Muscle Building Vs Muscle Loss With Various Diets And Or Protein Amounts

All right, we are trying to sneak this one in during Nutrition Month, which is of course March, and I may be barely making it in on the tail of the month on this one. It was a challenge because of Mother Nature. That bitch brought us a snowstorm, got my guest stuck. She couldn't get back to do the recording, so we had to postpone. But no matter when you're listening to this, in real time or you're listening much later, it's going to be an important one. We're going to talk about protein, how much and how. If you're following a certain diet you're kind of really attached to, or you've been flirting with the idea of one to reach certain goals that you've got, are you compromising muscle or could you be by doing that? We unpack it all right here. Great conversation. I think you're going to love it. In honor of National Nutrition Month in March, this idea popped into my head because it's a recurring theme and recurring question, like this whole protein dilemma and the question of how many grams of protein do you need? Is there a specific type and timing that are more important? What if you're combining them with no carbohydrates or no vegetables, or you are combining it with a very varied diet, or you're in a huge calorie deficit and eating high protein, we actually unpack all of those things. So whether you're doing keto, you're a vegetarian, you're a vegan, you're going to hear some things you may or may not like. Whether you're a carnivore, you think you are flirting with it or want to, or you're eating a very varied diet but not getting results, I think you'll pluck something out of here. And certainly the overarching theme, and I will give you the spoiler alert right now, is keep it simple, keep it easy, make sure that it's something that you can do and you can follow. There are certain things that might be valuable to you short-term that were never intended to go long-term. And might indeed backfire if they go too long. My guest today is returning as a favorite, I think, Esther Blum. She is an integrative dietitian, menopause expert, host of the Midlife Realignment podcast, and a TEDx speaker. She helps women find the right, or the light at the end of the tunnel, the right light, can I say that, at the end of the vaginal tunnel through nutrition, hormones, and self-advocacy. Esther is the bestselling author of See You Later, Ovulator, Cavewomen Don't Get Fat, Eat, Drink and Be Gorgeous, Secrets of Gorgeous, and the Eat, Drink and Be Gorgeous Project. Known as Gwyneth Paltrow's menopause mentor, Esther has appeared on the Today Show, ABC TV, Good Day New York, and is frequently quoted in Goop, Oprah Daily, Well+Good, and Forbes. You might say she's somebody. And she's here with us today. Welcome back to our— maybe our most popular and most frequent registered dietitian, Esther Bloom.

How are you? Hey, Deb, how you doing?

Good. All right. There was one person I thought of when I was coming up with this question, and it was a question I think they're born out of years of multiple questions about women doing X or Z or resisting doing X, Y, or Z. And, you know, I think right now as we do this live, 2 days ago, the exercise guidelines and position statement from American College of Sports Medicine changed. I don't know that it changed all that dramatically, but I think the underlying message that everybody should get, and maybe everybody is health and fitness coaches most of all, that it really doesn't matter. If you're trying to sell a program that is very nuanced, it doesn't matter as much as just getting somebody moving. So I guess that's where the question really lands, is how important is the amount of protein somebody consumes, and consumes in conjunction with the other macronutrients and their overall micronutrients, important for maintaining muscle mass? So as a very broad introduction.

Well, it's interesting because people used to— and I'm sure you remember this— when, you know, we were taught, uh, and taught to teach the timing windows and, oh, you've got to get in your protein within this many hours of working out, working out fasted versus not, where versus non-fasted. And research really concludes that as long as you get protein in within, uh, that 24-hour window, you're going to be fine. And that is it. It's So freeing because, A, so many people love to follow rules and make things far more complicated than they need to be. So to me, this like keeps it very relaxed so we don't obsess and, you know, make ourselves crazy. But the challenge can be is if you're somebody who's intermittent fasting, for example, the shorter your window to eat, the harder it is to meet your protein needs. And typically, people who are intermittent fasting, I mean, they're not eating 8 to 10 ounces of protein at the 2 meals they're having to, you know, hit that 20-ounce-a-day goal. So that can be, you know, where you can fall short.

Amen. Yeah, and I think that would definitely be one of the questions on my list, especially those longer, you know, 18:6 or 20:4. And for a while, those gave you bragging rights, right? I mean, everybody was so proud of themselves, but it was like, okay, well, what kind of results are you getting? And I, I think maybe we should back up and start there, you know. I love that you said the, the recommendations are, are much looser, you know, as long as you're getting it in. And then, you know, we would say getting it in still is kind of checking off a box, but the outcome is really what we want to track Are we getting the results? There's no damage being done. We feel good, you know. So with your dietetic or dietitian clients, where do you have them measure? What do you have them look at so that, you know, they're not losing something, and particularly muscle and bone? And so we're, we're doing okay.

Yeah, I love the InBody scan. Um, I think it's so great. For those of you who don't know, it's bioelectrical impedance. You stand on a Your feet are on two little metal foot plates, and then you also, your hands are holding a metal measuring device, I guess. And it runs. Now again, and people say, oh my God, well, how do I, do I have to take it fasted, non-fasted? Just take it in the exact same conditions. So if you show up to the gym at 9 o'clock on a Monday after you've had breakfast, just do it again 4 weeks later with the same conditions. Don't do fasting versus non-fasting. Just keep the results consistent. That's how you develop a controlled experiment. So if you always exercise fasted, take it fasted. If you exercise non-fasted, take it non-fasted. But don't do it more than once a month. That's really, um, you're not going to see dramatic differences from one week to the next. It's better looking over the course of the month. Now, if you don't have access to that, use a tape measure. That's also another way to see at least are you changing inches and you'll know you are because your clothes will fit different and you'll look different naked in the mirror. And we all know what we look like naked in the mirror. But if you truly want to measure body fat versus muscle, then you do have to get scientific and get— InBody is my favorite measurement. What's your stuff? What do you like to use?

Definitely like it. So as a consultant for gyms and studios, I actually, I recommended for a long time without any credit or affiliate commission. The InBody because it gives them a great— it's actually leverage for selling personal training, you know, to look at somebody and reinforcement for keeping members. They've made progress, here you go, this is the benefit you're getting from it. But I also have one, I call it the Rolls-Royce of a smart scale. So I have one for home and I got it during the pandemic and now I'm also glad I did, you know, because now I've got all that data. And, you know, I think there are people who want to— want to weigh like every day. And I think even some of my good and respected friends and colleagues will say, do that every day. And I'm like, oh, you're just going to drive yourself crazy. I mean, especially if you're cycling. We fluctuate so much, you know, so much. Yeah. So I love watching trends, definitely. What's your take? And I'm going to sideline here. What's your take on a smart scale that measures bone density?

Supposedly, I'd be very curious to see one that does a good job at it. To me, I mean, the DEXA scan is the gold measure and you— we should— what I think women really need to know is we should start doing our baseline at age 40 to 45. Um, it was something I had to ask my GYN for. And even the technician who did, she said people should be starting these age 40 to 45. And most physicians, like when I asked my GYN, she said, oh, you need it to your 60s. By the time you get to your 60s, ladies, it is way too late, right? Way too late. It's never too late, but it's, it's later than it should be.

You should always have a baseline Interesting that you said that because I even backed that out to like 30 to 35 to look at—

oh, interesting—

when you're in your peak, where was it? Yeah, like, so that we know if we're comparing you to you, we see where were you, where did you get to, which even that could be interesting because, you know, if we had a whole bunch of 30-year-olds, those who did gymnastics as children and those who swam, you know, could have very different scores. There's so much involved there. Let's circle back to, to protein and its importance. So you mentioned, do you have a bottom line, like you'd like to see every woman hit this number?

Yes, a minimum, like do not dip below 100 grams per day. Now, where did this number derive from? Where did I pluck it out of the air? Well, it's interesting, and it's interesting because I'm going to break my own rules here and tell you that although I say women are not tiny men, Or I do base this number off of a study from— done from Navy SEALs who were tested during SEAL Week. And for those of you who don't know what SEAL Week is, you know, it's when— it's that— it's like Hell Week for Navy SEALs where they're deprived of sleep, they're deprived of food and calories, and, you know, they'll get a break in the day to put as much food on their plate as they can and about 5 minutes to eat it. And then they go right back out into the water or doing their strength work. But the, the study was done looking at their muscle mass before and after Hell Week. And as long as they ate a minimum of 100 grams a day, they were able to preserve muscle mass.

Wow.

And most women I see are eating, you know, what I call ventilator calories or diet where it's the amount of calories and they're eating less than that. Like when I worked as a hospital dietitian, I was feeding people in the ICU through a stomach peg or through an intravenous TPN. It was total parenteral nutrition and the minimum amount of calories they needed a day just to lie in bed breathing, not moving. Not doing anything was 1,200 calories. And often we— I had people on 1,800 calories just lying there to preserve muscle. And women come to me eating 900, 1,000, 1,100 calories, and they're dumbfounded that they're not losing weight. Yeah. And I'm like, well, your body thinks it's in a place of starvation. It's going to hold on to every calorie it has, and you're also going to lose muscle in the process. So Every woman needs to, I mean, I'm spending more time refeeding and refueling women's bodies than I am dieting them down at this point. It's absolutely fascinating to me.

Yeah, do you use this term reverse diet? I keep hearing it popping up. I'm not sure that anybody knows what it means.

Yeah, yeah, I try to say refueling or refeeding, but refeeding is associated with true starvation. That's like what we learned in our clinical textbook. Books as dietitians.

This episode is sponsored by the Flipping 50 Menopause Fitness Specialist. It is the framework that we designed our entire membership and program based on. Since 2013, I've been developing that after 30 years of working with women in midlife. That was born, and in 2018, we rolled out the Menopause Fitness Specialist. To train other fitness and health pros on how to actually prescribe exercise. Here's where we're going next, in case you want to get started now, that we're actually training physicians on exercise prescription, knowing they get very little of it in medical school, and hoping that it also bridges the gap for you who may be a fitness or health professional, or want to be, who works with women in menopause. Because there is so much demand and so much room for you right now. If you are working with women in menopause but not getting all the results, don't have a reliable, predictable framework that gets you results over and over that people know, like, and trust, come and talk to us. We'll put the link in the show notes for today. That's the Flipping 50 Menopause Fitness Specialist. And if you want to head on over to fitnessmarketingacademy.com, to where we have all of the content dedicated to you, health and fitness pros.

Whatever you call it, reverse dieting, refeeding, refueling, it's ramping up calories slowly to the tune of 100 calories a day for a week or two, then another 100 calories. And often it's a toss-up as to whether I start with protein or carbs. Initially, you would think, "Oh, I'm going to start with protein because I'm going to build muscle." However, If I see a woman who has exceptionally low cortisol, poor adrenal function, chronic stress is pumping out tons of cortisol as well, then I often start— oh, and low thyroid function— I will start with carbs first because carbs, eating carbs, and I'm not talking Twizzlers and movie popcorn, I'm obviously talking about like sweet potatoes, rice, fruits, and vegetables. Legumes, like that is what is going to enable your thyroid to convert T4 to T3, which is the active form thyroid hormone. So it's going to refuel your thyroid. You will lose weight doing this. That's the shocker. Metabolism will get unstuck. I could tell you personally, listen, um, I years ago, uh, I hired Ali Gilbert, who's now Ali Weingroff, really fit human being. Um, and I hired her to do my macros because I would— now, I was in the throes of perimenopause and insomnia and Lyme and all these things, but I was like, I was just curious because my weight was going up. I mean, I was 10 pounds heavier than I am now. And she, um, bumped up my carbs by quite a lot, and I lost 5 pounds in a week. And I am not someone who loses 5 pounds in a week. I'm someone who loses 5 pounds over 5 months. I mean, I— my body just really likes to be in one place. It doesn't really— it perceives weight loss as a lot of stress.

Yeah.

Um, so yeah, I mean, it's— I, I was profoundly thrilled by that, but also found it so clinically interesting. Um, but if, if your cortisol— if your sleep is pretty good and your insulin's regulated, you know, and, and you have good gas in the tank, but you're just not losing weight, start with protein. Protein first and really level out your sugars, level your cortisol, and really, you know, start building your muscle.

Yeah, I love that. And I can share two stories. So one very recently with a client of mine who's going through all kinds of mold and detox from parasites, and it seems like just she gets one taken care of and then another problem crops up. And so she's dealing with letting go of all of this stuff. And so she's getting better, and yet she'll feel this wave of fatigue and nauseousness because her body is working really hard to get that out. And I said, you need to get more. We need to feed you. Yeah, we have to nurture your system. And so, you know, that's scary for her, but, you know, she did it. She was like, my energy was so much better, and I did this, and and it didn't bother me and I really lost a couple of pounds. And I'm like, "I know, keep going." You know?

Yeah.

I said this in my TEDx talk too. I worked with a woman for, gosh, over a decade. And, you know, a larger-size woman, had 100 pounds to lose and probably a little bit more. She's not done, but like you said, she came to me 800 calories, moving 2 to 4 hours a day and walking consciously and on her feet all day as a healthcare provider up and down hallways. I was like, no wonder you're in a boot with a fracture. Uh, your body's not just dealing with the stress, but you're just not getting any micronutrients to it at all. So we slowly ramped up, but it took a long time. Because here, between the ears. And yet that was the first win, that she hadn't gained weight by increasing calories. We had to get there first to feel safe to increase further so that she could get to that point where her body was willing to let go. It was— it's very interesting and very hard, I think, mentally for a lot of women.

It is, but it's also such an embarrassment of riches. You know, I try and flip it. I'm like, do you know what a good problem is? Do you know how many women would kill to be in your position of having to eat more?

Yes.

And, and not being able to eat enough. What a high-class problem to have. And then they laugh. They're like, oh my God, that's, that's actually true. But then also we have to remember what a massive neuroendocrine storm perimenopause is. And when the body is under so much stress, Adding in the complexity of starving ourselves is not going to help matters and it's just going to make you feel craptastic. So, yes, it's like, it is getting women to trust their bodies of like, that they won't do them dirty, that they will not only not gain weight, but they will lose weight. Or some women, I mean, I will say, I'm thinking of one client in particular. She was my 900-calorie lady, working out, just like your client, working out a ton. And She gained 10 pounds first and then lost, but we did have to diet her up. And I said, "You're going to hate me. Buy loose clothes for a month or two. Don't look in the mirror if it's going to upset you that much. Definitely don't get on the scale." You know, so she was understandably upset because who wouldn't be upset gaining 10 pounds? Nobody wants this. But long-term, she course-corrected that. And Allie, too. You know, I will tell Allie's story because She put it on social, and I, I know her, so I'm not telling you anything she hasn't shared. But okay, you know, she had breast implant illness and mold. There was mold growing around her breast implants. Oh my God. And yep, and she called me like so upset, you know, and, um, and she did— she had to gain 10 pounds, and she bought big, uh you know, looser hoodies and sweats and dieted up and then dieted down. And now she is, I mean, she has some of the lowest fat I've seen on any woman. Um, but she, and she strength trains a lot and she eats a lot of calories. I mean, she's really fueling her body with protein and carbs.

Yeah.

And, you know, it's just, we have to give ourselves permission to not be at our leanest weight sometimes when we're healing. We have to give ourselves permission and our bodies to trust the process. And we, we really do have to work with someone who will— we can trust and who can emotionally support us through. But it's not the end, it's actually the beginning. And sometimes we have to take 2 steps back in order to go 10 steps forward. It's, it's healing. And I, I can tell you too, like, I, I have lost 10 pounds since going through, um, you know, perimenopause and healing my Lyme, I found some videos of myself. I used to have a video on my website, right? And my stomach was like, I had the big old menopot. I mean, big-ass rubber tire. And it surprised me because at the time I was— I thought I looked great and I did. I looked fine. But I looked at that and I'm like, wow, like that. And of course, the scale tells a different story now, but I am literally 10 pounds leaner. Now, some of it wasn't all dieting. Some of it was when I had my hysterectomy. I lost 5 pounds of inflammation because I had adenomyosis and, and fibroids. And my body was like— it was immediately 5 pounds lighter. I got on the scale, I was like, wow, thinking, oh, I'd be so full of fluid and retention. And no, my clothes were hanging on me. And so, but So, not all of it was diet, but the rest was just, it was just calming down. Have my calories altered? I probably shaved off 200 calories a day. That's it. But, I didn't ramp up my exercise dramatically. I just really worked on the inflammation and my hormones, and I also did a tremendous amount of gut healing too. I'd been struggling with chronic H. pylori and just a lot of gut issues post-mold. So that's why I want to tell you all, it's not only about the diet. It's the inflammation. It's the hormones. It's the— and my sleep sucked too for a long time. So it's getting my sleep back, you know? So it wasn't— and for me, it was not insulin or glucose dysregulation at all. It was super low cortisol and inflammation. So it's so different for everybody. But fuel your body throughout, people. Fuel it.

Yeah, I love that. And I want to do a little callback to something you said. You said, I didn't increase my exercise. And, you know, then right after that said you focused on the inflammation, reducing that. And, and I just want to say to every woman here, when you're in the middle of that, had you turned up the exercise, it actually could have backfired and contributed to more inflammation. I think a lot of women don't put that together because it's not intuitive. It's not what you've been messaging. And I hesitate to say taught because, you know, I do think maybe it's been very common for doctors to say easily, you know, more exercise, less food, or general public and media memes. But that's honestly, you know, if you're talking to a professional, they are going to get in there with you and really look at, is that what you need or is something else going on? And at least today we know a little bit more to do that. One thing that I found very recently, and I say that probably 6 to 9 months, that, you know, we've always talked about, you know, if you want muscle, okay, protein. Protein's the help for building blocks. But recently with studies for older adults, this one really jumped out at me. It's that older adults need to get adequate— I think it's a threefold now— it's adequate calories overall, but adequate protein within those calories. And also adequate micronutrients, which, back to the talk about intermittent fasting or just simply caloric deficit focus, it's really hard to do all of that.

Yes. So, okay, so let's address this. If you are someone who's listening to this and is like, "No, I know I overeat my calories and I still need to be in a deficit to lose," Short term, there's no long-term damage there. You know, 3 to 6 months, that's not going to be a problem. But you should, A, take supplements, right? And B, if you're someone who is just wanting to maintain but be healthy and have optimized every opportunity for longevity, then yes, micronutrients matter and gut health really matters. You want to make sure that you're digesting and absorbing your nutrients. Otherwise, you're just going to have expensive urine. So, um, certainly making sure there's fire in your belly— that means taking digestive enzymes. If you find you don't digest protein well, you can get a broad spectrum digestive enzyme with some hydrochloric acid in there to make sure, and some plant-based enzymes to make sure that you are breaking down your proteins, but also the cell walls of the plants, because plants can be very hard to digest. Um, But second is, yes, I do love trace minerals. There's, you know, I, I get no financial compensation, but I love Mintran by Standard Process. It's a very old company that makes food-based supplements and it's a mineral tranquilizer. So I take it at night for sleep. But I love it because it has a lot of beautiful calcium and magnesium and iodine. It's got kelp. Kelp is the iodine source, but you can certainly also take, you know, zinc, super duper important because a lot of older adults lose their taste and smell and that's why they kind of lose their appetites and become very frail. So zinc is really important, you know, 25 to 30 milligrams or if you're super deficient, 25 milligrams twice a day. That's a really important one. And of course, my favorite is magnesium glycinate. Now, why the glycinate form? There's so many forms of magnesium, but most midlifers are really struggling with severe anxiety and/or depression, and magnesium glycinate specifically tackles anxiety. So I— you get the mental health benefits, but you also get the muscle relaxing, digestive regularity, blood sugar balancing pieces of it. It's great for fibromyalgia too, because you can really take higher doses without it causing GI upset.

So good. Do you like to see somebody do a micronutrient testing before they begin supplementing, just to look at where are you and, and we're not just shooting blanks? Or is it safe for you to say, okay, here's what I like to see women on who are doing these activities?

Yeah, I mean, if you really want to, to me, micronutrient testing, it's couture versus off the rack, right? So if you really want to know exactly how customized to go, then, and you have the financial resources, go for it. There is absolutely no downside and it is nice to know. I will say, if you want to just say, you know what, I don't wanna complicate things, I just wanna go for it. It's very safe to say that zinc and magnesium are pretty much absent in the soil. I think it's a big reason why we've got so much ADHD going on and just cardiac arrhythmias and irregularities. We're all very magnesium deficient. So there's really no downside, maybe to your wallet, I don't know. But it's safe to say, and low libido low fertility and low immune function, like all those things are zinc deficiencies. So partially, you know, it's a piece of it.

So good. So talk to me about plant versus animal protein. Do you see, and is there any science that you're aware of, but do you see in the people that you've worked with a difference in ability to maintain or gain lean muscle mass and/or strength? We could separate them. With someone who's on a plant-based, sole plant-based versus animal protein diet?

So on the application to work with me, I clearly state that no vegans or vegetarians are, are going to— I will not— are not— don't even apply. Not because I don't think you're lovely, wonderful humans, but because I can't in good conscience take your money because I can't help you. And here's how I know that, because when I look at the, the blood test, the micronutrient deficient— I mean, the deficiencies are significant in B12, in zinc, um, in ferritin, in iron. You know, you're— I can't— I also can't balance your blood sugar. You know, if, if you are eating 2 cups of quinoa or legumes to get the same protein as in a 4-ounce chicken breast, the scales are going to be really tipped. Now, some people say, Esther, I do great on pea and soy, you're still going to be so deficient in nutrients, you will be anemic at some point. Um, your adrenals cannot— I do not see women who have been able to balance their adrenals and cortisol on a plant-based diet. I'm not saying they're out— they're not out there. They very well may be. Lots of people are going to be like, screw you, I'm on a plant-based diet and I feel great. They just don't happen to be the people who walk into my practice. Same. So I'm very biased. This is not a true scientific experiment, but I mean, I had a very well-known fashion designer come to me and she was plant-based. I said, I can't help you. And she said, at least look at my labs. And her doctor had literally circled in red, like her rampant deficiencies and wrote, he wrote all over it, like, This will never change until you start eating meat. And I like gave her her papers back. I was like, call me when you're ready. I cannot help you. Um, she hasn't called me. That's fine. That's actually fine. Uh, so, but yeah, you see what I'm saying? Like, absolutely, you know, you've written the playbook.

My experience has been absolutely the same. And, and yet, like you, it's like They've gotten it from one place, they get it from you. My guess is she's gonna continue to going until she finds a person who's like, "Yes, I'll work with you," and tells her the answer she wants to get. I had that too. And so I've had to send people to a functional doctor or onto the next person who told them the same thing. And it just, whether it had to be in different words, had to be the 7th time or whatever, Yeah, totally true.

These are great questions though. I'm loving them.

What about— talk to me about— well, I love the vegans need not apply. I love that. Okay. What about keto? Where does that fall for you? Does it matter? Does that change the ability to gain, maintain lean muscle mass and age strong? So I think we're talking long time. We're talking maybe sarcopenia and osteoporosis, but today is what a lot of women really care about, immediate gratification.

Well, a couple really interesting things about keto. So number one, um, I do, uh, GI MAPs on all my clients, and I see a significant change for the worse on keto/carnivore because you're just not getting the fiber to feed the commensals. So when you go, there are a lot of Even physicians out there touting these extreme diets and no one's addressing the gut and they're saying you don't need fiber, you don't need it, you can live on beef tallow and meat. But it's like if you're actually looking at stool tests, you might otherwise disagree because the evidence is there to show that it can impact adversely. So if you are on those diets, make sure you are getting some flax, some chia, some fruits, vegetables, God forbid, you know, some— or fiber supplement. That's number one. Number two, again, this is what I have seen in practice, is that because there's very little to no research on it for women, but a sweet spot seems to be 3 months. Now, again, I don't have a lot of women who are maintaining longer than that because the deprivation is very real, number one. But number two, What happens is at that point is that the adrenals and the thyroid become really unhappy and the weight either plateaus— the weight loss either plateaus or you start to regain because you're not eating enough carbs at that point to fuel your thyroid and your body is very unhappy. Now, it's, it's cool though, because in the beginning, keto really helps eradicate hot flashes. Now, why is this? Because quite simply, you're stabilizing your blood sugar and your cortisol levels, but not for too long. For women in particular, like, a little is good, but more is not better. And so, you know, and most women are like, there is no way you're going to keep me off carbs the rest of my life. It has to be sustainable. And carbs for president, right? Oh my God, yes. Carbs for best president. And, uh, who's the Veep? Is fat the Veep? And protein is like— who's protein? I don't know. I always say protein is the, the dominatrix of the brain and carbohydrates are its bitch. That's like what I think of it as. So good. Oh, I love it.

So I wanna, I wanna hit on something because I feel like this is just emerging. There's been some recent science on it, and this is, I think, for all of those who are— maybe were in love and romanticized by intermittent fasting, but now also are like, oh, but I need my protein for my muscle, and they're swinging back the other way. Because a lot of people who were talking intermittent fasting and really hard go-getters now have swung back the other way and are like, But muscle is really important. And they even are saying, you know, for some, yes, or for a period of time, it's got its place. But for longevity, you gotta feed your muscle. You gotta be watching that. There's something called— and I find this name a little off, it's not what I would use— but the protein-sparing fasting diet, where you're going low caloric. So it's caloric deficit. You're really going low calorie. But your calories are made up of a high percent of protein, whether or not that's all protein that you'd get, like minimum of 100 grams or not. Are you familiar with that? And is that a short-term— is it an occasional day of the week? Is it, is it sustainable in any way? And is it optimal to try?

It sounds exactly like an influencer went and looked up my dietetic training books and plucked it out because, and just said, oh yes, now we can apply this to midlife women because a protein-sparing diet was what we put people on when they were on a ventilator.

True.

So we're right back to that old school again. Short term, fine, a couple weeks. Long term, you're really getting into muscle loss and potentially bone loss and long-term damage because Look at an eating disorder called anorexia. Prolonged deficiency, you know, are you really sparing muscle with that low calorie and not enough carbs? That's debatable. I would love to see that reproducible in a study.

That's, you know, I always come back to this, which I think is really interesting. So like, if pregnancy is like whatever we do in pregnancy, it is to sustain the health of the fetus and the health of the mother. So there are certain things that we stop during pregnancy because they're not ideal for a person to thrive. And it makes you wonder, why are we doing them regularly then anyway? Well, exactly, you know. So, and, and I think people are saying, "Well, I did this and I lost 14 pounds and it was fat and I maintained my muscle." And yet it's like, "Okay, but now you're pregnant and now you're stopping it." And so it just begs the question, is this really healthy to do? And would it be— is there a scenario where, okay, this would be okay, maybe 1 or 2 days a week? Would be all right. If metabolically somebody might be more healthy by losing some weight.

Yes, in those cases, absolutely. And I do have— I mean, I have worked with women, again, not a lot, because not a lot of women need to go to this extreme to get the results. This is what I really want to drive home before I say this, okay? But if you are someone who actually feels better on intermittent fasting, who notices that you're sleeping better, your inflammation is lower, the food noise is quieter, and you just are feeling rockstar. One of the ways you can intermittent fast is the 5:2 method, which is rarely used, but it's 5 days of normal eating and 2 days a week, ideally spread out at least 3 days a week. So maybe on a Monday and Thursday or, you know, Wednesday and Sunday, you eat no more than 500 to 800 calories, right? And you'll have a chicken breast. It's like no food all day. You have one meal and it's, you know, a 6-ounce piece of chicken, steak, or fish, and half a cup of cooked starch and 2 cups of steamed vegetables. And that's it.

Yum.

So that, again— but again, I have tried, I have offered this to my clients who do want intermittent fasts. That doesn't usually work. That's not the one they go for. They prefer just the daily window of eating, you know, in a shorter window.

Yeah.

But again, 9 times out of 10, I have a client now who is 200 pounds at 5 foot 8. She is eating one meal a day and her cortisol is circling the drain. And I'm like, lady, I can either put you on 500 supplements and hormones to recover your cortisol, or you can actually eat 3 times a day. So she went with the eating.

As you might.

As she might. And yes, we do need to get her on some progesterone and testosterone because those were genuinely low. But I'm like, you actually don't need adrenal supplements as long as you— or adaptogens— as long as you're eating, your cortisol will come up. So Keep it simple, everybody. Just keep it simple. Like, it's so funny too, because like, have you— you've traveled to Europe or all over the world. Like, do you think in Italy they're sitting there talking about intermittent fasting? No. Italy, it was some of the most ginormous plates of pasta I've ever seen. I couldn't— I was like, this is like 3 meals for me. They're just piling it on. They're drinking their wine, eating their bread. No one is dieting. You know why? Because they have learned that pleasure is the greatest nutrient of all, and they eat just 3 solid meals. They're not snacking, or if they do have cocktails, it's always with food. It's not on an empty stomach, so they're not dysregulating. It's like— and they're walking. It's so simple.

Yes, yes.

Overcomplicate all of this and It's complicated because we do have a lot of crap and processed foods. We have tons of glyphosate sprayed on our crops and we have a lot of processed foods. And, you know, I think our gut microbiomes are so different and we have a lot of disadvantages that Europe doesn't have. Europe, it's far more farm to table. It's local, it's fresh. People are cooking more. Um, but even that being said, like, you can still lose weight here. It's not an ex— it's a reason, but it's not an excuse why you still can't lose weight and recover and get healthy.

So important. Yes. Thank you for joining me. So anything else that you want to add? Is there a question I should have asked in regard to muscle? Muscle for now, I think, for body composition, which is where we all are most concerned in the moment anyway. And then muscle for, you know, our 85-year-old selves for strength and avoiding sarcopenia. Yeah. Anything that I should have asked you that I didn't?

I mean, well, one thing I want to bring up, which you really drove home for me years ago on our last podcast, was people always ask, "Do I have to strength train 3 times a week, 4 times a week?" And I remember you had talk to me about having a minimum of 2 times per week. So I think if you can drive that home too, I think, is it— is 2 times a week truly enough? Do you have to train your whole body?

Yes, yes, yes, yes. And so just 2 days ago, the American College of Sports Medicine revisited its guidelines for the first time in 17 years, and some esteemed colleagues who we've had on this show, and I'm sure you're familiar with Dr. Stuart Phillips, Abby Smith Ryan, um, um, Brad Schoenfeld. You know, those are three who I think of as colleagues and go-tos, but their names are on that committee, and so they were a big part of it. And I think the bottom line is what we are all trying to get to is stop complicating it. Let's make it easy. For years, the research has said there's no significant difference between 2 and 3 times per week strength training. So to make it easy, let's say 2. Let's get it in first. If you get hooked and you love it, you want to do a third and you recover well, okay, great. But you don't have to.

Yeah. Which is so liberating because for busy people, to only to hear like you've got to put in what, how, you've got to put in probably an hour to hit all muscle groups, right?

And I think the hour, we have to say, no matter what you do between, you've got to warm up, cool down. So, you know, then we're talking really it's a 40, 45-minute workout doing— and that's, that's not that long when you think it takes a little while to do a good set and rest a little in between so you're ready to go again.

Yeah.

And, you know, I think the point is let's just make it easy to do. And you have to recover. So just doing more may not mean you get more benefit because your body has to recover and repair between. So there's that big factor. And like we've talked how many times in this response about adrenals and cortisol and thyroid.

Yeah. Yeah, I love that. That to me is so great. And yeah, keeping it easy, not overcomplicating. Fuel your body, work out, rest, and go live your life and free up a lot of your mental real estate and trust your body. You know, we are our own best doctors. We are innately attuned to our body. And yes, sometimes we do need to bring in outside help to guide us, but ultimately we let our bodies guide us and let us know if things are working, not working. If intermittent fasting isn't working, you don't continue it. If you are on a low-calorie, low-protein diet and losing muscle, you definitely don't continue it, you know. So use common sense too. Amen.

And on that note, thank you so much for your time today.

Thank you.