Transcript for:
Sănătatea musculaturii și calitatea vieții

you say the quality of your life is a direct correlation to your muscle Health why because muscle is the organ of longevity and your capacity to show up and execute anything and everything that you want in your life depends on your strength and in order to build physical strength it requires mental strength it requires fortitude it requires resiliency and right now we have this conversation about longevity and health span what does that actually mean that actually relates to the tangible plasticity of skeletal muscle and by the way you know we were kind of joking around podcasters in Austin but when you think about skeletal muscle you often think about broscience you think about the big dudes skeletal muscle is so much more than that and in fact the health of your life depends on the health and the quality of your tissue interesting obviously the byproducts of building muscle uh discipline resilience being able to overcome hard things consistency motivation so on and so forth somebody quite easily could say well I get that with distance running I get that with rowing I get that with doing yoga what is it specifically about muscle building that is important for longevity well when you think about skeletal muscle there's there's a couple things that you have to think about skeletal muscle is the primary site for glucose disposal right now if you look at the CDC and they'll give you a list of causes of death it'll put uh cardiovascular disease it'll put cancer it'll put diabetes it won't put obesity on there and it won't put lack of skeletal muscle it'll also have Alzheimer's what you'll see is that these diseases at the root all have its place in skeletal muscle first and foremost so if you care about any of the top eight or nine causes of death you have to care about skeleton muscle now what's what's the next level to that could endurance running be great yes it's amazing is Yoga great sure absolutely you have to also train for strength and train for Life having skeletal muscle is like your body armor we've all had friends family members that have gotten sick if they were amazing in endurance training but had very little skeletal muscle what is going to protect them in those moments of catabolic crisis so we don't age Chris we don't age linearly it's not as if that this slow decline what happens is there's an insult and then there is a rapid Decline and then depending on your capacity to step back up is based on your ability to have healthy skeletal muscle in part it's called catabolic crisis what what do you mean when you say insult or catabolic crisis so for example if you fall and you're injured or you get sick and you have pneumonia for a week when you're younger your ability to get back up to Baseline to be more physically active is more flexible as you age we've all seen it as you age an individual um grandmother breaks a hip she'll never be able to rise back up to her Baseline level of functioning potentially she could but as she gets older the ability to return to a more youthful Baseline decreases and that has to be trained for you have to be able to be strong you do have to be able to build muscle and skeletal muscle is interesting the skeletal muscle MUSC is a nutrient sensing organ skeletal muscle is an organ system it's a nutrient sensing organ system that senses the quality of the diet and specifically these amino acids specifically Lucine I'm sure we'll get into it but that efficiency goes down as we age if you train and eat and do the things you did in your youth you not evolving um you know there's you know mental Evolution there's all kind of more esoteric Evolution but you also have to keep up with an evolving physiological process and a biological process and that's where focusing on hypertrophy and strength obviously they're not the same but focusing on skeletal muscle as a tissue as it relates to medicine is Paramount so I understand definitely from the literal physical body armor perspective somebody Falls if they have more muscle that is supporting around their joints it means that there's going to be less atrophy it means they're going to be able to get back to function more quickly but you went through this whole Litany of other things like Alzheimer's Parkinson's dementia you know heart disease talk to me about the mechanism of what having skeletal muscle is doing that helps to mitigate the onset of that or delay what what's skeletal muscle doing to our health span well can I start with a just a very short story a very short story to bring the listener in because they're thinking dude Chris is jacked he's bringing in these tough big dudes talking about muscle you've had myre everyone is thinking it everyone that's listening they can't stop thinking it they TR they can't look at you they can't you've had Stan eering you've had Chris plumstead people that I just know and love let's talk about muscle from a different perspective and I promise I'll make the story short I did um my fellowship in nutritional sciences and geriatrics and I did that in uh at wasu for those the listeners that don't know it's a very rigorous program it's considered the Harvard of the Midwest it's very challenging and I actually didn't want to do geriatric medicine the deal was in order for me to study nutritional sciences and obesity medicine I had to get funded and the way that I was going to get funded was through geriatric training so during the day I was working with individuals that were over the age of 65 and they were the majority not healthy um on the alzheimer's unit in nursing homes end of Life pallative Care it gets extremely depressing when you're seeing 30 patients a day talking to their families about what their wishes are Etc right and I think any doctor would attest to that and then early mornings you know when you're a fellow you have very minimal quality of life especially if you're a combined research fellow waking up at 4 in the morning doing fat and muscle biopsies and then in the evening doing cognitive testing um and I fell in love with one of the participants and she was in her mid-50s a mom of three and she was like so many women that we know she always put herself last she yo-yo dieted Weight Watchers you name it she did everything every single thing that we told her was the right thing to do I imaged her brain and her brain looked like the beginning of an Alzheimer's brain and I realized that we failed her we failed her the medical community had failed her and I couldn't stop thinking about it I needed to find a solution that how was it that we were giving this information um move more eat less follow a food guide pyramid how are we not getting this together what is happening and then I started thinking as I'm rounding in the nursing homes and I'm seeing these patients and I'm seeing them die and I'm watching kind of this spectrum and I realized that it wasn't that they were overfat it was that they were under muscled and that we have been trying to fix the wrong Paradigm for the last 50 years and that the diseases and the disease process that I was seeing and we'll call her Betty was beginning in her 30s like this began in her 30s and this constant iteration and plethora of information of focusing on what we have to lose the quote obesity epidemic it's not an obesity epidemic obesity is a symptom of unhealthy skeletal muscle obesity and like you mentioned Alzheimer's the things that ride along with it have roots in skeletal muscle decades and decades before they become an issue and I wanted to frame that for you because that's what's critical to understand we have a whole population focused on what they have to lose we have over 40% of the population focus on the wrong thing we are setting themselves that we are setting them up for failure it's not an obesity problem skeletal muscle is at the core skeletal muscle skeletal muscle insulin resistance there's some great data um that one of the Hallmark studies came out of Yale looking at 18-year-old in college students that had no outward signs of insulin resistance when they became sedentary pathology in skeletal muscle started skeletal muscle is a primary site for glucose disposal you know I know that we've got a lot of mutual friends when they're running and doing a million miles skeletal muscle where they're going to put their carbohydrates is it's going to be stor as glycogen and skeletal muscle people talk all about carbohydrates nutrition is more electric than probably religion skeletal muscle is again the site of carbohydrate disposal it is a site of fatty acid oxidation we have 40 million people on statins why not focus on the health of skeletal muscle prior we have um of mitochondrial density in skeletal muscle when skeletal muscle contracts it releases myocin skeletal muscle is an endocrine organ system interfaces with brain for neurogenesis you name it skeletal muscle interfaces with the immune system and and in multiple different ways it releases interlukin 6 which is a myokine the most famous one also releases glutamine Contracting skeletal muscle releases glutamine which directly feed lymphocytes cells of the immune system so if we are truly going to change the Paradigm of Health we have to frame the question correctly so that's what skeletal muscle does and then of course you look good naked and all the other dating things that you may be talking about there's all that other stuff okay so there's look good naked and then be strong and capable and age well and be able to do the things that you love so that you can show up for the life that you've created in a strong and capable way I often think about my kind of Heritage training in my 20s and how I was 18 years old and I got to the Center for sporting Excellence at Newcastle University and I was I think I was about 63 kilos which is just not heavy I'm built to be very small I'm built to be very very slight and um I remember the first day it was about 2 and a half years later I hit 70 kilos and I was like I am massive uh and now I walk around at like a a portly 88 and I'm like God I wish I was 70 it was so much easier to move around when I was 70 but I think about the fact that the reason I started training is because I wanted to be more attractive to girls and I wanted to feel more powerful I wanted to look and feel like a man right even though you've still got the body if you're an like ectomorphy kind of guy 18 years old you've still got the body of a teenager you don't have the body of a man and I didn't want that I want it to change but it's kind of like um come for the gain stay for the longevity right that you arrive because of how it makes you look and how other people respond to you and the progress that you see in the mirror but it seems as you're saying here that Downstream from this the benefits that you get from a physiological perspective from a longevity Health span perspective are pretty drastic so if it's the case right if there is an unseen mechanism which we could be using a pathway physiologically which would mitigate people from getting ill and help us to defeat disease disease more effectively and blow off glucose and and improve insulin sensitivity all of the things that you've just listed why is it the case that there is such an obsession with BMI with losing weight with reducing fat I spoke to Stan eing Stan eing said on this very podcast he was talking about the pivot between um moving from sugar to aspartam uh aspartame on um diet drinks and he said what people don't consider is the sheer impact of the weight loss itself will be so beneficial that any increase that you are concerned even though the concern about like Aspartame is is like 8,000 Cokes a day you'd have to drink in order for you to hit some sort of threshold that would be dangerous even him the strongest bodybuilder on the planet was telling me weight loss is very important so talk to me about this relationship between obesity like being overfat and underused as you call it like what what's this relationship where is it important and what what kind of gets missed off in this conversation well first thing I think it's really important to recognize is that we don't directly measure skeletal muscle mass routinely again this flies in the face of have we been asking the correct question and in my mind the answer is no we use dexa which is a dual x-ray we've all heard of dexa and that actually measures uh bone and fat and then there's lean body mass and lean body mass includes everything we've been directly measuring adapost tissue and Bone but not skeletal muscle first and foremost we have to recognize that when we talk about skeletal muscle when we talk about how much we haven't had a consistent way of looking at it just one that it which we will eventually so there's a something called D3 creatine which will eventually come out it's a tagged it's a deuterated creatine it's tagged uh you'll take a pill you'll be able to pee on a stick and see how much muscle mass you have but up until that point ctmri or not really feasible for everybody to be doing and especially tracking over time so the big the big picture is we haven't been directly measuring skeletal muscle mass we have estimations at best secondly we measure body fat because that seems to be at a certain level we know that that can cause implications whether it's 30% or more body fat we know that there is an increase in inflammation potentially triglycerides hypertension uh Etc that is important to know but again this just goes in the way of thinking of looking at the wait until a problem comes and we know that this is the problem there is data to support that it actually it is the loss of skeletal muscle versus the increase in body fat that may be more detrimental and again um I think that we're going to start to see an emergence of more data as we begin to directly measure skeletal muscle mass but you will see that the survivability of an individual they will have a greater survivability the more healthy skeletal muscle mass they have do uh you know whatever it is 50% of Americans are obese maybe more than 50% of Americans are obese are overweight presumably someone that has to carry around that much Surplus fat yeah has to if you were to lean them out they must have an okay bit of muscle underneath surely is that not the way it works um well in the data it says that they have more muscle and so glad you brought this up have you ever had a riye steak many times many times have you ever had a filet yes okay um individuals that have obesity not all of them but typically what happens is you get fat infiltrated into skeletal muscle intramyocellular fat while an individual may have more muscle it talks nothing about the quality of that tissue you want your tissue to look like a fillet and actually when we talk about pathology of tissue what SK Cal Muscle really requires is flux it requires activity it requires stimulation not just walking I mean walking is great but people are saying well just walk you'll do that it's not frankly enough um but it's that flux that utilization of glycogen you know fatty acids are used primarily by skeletal muscle at rest which is interesting the health of skeletal muscle is determined by its activity while an individual could be obese and have potentially more muscle one has to ask the question is it healthy skeletal muscle that's interesting yeah because I remember seeing this uh it's an illustration of a a normal-sized person and a really really overweight person and it's an x-ray of the inside of them and you see that the bones that both people's bodies are scaffolded by are exactly the same and yet you look at the amount of mass that is scaffolded upon them and you go wow that is crazy to think think that somebody that's you know 500b or 600b is only being held up by the same buttresses that a person that's 120 pounds is yeah yeah and and I think what's so fascinating is that it goes to the the point that this is very plastic tissue you can change it it's very uh pliable and you literally can add Mass to an organ system in a healthy way last time I checked you can't grow your liver I'm not talking about alcohol but by attention and awareness you can make very specific changes that have a measurable outcome and 50 and by the way Chris 50% of Americans don't exercise yeah well give explain given that we know however many percent of people are overweight so on and so forth what's the stats when you look at it from your lens right the Bros lens what is it what is it that people are or are not doing when it comes to protein intake resistance training muscle mass grip strength ability to pick something up is it like some ungodly percentage of fathers can't lift a a daughter after four years old or something yeah I mean well I think that you're changing the conversation because your guests are all in order to be a guest on your show you have to be at least 250 pounds I think you have to at least be um so I appreciate you having me on because I am substantially less no it's the deadlift it's the deadlift numbers you've got it wrong it was deadlift 250 pounds not B250 pounds okay perfect perfect um so 50% of Americans don't exercise you know I'm not exactly sure why but the reality is 100% of people eat if I were to say which is going to have a bigger impact on skeletal muscle Health it would be training the influence of exercise and its effect on all of the homeostatic mechanisms in the body is profound it influences every organ system however you could go your whole life without exercising we're not saying that that's healthy but you essentially could 100% of people have to eat and you really must begin to pay attention to this especially as you age and listen the human body is totally flexible you talk to Stan he'll eat a certain way you talk to Chris they'll eat a certain way the human body is amazing the question becomes what is the ultimate outcome that you're looking for and from my perspective my perspective of muscle Centric medicine skeletal muscle is the Pinnacle of health and wellbeing muscle Centric medicine I love that yeah so that I poined that in 2015 and began to develop it and that's something that we teach to other providers very cool what was that thing I think I read in your book something about the relationship between a mother's Fitness and the health of her children yes yes ladies train women need to train and you need to also continue your activity while pregnant you're not just departing and deploying behaviors but there is some epigenetic change the healthier and more fit the mother is the better their offspring will be wow yeah what um what's the 30,000 foot view of uh training while pregnant well first of all they say continue to do what you do there's very little data in literature on training while pregnant I can tell you what I did and I can tell you what I tell my patients to do throughout my pregnancy I swung kettle bells I lifted heavy things I wasn't trying to do a one rep max but I was incredibly active by the way I also had hyperemesis gravitum do you know what that is that sounds like some Egyptian pharaoh no something that you will never experience and thank goodness it's basically where you're throwing up all day long I mean it is impressive it is aggressive it is a something that they don't sell you on pregnancy in the beginning but number one you have to understand that you're going to feel bad so you might as well train anyway I felt terrible I would swing CLE Bell throw up swing CLE Bell throw up I mean it was a sight to see man when I went into the gym instead of having a water bottle I had like a a bark it was the worst yeah uh I think they lost a lot of gym memberships that I bet they did Doctor Over The Far Side hurling everywhere so is there anything are there any movements uh in density levels that you would say you know there's a girl that's listening or a guy that's having a kid with her it's like darling don't do what like don't try and pull Sumo I don't know like is there something that you would try and avoid people from doing lot of burpees maybe I don't know yeah I mean it depends right so they'll they'll say that um activity and walking and moving and lifting will actually can induce labor later on again obviously people have to figure out how it's going with their pregnancy and what their individual provider recommends but listen giving birth is is like a sport so doing squats doing those things it's very difficult to deadlift uh pregnant and swing kettle bells but you should be able to carry you should be able to move um and again it just depends on the individual but my best advice is be fit going into pregnancy and continue it is there anything that you've looked at to do with Dad fertility let's say that there's a a guy and a girl who want to get pregnant a bunch of my friends have had what do they call it conception moons which is kind of like a baby moon but it's before it's like for like we're going to go one of one of them was really really Keen to give his daughter a French name so went to Bordeaux in an attempt to conceive didn't happen I'm pretty sure it happened when they were on in Nashville or something on the way back airport call a k call a Kid Rock um so what about for dads you know I I've heard a lot of my friends they'll go like um dialing in the diet adjusting these sorts of things is there anything that you've seen for improving fertility improving the quality of of sperm for men yeah certainly diet plays a role diet plays a role in fertility and these this is also multifactorial it's not one thing you can't just have a good diet and all of a sudden your um you don't even know your your children's names like that is not happening but I would say that the obvious would be have a good diet have foods that are rich in zinc and proteins the other thing that I would say is we do know that the better body composition an individual has the better their sperm potentially the health of their sperm is resistance training is plays a role in that um the other aspect that I will say because I'm a physician is Clomid or en chopine I don't know if you've heard of that so selective estrogen receptor modulator very safe been it's been used for quite some time it's typically used in women but we use it a lot for men um and it's it can help improve sperm volume how long can guys run and Chine for before you get before you would start to be like it's time time to back it off now mate you could the way that there's there's multiple ways in which uh you could run it but we run it for we'll run it for 25 days on and five days off and we could run it for every day um so my husband actually I don't know if you no this but my husband was a seal for 10 years and now is a Urology resident so he works at Baylor and in neurology which is where Men's Health was born so lip Schultz have you heard of lip Schultz no what you got to get him on or mohead Cara these guys are major in andrology these were the guys that created you know where we talk about trt these are the guys that created this medical practice and um I I could say really an appropriate joke what I'm want n okay right so yeah in your opinion is exercise more more important than nutrition yeah wow I mean do I have to pick one you got to prioritize 100% of people eat so get that right yeah it's interesting to me to think about this pivot now from what has been quite an obsessive diet culture for 40 years 30 years something like at least at least yep at least and now thinking well what are the reasons why what are the reasons why the diet culture is so much more fervent and and religious as you mentioned compared with training culture like the 5x5 and the 531 and the gvt and the push pull legs and the five-day split guys aren't they're all friends jeweling it out on the internet the only people that they all hate together are crossfitters right so that's fine but it it's very interesting to me and I wonder whether this will become a Battleground as more people plant a flag because they're very passionate about my training modality is an important part of who I am as a person and it's I think a big chunk of the nutrition uh argument comes from almost like a fear of death a lot of people that are into this are doing it because they want to improve their health span improve their longevity and me attacking your approach when it comes to a nutrition Foundation is kind of the same as me saying you think you're going to live a long time but you're not and I know that you're not so it's it hits very very deep and I don't know whether people have that same amount of existential attachment to their training modality but if what you're saying here and muscle centered medicine continues to grow as it has been it's going to get to the stage where you are going to have religious fights over what split should we do you're absolutely Ely right and I think that's interesting when you think about training and you think about nutrition part of the reason why people again this is just my opinion are so at odds with each other is because they are unaware of the lens at which they're viewing something through it's almost as if they're ponds so if you look back at the history let's say you look back at the history of nutritional Sciences which by the way isn't that old you look back at the history and after the Great Depression moving into World War II when the backs the Americans at backs were against the wall and were going to lose a country they drafted the first million men and the first million men were unfit for war 38% I'm sorry 38% of the first million drafted were unfit for war they said things like they had flabby muscles they had poor eyesight because of vitamin A they didn't have any teeth obviously because of the Great Depression there was a lot of undernourishment this became a real threat this was the first time that the US really identified that nutrition was a real threat they issued a series of I don't want to say propaganda but a way of educating and what they issued was in one hand they said are you going to support Uncle Sam and in order to support Uncle Sam here's what you're going to do and what they said was you're going to eat high quality proteins you're going to eat liver and eggs and beef and Dairy because you need to have strong muscles this is in this is in the 40s no idea they said you're going to minimize processed foods and you're going to eat uh fruits and vegetables and even have some like it was like sodium electrolytes they I was really shocked when I when I saw that part and then they said are you g to help Hitler and and they showed an individual who was skinny and scrawny and here here is the way you're going to help Hitler you're going to not eat high quality protein you're going going to eat processed foods you're going to eat white bread in the 40s they established these guidelines and they started this whole campaign about how we could be stronger and more capable and vibrant and courageous and that's what we needed then obviously all these high quality foods were shipped to overseas to the soldiers they started to um for need uh increase in processed foods you have Sylvester Graham and John Kellogg Sylvester gr was a minister I don't know if you've heard of him but he was kind of the move the The Godfather of this what do you call vegan movement and he started to talk about the idea that in order to be a moral person you needed to reduce any kind of animal products you shouldn't drink you shouldn't have sex you should eat very plainly and he got um a really influential follower and that was uh Kellogg who then made granola and a gram cracker what's the story how much legitimacy is there around the Kellogg origin trying to Soy the men cook them into low testosterone give me your put your tin foil hat on and let's go let's go full okay fine I mean I wasn't I wasn't around at that time I wasn't there but I think what happened was there was an early recognition that high quality foods were imperative to health and wellness and we're going to lose the country this became a high priority then obviously we have a nation to feed and ultimately a global a global industry and a just a global feeding zone right we have to do those things process foods which are under two different jurisdictions and commodities in these Whole Foods um require money they get money they make money Whoever has the money controls the narrative so whatever the agenda is Whoever has the most fortitude behind that gets to control the narrative and this is kind of circling back to the question of why is it so crazy I wake up and I choose violence Chris I post something and I go oh man I cannot wait just just I and I have to do it see we talked offline before and if you have a certain skill set then you have a responsibility to share that is that true I think so I've been a physician since since 2006 I've seen a lot of life and I've seen a lot of death and so why I even started talking about this is because I saw so much misinformation and here I am as a geriatrician at the bedside of like oh signing this death cert certificate and then this death certificate and all these people are talking about how you know going plant-based is going to save the world and all this other BS and not thinking about uh how that is going to influence the midlife people and what that end result result is going to be what is the impact of going plant-based on people that are no longer 23 I think that we are going to see an epidemic of osteoporosis and sarcopenia like we've never seen before what is that for people that don't know uh sarcopenia is a loss of skeletal mass and function and osteoporosis is bone density and could you be young and plant-based could you get all the protein again this is a very um just like a very small perspective this idea that plant and animal foods that it's all just about protein protein we talk about generically but Protein that's 20 different amino acids nine of which are essential those nine essential those are individual nutrients these things are not interchangeable we are not just talking about dietary protein we are talking about food as a food Matrix and the things that ride along with it for example if you're eating high quality protein you're getting creatine you're getting carnitine you're getting torine you're getting an Serene High B12 iron these things are necessary for young children and women and as you age it's not like your appetite increases the lower your quality of protein or the lower your diet is in protein the higher it needs to be animal based because you're not just eating for dietary protein you're eating for other nutrients and so what do I think you could be plant-based and healthy I think that you can I think that the body is very adaptable I think we're going to start to see um ways in which maybe the gut microbiome plays a role but do I think it is an ideal diet for an aging individual absolutely not I don't and this is based experience looking at the the way to improve your body composition what are the principles of optimizing body composition in your opinion well nobody likes to hear this but you track your money and you track your speed right say yes Chris sometimes Monday Wednesdays and Fridays you got to track your food it's just a reality I know people want to do intuitive eating I'm sorry guys just get a sense of what you're actually doing and it's annoying but if you have goals and you know that you need to hit those you have to be able to track okay what is your I'm G to stop you and get tactical each step of the way what is the most seamless way that you have found to track food because it's not my fitness pal I will fight you if you say so so what I do is different than what I think is the easiest thing right what's the easiest thing um like chronometer just an app what's your favorite what do you tell your clients to use chronometer why because it has just like nearly everything in there all these different nutrients again typically the the label only has 14 different nutrients is that is chronometer the one where you can take a picture of your food or you can speech it in and say like one uh slice of toast with three eggs hardboiled blah blah well again I haven't been using it because I didn't I didn't tell you what I do what do you do I haven't used it I want to know what this this tapped into the Matrix version is it is called pen and paper oh God that's lame oh no are you kidding super lame what are you talking about you can write it and then you can look at it I'm old school I'm old school man I can tell yeah okay so uh I write it down but then I know exactly what I'm doing and also by the way my food diversity is not huge and you're going to be talking to our good friend bados kolan I want you to ask him what he had for lunch three weeks ago on a Wednesday he'll be able to tell you is it because it's the same thing that he had for lunch every other day yep consistency so once you know what you're doing then uh like Smooth Sailing well I mean this was what uh a really interesting Insight from Alex hosi he says that most people work really hard at trying to alter their diet and alter to their caloric intake and stuff but really your diet isn't a diet it's probably five meals that you've got in the locker that you eat very very regularly and it's a case of just nudging these five meals right or getting rid of one entirely okay I don't do the bges anymore because it turns out that I'm an addict for cheese and that cheese is making it two 2,200 calories right it's not that complicated but if you were to go on social media you would spend at least six months in paralysis true right so what doesn't get man what doesn't get measured doesn't get managed so you need to be measuring the food that you're taking in at first at first and I'm gonna walk you through um and I actually talk about this in my book for ever strong you know we haven't really mentioned it but I wrote this book for ever strong so that it could be something applicable for everybody you literally can read it it talks about the history I know that you read it um and it's you know an Evidence based it's an evidence-based manual and when you think about how you put together a diet it's quite simple what I recommend and what the data would support is 7 grams of protein per pound body weight or ideal body weight if you want to go higher so simple so you're what 88 180 call me 180 okay 180 is and you're happy with that weight feel great yeah I I should recm uh I need to lose a bit of weight I actually did a dexa at Fountain life in Dallas a few months ago and it came back back at 19 and a half% I was like that if I'm 19 and a half% I'm the leanest looking I don't know where this weight's gone it's like all in my all in my foot or something uh and then when I do an electrolysis I'm much closer to kind of 13 and a half or so uh so I don't know whether I don't know whether the Dexter was uh having an off day yeah clearly clearly having an off day that's interesting and then it'll be interesting to see as you track your skeletal muscle but again this we we have to understand that that is uh do we know your optimal skeletal muscle I would say we don't so yeah 180 so I think I I try to hit 180 I Tred to go for one gram per pound Great but it's hard it's hard why is it so hard for me to hit high volume protein you're not hungry the body you're not hungry so dietary protein number one I I want to mention something that I think often gets overlooked as we talk about quote macronutrients is that protein need is really the only macronutrient that changes as you age the intake or need of carbohydrates and fats like who cares doesn't actually change but the biological and physiological processes of the body require more protein as you age more protein as you go through if you have a catabolic crisis or if you're going through cancer your or if you get burned no other macronutrient changes in that way so we have to get the story of dietary protein right we just we have to because it is the most effective macronutrient when it comes from when it comes to body recomposition when it comes to when it comes to body recomposition when it comes to understanding that each of these amino acids have diverse biological roles again we are talking about dietary protein but if we look at these other amino acids like thine thine is essential for mucin production in the gut tryptophan is important and essential for serotonin production phenol alanine is critical for dopamine production Lucine is critical for mour signaling which is important for muscle protein synthesis so we talk about protein but what we really are talking about are these individual nutrient needs which by the way I think that that is the next iteration of the protein conversation is really looking at these limiting amino acids but I'm digressing so I'm going to go Circle back to the 7 to one gram per pound ideal body weight everybody who does that in my opinion is going to do better when it comes to people who say Dr lion that sounds great but I get to 90 gram of protein a day and just sick what do you advise to your clients or what are your best hacks for increasing that protein intake are there any recipes any food types any what is it what is it that you give to people well the the question is why are they really struggling to get that it is very satiating you know it does uh influence GP and pyy gut hormones the question is why are they so full is it because potentially their metabolism they've had some kind of adaptive thermogenic Genesis or is it that they just don't have a protein appetite so the first thing that we do is we get a sense of what their total calories are that's the first thing that you need to do you have to know what you are ingesting again like you said what you measure changes tracks blah blah blah blah understanding that hitting that first meal of the day and hitting it early on again a lot of people talk about fasting and pushing that fasting window later I think that there is something to be said for eating after you are coming out of an overnight fast your muscle is primed to be stimulated whether it's an hour to two hours after you wake up and then stopping eating later on so you begin to retrain your body through feeding patterns the fastest way to increase dietary protein would be a protein shake whether it's a whey protein shake that's my favorite or even a a whey concentrate so it doesn't have to be an isolate a concentrate concentrate has immunoglobulins lactar alphaa albumin other again thinking about food more than just the macronutrients I think the old school way and you know uh we could teas Stan about this who's kind of evolved more into the more nutrient dense foods but the old school way is just thinking about the macronutrients the new school way is thinking about the other low molecular weight molecules and things like anthocyanins and and other compounds that have metabolomic properties Nutri other intermediate properties one of the things that I used to do was I got into fasting when David Sinclair first came on the scene probably five years ago ish I went to go out to see him in Boston and he tells me all of this amazing stuff and I you know I still think there's a lot of there there with it but I noticed that my composition suffered I didn't I felt soft uh I I looked soft comparatively um and one of the other thing I've been through every Bro Science Diet I did car backloading then I went into carb Knight then I did Skip loading did you ever do skip loading this is impressive I've never never even heard of that one right so skip loading was go carb free throughout the week and then on a Sunday eat as many carbs as possible it was advised to try and have a full box of cereal just for breakfast and it was like if you can get yourself to like a kilo of carbs by the end of the day that was considered a win um and just every single different one what I realized was i' kind of inculcated this um sacrifice reward Dynamic I often cheat if I am going to cheat on my diet I'll do it on an evening time very early in the morning right I think this is quite common you know how many people are picking up a marsar first thing in the morning but they maybe do it on an evening their will poow is depleted they're in the house whatever whatever but my sleep is really really negatively impacted when I eat even within like two and a half hours of going to bed which is awful because out here in Austin everyone wants to go for dinner at 8:00 at night I'm like right okay dude but by the time I finished eating that's 9: which means that I can maybe get some good sleep by midnight and it's a Tuesday right so yeah I I'm I'm coming round to the idea that um still you know have the window if you want do like a a 168 if that's what you like the sound of or like you know even in 186 but I think that pivoting that window a little bit earlier and then trying to maybe cut off calories at 6 p.m. at night something like that sounds like a sounds like a pretty good way to start it I think it's it's a great way to start and then understanding the next macronutrient that I think about is well I before I say that I number one the data supports that the 24-hour dietary protein intake is most important meaning um how much protein you have during the day right within a 24-hour period I would say that protein distribution matters and there is uh kind of two schools of thought one is that just make sure that you're getting it all in it doesn't matter how you do it I would say if you believ that then you wouldn't believe any uh meal distribution study or any study that indicates muscle protein synthesis happens because it happens at that first meal for the all the majority of the literature that I've ever seen it's always about this first meal which in my mind means that a meal distribution matters it's not just about this 24-hour period where you're just having one meal of the day so for the listener who's thinking gosh you know they're thinking two things right now they're thinking does Chris really have 19% body fat and then the second thing that they're thinking is well how am I actually going to move the needle if I want to lose weight and I would say Obviously you figure out your chloric uh intake I talk about that in the book there's it's just super easy it's a calculator and then you begin to segment out how you are going to ingest dietary protein I wouldn't go above 50 grams per meal you know for someone like you I'd probably hit 40 to 50 at that first meal for sure it's not very much data for that middle meal and then potentially that last meal but probably closer again 40 to 50 40 40 to 50 grams of protein in the food is a massive amount like it's a very very large amount of meat that's it's like two two scoops of whey protein oh that's true if you were looking to do it through supplements but if you're looking to do it let's say that we're having it through salmon or we're having it through uh eggs I mean how many EG what's an egg eight six eggs that would be six yeah six eggs would be about 30 grams when you six six eggs is no joke okay hang on hang on you brush past this forcing 50 grams of protein six eggs so it's five five grams per egg is yeah right okay so you're you're talking about 10 eggs 10 eggs is a lot of eggs you better get started I I it's so it seems but this is my point right you look at this plate and I think even for me now I see it now in myself I'm like God every single I think you did an Instagram you did an Instagram post about this right you hit your protein you hit your protein goals for the day and then you realize God I've got to do it all over again tomorrow embarrassing I have a an amazing aming team that makes me uh they tell me I'm more relatable if I look like an ass so yeah how's that goinging oh it's so terrible um but yes this is you are not alone in that now I'm gonna challenge you Austin so we live in Houston I have been down to Austin and they have a lot of restaurants I can't even believe I mean they have a lot of restaurants you go and you order at one of those restaurants a like filet and this my friend is your 8 ounce filet that true or not true eight times seven I mean you're getting almost 60 grams of protein in that tiny little fillet that you spent $75 on so it can be done fair enough I should I should go for filet more on first thing in the morning okay so we are making sure that we measure because that's the only way that we can manage this stuff we are prioritizing protein within a 24-hour window we're aiming for 0.7 grams per pound of body weight or ideal body weight we're also then considering that there is a little bit of protein timing going on here in that much more than about 40 to 50 grams of protein in any one meal is probably going to be a little bit wasted presumably from an efficiency perspective but just I'm I'm pretty sure Stan taught me under 20 grams under 20 to 15 20 to 15 grams it can actually be metabolized in a different way so it's like The Sweet Spot appears to be more than 20 less than 50 something like that yeah I would say that that that is right when you're getting below 20 again you're you're not you're not hitting that Lucine threshold and Lucine is one of the essential amino acids it's that Branch chain amino acid and um my mentor of 20 years was the guy who put the science behind a lot of the um literature that we stand on today this idea of protein dosing this idea of a meal threshold this was some of his work that he put out into the world which is incredible to see this innov before they knew that Lucine somehow stimulated muscle but he really connected the dots and then translated it over to humans um and this idea that something below a lucing threshold so the average loosing threshold for an adult is two and a half grams by the way the RDA for for Lucine and we'll talk about this in another podcast is uh between two and three for the whole day but the actual are the actual uh influence and more optimal amount is two to three grams of Lucine per meal yeah there's a there's an imbalance here between what is being recommended and what is optimal I mean the Aging population is the fastest growing population I was just looking at data earlier um but so the idea of the 20 grams or less is it it will get counted towards calories but it's not going to do anything for muscle in that way okay so just to round out the timing thing which I think some people will be considering because everyone likes to obsess over stuff that doesn't really matter is the big hammer mover of this not less than 20 not more than 50 spread it out over you know no one's eating less than like 100 grams no matter how slight you are therefore you need at least three meals a day are you bothered at all about a post exercise window no no no there uh I think that is it beneficial I would say that the literature would say no it's as long as you're eating that protein does it have to be right after you train it doesn't I will say could there possibly be some benefit eating after you if you are untrained and you train and then you are older and you are prioritizing protein would your body be primed for a bit more efficiency quite possibly could I get a lot of push back on the scientists from the scientists in that yes it's something that I was having a conversation about this morning and from the literature they would say there's really not great data that the post exercise window is helpful my argument would be well there's probably a place for it there's probably it just seems like there's bigger there's bigger fish to fry here totally totally the the yeah yes you have to protect body composition at all costs we have to stop focusing on what we have to lose and we really have to hone in on what we have to gain what are we mentioned earlier on that uh your body is the average of the five most common meales that you cook um what never never heard that well I just made it up that's why why what are your most eaten meal preps like what what has most of your body been built on over the last few decades do you think uh eggs frittata turkey beef Dairy I'm actually a lower fat person um and then I I don't agree with high fat either my body really doesn't like it yeah I I don't do well on that and then adding in a lot of antoin so MIA Berry which is that really rich purple color um and I just try to add in um whether it's blue algae I mean I try to add in really colorful things why because I think that there are biochemical properties in them that again we just there's so many we just haven't gotten to it cool okay what about superfoods if you were to rank order you want to get the best yeah uh protein profile you want to get the best nutritional profile whilst getting protein in what's your top five well before I answer this do I have to actually eat it um no but if it tastes if it tastes disgusting then it doesn't count so yeah maybe but not for you for personal personal taste um liver is disgusting but it is so high in nutrition um women that are anemic individuals that need Vitamin A fat soluble vitamins liver is amazing amazing Iron Source o two ounces a day I mean I whatever you can stomach without throwing up holding your nose eating it however you have to do it uh I think it's valuable I I've got I've got a hack for it I've got a hack for it salt the living [ __ ] out of it when it's frozen throw it in an air fryer for two minutes either side and it doesn't really taste like liver anymore it probably doesn't it probably tastes like cardboard two minutes either side you crazy you're crazy you're you're crazy lady okay okay so liver first but you've got an issue with that you're bigoted bigoted against liver okay so what second um a lean beef lean beef is amazing again why because it has creatine anene torine iron zinc selenium these are all bioavailable uh vitamins and minerals really important so that would be my next one what cuts would you be looking at I don't actually care so I get really lean Cuts I I get it from buff cow have you ever seen a a ped Monte's cow yeah I'm with I'm with I'm sponsored by ped Mones yeah they're great they don't sponsor me come on guys I'll intro you I'll intro you to the guys got an entire freezer filled with ped Mones in there I literally had some uh filet before I came in but only but how many ounces uh 28 fair fair so um a lean beef is amazing the next thing that I would say with the next superfood from a bioavailable source of protein could be eggs eggs is great and whey protein also great but again A Way concentrate H again chicken I don't eat a bunch of chicken salmon is good for omega-3 fatty acids but it is a little on that the fattier side and over time you do have to worry about Mercury we test that in my clinic uh you do have to worry about some heavy metals and and tuna those kinds of things one of the things that always feels like a a rate limiting step on salmon for me is I I really struggle to make good salmon at home like it's kind of it's just not you know throw a steak in the air fryer it comes out you get it wrong by 5 minutes either side it's still edible you you throw salmon in a frying pan and care for it like a small baby chick and it just ends up it ends up atomizing itself all over the kitchen it's it's very easy to get wrong and um that just limits how much I can eat salmon at home I like it when I go out for food but I think it's it's like rough to to try and make good at home I would agree I I would totally agree so basically we've covered liver hold your nose and eat it lean beef ped monties choose a buff cow um eggs whey and salmon so I hit my five mhmh that's good that's good work okay fair enough talk to me about the relationship of sleep and muscle building of what we've going on here yeah there's um I actually just interviewed Dr Emily Lance on my podcast and she is out of the Galveston group she's scientist out of the Galviston group and one of the the studies that she worked on was that uh was looking at sleep and muscle protein synthesis sleep one night of sleep deprivation can suppress muscle protein synthesis by 18% can you imagine cumulative over time that's not good that's my life that's me that's that's being a club promoter for a decade and a half yeah yes and I will say one of the other things that we see so muscle protein synthesis on one hand is suppressed but there is some data coming out that if you are sleep deprived then kicking up training so like the military personnel they go through four days or five days of hell week I should know this because I've never heard the end of winter hell week it's just you know right exactly like that's hard um but there is some evidence to support that training during that time during a time of sleep deprivation can help support the tissue which makes perfect sense it can mitigate some of the effects from lack of sleep so we hear about you know Downstream some of the concerns that people have around uh you are more likely to like uh salty foods uh more likely to reach for highly processed foods more irritable lower willpower all the rest of that stuff but what you're talking about here is a much more direct mechanism from even if you go full bed Ross culing and and Wrangle your willpower and you don't eat the cookie and you do the thing you are still creating a glass ceiling on your ability to build muscle just based on how much time you had to sleep and I no amount of breath work or meditation or like ratchet hip hop is going to be able to get you past that so yeah I think I mean it's just it's just another another reminder that everybody is probably forgetting and again I we're getting tactical on this one I quite like the fact that we're doing this you need to try a sleep tracker whether it's an eight Sleep mattress whether it's a whoop whether it's an aura ring obviously if you use whoop that would be great because I think that they're an awesome partner but the main thing that you learn when you use a sleep tracker is you are not sleeping anywhere near as much as you think you are MH like that's I I can save you from having to buy one right it's great if you do it and it's important to learn this lesson firsthand but the lesson that you learn as soon as you start using a fitness tracker is Oh I thought I was getting eight hours of sleep but it turns out I was actually in bed for 7 hours 45 and my active sleep was 6 hours 20 oh [ __ ] like that's that's the realization that's what you spend most of your time time and now for me even if I don't have this on I know I'm like look if I need 8 hours sleep I got to be in bed for 9 hours like I have to even if I try and cranked my sleep efficiency as best as possible bit of latency bit of lost sleep efficiency some micro Awakenings throughout the night it's like guess what it's hard to hit and by the way and no offense to The Sleep ninjas out there sleep is annoying there's a lot of other things that I would rather be doing than sleeping sleep it is right but I will tell you that in when I was a fellow and we were in the memory and aging Clinic one of the risk factors for Alzheimer's was we always asked about sleep deprivation over time because when you sleep this is when the brain cleans itself these gal cells that and actually sleeping with a phone by your head yeah I mean anyone no one in my audience still has their phone in their bedroom Gabrielle no one not not one I know no one at all or else they are no longer allowed to listen okay so when we're looking at this sort of relationship sleep to uh muscle building is there anything else I want to get on training but before we get into that we've talked about diet we've talked about recovery is there anything else we're missing in kind of the milu that is life beyond now training stimulus I think the big picture is eating Whole Foods it doesn't have to be complicated it should be high protein from my perspective there's no reason that when you have the luxury to eat that way you don't it is a luxury and a privilege to be able to prioritize dietary protein other countries don't get that and it is a highly nutrient-dense source of um calories and a non-negotiable especially as individual's age you know when you had mentioned that when you were really into fasting and and you were reducing food intake that that um it just it may not be an ideal mechanism right just fluffy I was Fluffy we don't want too fluffy it would just ruin your image so I'm not supposed to be fluffy I'm [ __ ] 19 and a half% body fat compared according to that dexa scan in Dallas that should ruin your day for at least a week really did I think I I think I need to I think I need to go on a slight cut here's a point here's a question I've had in my head actually there is somebody that's listening who is both overfat and underused right yeah there is someone who just doesn't have the body composition that they want and they know that they are off on both ends of the scale M if it was me not knowing your world what I would do for me is I would probably diet myself down because I'm going to get the Aesthetics way quicker by becoming Lena first which I can crack out in the space of six months and then building my muscle up from there but what would you do what what would your advice be would you just try and recm through everything like how how do you go about this CU motivation is going to be gauged as much by the mirror as it is probably by anything else so we need to satiate that in people yeah if it were me I would focus on what I have to gain versus what I have to lose if I had very little muscle and a lot of body fat then from my perspective I would not actually be focused on anything aesthetic I would assume that I was not as strong as I should be and not as physically capable as I needed to be I would focus primarily on being a human that was physically strong and I'm not necessarily training for strength but maybe you would train for some strength and some hypertrophy but I would just start putting in the Reps I would start putting in the Reps I would obviously see what my Baseline diet is prioritized dietary protein is very difficult to store protein as fat it's very difficult like you said you're like ah I got to 90 grams if I have one more buffed cow I'm gonna shoot myself it becomes very difficult to overeat dietary protein and there may be some impact on this adaptive thermogenesis you know the body's very smart so if you start reducing calories to rapidly the body will adjust but dietary protein and from my perspective one of the reasons why it has this more thermic effect of food thermic effect of feeding is that um it's so valuable and it does stimulate muscle protein synthesis that that the Machinery of that may take more energy than the energy required to utilize carbohydrates could be 10% fats could be 5% and and protein could be anywhere between 15 and 20% again depend on the study that you look at um and foods are not just primarily one thing if you are an individual who needs to lose weight and build muscle could you do both at the same time you could would it be as effective no I would say you start with what you have to lose because that indivi what you have to gain because that individual didn't get there by focusing on what they had to gain I guarantee you they have spent a lifetime yo-yo dieting or having some uh feeling of just you know it doesn't feel good in your body if you're not feeling well right I I think that we can all agree on that potentially again I don't know but if this is for me this is what I would do I I I think that I like your framing around uh people are told that there is something that they have to lose it's all about getting rid getting rid getting that out of this body and it really is a it's like an anti-b building mentality within your physiology and I don't think that that is particularly constructive Okay so we've danced around it right we've got all of the things in place but we actually need to go out there and build some muscle now we need some we need some training stimulus if you only had 10 exercises for the rest of time to build and maintain as much muscle as you could what would they be in why 10 10 that's it that's it it seems like a I would definitely do a squat right I would do a back squat I would a lower uh a lower lower on my back a wider stance just because um yes so I would definitely do a squat why why why low why low bar why wi squat just my physiology just the way I'm built okay okay the way I'm built so I actually decided side note that it was a great idea to do a 50-hour event uh that was Non-Stop and so as I was training for that I torn my hamstring off the I evoled it around 80 some perc off the bone just a really uh wasn't my smartest decision yeah so it's it's been this process of repair let's just say that so I've had to modify some of my training so a a squat a wider stance squat some kind of deadlift whether it's a Sumo deadlift or some kind of deadlift because just the mechanics and also the full body uh movement of a squat I would also say a farmer carry we have to also begin to choose and this is what I think about this is I think about all the older patients that I've seen being able to carry groceries being able to carry a toddler being able to you know it's it's amazing when we think about traveling you know I I I travel a lot I also have two very little kids I have a two-year-old and a four-year-old um if you want some birth control I will send them right over to your right over to your house and you'll you'll see you know be careful you'll hear people say oh be careful about putting this overhead you you know the weight limit shouldn't exceed this and it's just a whole backwards way of thinking about it no no no you are afraid to then go into the gym and lift a 50 pound uh weight but you will have no trouble lifting your or struggling to lift your 50 PB toddler to to put them XY wherever you're putting them why given the fact that you've already got a good bit of midline activation with your Squat and especially with your deadlift plus you've got grip work with your deadlift what are you getting out of the farmers's carry that you haven't activated already well you're getting motion and you're getting something that translates to real life it's you know when we are if we're really talking about health span we have to talk about the things that will destroy Health span and the reasons why we require help why do we go into a nursing home what are the things that really affect quality of life the number one thing that affects quality of life is physical mobility in my opinion and I've seen this so not being able to can you imagine not being able to climb upstairs not being able to carry your groceries not being able to put them up I mean I was just traveling here to Las Vegas and there was a couple in front of me that couldn't put their uh luggage on their carry-ons on the con had oh no on the conveyor Bel [ __ ] conveyor belt oh okay and you know what I was like do I help them do I help them but if I help them they're never gonna get exercise so you watched this person struggle with a one rep max hand luggage carry but I I I know was ter I really struggle why but no because if that is the one moment they're going to be able to pick something up and move in a rotational way to put it there which is how we move we're not homeboy granddad's got Doms for the next two weeks because you didn't help him move his 15 pound suitcase okay three we've got a squat barbell back squat low moment arm wide stance uh a deadlift and a farmer carry what's next so the exercise I think that um this is not necessarily A weightlifting exercise so we didn't uh specify but doing some kind of an interval on a an assault bike or an airdine being able to push out above a 90% V2 Max just really hitting it you prove to yourself you can do it it feels awful but it is a way to improve insulin sensitivity it's extremely effective and I I I really do think that as we are training in the gym it's not just about the machines it's not just about the bands but it's about being fit and capable for real life it's true God forbid there is an emergency you better be able to show up and be a capable human well this is the uh this is you know I think Petra's biggest Flex from a training perspective at the moment or his kind of biggest Obsession when I spoke to him early this year and he's saying you know VO2 max is one of the best predictors that we have of someone's longevity and I was like what like what I thought it was all Zone 2 I thought it was all to do with resting heart rate and variability and blood oxygenation and and and galvanic skin respon he like just straight up V2 Max what's your V2 Max so that that was surprising to me to hear that and I do think that we are I think that there is um somewhat of a discrepancy in the literature when it comes to muscle mass and strength right now people will say strength matters in muscle mass it's not about the actual mass it's really about the strength I think that we are at the precipice of literature changing as we begin to directly measure skeletal muscle mass through some of these you know more Advan Advanced ways like this D3 creatine and I think that that May challenge right now if V2 Max is is the greatest predictor I think we're also going to see um a change in the literature when it comes to muscle size and strength I think that is going to be next and I I yeah so I'll say that just that it's interesting how there are theories about the way the way that the human body works but we don't have the measuring tools to be able to make it happen yet so what we do is we find proxies for that strength is a pretty good proxy for muscle mass there's very few people that are very strong without being at least a little bit muscled but what's the genuine mechanism that's going on here is it that the only thing that we can measure accurately is hand grip or bench press or vertical jump or whatever I I actually just had a conversation with I work with a um a PhD her name is Alexis Cowen she did her PhD at Princeton she's now at pen she's really helped with the Institute of Muscle Centric medicine and we were going back and forth about grip strength I think that again this is another you know Chris my perspective is just because something is spoken about over and over and over again doesn't make it true it doesn't mean that we're looking at it from the right perspective and yes we could say grip strength is a biomarker but if we take a step back we have to ask ourselves um are we potentially born with a certain threshold for grip strength is it really the end all Beall are are we sure that that's true and the next layer to that just goes in line with when we're talking about skeletal muscle so right now we're talking about V2 Max but again that's because perhaps we've had the tools to measure it and then bringing to the conversation which is often missed is that we don't highlight the things that we're doing well um I'm sorry we highlight the things that we are potentially doing well without the Insight of potentially the things that were're not and the oversights in um just measuring indices what is your favorite evidence-based protocol on an airine or an assault bike for improving V2 Max um great question I actually work with a trainer I don't do any of the protocols myself what does he make you do Carlos Carlos is a major [ __ ] [ __ ] you Carlos oh oh man the worst I mean so Friday right before I left we just did um max effort it was it was 20 seconds allout effort trying to push me above or to 90 um 90% And then he would give me 10c rest so I don't know if that's I felt like okay so like a tobata style thing but holding it for like doing it in 30 second intervals how many rounds do you do he only had me do three minutes thank God yeah that's still that's six rounds right that's that's that's enough to kill you okay cool uh so you've got only four things what anything else bed no no let's keep going so U we said a squat we said a deadlift Sumo deadlift for me we said a a carry y um I definitely think that you should be able to do an overhead carry I think that you should be strong in an overhead position even though obviously it's probably not totally stable for the reason that I just like I'd like to see you be able to do that over time um I also think being able to do things like push-ups getting off the floor you have to be able to do push-ups have to be able to develop that upper body strength um Also let's see what else what else do I think is a non-negotiable I mean I think a Turkish getup is great takes coordination it takes capacity you have to get balance uh and then gunar Peterson would say Gabrielle you have to add in something rotational so any rotational whether it's a swing or a uh something rotational he said being able to throw punches at a at a bag something like that yeah I mean the the FL it's interesting that you've brought up two things that get you down to the ground uh with the push-up and then specifically Turkish Get Up which I was thinking about earlier on Aaron Alexander from the Align podcast has he is one of these huge proponents of sitting desks right so a floor desk and I have in the other house through there I have this tiny little what look I think it's meant for Japanese calligraphy so I think it's meant for when you're sat doing your fancy Japanese like penmanship or something uh and I've got varying Heights of meditation cushion behind it uh and his whole thing is get yourself down on the ground spend an hour half an hour to an hour a day with your hips below your knees if you can and I have to say sitting down there feels so nice like glut me opens all of that out when I get into that kind of cross-legged position uh and you can lift your hips up and actually Lean Forward which feels really lovely on your lower back that feels like it kind of decompresses a little bit like it's so nice like all of that's really really good so I am in I'm down for ground stuff yeah um that I that sounds very interesting I cannot wait to see that and uh it's never going to be made public I mean remaining it's remaining private that's if I went full Austin psychedelic bro mode I wouldn't be at a standing desk I would be on the floor and I would be I would be like twirling a a what is it like a [ __ ] iasa stick between my fingers while I'm doing it okay so let's say that you've got three more three more things that you can introduce um I do think again so we we talked about how we would use uh grip strength so you know you're developing grip strength you're developing you being able to carry I don't know if we talked about a swing but I do think that you should be able to swing you should be able to do some kind of dynamic movements I think that that is important and again how do you translate these things to real life a Turkish getup so we have squat uh Sumo deadlift we have a throw up on the devil's tricycle we have um some kind of push-up right pushing up after off the ground we have um kettle ball swing farmer carry farmer carry what else I know see you gave me 10 and then you know you might Phil Heath wanted Phil Heath wanted 11 and Bumstead also like rolled his eyes at me only him 10 so you you've got bags of spare capacity you only needed eight I mean I think also you should where are we going to get like where are we going to get jacked arms from here I I I was actually thinking that but you said but your your question was that you could only do for the rest of time to build and maintain as much muscle as you could what would they be maybe may I would be tempted to maybe throw in some sort of pullup like we haven't got we haven't got much of that scapular attraction I guess in the dead that's a lie the deadlift we have okay fair fair C phases if Alex hosi was here he would say Cal phrases because he calls he keeps on texting me and telling me that Cals are the front garden of the of the body I'm like at best they're the backyard right at best they're the backyard they're not even on the front of your body you can't make this wait by the way women don't care about calves he would say that's because you haven't seen my cves that's what he would say I know that he would he would say what about what about these cves and I would say that's your backyard but okay yeah cool I think what's what's really interesting I'm loving asking this question to pretty much all of the health and fitness people that I speak to it's really indicative of where they're coming from from a health and fitness perspective you know it's obvious that you've got that like sort of geriatric care background because you're thinking training for life life right like no one else has said oh yeah I'd love to put a farmer's carry in because like so what like I just presume that my my deadlift or like my row or something is going to be able to get me through the carrying side but the you know that contralateral moving thing that being able to stabilize the trunk while the hips move underneath you I think that's really important so yeah we've ended up I think we've got like maybe a library of 80 exercises now you're the first person in all of them that hasn't said uh dumbbell side lateral raises but um that's hilarious that's okay uh but I will say my perspective comes from you know I talk about I did my training as a geriatrician but my patient population we take care of elite War Fighters my patient population is we service Elite Warf Fighters and like CEO Maverick guys that are just super physically fit and they I would say I mean I don't know what all of them are doing but I would say the major majority of them have a lot of well-rounded training programs right and my perspective is as a mom I have two little children can you imagine if I went down to pick one up and one's pissing on the wall and the other one's doing something else I had to grab the other one I have to be able to move fast enough so my new drapes don't get ruined that's obviously the priority when it comes to uh Tempo rep ranges set ranges what are people getting wrong in your opinion I think think there now first of all there is a phenomenal paper and that I think that anyone who's really interested in these uh this repetition Continuum the paper is called loading recommendations for muscle strength hypertrophy hopefully I'll get it right local endurance a reexamination of the Continuum repetition or the repetition Continuum very very sexy title for a paper please translate amazing and really basically um it it highlights that we've got this strength hypertrophy endurance that we've really put things into buckets and that maybe the evidence doesn't support that that there's multiple ways to get stimulus so what do I think that people are getting wrong potentially that you know if you're just going eight to 12 reps maybe that's just hypertrophy but for older individuals they potentially could do lighter weights and go for longer and still get hypertrophy uh influence so I think that this rep range Continuum uh could be reexamined what about what what's what's your thoughts on uh tot time and detention um all valuable Tempo stuff all valuable and all ways to change up your training program because what you're looking for is really a physiological adaptation right and there's multiple ways to get that multiple ways to improve muscle hypertrophy and strength and endurance so what you're looking for is where your stimulus is and where you need to potentially push on the lever to improve in my mind again as a physician you do have to track improvements it's not just that you're tracking your uh whatever you're eating your beef or Twinkies or Etc you also do have to track weights the same way now I think a baseline recommendation you know in my book I I want people to know how many push-ups they can do this morning I did 600 push-ups here in Vegas working out with Ben Newman it's a terrible idea why 600 why stupid number I I way too many I said this and obviously it wasn't all at once but I was just thinking myself man what an idiot idea that is you should have done less you should have said have we have you thought about doing fewer yeah exactly and by the way they all did probably more than I did um but again so that's the number one thing I think people are getting wrong is that it's either and I used to say you know my own personal belief is that you have to work really hard and that's just a belief that's not necessarily in the evidence I think that there's something to be said there is evidence to support this idea that the um the influence of what you are doing whether you are lifting light whether you are lifting heavy that the molecular influence is somewhat different right and that that makes sense but my belief had always been that you should train harder and that was the only way to do it and that is not necessarily what the evidence supports which is disappointing but for for the people that want to punish themselves with 600 press-ups on a morning in Vegas no it is I can see why that would be a like a personal insult uh when it comes to people tracking their sets and tracking their workouts there is an app called heavy set which is by far the most seamless and least intrusive of the workout tracking things that I've ever found it's phenomenal it links up I don't have one but it links up with your Apple watch it can track tonnage it can track progression it can you can work in super sets and drop sets and rest Paws and myor Reps and all sorts of other craziness and it'll tell you what your proposed one rep max is based on all of the calculations it's really good and I think it might even be free if you don't need to use anything fancy so that's heavy set it's definitely available for iOS it might be available for Android as well what else what else what given this global perspective of stop focusing on fat stop focusing on muscle these are the principles from a dietary perspective these are the principles from a a training stimulus perspective sleep is important is there anything else that we're missing from this Paradigm I I want to point something out because it's important for the conversation we've talked about skeletal muscle we've talked about nutrition influence in skeletal muscle we've talked about the history we've talked about exercise I would say that a lot of people will recognize these things as important Contracting skeletal muscle releases myokines myokines are hormones they are molecules that are released from Contracting skeletal muscle there's 600 or more it it the first myoc kind I think was discovered in 2000 by Patterson in Copenhagen so this is not that old and I just want to reframe the conversation into what does it mean from a muscle Centric medicine perspective a medicine perspective Contracting skeletal muscle we've all heard about these cyto kindes cyto kindes like interlan 6 interlan 15 and the cyto kind storm and you know it had its moment exercising skeletal muscle the degree at which you are exercising will influence the amount of inter Lucan 6 and Inter Lucan 15 that when released from skeleton muscle interfaces with the body differently than those inter lucans that are released from macras so there is a a blunting effect from an inflammation standpoint which I think is important to point out also why is that important because it's leveraging skeletal muscle tissue that you have conscious control over to augment your immune system and to augment your inflammatory response so it's a um something that you can do consciously that is going to tap into a system which is largely run on autopilot yes yes and Contracting skeletal muscle releases glutamine glutamine is a semi-essential amino acid that you know the requirements depending on if you're under stress or a highly catabol State Etc but Contracting skeletal muscle when it is when it releases glutamine glutamine serves as a fuel source for lymphocytes white blood blood cells so doing an action consciously I mean you can't tell your heart I don't know you live in Austin there might be people that could tell their heart to pump at a certain rate but for the most part unless you're whim Hof you're probably going to have a difficult time telling an organ system to do just the thing it's the only thing that you have that kind of control over so this influence of Contracting skeletal muscle we talked about Alzheimer's it releases bdnf and irisin and capsacin which stimulate bdnf release in the brain which help with neurogenesis with brain function this is critical in changing the conversation of muscle as it is thought of in this way of looking good naked and and uh a training all important and the only things that we have actionable control over but also reframing the conversation from an immune perspective from um a perspective as an endocrine organ really really critical very interesting yeah I um I'm going to be I'm going to be watching carefully I guess over the next few years to see if the the pivot does happen it seems like Diet culture which is what it is currently right it's diet culture is very ingrained it's the dominant ideology for improving Fitness and improving health and I suppose you know if you were to take somebody that is however many 00 and get them to lose 30% of their body mass like that a lot of their outcomes are massively going to improve but I would guess that for a lot of the people that are listening to this podcast they're actually thinking okay like I I understand that that's important and you know in like a charitable aspect I want to remind people Whole Foods and do all the rest of it it's like okay like what's the what's the next step what's getting yourself maybe from 50 to 70 or from 90 to 95 yeah I wonder I wonder how much of this muscle centered medicine is going to be something important I mean like I say the benefits are massive because it's one of the few things that you can do that is hard that is immediately gratifying of in the shorts to medium-term is gratifying and also has long-term Health impacts and you can't say that for many other training modalities you know you get really great at rowing you don't look that different you may feel great you know the metrics on your whoop will say oh wow my resting heart rate's in the 40s but really you know if you train Push Pull legs for six months and you eat 7 grams per pound of body weight in protein you look Worlds Apart if you're someone who's even like up to a probably pretty well done trainer right like if you've been training for even a while and you stick to that you're going to look great so yeah you have the opportunity to kind of come for the gains and stay for the longevity I think that I think it's a an relatively easy cell I I think it's an easy cell and I'll tell you some of you know one of the the aspects of being a physician is and I say this all the time is that a good physician recognizes patterns of diseases right a good physici that is your job that is your craft you need to be able to recognize patterns of illness an effective physician an effective physician recognizes patterns of people and that is how you move the needle we can talk about all of this stuff but the reality is there are certain archetypes of individuals and one thing that I will tell you is that individuals must feel worthy of doing the thing that is going to move the needle there is a self-worth threshold that people have they will only ever be as fit and lose as much weight or gain as much muscle if they start to feel too good or look too good it's a whole Litany of do I deserve this do I feel worthy of this can I really have these things and I have been a practicing physician for a very long time and then the second layer to that is understanding that you have to close the gap you show me who you are today and the habits you are doing today I can tell you I can tell you a handful of things number one I can tell you how successful you are there is a spectrum and an archetype of innovators and and Mavericks and CEO archetypes I can tell you based on your habits where you land on that Spectrum number two the actions that you take now in your health and wellness today I can tell you what you your life will look like in the future your present is your future especially from a health perspective an individual that moves the the needle has to be aware of their weaknesses we are in a culture where where it's all about what are your strengths and how are you doing and you're so amazing I don't care anything about that I need to know where you fail where you fall off and you have to know that because it's predictable every T every single time for example every time Chris I bet you if you did not mitigate when you did those Live Events you probably if you were not aware that at the peak of that EV event there was going to be a component of vulnerability right after you would have fallen off your nutrition plan you would have felt a little depressed and you would have stopped training did that happen or did you mitigate that yeah we worked around it you worked around it you planned for it you probably went in with a more neutral mindset thinking this might go well this might not this is my first thing this is so cool you neutralized it it wasn't that big of a deal and again I'm putting words in your mouth I don't know you neutralized it you must be able to close the gap between who you want to be your future self and who you're the actual actions that you are taking because time is limited and if you continue to do the same thing then you have to fast forward and the pain of failure over everything else is more effective in moving a patient to action you said in a a different interview I heard you say if if you think you don't have time for Fitness how are you going to have time for sickness and I think that's a that's a good way to look at it we everybody is busy everybody has a lot of things to do everyone has more emails to answer than time to complete the workout but yeah I feel it Dr Gabrielle L ladies and gentlemen where should people go they want to keep up to date with your work they want to check out the new book where would you send them on the Internet well you can go to my website Dr Gabriel lion.com and you can find all our offerings there uh I also have a podcast the Dr Gabrielle lion show which I've been trying to get you on Chris for I don't know at least like six months I'm going to convince you I'll say I'll bring you like some frittatas whatever um you can also get my book on Amazon it's called Forever Strong depending on when this comes out and I have a great newsletter I put out a ton of free content YouTube and I have a full practice we have a team so people can check out my website hell yeah gabri I appreciate you thank you thank you if you enjoyed that episode then press here for a selection of the best clips from the podcast over the last few weeks and don't forget to subscribe