is mandatory for us. You know, it's, there's very few things in medicine that we can say 100% of the time improve outcome and survivability. The more muscle mass, the healthy ... I don't wanna say the more. The healthier your muscle mass is, the greater your survivability across all disease states. Nearly all disease states. Cancer, cardiovascular disease, dementia. These are really big challenges for people. Every single one of those challenges can

  6. 17:37 – 26:33

    Muscle as an immune-modulating endocrine organ (myokines and IL-6)

    1. GL

      be improved upon by being fit. Uh, also low-intensity training, uh, for mitochondria is really important. You know, there's a huge push for resistance exercise, which is a non-negotiable. There's also value for doing cardiovascular training. It improves mitochondria. It, um, really helps overall wellness, and a lot of the data for muscle as this endocrine organ, which it is, when you contract skeletal muscle, it secretes myokines. Myokines go throughout the body. The, the most studied myokine is, is interleukin-6.

    2. RC

      Yeah

    3. GL

      This is interesting because interleukin 6 people think about as a cytokine released from cells of the immune system which create a pro-inflammatory state. But exercise is also skeletal muscle. What it secretes, this is an immune regulatory organ. Skeletal muscle is not just about fitness. It's not just about managing blood sugar. It is an immune modulatory organ. It interfaces with the immune system. So when you do cardiovascular activity, interleukin 6 can increase 100-fold, and it actually has a different effect on the body and can help counterbalance the inflammatory mechanisms in the body. Uh, that is profound.

    4. RC

      Yeah. It, it's, it's so fascinating. It really speaks to how the body really is one big interconnected system. Nothing works in isolation, 'cause you've already-

    5. GL

      Right

    6. RC

      ... so far mentioned how, um, better skeletal muscle will help you with longevity, Alzheimer's, um, type 2 diabetes, immune system function. We're gonna get into hormones later on. We're gonna talk about all these things, but it's amazing how one thing can impact so many different systems of the body. And I think this again really speaks to this point, Gabrielle, that I think we've thought muscle is just dumb muscle. It's just like a physical-

    7. GL

      Always

    8. RC

      ... thing that we can see.

    9. GL

      Always.

    10. RC

      We, we don't realize actually, you know, this is a, this is an active organ, right?

    11. GL

      It's an endocrine organ, yes.

    12. RC

      Yeah.

    13. GL

      It's an endocrine organ.

    14. RC

      It's, it's-

    15. GL

      It is not just about being jacked and tan. Like-

    16. RC

      Yeah, a- and we also, I think, there's a-

    17. GL

      Yeah

    18. RC

      ... in society we think about it for teenagers and people in their 20s, you know, they wanna look buff-

    19. GL

      Yes

    20. RC

      ... they wanna look good, right? So they're the-

    21. GL

      Yeah

    22. RC

      ... ones lifting weights. But I've come to the understanding over my career that actually it's more important the older you get, right? It's actually more important then. I'm not saying it's not important as a teenager, I'm just saying it, but it actually goes up in importance. Now, before we-

    23. GL

      It does

    24. RC

      ... tackle that, you mentioned three very practical things there that I think will be really interesting to people. So can we just dive into those a little bit just to get some clarification? So the first thing you mentioned is once a week do some form of high intensity interval training.

    25. GL

      Mm-hmm.

    26. RC

      Now, I wanna clarify this because a lot of people when they think of sk- skeletal muscle, they're thinking about lifting weights, whether it be in the gym or at home-

    27. GL

      Yeah

    28. RC

      ... to work on their strength. Yet, when you're doing HIIT training, like let's say people do these 20-second sprints all out, they rest for two, three minutes, and they repeat-

    29. GL

      Yeah

    30. RC

      ... three times, which can be done in under 10 minutes, which is very, very practical for people, what is that doing to their skeletal muscle?

  7. 26:33 – 34:44

    Resistance training mechanics: hypertrophy, “body armor,” and resilience

    1. RC

      Then your second recommendation was strength training or resistance training three to four times a week. Right. So resistance training, maybe you could explain what you mean by that, and then-

    2. GL

      Yeah

    3. RC

      ... what does that actually do for our skeletal muscle? I guess, and maybe compare it to what HIIT training does to our skeletal muscle. You know, why is this also so beneficial?

    4. GL

      Yeah. Well, we need to think about skeletal muscle as, again, this organ. And this organ is very unusual in that we can directly-- we directly have the ability to impact it. S- It's very plastic. And doing resistance training creates a few things. So it creates metabolic stress. It creates mechanical stress. It creates a turnover, a ribosomal biogenesis, a creation of new proteins. That is very adaptive in the body, and what it does is it allows the rest of the body to function in a way where we can burn more calories through exercise. So there's the physiological changes that happen with resistance exercise, and really the goal with resistance exercise in my mind is hypertrophy.

    5. RC

      What does that mean?

    6. GL

      Hypertrophy is muscle growth. Doesn't get longer, it can get bigger, right? Hypertrophy. If you are untrained, it can be very easy. But the better the, the better and the higher trained of an individual, the more it becomes difficult to continue to put on muscle mass. Um, you know, when I think about muscle, I think about those in-- as it relates to resistance training, the metabolic stress, the mechanical stress, and the ribosomal biogenesis, the growth of new proteins. And that becomes important because, again, we're building up body armor. Body armor muscle is an amino acid reservoir. The healthier that is, the, the capacity to, um, [lips smack] dispose of glucose, the capacity to increase total caloric expenditure becomes essential, and you leverage skeletal muscle to do that.

    7. RC

      Yeah. You know, you mentioned you improve glucose disposal, and glucose-

    8. GL

      Mm-hmm

    9. RC

      ... and insulin resistance has come up a little bit in this conversation. I think regular listeners of the show will know that insulin resistance, when our body needs more insulin than it used to need to do the same job and move-

    10. GL

      Right

    11. RC

      ... glucose out of your blood and put it into storage, that insulin resistance is at the heart of all kinds of problems like Type 2 diabetes and is linked to things like Alzheimer's and all kinds of chronic disease, right? So not being insulin resistant and being more insulin sensitive-

    12. GL

      Yes

    13. RC

      ... is really, really important for your short-term health and your long-term health. And you're saying-

    14. GL

      Mm-hmm

    15. RC

      ... that actually one of the things that strength training will do is make you more insulin sensitive. And-

    16. GL

      Yes

    17. RC

      ... we talked about the relationship with weight, of course, if there's higher-

    18. GL

      Yes

    19. RC

      ... caloric expenditure, of course, there's gonna be all kinds of knock-on benefits.

    20. GL

      Yes.

    21. RC

      But you mentioned strength training to you is about hypertrophy. Now, if we're talking about society and how society's changed so that many of us now are overfat and under muscled-

    22. GL

      Yes

    23. RC

      ... a lot of people, and I would say, again, I'm not a woman, uh, but from what [chuckles] I can gather, a lot of women are fearful of strength training because cosmetically they don't want to have hypertrophy. They don't wanna put on muscle and look really, really muscly.

    24. GL

      Yeah.

    25. RC

      Now, I have to bring it up 'cause I think some people will be thinking that. Ca-

    26. GL

      And it's very difficult. And I also wanna correct myself. So I think about it in terms of hypertrophy, but it's not because I think about it in terms of hypertrophy by how we look.

    27. RC

      Okay

    28. GL

      S- and I think that that's really important because the last thing that I, I wanna do is, okay, well, now I gotta do... You know, I'm happy with how I'm looking. I'm fine. I don't wanna go do resistance exercise. The reason I think about hypertrophy is we have to think about skeletal muscle as, again, body armor, as the amino acid reservoir, as a site for lipid oxidation, you know, everyone cares about lipids, fatty acids, as a site for glucose disposal. It's not enough to just do kind of the bare minimum, and the reason goes back to that anabolic resistance and that trajectory of aging. Skeletal muscle, you know, it's, it can be the first thing to go. Because it is the amino acid reservoir, the body in need will take from skeletal muscle, and that becomes really important to understand. And yes, we also have to talk about mobility and functionality and activities of daily life, and, you know, the wider the waistline, the lower the brain volume can be.

    29. RC

      Yeah.

    30. GL

      It, it, you know, so I, I would hate for someone to say, "Oh, well, it's resistance exercise, it's just for hypertrophy." Yes, but not for the hypertrophy as it relates to bikini. Yeah, that's important, but really the metabolic, the medicine that muscle provides us.

  8. 34:44 – 42:33

    Why everyday activity isn’t enough: progressive challenge and “embracing the suck”

    1. GL

      Yeah

    2. RC

      ... let's just unpick that a little bit. On an evolutionary level, of course, you know, our hunter-gatherer ancestors-

    3. GL

      Right

    4. RC

      ... didn't, you know, have these 30, 40-minute set periods three to four times a week where they would work on their strength. Their lives were their gym, right?

    5. GL

      Yeah.

    6. RC

      So they were always lifting heavy things, doing stuff. So for example, let's say someone listening to this is active. They move around.

    7. GL

      Yeah.

    8. RC

      They're gardening a lot. They walk to the supermarket. They, um, you know, they buy their shopping, and they lift, and they, you know, and they literally walk home.

    9. GL

      Yeah.

    10. RC

      Let's say they walk home for a mile lifting three bags of shopping in each arm. I know it's not common these days. I certainly... I do see it in the UK. I very rarely see it-

    11. GL

      Yeah

    12. RC

      ... in America, if I'm honest-

    13. GL

      Yes, yes

    14. RC

      ... um, because of the car focus of culture that I've certainly seen-

    15. GL

      Yes

    16. RC

      ... uh, when I'm ever in America. Um, for someone like that who is pretty active and is lifting things, is it fair to say that they may be okay without some sort of dedicated resistance training? I know it's hard to say.

    17. GL

      I would s- yeah, I would say no, and let's think about that. Where is... If we fast-forward 10 years, what is that gonna look like? The, so they have not... If they are doing the same thing that they did, and they do it for another 10 years, are they actually creating a stimulus for growth?

    18. RC

      Mm.

    19. GL

      No. They're doing the same thing. Their muscle is accustomed to that. Listen, it's better than nothing, but I would argue that that's baseline. I don't even consider that exercise.

    20. RC

      Right.

    21. GL

      I consider that movement and activity, and the reason is, is we always have to think about challenge. You mentioned resilience. Without those kinds of things, the body has a natural propensity to atrophy. And, you know, I think about this daily as in my own training I'm thinking, "Okay, well what am I doing that is actually challenging me, and what is going, you know, what do I wanna do for the next decade?" If, and in, and you see this in the gym for individuals that have always done the same thing-

    22. RC

      Yeah

    23. GL

      ... they don't progress. The idea in life in all domains, whether it is your work or your family, is growth. And I know that this sounds esoteric and now I'm translating personal growth to muscular growth, but it takes a certain mindset and discipline to push the body to a level that is a bit uncomfortable. And I believe that pushing the body to a level that is somewhat uncomfortable really creates a capacity to age well. So no, I don't believe carrying groceries and doing things that would constitute an active life cycle, uh, active, an active life is enough. Those individuals, I believe, and they don't have to go into the gym. They could use kettlebells, and it's very easy initially to put on muscle mass. Um, and you could... And it's also pretty easy to maintain muscle mass. I could go to the gym and I could do five sets per muscle group a week, and I could probably maintain my muscle mass. But for muscle hypertrophy, again, it depends on the, the age of the trained individual, and I'm sure that you've got a lot of, uh, fitness professionals on here, and they, uh, have seen it. They may, uh, agree or disagree, but I, I really follow the work of a, um, a PhD named Dr. Andy Galpin, and he gives-

    24. RC

      Oh, yeah

    25. GL

      ... great recommendations for progression of hypertrophy. It is absolutely necessary, and when we think about hypertrophy and we just think about resistance exercise, you know, you do have to go through a period of growth, and that could be 10 to 20, uh, sets per muscle group. That's a huge volume.

    26. RC

      Yeah.

    27. GL

      You don't have to start there, but, you know, again, everyone responds differently. You do have to get to the point where I believe that you are tracking your growth and that you are doing things that are challenging you. And I'm gonna, and I'm gonna say this, and people might not agree, but I think you should have at least one to two workouts you do not wanna do a week, that really kinda suck 'cause they're really hard.

    28. RC

      Yeah. One thing I really appreciate about you, Gabrielle, is your passion-

    29. GL

      Mm

    30. RC

      ... and your desire to really speak truth as you see it and as you have seen in your patients.

  9. 42:33 – 56:09

    Building a family culture of strength and movement (kids, teens, and modeling)

    1. RC

      Yeah. You're a mother of two young kids.

    2. GL

      I am.

    3. RC

      With everything that you know-

    4. GL

      Yeah

    5. RC

      ... and I appreciate they're super young at the moment

    6. GL

      Super, super young

    7. RC

      Super young. Like, my kids now are 12 and nine, so-

    8. GL

      Yeah

    9. RC

      ... you know, I'm pretty, I hope not full on, I'm, I'm, I'm pretty proactive with their health-

    10. GL

      Yeah

    11. RC

      ... let's put it like that. You know, I had monkey bars put up in the garden. I ma- used to get them-

    12. GL

      Yeah

    13. RC

      ... because you gotta be able to do monkey bars. You got, you know, we, we, we are pretty active as a family. Now, not as active as I would like some of the time with the kids, particularly, you know, my son started high school now, or secondary school, um, and I can see as certain-

    14. GL

      Yeah

    15. RC

      ... pressures come on with academic subjects, man, you can just see how physical activity starts to go down-

    16. GL

      Totally

    17. RC

      ... dramatically, which is why at the weekends we really focus on moving. So, you know, my son and I will do a 5K run-

    18. GL

      Amazing

    19. RC

      ... every Saturday morning as part of something called Parkrun. It's just, it's not negotiable. It's not, it- no one's putting a gun to each other's head. It's just something we do together. It's just a normal part. So, h- what is a 5K run doing? So this is, you know, I don't know, 22, 23, 25 minutes of moving our bodies, getting our heart pumping. How does that fit into your, uh, model of what we should be doing for skeletal muscle?

    20. GL

      I think that that's fantastic, and I also believe it's a non-negotiable. So what you're talking about is some cardiovascular and a bit of endurance activity. That is wonderful for mitochondria. It is also wonderful for movement. It's wonderful for cardiovascular health. You know, and I typically recommend at least 150 minutes of that a week.

    21. RC

      Yeah. So I guess what I was getting to is have you got in your mind an idea of what you're planning to do with your children as they get older? Because as a parent of 12 years, my [laughs] experience is society is working against you. In order to-

    22. GL

      Yeah

    23. RC

      ... stay healthy, in order to keep your kids healthy-

    24. GL

      Yeah

    25. RC

      ... you simply cannot do what everyone around you is doing because I just think it is so suboptimal, unfortunately.

    26. GL

      I agree with you, and luckily, um, I think that that's where setting a family culture is really important. Uh, we are an incredibly physically active family. We're already physically active.

    27. RC

      Mm.

    28. GL

      And even with the almost three-year-olds. We, um... You know, and I, and I suppose that we do have a, a little bit of a, a advantage 'cause my husband is, uh, former military. I'll give you an example. This, on Father's Day, just happened. We went over to the monkey bars, and we did a pretend obstacle course.

    29. RC

      Yeah, wow.

    30. GL

      You know? Um, we do pushups, and we do sit-ups, and we do that, and we make it fun, and we do it every day, just for fun.

  10. 56:09 – 1:00:35

    Efficient training in real life: skipping rope, bodyweight options, and consistency

    1. RC

      Yeah. Just on that subject of efficiency and a, and a lifestyle, a few weeks ago, uh, my family and I went on holiday, uh, to Greece, and it's really interesting-

    2. GL

      Beautiful

    3. RC

      ... yeah, it was, it was lovely. Much needed after a long book tour and, you know, all kinds of things this year. It's been busy work year. But what's really interesting, and I shared this in my, uh, Friday email last week, that, you know, we didn't take many bags, so I packed a skipping rope because I knew we'd be-

    4. GL

      Love it. Yes

    5. RC

      ... chilling a lot. It doesn't take any, uh, there's no weight. Super simple. And what I would end up doing before breakfast, sometimes out in the sun looking at the ocean-

    6. GL

      Incredible

    7. RC

      ... every now and again, I'd just do some skips. And then bef- I think on the first day I ended up over the course of a day-

    8. GL

      Incredible

    9. RC

      ... having like 500 skips. And it sounds a lot, but these were in little one-minute segments of-

    10. GL

      Incredible

    11. RC

      ... high-intensity. And then I just said in my head, "Okay, every day you can do 500 skips." And so for seven days, yes, I was chilling. Yes, I was enjoying time with my wife and family. Yes, we were walking sometimes or-

    12. GL

      Incredible

    13. RC

      ... chilling in the sun by the pool, but I was also getting 500 skips in a day. Now, the reason I share that is because I hope that's maybe gives people some ideas that it's not always about a gym, having a personal trainer. Like, let's make this easy. I'm not saying skipping's for everyone, but what's your take on that? Seven days, 500 skips a day whilst on holiday.

    14. GL

      Incredible. Incredible. So you're creating a stimulus. Again, it is what is our endpoint? So you're creating a stimulus. You did, it sounds like you did pretty anaerobic activity. It sounds like you put in quite a bit of effort.

    15. RC

      Yeah, it was tough.

    16. GL

      Uh, it, it was tough. That's amazing. Again, there, that is great for insulin resistance. It's grace- It's great for utilization of substrate. You know, it is great for disposal, so you... Disposal of glucose. You could have ate breakfast and then, you know, skipped rope, put a continuous glucose monitor on, and I bet you see a decrease.

    17. RC

      Yeah. So again, it doesn't have to be this, this thing.

    18. GL

      It doesn't have to be. A, I think that is a brilliant idea. I am gonna actually take that idea. [laughs]

    19. RC

      I love it.

    20. GL

      And-

    21. RC

      Put it in your book. Do it.

    22. GL

      Uh, yep, and I, I think that, um, again, creating a stimulus is really important, and you did that, and that is in and of itself is amazing. And again, can you get a, can you do body weight exercises? You can. Um, those might take longer, and that could be a great starting place for people. Um, yes, I think that that is very valuable.

    23. RC

      Yeah.

    24. GL

      And again, we go through seasons. As long as you are training and doing something outside of regular kind of leisurely walking and, and really putting in meaningful effort, you are going to make improvements.

    25. RC

      Something you said before that I want to make sure I've got right and make sure we've hammered this point home. Let's say someone in their 30s, let's, let's take a, I don't know, a particular movement. Let, let's take a bicep curl just 'cause it's easy, low risk of injury.

    26. GL

      Okay. Yeah, yeah.

    27. RC

      I know it's not a multi-joint movement. And let's say someone at 30 can lift a particular weight 10 times in each arm.

    28. GL

      Great.

    29. RC

      Okay, great. Now, if we're saying after the age of 30, for most of us, there's gonna be a decline in-

    30. GL

      Right

  11. 1:00:35 – 1:07:21

    Women, menopause, injury risk, and adjusting training intensity

    1. RC

      Yeah. That's empowering. That's still empowering that there's stuff that we can do. Now, is there a difference between women and men in terms of this decline? 'Cause obviously women have perimenopause, the menopause.

    2. GL

      Yeah.

    3. RC

      Maybe speak to some of the differences-

    4. GL

      Yeah

    5. RC

      ... please, between women and men.

    6. GL

      Yeah. I, I, I love this and appreciate this lead in. Um, women- Typically have lower muscle mass than men just based on body size. We also have less anabolic hormones, testosterone. In terms of when women, we really see a decrease in muscle mass and strength is often around menopause when estrogen is low. That is really when we see changes in female hormones, estrogen, progesterone. There are receptors, there are hormone receptors for estrogen on the muscle. It is not really well-studied yet. It is just, again, in its, in its infancy. What we do see, and of course there's a, um, a misbalancing of testosterone. Sometime testosterone remains high while estrogen, progesterone go low. It really just depends on the woman. But overall, during times of menopause, this is when we see the greatest decrease in skeletal muscle mass for a woman.

    7. RC

      Wow.

    8. GL

      Um, and actually it doesn't necessarily have to happen. This is the time where I often have women really pick up their skipping rope or their high-intensity training. This is very important also because as estrogen goes down, there is, um, a mechanism, and we don't actually know why it happens, of less movement. Women move less. The estrogen creates a decrease in that, uh, non-exercise activity, which is just kind of you see me, I'm fidgeting, I'm all over the place. It decreases.

    9. RC

      Mm-hmm.

    10. GL

      Menopause is a really important focal point. The idea that women have to gain weight and lose muscle is not true. This is incredibly important because if they up their dietary protein, really manage their caloric intake, modify their carbohydrate intake and understand that carbohydrates really become a meal threshold ingestion, and increase high activity in terms of interval training and resistance exercise, you can absolutely... And you know, if you are in the scope of being able to do hormone replacement, this would be a great time to do it. These, um, that decline in muscle can be circumvented.

    11. RC

      Yeah. This is a very important message. Okay, so-

    12. GL

      Very important

    13. RC

      ... we're so-

    14. GL

      Very important because women are hopeless. They hit menopause, and it sucks for them, or they've seen their friends go through it, and it sucks for them, and it, uh, physiologically and physically doesn't have to.

    15. RC

      I think this is such an important point, right?

    16. GL

      Yeah.

    17. RC

      So again, taking a step back, we're all starting to lose muscle after the age of 30 unless we do something about it.

    18. GL

      Yeah.

    19. RC

      You've powerfully explained why having good amounts of muscle is important for all kinds of different reasons. Okay, great. Now you're saying that when it comes to women, around the time of the perimenopause and the menopause, this can accelerate. So this is an opportunity, instead of-

    20. GL

      Yeah

    21. RC

      ... accepting it, there's an opportunity to get help, maybe discuss HRT.

    22. GL

      Mm-hmm.

    23. RC

      You mentioned increasing protein. We're definitely gonna talk about food very shortly.

    24. GL

      Yeah.

    25. RC

      Then you mentioned something around carbohydrates. You said meal threshold ingestion.

    26. GL

      Yeah.

    27. RC

      Could you maybe-

    28. GL

      Yeah

    29. RC

      ... unpack that a little bit? What exactly-

    30. GL

      Yeah

  12. 1:07:21 – 1:20:42

    Protein strategy that “changes the trajectory of aging”: first meal threshold, leucine, and dosing

    1. GL

      Okay, okay. So carbs, obviously we know what carbohydrates are, whether it's, um, I don't know, rice or potato or fruit or, or whatever it is. It's, uh, those are just examples of carbohydrates. We often think about carbohydrates in a 24-hour period. How many carbs are you having per day? You're having, you know, the RDA for us is 130. The average American is having 300 grams of carbs. What becomes very important to understand is, uh, from a practical aspect, I, I know we're gonna talk about carbs, but I will mention, and I really wanna talk about protein, the first meal of the day is the most valuable. You have to get your protein intake right for that first meal of the day if we are talking about, uh, perimenopause, menopause, and really anybody, because you are coming into that first meal of the day catabolic. You've been fasting. You have an overnight fast. Hopefully you've de- depleted some of your liver glycogen, which is the organ, the main organ that is really maintaining your blood sugar levels. When that happens, that first meal of the day, you wanna practically optimize for protein between 30 and 55 grams per meal. That first meal of the day, uh, you really wanna hit that. If you are a plant-based individual, you need to go more towards 55 because you have to account for protein quality and fiber or whatever is in there, but a minimum amount of protein is 30 grams for that first meal.

    2. RC

      Sorry to interrupt. If you are enjoying this content, there's loads more just like it on my channel, so please do take a moment to press Subscribe, hit the notification bell, and now back to the conversation. But this is, this is so interesting. Right. So we're now going beyond the menopause and perimenopause, aren't we? This, you're talking to everyone here at the moment, which is, is-

    3. GL

      I am. I am. But I know you wanted to talk about, um-

    4. RC

      Well, no, that's okay. That's okay

    5. GL

      ... about... Okay. Okay

    6. RC

      No, no. So for all of us, you're saying overnight we're in a catabolic state, which-

    7. GL

      That's right

    8. RC

      ... for people who don't understand, we're sort of breaking things down. So therefore-

    9. GL

      Unless you're waking up and eating in the middle of the night, which I don't recommend. Yeah

    10. RC

      So, so that first meal, and I love the way that you're not calling it breakfast, you're calling it a first meal-

    11. GL

      Mm-hmm

    12. RC

      ... which of course let's get into timing as well in a minute. But-

    13. GL

      Yep

    14. RC

      ... you're saying you're being catabolic, you're breaking things down, so therefore-

    15. GL

      Yeah

    16. RC

      ... what? You need to give your body an anabolic, so, uh, growth, you know, put on muscle. You need to-

    17. GL

      Yeah

    18. RC

      ... give it that anabolic stimulus. Is that why?

    19. GL

      Yeah. So this is if people take away nothing else from this interview, this is, we are now getting into... We've conceptually talked about muscle. We know that there is stimulus required. We know that we have to do high intensity interval training. We know that you should have a baseline of cardiovascular health. We know how important it is to kinda embrace the suck, as they say. Now we're moving into... So exercise is the potent stimulus. Exercise is medicine. Muscle is the way to go. We talked about the movement, uh, perspective and kind of framing that we are not over fat, we are under muscled. Now we are moving into the next most critical aspect of the conversation, the aspect of the conversation that is completely missed. If individual- and I'm highlighting this because if the people listening do the following advice and execute on the following advice that I'm going to give, they will change the trajectory of the way in which they age. Okay?

    20. RC

      Wow.

    21. GL

      That is my, that is my commitment. Understanding that the first meal of the day, I don't care when it is, is the most important, and it primes your body for muscle protein synthesis. I don't care about your age at this point. This is the time. Listen, if you're young, uh, you know, like my three-year-old or two and a half year old, she can have 10 grams of protein and she's fine, because they're very anabolic. But if you are an adult and you are listening to this, that first meal of the day is the most important, and optimizing for muscle protein synthesis, turning on the machinery of mTOR, which is mechanistic target of rapamycin, which is the way in which we think about muscle protein synthesis over a lifetime, will be stimulated. If you are sub-threshold this amount of 30 grams, depending on your age, you will not stimulate the tissue. You... It's like being pregnant. You're either pregnant or you're not. You're either stimulating this or you're not. If you are sub-threshold, you do not stimulate this tissue.

    22. RC

      Okay. But this-

    23. GL

      Why is that im- Yeah

    24. RC

      ... this, this is fascinating because let's say someone is trying to have some protein at breakfast. Um, I was actually looking at this just before we had this conversation. So there's some wild salmon in our fridge.

    25. GL

      Great.

    26. RC

      And, you know, one filet has about 24 grams of protein in it. Right?

    27. GL

      Hey.

    28. RC

      Right. So I think for those people who do, do eat fish, and I, I appreciate we're now getting into super controversial areas of animal protein versus plant protein. We're definitely gonna cover that, so I think it's important to-

    29. GL

      Which was never controversial when I... You know, I've been, like, I have been mentored for the last 20 years by one of the world-leading protein experts. It was never controversial a decade ago.

    30. RC

      Yeah.

  13. 1:20:42 – 1:28:43

    Geriatrics, falls, and quality of life: why muscle and protein matter in aging

    1. RC

      There, there's a couple things here. Uh, I've been researching your work over the last two days in preparation for our conversation, and it just so happens that the last four days have been quite, um, quite stressful on a personal level because my mother, she's 81 years old at the moment, and she's pretty immobile these days. Uh-

    2. GL

      Mm

    3. RC

      ... on Friday, she had a fall where I had to-

    4. GL

      Oh my gosh

    5. RC

      ... go and, um, basically-

    6. GL

      Ugh

    7. RC

      ... pick her up by myself on the ground, which is pretty tricky. Uh-

    8. GL

      That's terrible

    9. RC

      ... and last night the same thing happened again, and you've mentioned a few times that you have worked in geriatric care, palliative care.

    10. GL

      Yes.

    11. RC

      Now, I just wanna bring those threads together.

    12. GL

      Of course.

    13. RC

      Can you just explain, you know-

    14. GL

      Yeah

    15. RC

      ... falls is a big problem, right? You've worked in geriatric care.

    16. GL

      Oh.

    17. RC

      I have to explain my own personal experience.

    18. GL

      Yeah.

    19. RC

      Put all this together for us. Why is protein, why is muscle so important?

    20. GL

      Well, I have to say that, you know, my time as a, a geriatrician was incredibly traumatic. Essentially, geriatrics is end of life. Um, obviously I'm not saying that [laughs] about your mom, but I'm saying in clinical experience, I worked at a nursing home. I did this for two years. I did hospital rounds. I did palliative care. You witness people fall. You witness the aftermath of the fall. You witness the complete devastation of individuals with dementia. Um, and that is ultimately at the core why I became so vocal because I believe that if you have knowledge and if you have experience, it is your responsibility, and I will say that it's not always easy to be as, uh, forthcoming as I am, right? As you know, there is a bit aggression that comes back at me, but it's not about me. It's about the experience that by me sharing this, we can help your mom. We absolutely can help your mom, and that is a very pinnacle and poignant part of, of my personal experience, and frankly one of the reasons I'm so vocal, because there's so much misinformation, and people that have not worked with aging or have not seen aging parents, everybody in the middle is arguing. Everybody is [laughs] arguing about longevity, and nobody is talking about quality of life.

    21. RC

      Yeah.

    22. GL

      This idea of restricting protein to live five years longer is ridiculous. D- has anyone experienced what the quality of life of having low muscle mass is? Poor balance, low bone density, that stuff is devastating. When I think about an aging individual, you must prioritize protein because number one, like you said, they don't have an appetite. They eat less. The calories that they eat really, really matter, and again, we are now thinking about a different season of life. Are we thinking about phytonutrients? I mean, yeah, but that's the equivalent of window dressing on a beautiful home. You have to get the foundation right.

    23. RC

      Mm-hmm.

    24. GL

      You have to get the food matrix right. Then you can think about your elderberry syrup or your resveratrol or whatever else there is, but if you miss the foundation, none of that matters.

    25. RC

      Yeah.

    26. GL

      None of that is gonna improve your survivability from a fall, which is one of the most critical aspects of, uh, an individual who is aging, what they are at risk at. Resveratrol in and of itself, for example, you know, it's not like res- I'm just picking on resveratrol. I'm sorry, resveratrol. But you, we have to really look, take a big step back and look at the big picture of what the fundamentals are, and that is increased muscle mass, improved balance, have good, uh, bone density, and survive and thrive and be functionally, uh, independent as one ages. And now I'm gonna circle it back to dietary protein. We talked initially about anabolic resistance, meaning the efficiency of protein utilization goes down. The most important thing an aging individual can do is optimize protein. They can optimize their protein. This can help offset muscle wasting. It can help offset the fact that they might not be training as hard.

    27. RC

      Mm-hmm.

    28. GL

      It can help with blood sugar regulation. It can help with, um, tr- you know, improving triglycerides. It can help with blood pressure. These things are very valuable. So for someone like your mom- If we gave her a 30 gram whey protein shake, whey protein has a high percentage of leucine in it, I would be very happy.

    29. RC

      Yeah.

    30. GL

      And we gave her two meals a day that really optimized for her muscle, and a little bit of creatine, 5 grams of creatine, I would be very happy.

  14. 1:28:43 – 1:42:21

    Animal vs plant protein: amino acid quality, calories, and optimizing muscle

    1. RC

      Yeah. Let's go back to food and protein. Um, you've given your view very clearly on what you think people should be doing to optimize skeletal muscle.

    2. GL

      Yeah.

    3. RC

      30 to 50 grams of protein, particularly at the first meal of the day.

    4. GL

      Yeah.

    5. RC

      Now, let's go there. Animal protein versus plant protein.

    6. GL

      Yeah.

    7. RC

      Um, this becomes delicate because of the... Well, as you say, you've been studying this for a long time, and it, and it-

    8. GL

      Yeah

    9. RC

      ... never used to be controversial, but it now-

    10. GL

      No

    11. RC

      ... is. And I think-

    12. GL

      Yeah

    13. RC

      ... the problem with the controversy is that many people are scared these days of speaking up. Now, I, I'll just give you a quick example here, right?

    14. GL

      Yeah.

    15. RC

      A very quick example, which I think you may resonate with. I have a very good friend who used to be vegan, used to-

    16. GL

      Yeah

    17. RC

      ... have raw food, used to be vegetarian, then went paleo, that is literally very, very knowledgeable, very health conscious-

    18. GL

      Right

    19. RC

      ... has tried a whole variety of things, and she is now pretty much carnivore, right? Uh, she has a maximum, I think, of 20 grams of carbs a day-

    20. GL

      Mm

    21. RC

      ... and she is thriving. And when I say thriving-

    22. GL

      Mm

    23. RC

      ... I mean athletically, cognitively. I don't know anyone who can stay cognitively as sharp for her, uh, for as long as she can.

    24. GL

      Mm.

    25. RC

      But she and some of her friends have said to me, "We feel nervous about even sharing that," because these days there's such criticism that-

    26. GL

      I know

    27. RC

      ... she only eats twice a day, sometimes once a day, but-

    28. GL

      Yeah

    29. RC

      ... it's mostly, um, animal protein, basically.

    30. GL

      Yeah.

  15. 1:42:21 – 1:46:18

    Closing takeaways: muscle as the “organ of longevity,” plus a simple action plan

    1. RC

      Gabrielle, I think as we bring this conversation to a close, it has been such a joy talking to you. I think you've shared so much practical information that I hope will help people think differently about muscle and protein [laughs] and, and-

    2. GL

      Yeah. Muscle is the organ of longevity. Yeah.

    3. RC

      This podcast is called Feel Better, Live More. When we feel better in ourselves, we get more out of our lives, and I think your work very much speaks to that concept.

    4. GL

      Yeah.

    5. RC

      So right at the end, I always like to leave the listeners, the viewers with some kind of practical take-home tips that they can think about-

    6. GL

      Yeah

    7. RC

      ... putting into practice into their lives. Now, I know you've mentioned lots throughout the conversation, but I'd just love you to finish off with some final words, right? Why is muscle so important, and what can people do-

    8. GL

      Yeah

    9. RC

      ... to start beefing it up in their lives?

    10. GL

      I love it. I love it. Well, as you know, muscle is the organ of longevity and really has the opportunity when leveraged correctly to change the trajectory of our life. And when we think about the two most important aspects about muscle and how we can impact them, number one, we do think about exercise. We think about high stimulation to increase adaptation, high-intensity intervals. Throw that in at least one time a week, maybe twice. Resistance training, that can be three to four times a week. To failure to perceived exertion, very valuable. Building a base of cardiovascular activity. Again, the recommendation seems a bit robust at 150 minutes of moderate to even vigorous activity. So that's the exercise piece. Now, the nutrition piece is equally as valuable, and that is understanding your dietary protein need. And from my perspective, one gram per pound ideal body weight would be optimal. You need to make sure that that first meal of the day hits between 30 to 50 grams of high-quality protein. If you, um, are more plant-based, you can always use a branched-chain amino acid, but you really wanna go to that higher end. And then understanding, I would like to see at least one more meal at between 30 and 50 grams of dietary protein. And then following up on the carbohydrates, if you eat carbs, keeping that between, you know, 40 grams, around 40 grams, higher 50 grams, 40 grams or less to mitigate insulin if you are at rest and, and not, uh, working out right after.

    11. RC

      Super practical.

    12. GL

      Those would be my takeaways.

    13. RC

      Super practical, super helpful. And, and just finally, are you optimistic? Is the message getting out there?

    14. GL

      Yes.

    15. RC

      Are people starting to change their behavior?

    16. GL

      Yes. Yes. We are starting to change the conversation, and I'm so thrilled. This has been a long time coming. I believe that we are going to start recognizing muscle as the pinnacle and really the primary site for insulin resistance, which everyone has been trying to tackle obesity, but obesity is symptomology of root cause, which root cause is skeletal muscle. And if we can learn to leverage it by training and really building our resilience and understanding we can leverage dietary mechanisms to optimize this over time, we absolutely can change the conversation from over fat to under muscled. It will happen. It's happening.

    17. RC

      I love it. Muscle is the organ of longevity.

    18. GL

      Yep.

    19. RC

      Muscle is medicine. You are certainly putting muscle on the map. Thank you so much, and I look forward to doing this again at some point in the future.

    20. GL

      Yep. Thank you. Thanks for having me.

    21. RC

      [upbeat music] If you enjoyed that conversation, I think you are really going to enjoy this one about the daily things you can do to lose weight and prevent disease.

    22. SP

      I used to think, you know, weight loss is just about willpower. It's about calories in, calories out. The energy balance equation is always true, but people always misinterpret it to mean that just eating fewer calories leads to body fat loss. It does not

Episode duration: 1:46:18

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