JJ Virgin: Does Protein Prevent or Cause Aging?

Coming up on this episode of the Doctor's Pharmacy.

It's a choice to be excited about aging or to fear it. So what if in your 40s and 50s you went, okay, my choice is that I'm going to be able to play full out in my 80s and 90s. And so I better train for it now.

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Welcome to Doctor's Pharmacy.

I'm Dr. Mark Hyman and this is a place for conversations that matter. And if you're like me and you're looking to live longer and stronger, you're going to love my conversation today with my longtime friend, JJ Virgin. She's a triple board certified nutrition expert, fitness hall of famer, four-time New York Times bestselling author. She's had over three decades of experience in this field and she's become a trusted authority in nutrition, weight loss and wellness. She's the author of For New York Times bestsellers, the Virgin Diet, the Virgin Diet Cookbook, JJ Virgin's Sugar Impact Diet, and JJ Virgin's Sugar Impact Diet Cookbook. Her practical and evidence-based approach to health has garnered the recognition from major media outlets, making her a sought-after guest on shows like Dr. Oz. May it rest in peace, Rachel Ray, the Doctors, and many others. She actively contributes to health and wellness community through speaking and online programs and her podcast well beyond 40. And her expertise extends beyond nutrition and weight loss as she advocates for a holistic approach to health that encompasses mindset, exercise, and emotional well-being. Now, let's get into what we talked about with JJ Tay. We had a great conversation. Fat and carbohydrates have been in nutrition headlines for years. And what should you eat? Low fat, low carb, high fat, high carb. And JJ and I dive deep into why protein is actually the macronutrient we need. to focus on, particularly when it comes to powerful aging to body composition, weight loss and overall health. It's sort of that neglected nutrient. We dive deep into the relationship between protein intake and muscle growth and maintenance, as well as why muscle is essential to metabolic health, hormonal health, brain health, immune health and longevity. She also explains, and I love this, she calls muscle our metabolic spanks. I love that. She shares her three keys to aging powerfully and we discuss the surprising reason why so many people experience resistance to weight loss. Why can't you lose weight? We're going to talk about that. As we age and our hormones change, it becomes harder yet even more important to build and maintain muscle. JJ talks about how to start or expand on an exercise routine at any age. And I did that. I didn't start till I was 59 doing strength training and it's changed my life. Now, we explore also the vital role that sleep plays in weight loss and also repair of muscles. It's not just about going in the gym and pumping iron, it's also letting your body repair and heal. And JJ shares her non-negotiables when it comes to supplementation, as well as her thoughts on living with purpose as you age powerfully. Now, let's dive deep into my conversation with JJ Virgin. Welcome back on the podcast, JJ. It's so great to have you.

How you doing? I am great.

I've missed you. I miss you too. It was COVID kind of prevented us from hanging out more, but I'm so glad we get to talk today. And, you know, you and I are just chatting a little bit before the podcast about powerful aging. And, you know, I wrote a book called Young Forever. You're coming out with a new one. I don't know what the title is yet, but you really are an example of powerful aging. I remember being in the gym with you, like, 10 years ago, and I was like, yeah, you know, I'm pretty fit. I'm, you know, exercise a lot. And, like, I was hurting.

Yeah. Yeah.

It took me, like, a week to recover from being in the gym with you for half an hour.

I know. And you never came back to the gym with me, Mark.

No, but I was so sore. I couldn't.

One and done.

So, yeah, you said you started training when you were 16. I didn't start till I was 60. But the good news is you can still make a huge impact. And I noticed my body changed dramatically as I started to change my diet and change my fitness routine to incorporate strength and strength training. And, you know, you really have been the leading kind of advocate for this for a long time. And I think your work is so important. and your understanding of human physiology, biology, nutrition, how to apply it, how to up level your health, how to optimize muscle mass, muscle function, and optimize your diet to enhance all that. You're like the master of this. And I kind of really look up to you actually in terms of this field because, you know, it's something that often gets neglected in medicine, you know, who the heck talks about muscle? Like, I never took a course on muscle other than like anatomy. And I never really learned what it does and how it's involved in everything that matters as we age, from not only our mobility and functionality, prevention of frailty and falls and all the things that we care about, but also our metabolic health, our hormonal health, our brain health, our immune health. I mean, pretty much everything is connected to muscle. So we're going to get deep into all things muscle and health and powerful aging today. and I think one of the things that we really see is that particularly women starting in their 40s start to kind of lose ground, right? We notice weight gain, especially around the belly, a little brain fog, fatigue, mood fluctuations, and it's sort of the opposite of aging powerfully. So what's going on here? Can you unpack what's happening and why this happens to people? And by the way, men get it too.

Men get it too, but they get a little later, let's be honest. And I'm just so so excited that muscle's finally getting its due. I will tell you, you know, back in my, my real work has always been in exercise science. That's what I was doing my grad and doctoral work on. But back then, Mark, everything was about cardio, right? Yeah. And in fact, I was even taught in graduate school to not have someone lift weights until they lost the weight, which couldn't be Like that couldn't be more wrong. Now, the good news for me in graduate school, number one, I did all my research in graduate school on lifting and developing strength. And I was like the rogue student because everything was being funded towards cardio. So I was like, but I was actually paying my way through graduate and doctoral school. And what I recognized very quickly was that I was not going to get paid as a personal trainer if I was making people worse. especially in Los Angeles where I was doing this and getting people ready for films and stuff. Like I helped Brandon Routh with Superman Returns. Like you had to have the results. So now a lot of my clients were in their 40s and 50s. And you know, men and women, that's why I say I really see what happens in women in their 40s. It happens, it's starting to happen younger now in men because of all of the xenoestrogens and the stress, but it really is something that hits men more in their 50s and maybe early 60s. but in their 40s, that's where women are starting to see estrogen really fluctuate. And boy, you see extra estrogen starting to fluctuate and starting to decline and all of a sudden you start to become insulin resistant. You start to become hungrier. You start to gain fat. You start to get depressed. All of those things start to happen. Now you look at it and think, it's my metabolism. But I don't know if you saw that study that came out that showed that really metabolism doesn't shift much until about 63. And so it's not really metabolism.

Really?

63. So this was really interesting. Now you look at metabolism and metabolism, of course, you've got basal metabolic rate, age, sex, genetics. I look at muscle mass in there and thyroid and then you've got total energy expenditure, which is that plus your activity level throughout the day and thermic effect of food. And when you balance that out, It was really about 63 where things started to shift. I think all of that, what's happening in your 40s and 50s is setting ground for that. And I don't think it has to happen. Like, look at you now. I would argue that your metabolism is better now than it was in your 40s.

Yeah, for sure.

Don't you think?

For sure. I mean, I think we could go.

To the gym together now and we'd be like, you'd be an equal. you know, partner in the gym.

Yeah, I think I'm getting there. I'm getting there. I still got a ways to go. But I, I do notice that, that, you know, when I, when I don't do this training training, I notice things drop off. And when I'm consistent with it, it's just incredible what I see in my body, even at 64 years old. So I'm kind of amazed at how the body can, at any age, actually Right.

And this is critical. When I was at USC, I was doing my doctoral work at USC in the Ex-Viz department, but was Ex-Viz and gerontology and nutrition. And we had people coming in in their 70s, 80s, 90s. And it was crazy to see what they were able to do. And it's important message for everybody because there is still this thought of, oh my gosh, it's too late for me. Whereas the reality is that if you were in your 60s or 70s just starting lifting weights, you're going to see way bigger Changes in your body than, than I'm going to see, right? Once you're fit, getting fitter is difficult. Getting to that point, boy, you start to see these big changes which are so motivating. So you look at what's happening in your 40s and 50s because it's really setting you up either way. And, you know, I heard that study from you about how people who have a positive mindset about aging live seven and a half years longer. And I went, all right, well, I, that's an easy one. I'll, I'll have that. I'll take that. Um, and what it really came down to then to me is, well, that's a choice. It's a choice to be excited about aging or to fear it. So what if in your 40s and 50s you went, okay, my choice is that I'm going to be able to playful out in my 80s and 90s. And so I better train for it now. I can start to offset what is happening with estrogen because estrogen is really going to create insulin resistance, less muscle mass, but if I can offset what's happening with the hormones, with diet, with exercise, with, you know, lifestyle and potentially hormone replacement therapy, then I don't have to go through that. I'll just skip that piece. Right. Which we can do.

Yeah. It's so. It's so interesting. And. And what. What also you sort of talk about is. Is just these changes that are. Are avoidable, like changes in our sex hormones, like the changes in estrogen you mentioned. the drop in testosterone, the change in our thyroid, insulin and stress hormones, all of these are basically regulated in part by the quality and amount and health of our muscle, which something I really never learned in medical school. So can you talk more about that?

Even when we talk muscle, we don't talk quality muscle. Like, you know, when you look at muscle, you've got muscle size, which we all talk about, oh, you've got less muscle, but what about the strength of the muscle? How about the power of the muscle? When you really look at the statistics of what happens with aging, we lose muscle and they say now it's starting around 30, you start to lose it. Let's say 40 plus, it's up to 1% a year, but strength is 2-4% a year and power is 6-8% a year. Here's what's interesting about this. The way you train, you know, when you look at exercise, I think one of the biggest challenges we have with exercise is it's this huge category. And so exercise could mean going out for a walk, although I'd argue once you're conditioned, that's not exercise, it's activity. Important, but different. In order for something for me to be counted as exercise, it needs to be progressively overloading so that your body will adapt and get better. Right. But the way you train to build muscle is different than the way you train to build strength, which is different than the way you train to build power. So all of that can be confusing.

That sounds a little confusing. So can you unpack that? Cause it sounds like three different things. And does that mean you have to do three different kinds of training or how does it work?

Well, I'd love to start back from, okay, if you're listening to this and, and I kind of divided people into buckets, the person who's really doing not much of anything. The person who maybe just walks, the person who's going to like a group X, like yoga or Pilates, and the person who is athletic and doing a lot of different things. And I think the first place we really need to start is to get that 8,000 to 12,000 steps in a day, which that range now, sure more is better, but there's this bell-shaped curve. And when you get to, I think, 8,000 steps a day, you reduce your cardiovascular risk factor by something like 46%. Then it's 64% at at 12,000, then starts to just kind of drape off. So the very first thing is, geez, we just need to move more. And because what I don't want to do is have someone go, okay, I'm going to exercise. They exercise 20 minutes a day and sit the rest of the time.

Yeah, yeah. Like, I'm sitting.

I'm sitting too. I have my stand-up desk and I'm sitting. Okay. However, I do have a walking treadmill under my stand-up desk over here.

I just think it's weird to do.

That on a podcast.

I see people with like these bicycle things under their feet. So the end of the desert is.

Kind of bicycle all day long. Well, there was that study that showed that people who did gastric nemesis, like calf raises all day long, actually had better blood sugar control, just calf raises while they were sitting. I mean, but who the heck's gonna do that? But anyway, back over to that. So let's go, let's get the activity in. We've got all these fitness trackers now. So just look at your aura ring, Apple Watch, whoop, Fitbit, whatever. Just do that. And I like Mark to start with one thing at a time because if you give people a whole lot of things to do, what do they do?

Nothing.

Nothing. No thing. So I always go, what's the thing? So after you've got that done, my next place to go is just a very functional resistance training routine because you will build muscle and strength when you first start. We don't have to get as fancy there. And when I look at training, we need to think of training as something that we're doing to get better at life, not to get better at training. Right? And so ideally we want this to be as functional as possible, thinking about what would I really like to be able to do when I'm 80 and 90? I had, when I lived in Palm Springs, I went to see a client and I said, what are your big goals? She was an 85 year old woman. She goes, I want to make sure that I can keep wearing my stilettos. and dancing. And I'm like, I love you. Okay, let's do that. And so what do you want to do at 80 and 90? I want to be able to get off the toilet by myself. What about you? Right? I mean, you think about the things. I want to be able to pick something up off the floor. So in looking at that, we need to do those activities in the gym, in a controlled environment. And I find that as we age, we tend to do less, which means we can do less. So we do less. and less and less, right? But if you went in there and you started to do great ranges of motion, things like squats and deadlifts and bent over rows and push-ups the things and pull-ups the things you think you can never do. But boy, will those make a major difference. And the first thing you focus on when you go in is you focus on form. Because when people talk about going to failure, going to fatigue, it's the form that stops you. you never push past that. Right. So when we're in the gym, and I'll tell you in all the years, because, and I started lifting weights at 16 with the high school football team, I have never gotten hurt in the gym. I've gotten. I've never ever. No, I've gotten hurt one time in the gym because there was a piece of broken equipment and they didn't have an out of order sign. I literally flew over it. Like, that's the only time I got hurt a piece of broken equipment. Other than that, like, I have a. But it's all. It's really. It's all for, it protects you from getting hurt in life. And so when you think about what happens as we age, we lose muscle size, strength, power. That size is gonna protect our bones. The minute we start resistance training, we start to become more insulin sensitive with the, you know, what is it now, 6.8% of the population metabolically healthy, I'd argue it's probably less than that. So I think the norms are off, you know? insulin sensitivity, you can start restoring it so quickly just by starting to lift weights. And then you look at flexibility, balance, range of motion, all of these things when you're doing more functional exercises like a squat, like a deadlift, like a push-up, those require your core, those require some balance and proprioception. It's huge. So that's where you start with someone. We can, once you get past the initial training and I built out a program that says, is here's how you start. Here are the simplest things that you can do to get started. Here's how you start if you've got bad knees or bad back. And here's the other thing I would argue. If you have bad knees or bad back, it's even more of a reason you need to be doing these things. You know, early on when I was like an early exercise physiologist, the way they taught us back then, they said, if you have a bad back, you should just do abs. And I, and I push back, I go, but if you have weak back muscles, why would you ignore them and strengthen your abdominal muscles? You would reciprocally inhibit your back muscles and make yourself worse, not better. So we need to work through these things again in a controlled environment so we don't hurt ourselves in life.

It's true. You know, actually what you're saying is so hitting home for me because I had back surgery in 2020 and I was a mess. I had a bleed into my spine. you know, the surgery went okay, but then there was a complication with bleeding and I just, everything was sort of off and I had so much pain, I barely walked. I was just miserable. And I started training with Tom Brady's team, like the TB12 system and the physical therapists. And I was like, wow, I realized how much of my system wasn't balanced and how I wasn't in symmetry in many ways and how I actually was weak in areas I didn't know I was weak. And so I began this training program and, you know, I noticed that my back pain got better and I felt better. And now I, you know, can do everything and I'm great. And it's just, it's kind of a surprise. I was like, well, you think, oh, well, you don't want to lift weights, you don't want to stress yourself, you don't want to hurt your back. But if you do it properly, you can, you can do it even if you have injuries. And particularly when I have an injury, it was even more important. I want to have an injury, like my did something stupid with tennis or I tore my rotator cuff. I literally can train myself through it and out of it by doing proper exercises that help strengthen all the right muscles in the right way so that I can actually recover faster from the injury. So I think it's people often stop, and this is really important for people to listen to. When you have something wrong, it's usually beginning the end. People stop, oh, I hurt myself or I can't do this or I can't do that. Instead of going, wait, I need to figure out how to recover from this with the proper training so I don't hurt myself and I prevent this from happening in the future. You know, I jumped off a golf cart to save my fiance and she hit her head and cracked her head open. I was like, and I twisted my knee and I never had any issues and I tore my meniscus. But I was supposed to go trekking in Nepal and I was like, oh shoot, I can't have to cancel the trip. I'm worried about it. But I called up my guy and he's like, no, let's go through these exercises. And I start all these different kinds of knee strengthening exercises. muscles around it and I was fine. So I think, I think the body has this incredible capacity. So JJ, I want to, I want to dig a little bit to three things that, that you talk a lot about that are the keys to powerfully aging or aging powerfully mindset and, and a few other things. So can you talk about what those things are and then let's dig into all these a little bit more?

So I've done this very carefully because I always like to make it so simple and memorable. Right? And when I first started introducing these, I actually was speaking in the Maldives. Someone asked me to come speak in the Maldives. What do you say when someone asks you to come speak in the Maldives? You say yes, right? Sure. Absolutely. So one of the things that I taught was to eat protein first. And it was such so much fun because I was then at the buffet and everyone's meandering around the buffet. Eat protein first. I'm like, Perfect. So there's these three things that are so easy to remember and so powerful.

Eat protein first.

Eat protein first. And I'll tell you why I say that. Lift heavy things. And I always get asked, How much should I lift? And I go, It depends what's heavy for you. And then the final one, it was funny when I first did this, I was like, Sleep like a baby. Then I went, Wait a minute, my kids never slept through the night. So it's sleep through the night. those three things, they're really bigger, like sleep through the night really is talking more about recovery because we build muscle in recovery, not at the gym actually. But I'd love to dig into the first one because the wild thing- yeah, protein first. Yeah, here's why I'm saying this. And there's so much cool research coming out now about protein because for the longest time, think about it, because you and I have been like in this world Together, what, now 30 plus years? I mean, I've been at it for 40 years.

You still look the same, Jamie. I don't know.

I think you look better.

I look better.

You've always said great. You just keep getting better. You're like wine. There you go. Anyway, the reason I'm looking at this is I thought, gosh, you know, you look at so many of the diet programs out there and they talk about manipulating what I call the energy macros, carbs or fat. and they don't talk about protein, but what's so interesting is when you manipulate protein, like I'm thinking of one study I just looked at where all they did was they had one group that were 15% protein, one group that was 25% protein, calories stayed the same, their weight stayed the same after 12 weeks. However, the 25% protein group put on two and a half kilograms, might have been three kilograms, of lean mass. They dropped two kilograms of fat mass. Waist circumference went down. Wow, right? Wow, no exercise, no change in calories. And then I've got a buddy here living in Florida. We have University of South Florida nearby and the only physique and performance lab in the country is here and it's run by Dr. Bill Campbell. And this is all of his research is around protein. He likes to study women. And that's what he's found is like, if all he does is push protein up with taking it away from fat or carbs doesn't matter that people start to hold on to or build more muscle, lose fat. Now, the reason I focus on this is number one, because I keep hearing from people, I can't get that much protein in. And I developed a protein calculator to help people figure out what that is. But I think a safe thing is like one gram per pound of target body weight. But they're like, how do you eat that much protein? Well, have you heard of the protein leverage hypothesis?

No, tell me.

Okay, so Ravenheimer and Simpson. So these were locust researchers out of Australia.

And what did you say? Locust? Locust.

Locust.

Like insects, you mean? Like grasshoppers.

Little bugs. Yes.

So they can't stand up on my locust research.

I can't believe you don't know about this. Anyway, so they found it locust and they found it in rodents. Now they found it in humans. And when I was reading this, I went, oh, I You'll get this immediately. What it shows is that we will continue to eat until we have enough protein that our body will do this, which can cause us if we're eating a lower protein diet with more especially ultra processed foods or fat and carbs will overeat in order to get adequate protein.

Protein leverage hypothesis.

So, well, especially look, think about this. when you eat these ultra processed umami foods that trick your body into thinking it's tasting more protein, because you know ultra processed foods, you tend to eat 500 more calories a day. So first of all, that's one reason I want people to eat protein first, but the other pieces are this, and I created the seven-day protein challenge where all they do is don't change anything else, just figure out how much protein you should be eating, using my protein calculator, put that in, track it, and let me know how you feel. Better satiety, because we know that protein's the most satiating macronutrient, you know, slows down stomach emptying. We know it's also the most thermic, like protein, 20 to 30% of the calories from protein are expended in the digestion and assimilation of protein versus 5 to 10% for carbs, basically negligible for fat. So we've got that.

But I heard that you basically burn about 7% more calories when you eat protein, right? Because it takes so much work to actually metabolize and digest the protein.

Yeah, and you think about it like in our total energy expenditure for the day, what can we manipulate because basal metabolic rate we can manipulate over time by adding more muscle mass so we avoid that metabolic adaptation that you saw with the biggest losers where they ended up at the end of their time at the ranch with a metabolic adaptation where they were 500 calories lower than they should have been based on their weight, which is what we never want to have happen.

So, metabolism slows down because you lose muscle and fat. And if you don't keep the muscle up, you end up having a slower metabolism at the end of the weight loss, which is not good.

Exactly. Which not, I mean, how would you ever be able to maintain it then, you know, and then you go back up. But, so thermic, the total energy expenditure is activity that exercise plus activity, right? And then food. So if we're pushing up protein and dropping carbs and fat, just like Dr. Bill Campbell did and saw people lose fat without changing their total calories. So it's an easy- Dr. You mean.

All calories are not the same?

Oh, come on. Well, all calories are the same, but where they come from isn't. Like when you look at it, okay, a unit of.

Calories in a lab, but not when you eat it.

Dr. Yeah. But not when you eat it. Like you and I have been arguing this forever and boy, did we get our butts kicked early on, didn't we? Yeah. Yeah.

Still, still, it's still amazing how many people are stuck on the old idea it's calories and calories and calories and it doesn't matter where they come from, if it's Coca-Cola or a ribeye steak.

Or olive oil, it's all the same, you know? Yeah.

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You've got all of that. You've got, you know, the trigger for muscle protein synthesis. But I think just in terms of diet alone, like looking at the popularity of the GLP-1 agnus, what is one of the big things that GLP-1 agnus are helping us with is hunger. and cravings.

Yeah.

What is the big thing that protein helps with? Hunger and cravings. It's a GLP-1 agonist, right? So, like, what if we were to, and we know as we age, we have anabolic resistance. Yeah. We know already that the RDA is about half of what we should have and that right now, I think it's 46% of the population doesn't hit the RDA, which is half of what we should have, and that we should have, I just was reading one study that said we should be 66% 27% higher than the RDA. I go, but no one's hitting the RDA.

So we need to understand what that is. That means the minimum amount of protein you need to not end up having a protein deficiency disease. It's not the optimal amount you need for health or for muscle building. And that probably is double that. So I think, I think, you know, people just kind of misunderstand these guidelines. Like, what is the RDA for vitamin C? It's the amount you need so you don't get scurvy.

Right.

It doesn't mean the amount you need for optimal collagen formation or proper immune function or many other functions of vitamin.

C. It's interesting though, there's just still a lot of fear around protein. And when I had Dr. Bill Campbell come over to tape a podcast here since he's local, and he said, How much protein are you eating? And I'm like, oh, you know, one to one and a half grams per pound of target body weight. He goes, every single lean woman I've ever worked with has eaten that type of protein amounts every single one. And so once you know that success leaves clues, it's like, why make this hard on yourself? Who can white knuckle themselves through? And the challenge is when you look at diets and look at the average diet out there, because this is the big argument about GLP-1 agonists, but my argument about that is that's any poorly designed diet you're gonna lose a lot of fat free mass, of which some of that skeletal muscle mass and good luck getting it back. It's like 35% of the weight loss can be from fat free mass.

But no, in English that means when you lose the weight, you lose not just fat, but you lose muscle, which is really a problem because then your metabolism slows down. And this is what the drugs, the GLP-1 agonist like Ozempic do. They basically cause about 40% of the weight loss as muscle. And so unless you're really rigorous about strength training and massive amounts of protein, it's hard to kind of prevent that.

But I've now seen enough people go on these and not have that effect because, and here's my thought, if I was the benevolent dictator of the GLP-1 agonists, I would say you cannot have this unless you're going to do a DEXA scan every three months, and you are going to make sure that you're eating one gram or more per pound of target body weight and you're doing resistance training. And a lot of that's to overcome that anabolic resistance that happens as we age where we now can't trigger muscle protein synthesis like we used to with protein. So we need more to push that threshold.

That's exactly right. So, so back up a little bit on this whole idea of the protein leverage. I'm not sure I completely got that or the listeners completely got that. What does that mean? What are the practical implications of it? And then we can go into anabolic resistance because I think that's important.

Okay. So with muscle protein leverage hypotheses, if you are not getting enough protein, you will keep eating to get to that level of protein. So if you're not eating protein specifically, if let's say you sit down, you have a big plate of pasta and maybe it has a couple shrimp on it. right? And you're having some bread. You'll overeat on that until your body goes, oh, okay, I got enough protein. Whereas if you sat down and ate a plate of salmon, and just think about this as a restaurant, if you sat down at a restaurant and you had a big grass-fed filet, and then they came by with another grass-fed filet, and they go, hey, it's on the house. It's your birthday. You'd be like, yeah, No, thanks. Right.

There's that restaurant in Texas where if you can eat a, I think it's a 70 ounce steak or something, you can eat it for free. You can eat the whole thing.

It said no one ever, you know, but yet they could eat the same amount of calories, I'm sure, in like cake, bread, and pasta.

Mm-, right.

So, yeah. Right. And you can have your little pasta meal and then they'll wheel by the dessert cart and say, oh, the dessert's on the house.

So what you're basically saying is that, is that we're going to keep eating until we feel satisfied. And if we, if we eat protein, it's going to make us feel satisfied. So we won't need to eat so much. So it essentially reduces our raw calorie.

Count and intake, which will help us metabolically lose weight. Right. And there's more. So there was another study that came out that showed that people who eat protein first actually make better food choices. They tend to eat more vegetables, they tend to do better. So, I just looked at this and went, well, what if? Like, I love the little hinges that swing the big doors. Like, what is one simple thing you can do that all of a sudden you'll notice a difference? And notice a difference quickly, right? Like, that was Virgin Diet. Oh, if you pull out dairy, gluten, corn, like the literally the thing with the Virgin Diet is it forced you to pull out ultra processed foods and people felt better. It's like, wow, surprise. But with this one, I'm not even saying, Hey, cut out that other stuff. All I'm saying is eat protein first. And I'll tell you a funny story. I had this client, this gal, a friend of mine, she's like, okay, I'm ready. You know, she's right on the verge of morbidly obese. And she's like, I'm ready to do something. I'm like, okay. So I was like, get a DEXA, you know, gave her a workout program with resistance training and HIIT training, gave her eat protein for, like, gave her all the stuff, gave her too many things. I will and she goes, okay. She didn't do anything except she said, I did the protein. So she pushed out some of the garbage ultra processed foods. I didn't tell her to do that. I said, just, you know, she ate the protein and she started doing resistance training two days a week. And as we know, diet's the biggest lever, you know, for really helping with the fat loss shift. She lost 25 pounds in six months. That was the only change. Now she's ready to go to the next step, but I thought, you know, this is really an easy way to meet someone where they're at where all your focusing and it might be a week, maybe it's a month, maybe it's like her and it's six months, who cares? You know, it's till you get that one really dialed and guess what? Once that's dialed and you go, now I'm ready, I think about this, it's not just critical for being able to hold on to muscles you lose fat, but it's also critical for being able to neutralize toxins that are released in your body fat when you are ready to start to think about it. Can you explain it?

For everybody.

Well, this makes me nuts. And it just literally came up yesterday. I was talking to someone and they go, oh yeah, my wife and I are on a juice cleanse. I go, what? What? You're a doctor. What are you doing? I go, so you're activating all those toxins, but then you don't have the amino acids from protein to neutralize them so that you can then excrete them. And so when you think about it, that, you know, here we are storing toxins away in our fat so that we protect our body, and then we decide we are going to go on a fat loss program and we'll do a calorically restricted juice cleanse, except we've just freed up those toxins and we don't have the neutralizing agents on board.

Yeah, you know, I think just to stop on that for a sec, I, you know, when I began learning about functional medicine and learning about detox pathways. They're very scientific. You know, here's phase one detox, phase two detox, here's all these pathways that you need to mobilize toxins, excrete them, and, and phase two detox pathways are, you know, glutathione, glycine conjugation, acetylation, methylation. Uh, you know, these are, are all needing amino acids from, to do these detox mechanisms. So it's, it's literally like, not having the basic ingredients to process the release of the toxins. And just for, for everybody's reminder, we're basically cesspools. If you did fat bias, biopsies on all of us, you would see enormous loads of these environmental toxins, whether it's pesticides, phthalates, PCBs, and toxins, all stored in our tissue because we live in a toxic world and it gets stored in our fat. And so when you start mobilizing fat, these come out. And actually, there's a phenomena that happens. people need to know about where there's a resistance to weight loss. And part of that resistance is because of how these toxins affect our metabolism and how they slow our thyroid down and how they basically screw us up as we're starting to lose weight. So we kind of get some ground going and then we stop. And that's partly because of the detox issue. And I think the protein concept here that you're talking about is using these proteins to support the amino acid needs of our phase two detox pathways. So I think it's a little geeky scientific, but This is not just some detox, like I'm going to a detox spa or get a wheat grass enema. This is actually very scientific here. And actually, what we do in functional medicine is understand how to activate these various pathways with the right nutrients, the right amino acids.

And it's so critical for our health. Yeah, and it is such a nutrient dense activity, right? And it's not talked about, you look at all of these weight loss clinics, and I'm like, they're never talking about this piece. of the other part of that. And when I was so deep into weight loss resistance, I found that research you just talked about by Tremblay, I think, in Montreal, about how our body temperature would shift down in order for us to hold on to that fat so that we wouldn't release these toxins if we couldn't excrete them. So this is a thing that's like, when you really look at it, you go, right, I want to hold on to, or better yet, we should be focusing building as much muscle as we possibly can. Like that is my big focus now is like I want to go into my 70s, 80s, 90s with as much muscle as possible, like quality muscle, you know, strong, powerful and that's a really important message, JJ.

I mean, that is just to stop there. What you just said is sort of the key take home here is that you want to go into your older years with lots of muscle. The more you have, the more you'll be able to do. The higher function you'll have in life, the better metabolic health, the less disease you'll have, the more you'll be able to do what you love to do. I mean, it's fine getting older. If you have a great mind, you want to sit in a wheelchair and read your books. Fine. But, like, I think a lot of us just want to be able to do stuff and why not play tennis when you're 100 years old?

Right.

And why not ride a horse? Why not do the things that actually because your body can. And if we start to lose muscle and we don't provide the antidote, which is protein and strength training, we're, it's going to happen. Like, it's just going to happen. I see that.

Well, you're not even going to be sitting in the wheelchair, you know, reading your books, because we know that exercise is probably one of the is, I'm gonna say is the best thing we can do to keep that, to avoid cognitive decline. Right? I mean, BNF Alpha, like we need to exercise for that. It's super important. And it also gives us that margin of error. Like I call muscle your metabolic spanx. It holds everything in tighter. And I say that because so many women market still.

Love that.

Like every day I get hit on Instagram by this, I don't want to get big. And I go, you know, I have been working out. Yeah, right.

I hear that.

Right. like, because I've been really pushing on creatine. I hope you're taking it. But I've been really pushing on creatine.

I've been pushing on creatine.

They're so afraid that they're going to get big. And I go, first of all, you want to put on muscle. But I will tell you, and it's interesting since I've been really pushing on putting on muscle because I decided for my 60th that I was going to get into the best shape of my life. I'm actually back where I was in my early 20s before I tried the vegan diet. which completely trashed me. But before that, I'm back to that place, but I think I'm actually even stronger than that now than I was back then, which is crazy. But what I hear and in putting on more muscle, I'm actually having trouble keeping weight on and so is my husband. We weigh ourselves every day and I'm like, I'm 10 pounds less than I used to be. and I'm having trouble keeping weight on. It's crazy because your muscles metabolically active tissue and it makes you very insulin sensitive. And it's also a sugar sponge. So you want carbohydrate to go into your muscles to sit there so they can be energy for your exercise sessions. You don't want them to be going on your belly to create that belly fat that as estrogen goes down, women will tend to shift from having fat on their thighs and butt to a belly where they can produce estrogen. So we want to avoid that visceral adipose tissue, right? And resistance training and high intensity interval training are super key for that too. So metabolic spanks, sugar sponge.

So the other thing you talk about is anabolic resistance. And before we get into sort of the next steps of your three-step program, I want to talk about this because it's something that most of us don't realize. As we get older, it's harder to put on muscle because when you're younger, you have a lot of hormonal inputs that support that, your sex hormones, your thyroid hormone, and things tend to change hormonally as you get older. So what is anabolic resistance? What do we do about it? And give us the download.

Yeah. So in your 20s, up until your 20s, you know, teens, 20s, a lot of your Muscle hypertrophy is hormonally driven and then we start to rely much more on our diet, nutrition. And specifically, and this is Dr. Donald Layman, I think you've had him on the podcast before. Of course, yeah, I have. Yeah, leucine and that leucine trigger of 2.5 to 3 grams of leucine to start to trigger muscle protein synthesis. So our body, our muscles go through a process just like our bones do. You know, we break down, we build up. and so we go through muscle protein synthesis to build and muscle protein breakdown. So you want to get rid of the old stuff, bring in the new stuff, just like our mitochondria do. And ideally as we age, one thing that happens as we age is we do more breakdown and less build up. So that's a problem. We're losing muscle mass. We don't want that. We want it to be even. Or if you're building muscle, you better have more muscle protein synthesis. and muscle protein breakdown. As we age now, this is driven by two things, resistance training and amino acids. And as we age, our body gets worse at using those amino acids to trigger muscle protein synthesis. So we have to push harder. And in fact, I was just listening to Dr. Stacey Sims, who's amazing exercise physiologist and nutrition scientist who talks a lot about women and, you know, women all through their lifespan. was saying, you know, women really, you know, 50-60 plus should be doing at least 40 grams of protein at breakfast. I look at this and I go, if we think about it, we go to bed, so now we're going to do muscle protein breakdown as we sleep. We should in the morning make sure that that first meal really hits hard so that we can trigger muscle protein synthesis. So, yeah, how much is that? that 30 grams, 40 grams, 50 grams? I think some of it depends on, you know, you get better at this as you do resistance training. I haven't seen this yet, Mark. I am dying to see the difference between a woman or a man on HRT and not in what's going on here. Oh, my God. Think about it. What would, like, I have been on estrogen, progesterone, testosterone. since, remember when my son got hit and everything went sideways? So 49 years old, my son is in a near fatal car accident. And fortunately, all my friends around me are hormone docs. And so everyone was helping me because everything went sideways. So I've always been on, I've never been in that place where estrogen just went into the toilet. I've always been replaced. But it would be interesting to look at the difference because I think the Women's Health Initiative just really did women a disservice.

Yeah, no, I was Premarin Provera, wasn't it?

What a disaster. And so you look at and go, well, if estrogen is really this driver for muscle, like testosterone is for men, could you offset a lot of these things that we think happen with aging? Maybe they don't have to happen as much. And then you combine it with getting that optimal protein. Now we know that the more resistance trained you are and the more quality muscle you have, the better you're going to be here. You're not so I'm going to assume though is if you're just starting out, you're not well trained, let's make sure, I'd rather see you err on the side of too much protein than not enough. I think we're, that's high risk.

So basically the idea is as you get older, you don't actually respond to protein the same way, so you actually need more protein.

Right, and then we also don't have as good a digestion. Think about it, our stomach acid's lower, we're not breaking down protein as well. our appetite supposedly is lower and not eating as much.

So, I think the protein first thing is so important too, JJ, for the morning. I think people don't understand that when you eat protein on a fasted state after training, you'll have the most impact of building muscle. It's like turns on the engine, like boom, right?

It's just gonna crank mTOR. So, here's what's interesting too on fasted versus non-fasted workouts. And we can also talk about like, like TR time restrictive feeding or intermittent fasting, all of that world. And it's different for men and women, but fasted workouts versus non-fasted workouts. And I think the big thing that came out way back when about this, and I remember hearing it and going, well, that's dumb. And it was all about, well, you want to work out fasted so you burn more fat. And I go, but the reality is, and I was wearing a CGM during my workouts to see how high I could get my blood sugar to so. And I was cranky. I got it up to 220. And I was like, right? It's because I was just pushing it. If you are doing high intensity work, hard lifts, high intensity work, you're not using fat, right? You don't, you're not. You're using either, you know, your phosphocreatine system or you're using glucose glycogen. So this whole idea that we should go into a fast, a workout fast and so we burn more fat, I'm like, no, that's, you burn fat. when you're sitting around, when you're walking around at the lower level states is when you're going to preferentially burn fat. And the reality is what we want to be really good is burning stored body fat. So we have to be a car that can shift from body fat to fat to carbs. We need to be able to use all the different fuel sources. And this, I, in the challenge I have with fasted workouts is I tested it all out. I'm always my first guinea pig. My workouts were 30% less when you were fasted.

When you were fasted, really? I just didn't eat before you work out.

So, I always like to be my own guinea pig. So, I tested for a month doing fasted workouts and then I went in and I could push so much harder. So, here's how I designed this and.

This is really- Fasted when you weren't, when you weren't fasting, you could- When.

I was not fasted. Now, I'm kind of obsessed with Dr. Satchin Panda's work. Like, I think this, this, It just makes sense that you should eat based on your chronobiology. So eating about two hours after I wake up, I like to wake up, meditate, cold plunge, red light, and then we just got a really fast sauna so we can do some cold heat, cold heat. And I do that in the morning because I don't want to do a cold plunge after my weight workout and, you know, right, blunt the muscle protein synthesis situation. Then I eat, and I like to eat about two hours after I wake up. Then I will go to the gym about an hour or two after that. That's my perfect world when I can do it, is waiting about two hours after I wake up to eat, letting everything wake up, and then stopping eating two to three hours before bed. I like to do three to four, but sometimes it's the worst case is two, but better is three to four. So, but here's the thing, I hear.

You, I love that routine and I love it, but the truth is, you.

Know, it's a workout.

I mean, it worked. I gotta wake up, work out, and then have my shake. And if I have something before I work out, I'm like, I feel like I can't really exercise.

And that's why it just depends on the person. Like I can do cardio fine. I can go do a HIIT workout. It's not gonna hit me, but resistance training is very different. And so, you know, you should have.

Something, even a little something. before you eat?

I'd say test it out. Maybe just a little bit of a protein carb hit, not the fat, but a little protein carb hit. Just see it, see what it does for you. Even if it was like a hundred calories. I also been taking, I do creatine every day. I think creatine, especially for women, is one of the most important things that you can do. I love to put a pin in that and talk about that, but I want to go back to fasted workouts. They actually compared fasted and non-fasted workouts and fat body fat expenditure and they were equal, like your body corrected. So it didn't matter. So if people are doing fasted and.

Unfasted, what do you mean?

Right. So I think you really have to look at your life, your schedule, how you feel and how hard you can work out because it is always going to be that quality of the workout that matters most, right? I mean, it's the, especially for when you're looking at building muscle, which is different than building strength or building power. But, but hypertrophy training is really, you know, the volume that you can do. Yeah. And the progressive overload of that.

So it can be multiple reps volume, or it can be heavy weights, lower volume. This is the total load. You mean?

Yeah. When I was in school, it was, if you wanted to build strength, it was one to five reps. If you wanted to build muscle, it was 8 to 15 reps. Now we know there's way broader spectrum, mainly for strength exercises, which I don't have someone do until they have a good foundation, a good hypertrophy foundation. Strength is 3 to 5 sets, 3 to 5 reps, 3 to 5 minutes breaks. It's really heavy and it's as hard as you can go until your form starts to go sideways. So, and when I do strength work, I prefer to do it on machines. It's just safer, like a leg press is going to be a way safer situation than a squat. So hypertrophy training can be anywhere from six to 30 reps. I mean, there's a huge range. Now, I personally don't have time to do multiple sets of 30 reps and nor do I like it. It's not fun, right? So I still think that eight to 12 rep range, but the important thing is if you're continuing to progress about 10% a week. And every once, you know, I like to every eight to 12 weeks take a like a little, what we call a deload week. But if you're doing that, there's a lot of different ways you can do it. How do you progress? If you can't get the weights heavier, add another set, add more reps, right? There's all sorts of ways to progress that you can do.

So, so you, you kind of talk about this sort of strength training. So now, so we've talked about the diet, eat protein first, I think that Makes sense. Um, and let's talk about the string training piece, because you're talking about lifting heavy things, building muscle. So it's muscle strength, muscle power. And there was a third thing you mentioned, high protein.

So it's size, strength, power. And the reason this is important is we want quality muscle. And, and so quality muscle means you have fillets, not rib eyes, right? We don't want fat infiltrated muscles. And this is where it gets really important, Mark, and I will take it to the story. And Tim doesn't mind me telling everyone he was a skinny fat. He was a normal weight, what they call normal weight obesity. He was 25% body fat. We went to do dexas.

Wow.

And I was the same dexa at 59. same body fat, same weight at 59 than that I was at 39, which is remarkable. And that's what you want. But the challenge is for most of us, as we're aging, if we're losing up to 1% of muscle a year and our weight stays the same, it's not the same weight. And it's ridiculous to me nowadays that you go to a doctor's office and they put you on a scale.

Yeah.

Like looking at total cholesterol. It is a meaningless Silly number. So you would have looked at Tim and never guessed that this guy- no.

I didn't know that.

You wouldn't know. You two look like brothers. You have the same body type, everything, and all of a sudden, but he.

Was always- But I'm 10% body fat.

And I think he is now too. And here's the funny part. I was telling him to do this stuff and he was doing it about 80%, right? And then he gets to the DEXA and it wasn't me saying, Hey, look at that. he had the DEXA. And so the DEXA showed that he had 25% body fat. What I love about a DEXA is we think of them for bone mineral density, but you know, they're incredible for showing you where your body fat is, if you've got visceral adipose tissue, where your skeletal muscle is, is it even, right? And so then, and it's very actionable. So I think we should be doing this every six months. It's inexpensive. It's really easy to find these things. And then what you do is you go home, you get an inexpensive bioimpedance machine for home that looks at your total body water. Not that accurate. You take the average over time, but you can see the trends. And that's all you're looking at. It's just like, you know, is your Oura Ring going to be as accurate as doing some kind of a sleep study? No, but it gives you trends. So we're just looking at the trends. You do that, you do a tape measure once a week. I actually have a Bluetooth tape measure and a Bluetooth scale, so everything just reports into my phone so I can see trends. and that way you can tell as you are doing things, is my skeletal muscle mass increasing? Is my visceral adipose tissue decreasing? Am I going in the right direction or not? Because, you know, if you are doing a program and you're continuing to lose muscle, something isn't working here, right? And again, like we said, you really want to be looking at the goal being, how do I pack on as much muscle as possible. And if you're a woman listening and that just made you gasp and go, I don't want to get big, we would be lucky to put on a pound of muscle a month. If you put on a pound of muscle a month for every month, you know, I can tell you what happens because I had a client like this. She came in total normal weight, 25% body fat, which is at the upper edge to me of where a woman should be. you know, had always done cardio and some Pilates, had never done resistance training. She wanted to lose 10 pounds. Well, over the course of a year, she lost 10 pounds of fat. She put on 10 pounds of muscle. She went down to clothing sizes. She went to 18% body fat. She looked amazing. But you know what, Mark? She wanted to lose 10 pounds. At the end of the year, she was still like, But I want to lose 10 pounds. like you lost 10 pounds of fat. Like you, you're actually two clothing sizes smaller. You can eat more, you feel better. It's this thing we women, you know, we need to get over this. And that's why I really want to get off of, of using the, the scale ever as anything. You have to do body composition and you have to see it as a biometric tool. And we got to get off this whole chasing weight. If we chase building muscle, we will become more insulin sensitive, we'll have a better metabolism, we'll be able to burn fat, we'll improve everything, and we won't make ourselves crazy and shamed in the process.

That's just amazing. I think so. So many myths you're busting, JJ. It's crazy. I think, you know, I want to sort of loop back on kind what you were saying a little bit earlier about body composition because so we went by pretty fast and I think this is really important. You know, a lot of people talk about the body positive movement, healthy at any weight, and you know, it's okay, it can be metabolically healthy, and I think there's a lot of challenges with that. And I think people say, well, don't focus on BMI, it's not that accurate. Your body mass index, don't focus on the scale, accurate. And, and that, and I believe that's true because what really matters is your body composition. If you're Shaquille O'Neal, your body mass index is 35. That doesn't mean you're obese. It means you're a giant with tons of muscle.

Right?

So it, it really depends on the composition of your body and where the muscle and fat is and how much muscle you have and how much fat that you have. And it's really hard to know that by looking at a scale or looking at a body mass index. So what really I want you to do is unpack this sort of what we're looking for on this DEXA scan. Like what? This is a test that you use for bone density, but it's a machine that also does body composition. It's a bit different software, but essentially it's. It's a less than a chest x-ray it's less than one flight from New York. LA, and it's a really important test to determine where you're at in your metabolic health. So talk about this subtle idea of a body audit and what's going on and how do we, and tell us about Vicki because I think she was, she was a key person that you wrote about.

Yeah, I know the two Vickies there, but, you know, just like you do a macro audit where you track your food so that you can see what, you know, how many calories you actually really do consume, I think that the the stats are we over estimate, underestimate by like 25 to 40%. We want to do the same thing. We really got to understand what our weight is made up of. And I'll tell you what, this is a very empowering thing because there is nothing more frustrating than thinking you've been really good and then getting on the scale and nothing changed or you went up a pound and we all, everyone has done this. and geez, maybe you're retaining a little fluid, maybe you're constipated. There's so many things. That's why you really want to be focusing on your body composition and you won't know unless you look. And again, we can do this at home correlated with an inexpensive bioimpedance scale. Gosh, they're like 20 bucks now.

Yeah, right. Right.

I have a $5,000 bioimpedance scale at the house that I've had forever, professional grade one, but back in the day that I used on Dr. Phil, back in the day these things were really expensive. Now, there's one that's equally, you know, equally valid for a hundred bucks. So, but you want to validate this, the DEXA is really the gold standard. So you just decide, I'm going to go in because people go in to get the DEXA for their bone mineral density. But you know what? Bone mineral density is like blood sugar. It's a lagging indicator. So blood sugar, a lagging indicator for insulin resistance. Like what if we were just checking insulin all along the way? We would not have the blood sugar problem. And bone mineral density is really a lagging indicator of sarcopenia, which, you know, it's like, I think, 15, 13 to 17% of people 50 and above now have sarcopenia, have low muscle mass, and you would never catch that stepping on a scale. You would never catch it. And so here's what's important about getting on a DEXA is you're gonna, of course you're gonna find your bone mineral density, but you're gonna find out your skeletal muscle. and you're going to see your skeletal muscle and you're going to see how much do I have in my arms, my legs, my trunk, is it even? And what is it relative to other people my age? And what do I need to do? And I want to be, I want to be like, I want to be a star student here. I want to be in the upper 25%. It's called appendicular lean mass index or appendicular skeletal mass index on the test. And then you're going to look at body fat. Now here's the thing. If we were going to look at levels of risk, your real risk on that that you're seeing in the DEXA is low muscle mass and high visceral adipose tissue. People tend to get all blown out about like, you know, their size. Well, if your body fat's mainly on your thighs and hips and you don't have visceral adipose tissue, right, it's like not a big deal. But what we know for women specifically is as they age. Now, men will be different with insulin resistance and then maybe converting more testosterone to estrogen. But for women, as they age, estrogen goes down. We take that subcutaneous, that thigh fat. My mom called it shifting sands where all of a sudden your butt fat goes to your gut. You got belly fat where you didn't have it before. And you really want to see that because that's that dangerous fat. so. But you can affect it, you know? And again, what I look at is if I have a DEX and I go, all right, we have to build some muscle and you seem to be way weaker in your size. You've got fat infiltration, you know, here you've in your. In your upper body, you've got visceral adipose tissue. What do we need to do? Like, what do we need to. Or, you know, your right arm has more muscle mass on your left. Right. We can start to now put your body back into which is another reason why I like doing resistance training with more dumbbells, etc. to help us not favor our strongest side, because we always will. But that's what a DEXA can show us. And then we go home and we use our bioimpedance machine and we use that. We just do it every day. We get up in the morning, pee, get on the bioimpedance machine. It goes into our phone. We track the trend. We don't get emotionally involved. It is not a mean friend. It's a biometric tool. You would never take your blood pressure and beat yourself up about what a bad person you are and that you blew it the day before. Never, you know? Right? So we need to behave the same with this. This is information that will then let us know what we need to do, what's working, what doesn't. I love to combine that. Like, I think tracking your food for at least a month is one of the biggest game changing things that you can do. Yeah. Right? I mean, if all you did was just track your, that's why I tell people, let's just track and focus on protein. Don't, no, nothing else. But I know that just by tracking you'll make better choices. And then you put the protein in and I know if you're eating protein first, you'll make better choices, right? So we put that stuff together and it's really important, Mark, for someone to do bioimpedance when they're increasing their protein because they may either see that even though they're in a caloric deficit, their weight going down very little, or they may see maybe their weight goes up a little bit at first, especially if they've maybe added in some creatine and now they're building more muscle and they're freaking out and yet their clothes are fitting looser and they look better naked. So, you know, that's why we have to really understand what's going on because if you haven't lost any weight but you've dropped body fat and put on muscle, Holy smokes. You know, the other Vicky that I talk about was this poor, huh? The first Vicky was the one that lost 10 pounds of fat, put on 10 pounds of muscle. And, you know, here's Tim who literally now has gone from 25% to 18% to 14%. I just did the Tanita at home. He was 11. We're about to go do a DEXA. So, I sense he's somewhere now in the 8 to 10%. but his weight has only dropped five pounds.

Wow.

So, you know, and this has been now a year and a half, but very solid on his protein, very solid on creatine, like doing all the things that you need to do.

So, JJ, this is so fascinating. I think it sort of upends a lot of our kind of conventional wisdom around what to eat and what we should be doing with exercise as we age. Let's, in the few minutes we have left, let's talk about some of the other pillars. that you have a third pillar, which is sleep. And then just a few minutes about supplements and then we'll sort of kind of wrap it up. But tell me why sleep's so important and how does that relate to weight loss and diet and exercise?

Back when I was obsessed with weight loss resistance, sleep was obviously one of the things I looked at the most because just if someone slept more, you know, because you know the research of failure to get the recommended seven to nine hours of sleep a night, even if you're eating healthy and exercising, is a risk factor for obesity because of elevated hunger hormones, because of insulin resistance. So, you know, first part, just for fat loss, sleep is mission critical. But muscle repair is happening when you sleep. So we have to make sure, and that's why I really, I'm also focused on in terms of the bumper meals for protein that you make sure that your breakfast and dinner have really got that two and a half to three grams of leucine in them, that you're doing that. You know, I think really for our age it's 40 grams or up a protein at those meals and at minimum 100 grams of protein overall during the day, but probably more. I'm getting 140 to 180 grams a day. That's a lot.

That's not what I'm getting. I'm bigger. Well, you're about six foot tall. You're probably close to me.

You're six aren't you 6-3?

6-2, 6-2-3. Because I shrunk a little.

So, you know, so sleep, when I think of sleep, I'm also thinking of all the different things that we need to do to recover and repair. And so it's sleep, it's Epsom salts baths, it's foam rolling and massage, it's sauna, It's cold plunging and red lights. So all the things that you can, if you can get access to these things and if you can't, if you don't have a cold plunge, we literally got a cold plunge and we put it in the house. But you can have a cold shower. You know, if you don't have a sauna, take a hot bath. All these things are going to aid recovery, but sleep being the most important of all. Like we've got to prioritize sleep. And I think there's an idea just like we think we don't need to eat as much as we age. Sure, caloric needs might go down some. I would argue that if you are doing the activity that you need to do and building muscle, it's not going to be as much as it would be otherwise, that that's really more of a devastation in your metabolism. But we also don't have less sleep needs as we age. I think probably what happens is we've got more cortisol, we've got lower progesterone in women, and we're just not sleeping well.

But we need to prioritize it and make it happen. Yeah, I think sleep is key. I think most people forget about how important it is just in terms of your metabolic health, immune health. If you just don't sleep, you're gonna.

Crave carbs, you're gonna be tired, you're gonna be tired, I mean, I don't know if you know when I met Tim, Tim used to eat a little bit higher, he would eat sugar and he slept five hours a night. And I'm like, well, this isn't gonna work. This is the problem. And it's funny because I got him sleeping eight to nine hours a night and boom, he immediately lost weight. Like, didn't have sugar cravings anymore, you know, just weight dropped off of me. He's like, gosh, I, you know, I, I need to eat more. This is not working. So it can, it's that dramatic. Like these again, when I look at these things, I go, what are the biggest levers that if you were just to do these things, like you just said, okay, I'm gonna eat protein first. I'll eat the amount that I need, and I'll eat it first. I'll make sure I get it in, and then I'll just focus the exercise that I am going to do. I'll do resistance training, and I'll focus. big compound movements rather than doing a little bicep curl or tricep extension. You know, I'll do a pull up or a dip or a push up, and then I'll make sure that I get, I prioritize my sleep. I'll make it a priority. I'll get my seven to nine hours every single night. Just those three things. Do you know, like I think we have probably, we'd flip the metabolic health parameters. We probably have 6.8% of the population who wasn't metabolic.

Healthy. It's not that hard. I mean, it's not that hard. We have the science. You've unpacked Toma, which you've been. There's so much more. One last thing. You take supplements. What are the supplements you take and why?

So I'm gonna tell you the ones I think are most important. Most important in this area. Because I'm like, you mean the 50 supplements I take? But the ones that. That no matter what are my non-negotiables yeah, it's creatine. Holy smokes. I don't know when you started to take creatine, but I only started taking it, gosh, I don't even think a year ago. I'm like, why wasn't I taking this? Do you know women have 70 to 80% less tissue stores of creatine than men? We make about a gram a day.

Wow.

But we really need more than that. We need tissue saturation. And when you're doing high-intensity exercise, if you're really pushing that you have to use this system in your body called the phospho creatine system. It's creatine dependent. So you can work out harder, recover more. Also for women, they found like major important for mood, for cognitive decline, like women on antidepressants who were given creatine had a way bigger effect, way happier mood. So- Really? Yes. Yep. And wrinkles, skin, mood, food, bones, muscles, recovery. I mean, it's like, it's incredible. And women need it more. And they're so afraid of taking it because every time I talk about on social, I get bombarded. I'm gonna get bloated. I'm like, you know what? Just creep it up. You'll be fine. And if you are the one of the fortunate ones that actually is going to get more water in your muscle, which you could see by doing your bioimpedance scale, celebrate that. you want that. That's good. You know, like we want muscles that have got good water in them. That's good. So that would be one. I know you and I are both fans of Mitopure Urolithin A. That was another one. Like I do one thing at a time. And wow, did I notice a difference when I started taking that in terms of how hard I could work out? So that is one. Yeah, huge. Some of the ones I think that are really important and there's more research coming out now about vitamin D helping with, right? So, you know, we think of vitamin D, pro-hormone, bone health, immune health, but also now Moore's coming out about it for muscle mass. Same with fish oil. Like I always thought, well, is fish oil, like I know fish oil helps bone remodeling, but, you know, there started to talk about fish oil possibly for an anabolic response. The latest research showed that with frail people, that it improved gait speed. I was thinking, oh, I wonder if it's the anti-inflammatory effect because if you've, if you're inflamed, which we know there's inflam aging, it can block muscle protein synthesis. But it's apparently a different way it does that by improving your sensitivity to amino acid. So maybe it's pushing you out of, you know, it's, it's helping you with that anabolic resistance. It's still kind of, we'll see. But, you know, those are my, like, for this, I think those are some of the key ones. I also have really focused on getting in my electrolytes and being, I know you're well hydrated, as you've already proven today. Um, but I think this, this information from Rick Johnson about dehydration. Yeah. And how when you're dehydrated, you will convert glucose to fructose in the liver and store it as fat. You're basically becoming a camel. I'm like, holy smokes.

You know?

Yeah. No thanks.

Yeah, I mean, I think that's true. People don't realize that we need not just hydration but intracellular hydration. For example, if you over-hydrate with water, you dilute your blood, you can end.

Up with coma, seizures, and death, right? Well, Brooke Shields just passed out because of it, remember?

Right.

That in the news.

Yeah, people need to think about drinking electrolytes with their water. And, this is not the sugary stuff. I use one that's called Light Show. I like it. It's a little scoop I pour it in. It's got a teeny bit of Stevia. There's another version of it that has none of that. It's just tastes like a little bit of salty water, but I don't mind it. It's profound in its effect. I mean, I notice when I work out or when I'm on a hot, sunny day playing tennis and I actually drink it, it's like the Energizer Bunny just gets turned back on from the droopy little guy. So, I think it's important to get intracellular hydration. So, I think this is just such a wealth of amazing information. JJ, why don't you share in closing what it means to you to live with purpose and age powerfully as you get older?

So, I have a theory about the blue zones in that, you know, when you really look at the unifying factor between all those different areas, they're super I was looking at some video you did somewhere where the guy was pulling his cart and he was walking up the hills. They're super active doing powerful things, right? But they also have a purpose. They're relevant in their society. They're regarded as elders, which we suck at in the United States, let's be honest. When I look at this, I think this is such an opportunity for women especially, because if you look at it, okay, we're aging. If we left that unchecked, we'd lose muscle size, we'd lose strength, but we'd really lose power. And women their whole lives have tried to shrink, be smaller. I mean, you know, being six feet tall, people always say, oh, you're so big. And I'd always say, no, I'm tall. Like, I never wanted to be big. And then I thought, well, what happens if we show up bigger, if we show up more powerfully? And I really think that as you start to get stronger, like the way you do one thing is the way you do everything. Like you start to to get stronger in the gym, you get stronger and more powerful in life. So it's my big goal that this message is goes beyond just, you know, physicality.

That's beautiful, JJ. It's such a beautiful framework. And where can people learn more about your work and how to apply this? Because you've created so many resources for people. You're coming out with a book in 2025. We'll have you back on the show. It's going to go through this. But, but for now, where can people find information that will help guide them toward the strategies that you sort of outlined in this podcast.

So we created a very simple, again, I wanted to prove a point, very simple challenge that gives them a protein calculator so they figure out their range, their personal range for protein based on their age, sex, genetics type of diet, and then a simple seven day protein challenge. And that is at JJ Virgin proteinfirst.com forward slash protein first.

That's great. Protein first. I love it. So, JD, thank you so much for everything you've done for being my friend for decades and decades and being on this journey together forever. And it's just great to see you thriving and doing well. And, and it's just an example of how we can all age powerfully. So thanks so much.

Thank you.

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Thank you again and we'll see you.

Next time on the Doctor's Pharmacy. This podcast is separate from my clinical practice at the UltraWellness Center, my work at Cleveland Clinic and Function Health, where I'm the Chief Medical Officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only. It's not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, seek out a qualified medical practitioner now. If you're looking for a functional medicine practitioner, you can visit ifm.org and search their Find a Practitioner database. It's important that you have someone in your corner who is trained, who's a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health. Don't forget, there's a way to listen completely ad-free. With Hyman Plus on Apple Podcasts, you can enjoy every episode without any breaks. Just open Apple Podcasts and tap Try Free to start your seven-day free trial.