#205 - Energy balance, nutrition, & building muscle | Layne Norton, Ph.D. (Pt.2)

Hey everyone. Welcome to the Drive Podcast. I'm your host Peter Attia. This podcast, my website and my weekly newsletter all focus on the goal of translating the science of longevity into something accessible for everyone. Our goal is to provide the best content in health and wellness, full stop, and we've assembled a great team of analysts to make this happen. If you enjoy this podcast, we've created a membership program that brings you far more in depth content. If you want to take your knowledge of this space to the next level, at the end of this episode, I'll explain what those benefits are. Or if you want to learn more now, head over to peterattiamd.com subscribe Now without further delay, here's today's episode. My guest this week is Lane Norton. Lane was a previous guest on episode 163 back in May of 2021. In that discussion we we only got through about half of what I wanted to, so it was pretty clear that Lane was gonna come back for round two. In this episode we really dive into two major topics. The first thing that we get into is energy balance and what role macronutrients and calories play in weight loss. This really gets into the energy balance equation and what it means. What it doesn't mean is a calorie, a calorie and what this means in various contexts around different diets. We also speak about the struggle people have with tracking food and calories on their own across a variety of diets and how all of this can impact someone's nutritional habits and behaviors. The second half of our conversation really looks at the importance of protein and weightlifting through two different case studies. So the first is how Lane would work with a roughly 50 year old female who wants to improve her health through nutrition and exercise, but was more interested in cardio than lifting weights. The second is a case study looking at a 40 to 50 year old male who wanted to begin to focus on maximizing muscle mass. Now again, these are both hypotheticals, but I kind of chose them because I think they can be quite illustrative of of what many people are going through. We end this conversation by looking at a number of supplements including whey protein, branched chain amino acids, leucine, specifically as one of the branched chain amino acids, creatine and nitric oxide boosters. Now, by way of background, Lane is a bodybuilding figure and physique coach, a natural pro bodybuilder and a professional powerlifter. He received his undergraduate degree in biochemistry and a PhD in nutritional sciences from the University of Illinois. So without further Delay. Please enjoy my second round conversation with Lane Norton. Hey, Lane, good to see you again, man.

Yeah, I'm happy to be back. I'm stoked for this. We had the marathon session the first time and I think we got through like a third of the topics that you were interested in. So we'll see how we do this time.

Yeah, yeah, well. And of course a lot of people had a bunch of follow up questions. So it's some combination of all the things we didn't get to talk about the first time, plus some new things I thought about. And you and I have had a bunch of emails exchanged over the last few months, coupled with some of that residual stuff. But one of the topics that people really want to hear you and I talk about because I think there's this belief that we are going to be so orthogonal in our views and we will have not a single thing in common. Although I'm pretty sure this isn't going to be the case, is on energy balance and the role of calories in weight gain. So why don't we just lead with the fireworks that everyone is hoping for? So talk to me about energy balance, calories and weight gain.

So I think one of the big misunderstandings is people don't really understand what energy balance truly is. If we look at what most people think it is is, well, I track my calories in, I track my calories out. Therefore, if I am burning 2,500 calories a day and I'm tracking 2,000 calories a day, I should lose 1 pound of body weight per week linearly. And that's just how it should go. Perfect math. And when that doesn't happen, they go, well, see, this doesn't work. And there's a lot of different reasons for that. But before we get into that, let's talk about what energy balance actually is. So it is calories in versus calories out, or the energy you consume versus the energy you expend. And it's worth talking about real quick. Before we get into that, what do we mean by energy? A lot of what people say, well, calories, they don't even exist. You can't look at them under a microscope. No, you can't look at them under a microscope. What we're talking about is the energy stored in the chemical bonds of food. And when you break that food down, when those molecules go through metabolism and they go through glycolysis, the Krebs cycle, that energy is liberated but captured ultimately as mostly ATP, which is our high energy phosphate. But you can't just store a bunch of ATP. It's not practical for the body. And ATP is very unstable molecule. So we evolved to have fat stores or adipose tissue, basically to store excess energy. Now you can store some in glycogen. I would argue that you really can't store some as protein. Some people will say, well, you can break down lean tissue. To me, that's kind of like saying lean, let's build a house so it's a reservoir for wood. I don't really think that that's a.

That's a great analogy. I built this amazing teak table such that if I need firewood, I've got it right there.

Right. In practicality, are you. Right, sure. Yeah, you could, but that's not why you built the table.

Yeah, that's the nuclear option.

Yeah, right. For sure. And if you look at the contribution of glycogen to your relative energy stores, it's actually really small. I mean, you're talking about 1500-2000 calories of energy. So your adipose is by far the biggest store. And you store it that way because one, it's economical for space because you can fit a large amount of lipid in a small area and it's energy dense and it's relatively easy to convert.

To ATP and it's anhydrous. So therefore it's incredibly well packed. As you said, glycogen has to track with all that water. It's not a very efficient way to store energy.

Correct. You would be £800 if you were trying to store the same amount of energy as glycogen. There's a lot of really practical reasons why the body evolved that way. Now, when we say calories, calories are literally a measurement of energy. And so this is really important to understand. When people say, well, are all calories created equal? That's like saying, are different notches on your speedometer different? No, this is just a unit of measurement. Literally all that is. And you truly have to think of it as energy. So if we think of it as the energy stored in the chemical bonds that can be transferred throughout these various metabolic processes, and that's what metabolism really is, is trying to capture that energy. When we look at what the energy inside of things is, that is essentially the metabolizable energy in food, there's a couple important caveats to that. Notice I said metabolizable energy because not everything in food is metabolizable, especially with regards to fiber, and specifically insoluble fiber. It used to be thought that insoluble fiber can't digest it at all. It's absolutely zero calories. And I wouldn't say that there's good evidence, but there's starting to be some evidence that suggests that our gut microbiome can actually extract some calories from the insoluble fiber you eat. That's coming from a friend of mine, Suzanne Devkota, who's one of the premier gut microbiome experts in the world. She actually did her master's at the same lab I was doing my PhD in. Very smart person, has been to like the Nobel ceremony. Incredibly well respected scientist. So there is some evidence of that. And then when you come to soluble fiber, it's pretty variable. It's like anywhere from 1 to 4 calories per gram. So anywhere from a normal carbohydrate amount to one calorie. And it also probably depends on your individual gut microbiome. Even before we get to the calories outside of thing, we see that there is some variability and probably some individual variability in how many calories one person can consume and then actually have available as energy.

Lane, I like that you started with this. I'm just going to add a couple of points so that we can build off this together. So let's even give people the definition of a calorie. And I think we should remind people that when you and I and most people are talking about calories, we're really talking about kilocalories. And some people will get those confused. So big C calorie is equal to a thousand little C calories or a K calorie. But regardless of that nomenclature, I think most people, when they're saying I eat 2000 calories are of course referring to kilocalories. One of those, if I'm not mistaken, and you're going to be probably remembering this better than me. Lane. One calorie, I believe, is the energy required to heat one gram of water from 14.5 to 15.5 degrees Celsius at one atmosphere. Correct?

Bingo. About right. I actually have specifically forgotten the exact definition, but it's basically the amount to increase the degree of water by 1 degree Celsius.

So again, to your point, it's simply a unit of energy, just as we would think of a joule that as a unit of energy. I also want to highlight something you said, which I think is a very important thing for people to understand, which is when we talk about the conservation of energy, that also implies when you change forms of energy. So when you eat food, the energy as you said, is stored within the bonds. It is chemical energy. We turn that into electrical energy via electron transport chain and then we turn it right back into chemical energy, both in the immediate sense of ATP, where you again now create the energy in the phosphate bond. But more importantly, as you said, when you're storing it, you're putting it right back into a hydrocarbon. And it's those carbon, carbon, carbon, hydrogen bonds, that, if my memory serves me correctly, are the most energy dense bonds within our body, much more than say a carbon oxygen bond would be.

And that's why we see fatty acids have much more calories or much more energy per gram compared to carbohydrate, because carbohydrate has more oxygens, whereas fats, through beta oxidation, where you're having lopping off two carbons with hydrogens, you can pretty much, I mean it's not direct, but you can pretty much create acetyl CoA right from that, which then goes directly into the Krebs cycle. Whereas glucose, there's a lot more involved in generating ATP from that. Now, glucose does have benefits in terms of amount of oxygen required to generate the same ATP. It just depends on the metric you're looking at.

The final point you make there, Lane, I think is worth restating because it is so important, which is, and this will come up later, I think, when we talk about genetic differences in tolerance to amounts of macronutrients and things like that. But you can really liberate different amounts of energy from the same foods depending on many things. But presumably based on your gut microbiome, that's probably one of the things that's going to create a pretty sizable delta when it comes to how much food you're capturing. In other words, how much of that chemical energy you're able to recoup and repurpose into electrical energy.

There is evidence, for example, that obesity prone people, they have a gut microflora that is better able to extract energy from the foods they eat. Now that could be reverse causation as well. It could be that obese people eat a diet that causes this kind of gut microflora to bloom, so on and so forth. So we got to be careful about establishing correlation versus causation. And I will say that because they can actually assess how much energy is lost in fecal matter, it's usually around 5 to 10% depending on people. And most of your 95% of your Gaussian distribution falls in there. It is a significant difference. But what I would tell people is be cautious about saying well, this is why we see huge differences between individuals, maybe for certain individuals, but I think for the vast majority of people, unless you're literally an outlier, probably going to be somewhere relatively close. So I think establishing that, we understand that there is some variability in how much energy you can extract from the food you eat. And I'm going to come back to that as well, because there's another aspect, the tracking portion, that we need to talk about as well, that confuses people. Now, let's talk about the energy outside of things, because this is way more complicated. So different ways people have broken it down, but essentially you have your bmr, which is your basal metabolic rate, and that's usually about 50 to 70% of the energy people expend per day. The way I tell it is it's basically the cost of keeping the lights on.

And we would determine that if you were putting somebody in a metabolic chamber. I believe that we don't require them to be sleeping, but it's laying there, but being awake. Correct. And that's slightly different from your energy expenditure while sleeping.

Yep. You have RMR and you have bmr, and there are some subtle differences between the two. But, I mean, essentially it's very similar. I've had my RMR assessed, which is basically you go into a lab, you lay down, they make sure you're stable for 20 minutes. You don't talk, you don't listen to music, you don't do anything, you lay there and breathe. RMR and BMR are going to be very similar. I'm going to simplify it for our audience, just because it's an already complicated subject. The other way to think about it is if you were in, like, a coma per se, where you're awake, having some brain activity, that sort of thing, you're not moving, you're not physically moving. That's still about 50 to 70% of people's total daily energy expenditure, and that's what we refer to as metabolic rate.

And when you had yours measured, Lane, did you have it done using indirect calorimetry?

Yes, when I had it done, I'm anywhere between 1900 and 1950 calories per day.

Pretty consistently tell folks how that works, because I think when most people say, I just had my BMR measured, it's usually not the rigorous way that we're talking about using indirect calorimetry. It's usually relying on heart rate and respiratory rate, which can probably give some approximation. But it's probably important for people to understand that there's an Enormous error that's introduced when you make that approximation. So what's the rigorous way to determine energy expenditure?

So direct calimetry is the most rigorous way. And that is literally kind of a bomb color, right? You're in a metabolic chamber and they are looking at how much heat you're generating, essentially. And from that heat that you generate, they're able to determine your total daily energy expenditure. And then using an equation based on your oxygen consumption versus your CO2 production, they can determine what. From that is your BMR, which is actually the same way they do it for indirect telemetry. You're inside this, like, hood, you're breathing into a tube, essentially. Basically, your metabolic rate is very closely associated with how much oxygen you consume, how much oxygen you consume versus how much CO2 you expire. Will one give you a really good idea of your metabolic rate? Because the end products of metabolism are CO2 and water. So when everything goes through this process of breaking down carbohydrates and fats, if you talk about, like, what happens to body fat, it ends up as CO2 in water. So if they know that, and you can use a constant for water, if they know that, it's also why they can use doubly labeled water to estimate energy expenditure. We'll get to that later. But if you know that and you know these constants and you make several assumptions, I mean, again, this isn't direct. You're making assumptions. You're making assumptions about how much is being generated. You can come up with a relatively accurate estimation of your metabolic rate.

And for reasons that I can't explain, this is something I can never forget, which is the coefficients for that equation, the Weir coefficients, right? So energy expenditure is 3.94 times VO2 plus 1.11 times VCO2. So as you said, it's heavily weighted to oxygen consumption. It's nearly four times the consumption of oxygen, plus about one times the production of carbon dioxide. And that gives you that. And for anybody listening to this who's ever had a VO2 max test, I would encourage you to ask the lab that does it for you to give you the raw data. Because what they'll spit out for you, usually in 15 second intervals, is VO2VCO2. And while the purpose of that test might be to determine your maximal VO2, you can also plug in these two variables to the Weir equation and get how many calories per minute you're consuming or requiring to maintain that energy output all the way to your max. It's actually quite Remarkable when you consider that a highly trained individual will easily get to 20 calories per minute of energy demand.

If you think about, we say lean mass is by far the biggest correlate total daily energy expenditure and resting metabolic rate. Lean mass requires quite a bit of oxygen compared to like adipose tissue, which is relatively nonvascular. It makes a lot of sense that you would see that. And then if you think about activity, obviously if you start doing activity, it requires a lot of oxygen. So we have our bmr, which is about, in terms of the energy out side of things. And I guess I should define that. Energy out is your total daily energy expenditure. So all the energy you expend in a day, that's your tdee, we call it, and the biggest portion of that is your BMR for most people. Now, if you're an elite athlete who trains like six, eight hours a day, you can get to the point where your physical activity is actually greater than your bmr. Those listening, don't be dogmatic about these numbers. But for most people, 50 to 70% is a relatively accurate representation. For me, it's probably about 55 to 60% of my total daily energy expenditure because I do train like two and a half hours a day. So that is a significant contributor. So we have that. Then we have what's called tef, which is the thermic effect of food or diet induced thermogenesis. And this is anywhere from 5 to 10% of your total daily energy expenditure for most people. Very, very hard to measure. Usually it's expressed in terms of calories per minute because they're only looking at it in the short term. And when we do studies of total daily energy expenditure, I mean, usually what they're doing is using a constant for tef. They're making an assumption because it's just so hard to measure unless you're just measuring that over like the course of a couple of hours or maybe a day at most. But we feel relatively confident based on the studies out there, that it's about 5 to 10% of your total daily energy expenditure. So not a big contributor, but still.

But it also seems to be macronutrient dependent, correct?

It is, it is.

We'll come back to that when we get the.

And then if we look at the last component, we have our physical activity, and this encompasses all physical activity. So people hear this and they think exercise. But actually for a lot of people, their biggest component, physical activity, is actually what's called neat, which is non exercise activity thermogenesis that is something that's actually extremely modifiable. We see it in terms of one, people who are obese resistant, what we term obese resistant, they tend to fidget a lot, they tend to move a lot. I was like this as a kid. I still am. Whereas people who are obese prone tend to have very low neat. In fact, there was a study done by Liebel in 1995 where they overfed people by, I want to say, 1,000 calories per day. They looked at their total energy expenditure in a metabolic ward. So very accurate. And then they took that number and added a thousand calories on top of it. And they looked at how much weight people gained. Some people gained more than they expected. One person did not even have significant weight gain. And what they found was this individual's meat. Their spontaneous physical activity went up so much, it just compensated for that extra calories. So I think this is what people really don't understand as well. I want to be very purposeful about how we define neat, because when it comes to neat versus exercise, exercise is purposeful. So something I'll hear a lot is, well, I'm going to go do a walk and get my knee up. No, you're doing exercise. Maybe I'm being a little bit pedantic, but it's important because neat is what I'm talking about. I'm waving my hands around, I'm moving from one foot to the next. I've seen Peter, that, like, you kind of move your fingers and you'll twitch your neck, all that stuff. Even though it seems like nothing, thousands of those movements over the course of a day actually add up. So then I have people say, well, I'm just going to tap my foot to get kneed up or fidget. Well, guess what's going to happen? Whenever you try to do something that also requires your brain, you're going to stop doing that, because you actually can't really do two things at once in terms of thinking about it. So this truly is spontaneous energy expenditure and appears to be modifiable by about 5 to 600 calories per day. And we do see this with overfeeding and underfeeding. And we'll get into talking about metabolic adaptation and how this affects things. But people who lose like 10% of their body weight, they've seen up to a 500 calorie reduction in meat. So that's a big portion of it. And then obviously you have your purposeful exercise. If we look at energy in, metabolizable energy, energy out, BMR tef, neat and exercise. I'm simplifying this equation a little bit, but that's essentially it. If people want to invalidate energy balance, what I always say is, listen, you ate those carbons. Something must happen to them. They don't flutter off into oblivion. And you don't create them out of nothing. Something has to happen to them. And we have a lot of metabolic tracer studies to pretty much know what happens to them. I think the confusion becomes, well, I tracked my calories, I ate in a 500 calorie deficit, and I didn't lose weight. First off, if we look at where these mistakes come in, people weigh themselves sporadically. If you only weighed yourself once a week, I would say it's virtually meaningless. When we are trying to get data on people, we're very regimented with how we do it. So it's, you weigh in first thing in the morning after avoiding your bladder and bowel, if possible, fasted. First thing you do, as soon as your feet hit the floor, after you've gone to the bathroom, you weigh in. And then we take that weight every single day. And then we look at the average, and then we compare week to week averages. Because anybody who's ever tracked their weight, I'm sure you've had this experience, Peter, you're eating very consistently, you're tracking your weight. It'll easily fluctuate by 1 to 2% per day. So if you're 200 pounds, you could be 204, you could be 196. And I always tell people it's like the stock market. Sometimes there's a good explanation for why it goes up and down like that. But other times, there's no good explanation whatsoever. You don't just want to take like one isolated data point. And this is also with people who get dexas done and they freak out because I've lost a pound of lean body mass. No, you went and had it done at a different time where you were.

Less hydrated or on a different machine, different software. Yeah, yeah.

I don't want to tell them not to get dexes done, but unless you're going to do it, same tech, same machine, same conditions. I'm like, cool. Doesn't really mean anything. But you have it. So when you look at that. So you could have somebody. I've shown this example with clients where I've said your average weight is down by a pound. But if I had weighed you on this day last week and this day this week, you would think you were up by two and A half pounds. So people will start doing a calorie deficit diet and they'll say, well see, I gained weight, so this doesn't work. No, that was a fluid shift. Day to day changes in weight are much more dictated by fluid shifts than they are adipose tissue levels. But your weekly and monthly changes in weight are much more dictated by your actual body mass. So that's one thing that confuses people. The other thing I think that really confuses people is their idea that they can actually track their energy expenditure correctly using one of these, the wrist worn devices. There was actually a study that was published in 2018 where they looked at about 20 different devices and found that they overestimate exercise energy expenditure anywhere from 28 to 93%. So you're doing this exercise that tells you you burned 500 calories, when in reality you probably burned something more like 260 to 400 calories. So again people say I burned a thousand calories on the treadmill today. And I always tell people, what do you think is more likely? That you have found a way to violate the laws of thermodynamics or that this watch might not be accurate? Because I'm going to go with the latter. It's very funny how people are very distrustful of certain things and other things. They're just like, oh yeah, I totally trust this thing. So there's that and then there's also the fact that we can't completely accurately track calories in either because there is up to a 20% error label that's allowed in foods. I think that's where some of the confusion comes in. The other thing I will say that's worth saying that will really upset some people is people are horrible estimators of their energy intake. There was a study done, I think it was back in the 90s where they took people who were self reportedly resistant to weight loss. These were people who said I eat 1200 calories a day, I can't lose weight. They put them in a metabolic ward and they also had them do doubly labeled water, which is basically a free living way of determining energy expenditure. Plus they had the direct calimetry and they said to them, we want you to track your food and report it to us, but we will know if you're incorrect. We will know. So the average underreporting was by 50%. So they were underreporting their energy intake by 50% on average. And that's right in line with a lot of the other studies. If we look at People who are overweight and obese, most of them under report by 30 to 70%. The demographic of obese women tend to be at the higher end of that. Obese men tend to be at the lower end of that. Even lean people.

Yeah, I was about to say for lean people, would the same bias, I mean, bias might be the wrong word, but would the same error in reporting still exist?

There is an error. It's less. I think it's around 18%. But even dietitians underreport by about 10%.

That's kind of amazing that they could be within 10%.

Yeah. Some of the subjects actually argued with the researchers about it, which is funny. But people don't like that self accountability sort of thing. Now the message people will hear when they hear that is you're saying I'm a liar. And I don't think that people were necessarily lying. I think people are horrible estimators of their food intake. Because if I put a salad in front of you and I dump 50 grams of oil on it versus 20 grams of oil, you will have absolutely no idea of the difference. You might be able to taste like a little bit of difference in mouth feel, but most people go, ah, that's a salad. It's got some dressing on it, probably 200, 300 calories. Meanwhile, it's got nuts, it's got bacon, eggs, it's got oil, all that kind of stuff. And I'm not saying any of those things are inherently bad. I'm just saying it's all energy. I think that's another big component is people are just horrible estimators of their food intake. And what I'll tell people is if you really believe that you are not able to eat in a calorie deficit and lose weight, I want you to just for one week, track every single piece of food you put in your mouth. No licks, no bites, no snacks, not on account. I'm not saying you got to do this for the rest of your life, but just do this for one week. And usually I'll come back with people who are mind blown. They'll say, well, I thought I was eating 600 calories, I was eating 2700. Because they didn't realize that they grabbed that handful of nuts or they grab a handful of potato chips or whatever it is, or they take a bite of a candy bar. Yeah, in isolation, none of that stuff is a big deal. But when you accumulate it throughout the course of a day, it can be a big deal.

Eight years ago, when I was really, really Interested in this topic? I had the luxury of being able to spend probably about a total of six days in total inside a metabolic chamber in two day blocks. So three two day blocks or four two day blocks inside metabolites probably wasn't.

Actually very much fun at the time.

But actually it was the most fun thing ever, Lane, because it was everything I love. First of all, I got to be in a room, nobody could bug me and we had arranged it so that I could do all my exercising. So I had my bike on a fluid trainer, I, I had tons of weights in there, plyometric box, a bed. It was literally a vacation. And I had this amazing food being prepared by a metabolic kitchen. Like you've got this staff that is making to the gram everything that we had agreed at the outset we were going to be testing. And then after the fact, I went and did the 10 day doubly labeled water experience, which I guess we could explain for people what that is. Right. So water Everybody knows as H2 hydrogen 2 oxygen 1, but it turns out there's a heavy form of hydrogen called deuterium and there's another form of oxygen that doesn't have 16. I'm so bad in my chemistry. Now, is it 16 protons or is it the neutrons? Neutrons, 16 neutrons. So instead they have one with 18 neutrons. And so you drink a D2 regular O and then an H2 heavy O. When you drink this, you basically get to exploit a trick which is by collecting your urine, you're measuring the hydrogen that's coming out without measuring the carbon that's coming out. So you can impute what your VCO2 is effectively. And you collect urine serially. And over the course of 10 or 12 days you get an estimate. And so the only instruction to me when doing this was try to be weight stable for that period of time, which I was able to do. And it was interesting. That was a time in my life when I was really tracking ins and outs pretty well. Mostly just out of curiosity, not because I was trying to lose weight or gain weight. I wasn't. And by my calculations I was about 4,400 calories in, which would imply about 4,400 calories of energy expenditure. The DLW ended up being 4,200. So I was surprised. It was pretty close because I agree, I expected it to be way far off, but it was such an amazing experience. And it's like, I almost wish stuff like that could be done commercially because of course I had to do this with an awesome guy named Eric Ravison at the Pennington Biomedical Research Institute. And Eric staff had done this for me. So it was, you know, I was able to do this in a research lab. This would be an amazing thing that I wish you could order a home kit, drink this stuff down, run it out for 10 days and truly get a sense of your energy expenditure.

What I would say is since you're supposed to be weight stable, most people could actually do it just by default. Because at the end of the day, if you're weight stable within reasonable amount, then whatever you're eating is actually, for all intents and purposes, your total daily energy.

I'm just saying it's so hard for people. To your point, that is a hard thing for someone to do unless they're going to have a food scale with them everywhere and they're. Yeah. And then the other thing is it becomes a little bit of an artificial exercise because even if somebody says I'm willing to for 10 days measure everything, then you get this sort of Hawthorne effect of they won't take that extra bite of the candy bar because a, they don't want to measure it and they won't grab the handful of nuts and they won't do this, that and the other thing. Whereas if you say, look, I'm just going to eat the way I normally eat for a week and not measure anything, all I have to do is maintain my weight and do what you're saying, right. Every morning you get on that scale and you kind of tweak it up and down. Then you can say, okay, in a truly free living environment without the Hawthorne effect, this is my energy intake.

So funny you say that. In science we know that right down to individual particles, when you observe it, it changes its behavior. And that's true for just on the atomic level and it's true for people. We have a coaching team called Team Biolane where we do one on one coaching. We have a team of seven coaches and one of the big things that we train our coaches on is like, hey, if somebody's like really resistant to something, just see if they'll just track what they're already doing to enlighten them. We'll tell them, like, listen, we want the raw data. We don't, don't change anything. And almost every time just by them doing that for a week, wow, I lost half a kilo or a kilo this week. And it's like, yeah, like you said, you didn't take that extra bite of snacks.

We have that problem actually in our Practice with our patients, because for at least half the patients, once we do our intake, we realize nutrition is going to be an important thing to modify. And a lot of times we want to see what the baseline is. We go one step further, which is we do exactly that, which is we don't want to see you do anything different. But we really go out of our way to say, please do not change anything. In other words, eat that candy bar and grab that handful of nuts, pour that glass of wine a little taller than you think it should be. Like, do everything naturally. And even still, to your point, it's almost impossible to get a true baseline once you apply those constraints.

That just shows you how inaccurate 24 hour food recalls can be and all that kind of stuff. So, yeah, so I think those are some of the biggest misunderstandings. Now I do want to address the whole. Is a calorie. A calorie thing? Yes, all calories are equal. Because again, calories are just a unit of measurement. All sources of calories are not equal in terms of their effects on energy expenditure and metabolizable energy. We already talked about soluble fiber and insoluble fiber. And then if we look at the TEF of various foods. Let's start with fat. Fat has the lowest tef. So if we talk about TEF is basically the amount of energy the system has to put in to extract the chemical energy out of food. So you can't just put it in and then, boom, you have the energy. Your body has to do work to get it. Now it's always a higher net, even on stuff like people say, well, celery is a negative calorie food because your body has to put more. No, no, no, no. Unless we're talking about tree bark, there is no energy negative food. Even Celery has like 50 calories. I think it's. Or it might be 5 calories per 100 grams. So very, very low, but still not negative. We would not have lived long as a species if we had energy negative foods. If we think about how much energy has to go in to get energy out, we have how many calories you consume and present as metabolizable energy and then how many calories we net out of that after the energy expenditure required to get the chemical energy out is done. So if we look at fats, fats are the lowest and they're about 0 to 3 calories, meaning if you eat 100 calories from fat, you net about 97 to 100 calories. And then we have carbohydrates carbohydrates are about 5 to 10%. So if you eat 100 calories of carbohydrate, you net about 90 to 95 calories. Protein is around 20 to 30%. So if you eat 100 calories from protein, you net about 70 to 80 calories. People will hear that, and they make a much bigger deal of it than it actually is. Because when you consider how much of a proportion of your overall energy expenditure it is, and I do this example where I'm like, let's double your protein and see how much more tef you get. It ends up being like 150 calories if you double your protein. And we're talking about people already eating, like, standard amount of protein to a really high amount of protein. So, yeah, it helps, but it's probably not the cure for the obesity crisis.

To push back on that for a second. One of the challenges when thinking about weight loss, sustainable weight loss over a long enough period of time, is how much is enough on a daily basis before an adaptation would take place that would correct it. So, for example, if we were talking about.

You're asking the right questions. You're asking the right questions.

Yeah. So if we were talking about. Let's just say one of your dietitians came to you and said, elaine, I've got this idea. I've got this patient who is truly, by every metric, 50 pounds overweight. We could do it on lean body mass, body fat, whatever. If this guy's 50 pounds lighter in a year, everything about his life has gotten better from a health perspective. And this person said, look, I'm going to double their protein intake. And let's not make it the extreme example of where you're getting an extra 150. Let's just say it's 100 calories or 75 calories. If you could create an energy deficit, and this again assumes that you can change nothing else. And there's so many silly assumptions. But think of this almost more as a thought experiment. If you could create an energy debt of 75 calories per day by a macronutrient, shift to more protein over a long enough period of time, could it be relevant?

It could. However, what we're neglecting to talk about is something I briefly mentioned, which is metabolic adaptation. I think this is the other big thing that confuses people. They think energy in, energy out. These are static things that do not affect each other. And the reality is they are intrinsically tied to each other. Anybody who's ever tried to lose weight if you went on a, let's say a 500 calorie deficit per day, which is a pretty significant deficit, do you just lose linearly one pound per week until you no longer exist? You die because there's no more body weight? No, we all know that eventually, like that plateaus. Now, part of that is just because you have less body mass. So your body has to expend less energy in order to just maintain upright posture and those sorts of things. But then there's also the neat component. As you lose weight, you become spontaneously less active. We see this in animals all the way up to humans. Then not just that. Voluntary exercise tends to go down past a certain point. Like if you're very obese and you start to lose weight, it's not really going to affect this that much because you have such an energy surplus. But especially people who are going average to lean, your will to exercise will go down. I've definitely experienced that during contest preps, getting very lean, just having to like, will myself to get up off the couch. And then if you look at their bmr, you actually get a reduction in BMR above what you would expect based on the loss of lean tissue and fat tissue, because fat tissue is somewhat metabolically active. There's actually up to like on average a 15% reduction in BMR almost at every level of energy expenditure. Your body is kind of fighting you to get back to homeostasis, to reestablish homeostasis. We see this in people who lose weight. So if we take people with the same lean body mass and fat mass, people who have never been obese, people who have been obese and weight reduced, the weight reduced people will have a lower BMR than the people that have never had to lose fat. John Speakman had a really good paper on this. This is kind of getting into set point theory that we have this kind of native set point that the body likes to be at. And the idea is kind of, okay, what's regulating the ends of that set point. So we understand that if we get too lean, lose too much fat mass, we die. That's a really negative outcome for evolution. Can't pass on your DNA if you're dead at the higher ends. There are things that work against obesity. Like we already talked about, that neat goes up if you overfeed. Your BMR also goes up if you overfeed. But obviously, based on what's happening in society with this shift towards adiposity, the regulations going up are not as strong as going down. If you think about it from an evolutionary perspective, the risk of getting too overweight in the short term because obesity is not going to kill you when you're 40. It's going to be the difference between you dying at 80 versus 70. That's what the research tends to suggest. The risk in the short term is predation or fighting or that some sort of physical altercation where you can't defend yourself very well or you can't run away. The risk of predation after man learned how to use tools pretty much went to zero. Yes, you have shark attacks and you have these things, but I mean, they're essentially lightning strikes when humans get killed by animals or even other people. I mean, it's very, very rare. But then we look at the risk of starvation. It's very real even now in some parts of the world, and was very real in this country until the 1900s. I mean, even into probably the early 1900s. And so it makes sense that the regulatory mechanisms were more powerful on that bottom end to prevent people from becoming too lean than they are on the top end. And so, bringing this back to energy balance, you have to think of energy balance like a car that changes its gas efficiency based on how full the tank is. So think about if you had a car that when you have the gas tank filled all the way up, it gets horrible gas mileage. But as that gas tank starts to go down, and think about your gas tank as your body's adipose stores, your energy stores. As that gas tank starts to go down, you become more and more and more efficient to buy the time. There's very little gas left. It's just sipping gas. It really is kind of a dramatic comparison. It is an apt comparison. And I think the biggest thing to take away is we cannot know. We can know at a snapshot in time what your energy expenditure probably is, but it's likely to change. And it's a sliding scale, and it depends on a lot of variables. That's also led people to say, well, see, we can't accurately track calories in, we can't accurately track calories out. There's no point in tracking calories. And what I would say is that you're kind of throwing the baby out with the bathwater. I'm not saying you have to track calories to lose weight, because obviously you don't, because there's all kinds of methodology that people use to lose weight that doesn't involve tracking calories. But it would be like saying, well, keeping a budget is worthless because I have Multiple streams of revenue. And I have investments, and so I can't know exactly how much income I'm getting. And also, things pop up, like your car breaks down, you have repairs to your house, so you can't exactly know what your expenses are going to be. So therefore, keeping a budget is worthless. So the comparison I make is you don't have to keep a budget to save money, but it's a useful tool. It gets you in the ballpark, and it gets you a baseline. And I would say the same thing about tracking calories.

The act of keeping a budget alone is what enables you to think twice before a frivolous purchase, as one example. Right?

And we know this, too. What's so funny is the parallels here. So did you know that the average person. I'm kind of a finance nerd. The average person under reports their debt by about 155%. And again, it may not even be a lying thing. It might just be they have really horrible ideas about how much debt they actually have. And so, same thing when you have people track their budget. Well, now all of a sudden, they're on their best behavior because not only do they not want to admit to anybody else, they don't want to admit to themselves where they're actually spending their money. I use that comparison a lot when it comes to tracking calories, and we use it a lot with our clients. Hey, look at this thing like a budget. So, Peter, you made the example that you were maintaining your body weight on 4,400 calories a day.

By the way, for the listener wondering, I was training a heck of a lot more than I train now. That's when I was truthfully probably exercising three hours a day.

You had a very large budget. If you have a large budget. If I'm talking monetary, is a sports car a good purchase? I mean, if it brings you happiness and joy, sure, but not if you can't afford it. If you have a large enough budget that you can pay your mortgage and you can pay your utilities and you can do all of the responsibilities that you need to, and you still have some leftover to buy that sports car and it brings you happiness, I would say go for it. By the same token, if you make 50,000 a year and you're going to buy a $70,000 or $100,000 sports car, I would say that's probably a really bad idea unless you've got a ton of money socked away in the bank. By the same token, when people see what I really tend to utilize flexible Dieting for myself and a lot of our clients. People say, well, they're just eating junk food all the time. No, no, what you're seeing is people are posting this because they're so shocked that they can eat some junk food and lose weight that they tend to post that stuff. And people say, well, you know, that can't be good for them. And my response is, everything is on a continuum here. There's a big difference between somebody having like a small bowl of ice cream that they fit into their budget for the day, that allows them to feel less restricted and feel like they're not missing out. That prevents them from having a huge binge session, you know, down the road when their willpower eventually breaks. It doesn't work for everybody, but it works for some people. If they can have that little ice cream, but they're still getting enough dietary fiber, they're still hitting their protein, they're not going over calories, they're getting micronutrients in. I would say, what's the problem with that?

This is probably the question I actually get asked the most, Lane, from patients. And I'm guessing you do a lot, which is, Peter, do you think it is better to be completely restrictive or to have frequent cheat meals, like one meal a week or one day a week, where you go completely off the rails, or just to have a little bit of stuff that is an indulgence every single day? And actually, I don't have a great answer for them other than there is no right answer here, even for an individual that might change. And I'll use always my example, which was for three years I was on a ketogenic diet. With the exception of one day, whatever, 365 times three is for that many days. I never deviated from a ketogenic diet except for one meal when I had about seven pieces of cake at my wife's birthday. And I said, that was really interesting. I'm amazed I was able to do it. I look back at that period, which was 2011 to 2014, and I think, I don't know how you did it. I could never do it again. It would be very hard for me to go on a ketogenic diet for more than two weeks now. Someone put a gun to my head and said, I really want you to do this for a year. The reality of it is that would be a very difficult thing to do. So for me, I can definitely get away with a daily indulgence or a weekly indulgence. And it's very easy for me to get right back on program because I basically follow a very simple rule which is never do two bad things back to back. If you ever miss a workout, which sometimes is going to happen, the single most important thing is making sure the next day you work out. And if you ever have a complete blowout meal, the single most important meal is the next one. So that works for me. But I also realize in working with so many people, there are some people who do very well in a highly, highly restricted environment. And when they deviate from that restricted environment, it sets them off on a path that doesn't make sense. So do you have any insights for helping someone predict where they're going to be? Or did you just say no? You know what, just try them all out. Try all of these approaches and let's revisit it in a month.

Part of it depends on person's personality and their individual psychology. What we know is that if you want to lose weight specifically, you are going to have to use some form of restriction. Whether it's calorie counting points, carb restriction, fat restriction, unprocessed food, whatever, you're going to have to use fasting, you're going to have to use some form of.

Restriction, either some form of dietary restriction, calorie restriction, or time restriction, you have to do something there.

When we say calorie restriction, we talk about counting calories and actively. But all of these things work because they restrict calories. That's also important to note.

I want to come back to that, by the way, because this is to me the crux of where I think people will assume you and I don't agree, but I'm pretty sure we do agree. But let's go with that thread and then I'm going to come back to the jugular question around that.

Very simple. You have to have some form of restriction, but you should pick the form of restriction that feels least restrictive to you as an individual. And this is where people get really crossed up. And I'll give you an example. People will find that form of restriction that felt really unrestrictive to them. And you hear it all the time. I tried intermittent fasting. It felt like I wasn't even dieting. I lost £50 and it wasn't even hard. Then they will assume that one, this is the right approach for everyone because it was the right approach for them. And we tend to retroactively then try to justify why physiologically that also is the best approach. And this is why you hear people make crazy claims about whether it's Low carb or intermittent fasting or any one of these diets, which are all excellent tools. People think that I don't like ketogenic diets or that I don't like intermittent fasting or anything like that. And that's not true. I just am not a fan of insane claims about those particular diets. I think part of the problem is people will say, I tried restricting calories. That didn't work. I went on a ketogenic diet and I was eating more and lost weight loss. You probably felt like you were eating more, but unless you were weighing out, again, you were weighing out. And the other thing that we should talk about is when you go to a ketogenic diet where you have really limited food choices, there's not a whole lot of options for snacking. You're mostly eating defined meal food, intermittent fasting. You're not really snacking. You're having defined meals. By the way, that is a very, very, very vigorously present characteristic of people who lose weight and keep it off is they don't really snack. They have defined meals. I realize I'm going on a tangent here, but there is something to be said for snacks do not appear to be as satiating, not just because of the food, but because of the mindset. Because when you snack, you tend to do it not being mindful about it, and it doesn't have the same satiety effect. So one of the things we tell our clients is, hey, stop snacking. Again, if you like snacks and they work for you and you can fit them in your calories, it's fine. But if you're having trouble, try, stop snacking. And they say, oh, my gosh, I didn't even really feel like I was that less hungry. And all of a sudden I'm losing weight again. Cut 3, 400 calories out.

I'll add one point to that, Lane, which is I agree just empirically that if you can absolutely eliminate what you eat between defined meals, and that could be two or three meals per day, most people will have not just an improvement of body weight and body composition, but biomarkers get better. I mean, you tend to not be snacking on the best things to begin with. Actually, this is where one of the things where I have found fasting to be a valuable tool, because if you put somebody through a 3, 5, or even longer day fast, I'm talking water only fast, even once in their life, they learn a very important lesson, which is, I'm not going to die if I'm hungry, acutely, if I made you fast for 40 days. You might die. But I pretty much don't think there's a human being on this planet outside of the most sick individual who couldn't go five days without food subsiding only on water and minerals. And something about doing that, even if you do it once for no other reason, it teaches you a couple of things. One, you can do it. That's a big aha moment. Two, hunger comes in waves. So that five day period of eating nothing, you will have periods of time when you literally want to eat your arm, and you will have periods during that five days when you have forgotten that you're fasting. And so when you take that mindset into, okay, Lane, I just put you through this. Five days of very difficult fasting. Now we're going to go to a regimen where I just don't want you to eat any snacks. And that means from noon till 6, I don't want you eating anything. And now all of a sudden you're like three o', clock, I'm really hungry. But you now anchor that to something that was so much more severe, which is, wait a minute, I'm really hungry because I haven't eaten in three hours. I'm going to eat in three hours. I think I can make it, at least for me and for a number of patients that I've used this sort of method with. It's a very powerful tool. And you don't need to become a fasting guru to do this. Right. You don't have to do a quarterly fast to experience this. I think just one fast will teach a person this lesson. I certainly remember the first time I really had that aha moment when I did my first really long fast and realized everything that I knew intellectually, but all of a sudden it emotionally made sense as well.

Well, people confuse hunger and appetite a lot. Here's the other big thing is people say, well, you don't get as hungry on the ketogenic diet, or you don't get as hungry on a plant based diet. You don't get as hungry on xyz. I say that's true, but there's a lot more reasons people eat other than hunger. In fact, I would argue that some of the major reasons people eat has nothing to do with physical hunger, that it's actually societal cues, stress and various other things. One of the things we'll tell our.

Clients, boredom is a big one for me.

Absolutely. One of the reasons exercise works so well is one, it sensitizes you to satiety signals. That's actually the most powerful effect it has on weight loss. You actually become more sensitive to your satiety hormones. But two, you're spending an hour doing something physical, you're not bored and eating it makes a difference. But one of the things we tell our clients is like, listen, if you want to lose weight, you're going to be hungry at some point, physically hungry, you will be. This is coming from somebody who has been stage lean as a bodybuilder with absolutely minimal amounts of body fat. When I talk about the level of discomfort, it is an all consuming. You cannot think about anything else other than when you're going to eat next. When you finish your meal, you're hungry five minutes later and already thinking about your next meal. And the level of fatigue is so high that the best way I can describe standing up off a chair is a monumental effort. There's no other way to describe it.

And we talked about this in the first podcast. But just because I find it so amazing, can we relive a few minutes of that Lane? So going into a show, we're obviously referring to your bodybuilding stuff, not your powerlifting stuff. You'll be what, 4%, roughly on stage.

I've calipered at 2%. Dexa is the gold standard. But again, I tell people unless you're a cadaver and they're excising your adipose tissue, you'll never know exactly what your adipose tissue is because all these measurements make assumptions. On Dexa, I was probably 5 or 6%. That's where a lot of stage lean bodybuilders end up being.

So how many days leading to that moment on stage are you really in the throes of this type of discomfort that you're describing?

I will tell you that on calipers I can get to about 7%, come down from like 14 or 15. If I'm up to like 230 pounds, I'll be 14 or 15. Probably more like 15 on calipers, get to 7, no problem. Doesn't even hardly phase me. I've done it so many times. From 7 to 2 or 3% is exponentially more difficult.

That'll take you how many weeks, probably.

12 to 16 to go for those from 7 to 2? Because again, it's not just losing the.

Weight, it's also sort of maintain the lean mass too.

Maintaining the lean mass as a drug free athlete is extremely difficult. That's conversations I have with our team violin clients all the time. If they want to do a show is 12 weeks is not going to do it if you're drug free unless you're already extremely lean. The best natural bodybuilder I ever coached, his name was Brian Whitaker and he won the WNBF lightweight world title six times and is the only man to win the WNBF overall world title and the IFPA overall world title, which were the two biggest federations. The only man to ever unify them. And this guy at 12 weeks out, you would say he's ready and then he would lose 10 more pounds from that.

Of those 10 pounds, how many would be fat?

Probably six or seven. This is the problem is the loss of body fat and lean mass. What we see, and I realize we're going off on a tangent, but this is really interesting is when you're looking at people who are like overweight and obese, they can lose almost 100% fat tissue. Now what people don't realize is adipose is actually about 13% lean tissue. So it is very normal to see about a 13 to 20% loss of lean tissue when dieting. Because even if you lost just adipose tissue, you would lose some lean mass.

You mean lean mass in terms of some of the water loss.

Water. And adipose also has protein in it as well. And part of that is lost during the remodeling of the tissue. You have that. But then as a drug free bodybuilder, again, it's important to make that distinction because if you're on steroids, that obviously changes the physiology and tilts things much more towards retention of lean mass. If not building some. As you get leaner and leaner, you are going to have a progressive shift of more and more lean body mass loss for a few reasons. One, because your adipose stores are lower, your body is sending out hormones to try and conserve fat tissue. Think about it from this perspective. If you are 200 pounds and 190.

Of that is lean body mass, you're 5% body fat.

Yeah, that last little bit of body fat. Now guess where the biggest reservoir of energy is? It's the wood table. So now we're in emergency mode and okay, well now we can start to tear the house down because it's more important to keep this fat tissue than it is to keep this massive amount of lean tissue. So it really is interesting. So for him, people might look at that and say, well, he lost ten pounds and almost half of it was lean mass. Yes. But fundamental things that people do not understand is the best way to look as muscular as possible is to be as Lean as humanly possible. And I would encourage your listeners to go look up a guy named Brian Whitaker. He's actually a professor of economics at Oklahoma State, one of the greatest natural bodybuilders of all time. And also a very smart guy. Lovely person too. His gluteus muscles, he's so lean that he has veins in his glutes and striations that look like fingers. It's really incredible.

I remember the first bodybuilder I ever saw that in, which is not to say it was the first bodybuilder it appeared in, but I remember as a kid seeing that in Samir Banu, who was the 1983 Mr. Olympia. And I was like, I remember as a kid, like, you know, I'm maybe 13 years old, seeing him looking at the striations in his lower back and in his glutes. And it was exactly that look that you describe. To think that one could achieve that without steroids and diuretics is pretty amazing.

Brian was about 160 to 165 pounds on stage and he's five foot nine. If you saw him in his shirt, you would go, oh, he's nothing. He looks athletic. If you see him with his clothes off, you would say, oh, he's 200 pounds at least.

And so. Right. You said he's 59 and was 165.

Yep. You can't hardly see it. But the photo right there, we did a three times bodyweight deadlift challenge at his at Oklahoma State years ago because Brian's also very strong. That's him there.

And he would walk around at what.

In his off season? 185, 180, still looked very lean. So again, when you're talking about bodybuilding, and I realize we probably lost about 90% of the audience talking about this.

We'Ll bring it back to the other stuff in a second.

But I think bodybuilders can really teach important lessons about physiology in terms of energy metabolism.

I think it is such an underappreciated discipline because it's very easy to dismiss bodybuilders as drug using, whatever. And everything you're saying applies to the steroid using and the natural. It's just that in the natural it's a bigger leverage, but it's still a huge lever if you're a drug competing bodybuilder. Whenever I interact with these guys, I am blown away at how dialed in they are on their nutrition. Insane.

And so one of the things we tell our clients and one of the things I've heard so Many times from different competitors is you have to learn to sit with your discomfort. That can apply to many things. I mean, even in business, I'm sitting with my discomfort right now because we've expanded our businesses and our expenses are way higher now. We're making good revenue. But the 20 year old lane in me goes, it would just take one bad month and these expenses will crush us. That voice is in there. So it's talking yourself through and sitting with that discomfort. When it comes to food, it's really asking yourself, okay, am I actually hungry or am I just queued up to eat right now? And then if the answer is yes, if it truly is physical hunger, it's really talking yourself through this and saying, okay, what are my goals? What's important to me? Could I eat?

Sure.

Is it going to make it more difficult later? Like for example, if you're hungry at 11am okay, well if I eat a big meal now, I'll feel better now. But then what's it going to be like later? All these things weigh in. And again, there's no right or wrong answer to this. But what I would say is most people can handle a lot more discomfort than they think they can. Just because you're uncomfortable doesn't mean you have to do anything about it. You can sit with that. I think a lot of people really haven't done that. And even that like internal conversation again. This is why obesity is so difficult when we talk about people, because people want to make it about the X's and O's. It's not about the X's and O's. It's not about, eat this protein, carbs, fats. It's not about any of that. I remember when I first got into coaching people, you know, 15 years ago, I was like, well, if I just tell them to eat this, they're going to lose weight. And then you realize that stress and trauma and hardwired habits and behaviors are so difficult to change. And it really is. If you look at the research data, it really is more about changing people's habits and behaviors than it is about the X's and O's. And I mean, even right down to like sports, I'll use this comparison. X's and O's matter. But you know what really matters for a head coach? Leadership. That's what really matters. Communicate and get everybody on the same page. They call it changing the culture. This person came in and they changed the culture of this team. That's not X's and O's. That's Habits and behaviors. There was a really great systematic review by a gal named Marie Sprechle. She's doing her PhD over in England. Humble brag. She actually messaged me and said that reading my book is what inspired her to go do her PhD. And now she's done this great systematic review. So that's always like the most cool thing when I hear that. She did a systematic review and looked at people specifically who lost weight and kept it off. What did they have in common? What were the things they identified as being really difficult and what were the things that they identified as being really motivating? The things that came up weren't dietary really. It was their environment. It was their habits, their behaviors. One of the big things that came up was support. Either good or bad, that support made a big difference. And specifically support in terms of, I believe in you, I know you can do this, how can I help you? Those sorts of things versus the criticism, micromanaging type of support. And then also stress was a big one. Trauma was a big one. Binge eating was a big one. That's a really underappreciated part of this is the binge eating component. I think a lot more people struggle with that than would like to admit. Because if you look at people, I would say Monday through Friday, a lot of people do great. Then they get to the weekend and they get the pancakes in the morning, they're drinking throughout the day. By the way, everyone, alcohol has calories and it's really calorie dense. It also causes you to make not so great food choices. And so a lot of people eat 1500 calories through the week and then they'll easily go 4000 calories on the weekends. A lot of this is just reprogramming habits and behaviors. And that's what really came up in that systematic review, was it was not, hey, this diet came out as this was what these people were using. No, there was no one diet that came up as being superior to the others. What came up repeatedly was these series of habits and behaviors that people had that helped them do this.

Yeah. And I think bringing it back now to the energy balance question, I think today we know a lot more than we did 10 years ago. I think 10 years ago, at least for me personally, there was still an open question about the impact of different macronutrients on energy expenditure, both deliberate and non deliberate. So. But I think when you look at the body of literature, so I used to be part of an organization that actually funded two of the really big studies in this space, one out of Boston Children's Hospital by David Ludwig, and then one was a consortium of people that included Rudy Leibel, who you mentioned a moment ago. Kevin hall was the PI, Eric Ravissen, Steve Smith, et cetera.

That's like the heavy hitters name of metabolism right there.

The six PIs on this study were six of the biggest names in all of this space. And this was a very rigorously done study. Look, was it a perfect study? No, it was a pilot study. It was really designed to be the study to work out the kinks, to do the enormous study that actually never got funded. But it was still a very good study and it still answered an important question, which was at least comparing a relatively clean standard American diet to a ketogenic diet. It'd be hard to make the case that there was more than 50 to 150 calorie difference in energy expenditure at an isocaloric swap. There's different ways to interpret that. Some would say that's huge. If you have a 50k, which is what the difference was in the chamber, versus 150 or 160, which is what the doubly labeled water showed, that could still be very significant over a long enough period of time. There has been a significant debate about the validity of doubly labeled water in a ketogenic diet. You mentioned John Speakman. He and Kevin hall wrote a review about this suggesting that doubly labeled water really doesn't apply. There's an artifact in a ketogenic diet. So if you just look at the chamber data and say, well, 50 kilo calories per day, does that really matter? Not sure. But regardless, it wasn't 250 or 500kcal per day. And to me that was a very important insight because prior to that point I didn't really know. Because if you look back at the Vermont study from the 1960s, if you look back at Ancel Keys stuff where they didn't have metabolic chambers, they were on wards, but it wasn't quite the same. It was really unclear to me. I would say today the evidence has to be overwhelming that if, for example, a ketogenic diet produces remarkable weight loss, it has to be doing it through intake reduction, not through an increase in energy expenditure.

I think that you're 100% right and I'm going to take that kind of piecemeal. So the first thing I will say is let's throw out the energy expenditure stuff for now. And I know we just spent a lot of time talking about energy Balance, it's important. But we're assuming that these measures are accurate. There's even error in direct calimetry because you can only measure as accurately as your equipment that you have to measure it.

Those numbers I just touted, you could argue that they were at the limit of detection, at least for the indirect calorimeter. The 57 kcal per day was probably right at the detection. So it could have been zero, it could have been 100. We're really on a razor's edge of detection.

The point you made was that the carbohydrate insulin model of obesity would predict a much bigger change in energy expenditure. So therefore at least that version of it, it has to be falsified based on that. And even with the 150 calories, that would not explain the difference. And again, if we look at studies that assess loss of body fat under controlled environments, we just don't see differences between low carb and low fat. When calories and protein are controlled, we don't see it. In fact, there's actually very small favoritism towards low fat. But again, I think that that's probably a data artifact and not actually a real difference. There was, you mentioned David Ludwig. There was a more recent meta analysis he did that got a lot of buzz because basically his assertion was that, well, if you look at the short term data, yes, there doesn't appear to be much difference. But if you look at after 17 days, there appears to be a large difference in the energy expenditure, anywhere from like 150 to 300 calories per day favoring low carb.

Was that with doubly labeled water?

Again, that's it. So the issue was, and I went through this with a fine tooth comb and again, the meta analysis itself was very well done, the statistics were very good. But when there was metabolic chamber data available or doubly labeled water, they used doubly labeled water. What I would tell you is that's like saying I've got caliper data available and DEXA data available, but I'm going to use the caliper data. Well, that's fine, but keep in mind that DEXA is what calipers are validated against. So you're talking about a primary measure versus a secondary measure.

By the way, I've already forgotten Kevin hall and John Speakman's primary criticism of DLW in a kd. Do you remember the gist of the thesis, where the artifact comes from?

So Basically there's more CO2 produced than is accounted for in the constant of.

The equation, the 1.11 is probably too low a number.

Yeah. So you overproduce CO2 compared to what the prediction would be based on that equation. Basically, what that means is that in a low carb setting, you're probably getting an artificial increase in energy expenditure.

Oh, so the 1.11 would actually be too big. It's probably too big a coefficient.

What I went back to is I said, okay, you know what? Let's say that this isn't an artifact effect of the differences in measures. And again, direct calamity. If you're on a standard diet, the association with double A level water is an R of 0.8, which is pretty good for, like free living stuff.

It ain't 0.99 either.

Right.

0.8 is good, but not exceptional.

And then a Low carb is 0.5, which is a pretty big difference from a 0.8. It basically just means it's not as tightly correlated. But let's throw all that out. I went through every single one of those studies that Ludwig looked at, and they looked at, did they measure body composition and what did the body composition stuff say? Because what do we really care about? Do we care about what energy expenditure says on a readout or do we care about losing body fat? I think most people would say we care about losing body fat. Not one study saw a difference between the low carb conditions or the low fat or balanced diet when calories and protein were equated. So to me, that's truly the metric and that's what we care about. So to me, that's actually great news because what it says is, hey, do whatever diet you prefer. If you like low carb, heck, yeah. It's certainly not any worse than doing a low fat diet. If you don't like low carb, there's other options, by the way, you can just do a balanced diet too. There's nothing wrong with that. I think balanced diets sometimes can be a little bit harder for people to moderate, unless you're doing some kind of portion control. But yeah, it says that pretty much you can do what you want and still lose body fat. So I'm not trying to throw shade at David Ludwig, even though I have on Twitter before, it just goes to show you that if you change the inputs for a study, and this is one of the really fundamental problems I think is out there, some doctors and scientists just aren't equipped to understand studies, to interpret studies correctly. And people have asked me, how can I get better at reading this stuff? And I hate to be somebody who sits in an ivory tower, but I'll tell them, if you really feel so passionately, go to grad school. Because I can tell you, sitting down with my PI, Don Layman, who I'm sure you're very familiar with, and just talking about studies and having him literally, not in a nasty way, but just crush me so many times based on my hypotheses and everything and say what? Have you considered this that was so enlightening for me? I mean, the best part of grad school was just sitting around a table with graduate students and Don and just rapping back and forth and doing these studies. And you just really get a good idea for how to look critically at this stuff. And now I'm to the point where I tell people, I'm like, I don't get excited about one study. Wake me up when there's 10. You know what I mean? Wake me up when there's 10. And even then I'm going to look at how it was done and make sure. And I tell people, I hear this a lot. I don't trust science because this study says this thing and this study says that thing. I said, if you truly understand what you're looking at, you understand statistics, you understand research design. When you go into the methods and you look at the results, don't read the conclusions of the authors, look at the actual results, look at the methods, and you can usually understand why they seemingly found differences, results.

Yeah. I'll put in one shameless plug for something we did. We have a series on the blog called Studying Studies where we go through all of this methodology. But I agree with you, it's not a substitute for getting reps on the field. In other words, that's sort of like reading everything about playing a sport, but you actually have to play. And one of the things we've done internally and we've toyed with the idea of if we should just put them out there is journal club. What you describe is basically journal club. That's really how you learn how to read studies. You sit around with a bunch of people and it's formal. We had it every Monday morning, I think, or maybe Thursday afternoon, I can't remember. But twice a year, depending on the size of the lab, or four times a year, you present a paper for an hour, and everybody else's job is to see how you've maybe missed something or misunderstood something and really poke and pry. And so every single week you're getting those reps on the field and you get pretty darn good at reading the fine print. We do this once a month internally with our team, in part because it's just such a fun experience. And two, it gives us a chance to pick a paper a month and really dissect it. So maybe at some point we'll put those out there just so people can at least watch. It's one step closer, I guess, to doing the reps. But, yeah, you kind of have to do it.

Yeah, it's tough. There's no substitute for that experience. Now, that being said, understanding this, I started thinking about how can I help people with this? And so we're actually going to have like a periodical research review coming out monthly through our website that's going to be subscription based that we're going to take. There are other research reviews out there, but we're really going to try and make this for the layman, for somebody who has no. We're going to say, here's what they looked at, here's what they found, here's what we think they found. If we disagreed, because I've read studies where I'm like, I read the author's conclusion. I'm like, well, that's not what you found. You actually found this. We're gonna say, here's what it means for you, practically. So that's funny that we've both seen that need. And again, a lot of this is also media driven because it's about what's the most punchy headline we can get out there. I remember a great example was this happens so much with mechanistic stuff. It's like there was an article, if something to the effect of smelling your partner's farts might help prevent cancer. What the research study actually showed was that one of the volatile fatty acids that's produced by the gut microbiome in response to fiber may have a protective effect on breast cancer when they gave it to animals in a high dose. And it's like, that's a long way from you taking a sniff of your partner's fart and preventing cancer. But that's what confuses people.

All right, let's pivot to another application of this. Everything we've talked about so far has really set the stage for understanding the role that macronutrients, but more specifically calories and energy intake and expenditure play in weight loss. Let's now talk about a very specific macronutrient, which is protein and its importance in muscle acquisition. So I have a saying that I'm sure many others have said, and I'm Sure, I'm paraphrasing it from somebody, but never in the history of civilization, I will assert, has a 90 year old person said, I wish I had less muscle. That can't be uttered.

If you want to be metabolically healthy, the best thing you can do is have lots of lean body mass. It is a metabolic sink is the best way to describe it. If you look at people who are even like obese, who are powerlifters, they might have some elevations in blood lipids and whatnot, but usually their insulin sensitivity and blood glucose is still okay. If you look at people who train really hard, even with excess adiposity, they see this with people who are obese, who they start them just exercising. Exercise is one of the only things that we know of that without even weight loss improves metabolic health substantially. Really substantially. I was actually on the Rogan podcast and one of the points I made a few years ago was I said.

This was the one with dom.

Yes. So I said, you know, a lot of people get real caught up in carbs and fats and all this and they're not even exercising. You are stepping over dollars to pick up fractions of pennies right now. If you just got active. And it's not even a high dose that's required. It's not. I mean, a high dose is great, but just going and being sedentary and walking, you will see improvements in health markers for 100 minutes a week. That's it. And then obviously there can be a linear effect. People will look at me and I remember I had my blood work done a while back. Now I do have familial hypercholesterolemia, so my LDL tends to run a little bit high. But people were speculating that I would have like really high inflammation because I talk about I still will eat probably around 70 to 80 grams of sugar a day, but I'm also getting 60, 70 grams of fiber along with that. Oh, your CRP is going to be all of it. My CRP wasn't hardly detectable. It was on the low ends of detection. Again, that just speaks to the fact that there is a big difference between somebody who is a athlete training hard, who has a lot of muscle mass, versus somebody who's sedentary with excess adiposity. It's just not even comparable when you talk about food choices and whatnot. You have a lot more you can get away with with a lot of muscle mass. Your point that being older and frail people don't think about this. The funniest thing I get Peter is people say, oh, you do all that heavy lifting, you're going to be in pain when you're older. You're going to be in pain when you're older. Regardless. You might as well be in pain and strong versus in pain and weak. I have members of my family who I love dearly, who have been sedentary for a long time, who have all kinds of sciatica and back issues. I mean, I have had back issues from heavy lifting, but they come and they go, and I'm still here. I'm still able to lift.

And honestly, I find most people who have experienced activity and inactivity will almost always tell you if they're being deliberate in how they recall it. You're generally in more discomfort when you're inactive. I don't remember where these zingers came from, but none of them are mine. But this is one of my favorites. Sitting is to lower back pain what bourbon is to alcoholism.

Hell, yeah. The worst thing you can do is be immobile.

I say, as I'm sitting here, right, I notice you're standing, but yeah, yeah.

Part of Journal Club. In grad school, we had seminars every week where people would either present their exit seminars for their Ph.D. or we'd have outside speakers come in. And one of them, interestingly, was a lower back pain specialist. And this would have been circa, like 2007, 2008. And one of the interesting things he said was, which is now common knowledge, if we MRI an elite athlete, a lot of times I'll look at their MRI and go, oh, my God, you must be in horrible discomfort. And they go, really? No, I feel fine. And they've got all these disc bulges and herniations and whatnot, and they're completely asymptomatic. He said, we'll have sedentary people come in and they'll be in excruciating pain, and I'll pull up their mri, and they've just got a little tiny disc bulge.

There is probably no more diagnostic test that is uncorrelated from clinical outcome than an MRI of the lumbar spine.

Not a specialist. You know, I've spoken with lumbar specialists like Stu McGill. It's data. It's kind of like a DEXA. It shouldn't really dictate treatment. Treatment should be based on pain and what triggers your pain. And that's a whole nother rabbit hole. The pain world is a whole nother rabbit hole. People think the human body is like a bag of meat that's just connected to Your brain. And now we know that pain is more like an emotion than anything. But I digress.

So let's talk about it now through this lens. I want to talk about it whether we're dealing with a 50 year old woman who comes to you, who's never lifted a weight in her life. Okay, so she's the mom of three, has never touched a weight, she's going through menopause. So now she's actually starting to put on a little bit of weight, maybe for the first time in her life. So she's actually starting to get a little chubby and she's not overweight, her clothes are getting a little bit snug and her assumption is I need to do more cardio, I need to be more active. And it probably needs to be disproportionately cardio. You look at her and you make the diagnosis, ma', am, we can do some cardio, we gotta put some muscle on you. So you do a DEXA on her and she comes back 30% body fat. But it's kind of skinny fat. Her almi is 6, puts her at the 10th percentile of muscle mass. What are you going to do with her and what are you going to make her eat?

Yeah, so I think the first thing to say is that muscle is a lot like bone in that you want to lay down as much as possible because eventually it's going to start receding. But it is still possible to add muscle. People will hear that and go, well, I'm 50, I might as well not even.

Yeah, it's exactly.

No, in fact, right across the street from my lab at the University of Illinois. Sorry, not my lab, the lab I was in, right across the street at the exercise physiology building. They did a study in 80 year old, frail elderly. Well, they basically had them start where they would squat to a high chair and come up gradually. They put the chair down. This was like a 16 week study. And I don't have the citation, but I just remember talking to the other grad student about it. So please forgive me everyone out there, but they said they were amazed because by the end of it, one, these people as a percentage of their body weight, increase their lean body mass pretty much the same amount that a 20 year old does. The relative increase was similar. Now they had less overall mass they put on because their weight was lower to start. And then he said by the end, some of them were actually able to add weight.

Squat with weight.

Yeah, and squat all the way down to a parallel chair. The people in the study were completely mind blown that this was possible for them. And it's 16 weeks, it's not even a long time. And we're talking about people who like probably think that they're heading for a wheelchair. It is not never too late to get active.

And let's bring it back to your finance example. It's never too late to start saving. It's true. If you can be one of the fortunate people who right out of college or who doesn't even go to college and goes straight to work out of high school or whatever and you can start saving right away, well that's fantastic. But just because you've made it to 40 and you've been scrapping by and you haven't been able to save, but now you come into a little bit of disposable income and you can start saving, there is zero downside to that.

Better late than never. Absolutely. That's a great comparison. I actually never thought about that before, so I'm going to steal that for later. So I'll give correct attribution. And then as far as diet wise.

When I see that woman in my practice, which I see all the time, I'll tell you what she looks like and I want you to compare it to your version of that. But when I see that woman, she looks exactly as I've said, right? So she's 50, she's going through menopause, she still looks normal, but the composition of her body is really changing. You do that, Dexa. She's 30, 35% body fat, very little muscle mass. You take a close scrutiny of what she's eating, she's getting 50 to 60 grams of protein a day on a good day. And when you do a strength metric assessment on her, she is incredibly weak. Even if you were to compare her to another female at an appropriate age adjustment, I have a very stark conversation with her and I pull up something called the death bars. So the death bars are this analysis that Bob Kaplan did for me, God, probably about six months ago, a year ago, which is basically just causes of death by decade. I double click on accidental deaths. This death bars is so cool because you can double click on it all over the place. And once you call out accidental deaths, you realize something really interesting. Unlike cardiovascular disease, cancer, Alzheimer's disease, which are very age dependent, meaning the older you get, the more the incidence goes up. Generally with cancer it actually comes down a little bit in the last decade. Accidental deaths are basically the same forever. So from 10 year olds to 20 year olds and 80 year olds to 90 year olds, they all have the same number of accidental deaths per year, more or less. What differs dramatically is the type of accident. So in young people, it is disproportionately, sadly, overdoses that are the lion's share, followed by automotive accidents in the oldest subset of the population, it becomes almost entirely accidental falls. And when you show somebody this graph, because it's so pronounced, I've never seen a person who doesn't just stop in their tracks because they cannot believe how much morbidity and mortality results from falling and frailty. Once you reach about the age of 70, 75, I mean, the data is.

There to back it up. I may butcher this citation, but I believe there was a study by Bob Wolf, kind of a review, that showed essentially after age 65, you could tie the majority of deaths to some kind of lack of muscular strength or lack of muscle. And if you look at they've done these meta analyses of mortality showing that your lean body mass is inversely proportional to your risk of mortality after age, like 50.

And by the way, strength is even slightly higher.

Yep.

So the hazard ratio for being strong to not Strong is about 3.2 for all cause mortality.

Think about that big hazard ratio.

Freaking staggering hazard ratio.

You're talking about on the level of smoking right there.

No, it's higher than smoking. Actually, smoking is about 2. So to put that in perspective, end stage renal disease is about 3. And the only thing that's higher, and I talked about this on another podcast, is elite, meaning top 2.5 percentile of VO2 max compared to bottom 25th percent of VO2 max. That has a delta of 5.5.1 is the hazard ratio. And of course, these are not mutually exclusive, so why not have remarkable cardiorespiratory fitness, muscle mass and strength?

So I think one of the big barriers, especially with the type of client you're talking about, is, well, I don't want to get too bulky or too muscular.

Can you dispel the myth of accidental muscle, please?

Yeah. So as someone who's spent their entire adult life trying to get too muscular and basically just looks really fit in a T shirt, don't worry about that, you're going to be okay. And if you do start to get too muscular, you can always just back off pretty easy. That's like saying, I mean, literally, let's use a financial comparison.

I'm worried about getting too rich.

I might get too rich. And if you're worried about that, we've.

Got some great philanthropies that we can introduce you to.

Yes, exactly. So it's like getting in a car and worried about becoming a NASCAR driver spontaneously, you know, just the amount of benefit you will get from three times a week, 30 to 40 minutes of resistance training, not even crazy intense resistance training, just an amount that forces your body to adapt will be unbelievable in terms of your level of fitness and your ability to live a long, healthy life.

So tell me what you would do. So let's use this again, this generic but rather very specific example of this 50 year old woman who is not completely unfit. So let's even give it to her that she still does yoga walks, does some stuff, but she's never lifted weights before. Tell me what her first four month program looks like from you.

First off, what's reasonable for her lifestyle? Like what can she actually do?

So let's say she says, lane, I'm willing to commit to 45 minutes three times a week in the weight room.

I think that probably lower body strength is a little bit more important than upper body strength in terms of preventing falls. I mean, we always think about falls from a bone density perspective. We don't want people to fall and break their hip because that specific fall, fall is pretty much a death sentence if you're over the age of 65. People worry about the bone density. Well, if they didn't fall in the first place, if they had the muscle mass to catch themselves, you wouldn't have to worry about that. And also, by the way, bone density is increased by lifting weights much more than anything you'd ever get through your diet. So I would say let's just see what you can do. And then I would probably do two lower body days. One upper body day could even flip flop it on alternating weeks if you wanted to even it out. And it would mostly be honestly just some machine stuff that's very easy for her to do to get in there because honestly, she's never trained before. Everything's going to cause an adaptation and that's what we're looking to get. And I'm not going to have her come in and try and free squat or deadlift or anything like that. That's a really horrible idea. It's just going to frustrate her and not actually apply the load where we want it because she's not going to be able to balance it. Very.

So when you say machines, would you be thinking like, look, you'd be happy with her doing a leg extension, a leg curl, a leg press? Yeah. Would you have her do anything that's A little more compounded and complicated. For example, holding dumbbells and stepping up onto a bench where now she has to manage grip strength with a bit of balance and also getting the leg load. Or is that not first cycle?

I probably wouldn't do that in the initial weeks, just because the soreness is going to be so high, it's going to impede a lot of that movement. Well, and people tend to think about soreness in the wrong way. It's correlated with muscle growth and strength, but it is not causative. And so what I'll tell people is if you're sore all the time, you're probably training incorrectly. If you're never sore, you're also probably training incorrectly. So it's something that if you're doing an appropriate amount of volume and intensity, there probably should be some soreness from time to time. But if you're getting sore all the time, then your programming is pretty bad. What I'm trying to do in the initial stages is just actually get enough to adapt and not cause enormous amounts of soreness.

Can discourage her as well.

It can be discouraging. That's it. I mean, if you can't go about like, everybody's known that feeling after their first, like, hard squat day, good luck doing anything. And so that's going to be a discouraging thing, especially if somebody's got life. Not all of us are meatheads who love that feeling. Also, it's going to impede her subsequent sessions, especially if you're talking about something like a step up that requires more coordination. If you're overly sore, that's going to be really, really difficult. So I'm probably going to try and get her through like four to six weeks, which, if we look at the data on muscle protein turnover, I think we talked about this last time a little bit. You don't really see increases in hypertrophy during the six weeks, the first six weeks of resistance training. What you're getting is actually a remodeling of the tissue to be stronger, more resilient, and it starts protecting itself against damage. That seems to be where muscle protein synthesis goes up, but muscle protein degradation also goes up. So basically you're kind of in this futile cycle where it's just turning over the tissue. After about six weeks, muscle protein degradation tends to go down, muscle protein synthesis stays up, and that's where you start seeing those increases in hypertrophy and lean mass.

Does a trained athlete also go through that or have you long since passed through that? And are you now Generally at the point where degradation is not having this disproportionate rise relative to synthesis, I thought.

You might ask this. So I actually have a paper from Damas et al pulled up, which is really interesting. So if we look at myofibrillar protein synthesis in response to resistance exercise, we see what tends to happen is the amplitude of muscle protein synthesis in trained people is a little bit lower than untrained. So you don't have quite the same response. It depends on when you measure. If you measure it 16 hours post, they're about the same. They're about a 40% increase. If you measure it four hours post, trained is still about 40%, untrained is about 70%. So you've got a little bit of difference in amplitude. But what really is the difference is the duration. In trained people, it's back down to baseline about 10 to 20 hours after the initial resistance training bout. Whereas the untrained people still have elevated rates of protein synthesis, even like two, three days later.

And sorry, Lane, this is just synthesis, or this is net accumulation.

This is just synthesis.

Got it. So it could be offset by degradation.

It could be. And degradation is much more difficult to measure, unfortunately. If we get into the techniques that are used to measure this, what you find is you really can't measure all three things at one time, unfortunately. So you can measure kind of the net balance. We do that with what's called an AV balance. You take a labeled amino acid, you're infusing it, you're sampling in the arteriole of a muscle bed and then the venous of the muscle bed. And so basically, depending on how much of that label shows up in the vein versus the artery, we know how much is being retained in muscle, so that we know what the net is. You can infuse a second label to presumably get synthesis as well, and then you can figure out the difference of degradation. But the problem with this is it requires a steady state. You can't do it when you've trained or had a meal or anything like that. It's pretty much exclusively fasted because there's too many assumptions you have to make about the rate of appearance versus rate of disappearance and those sorts of things. You can measure synthesis very easily. Well, I wouldn't say very easily, but much easier than degradation. And you can measure degradation, but the problem with degradation is how you're measuring it. We know that, for example, out of every amino acid that's used for protein synthesis, seven out of eight of them are actually from degradation. So it's amino acids being recycled.

Of all the things we talked about in our first episode, Lane, this was the most novel to me. And it's the one thing that I literally find myself thinking about every day when I finish a workout workout and go and get a protein shake is I wonder how many of these amino acids in said shake versus these amino acids that I've just eviscerated from Deadlifting are actually going to be the ones that form through the summation of new Myofibril synthesis.

What I would say is don't think about it that way. What I would say is if you want to maximize muscle mass, you want to maximize protein synthesis, obviously, and maximize deposition. The theory at first was, all right, if it's only one out of every eight, and you can only really deposit about 5 to 10 grams per day net in muscle overall of amino acids, I mean, that's kind of the max.

Wow. Say that again.

So about 5 to 10 grams a day. If you do that over the course of a year, every single day. I've done this calculation before, so I. I don't remember it exactly. So I'm going to estimate.

Look, if you do the math on 10 grams a day, that's eight and a half pounds.

But what do we know about muscle tissue? It's about 70% water. We're just talking about the actual protein content. So if you take that £8 and we divide it by 0.3. Yeah, 0.3.

Yeah. It's about £26.

About 26. That's a lot of lean body mass. I would say that's a lot of lean body mass, even for a novice trainer. So we know the max is probably about 5 to 10 grams per day. In terms of drug free, do you.

Know how much that can go up to with anabolic steroids?

I'm not sure, quite honestly. There's just a dearth of information about that. Just because it's hard to get IRB approval for doing research on steroids.

Yeah. I mean, it would simply be basically the anecdotal evidence of looking at a professional bodybuilder and asking.

Correct. I think the magazines exaggerate a lot of stuff. And I would even say 30 pounds of actual skeletal muscle wet tissue would still be a ton for someone on drugs. I mean, that's a lot of skeletal muscle tissue. Go to the store and look at 30 pounds of beef.

We just had a female patient in our practice who went from being not very active to getting very active, and she had a DEXA scan separated by five months, which I generally don't like doing dexas that close together. But the cardinal sin was just through circumstances were done at different facilities. The DEXA suggested she gained six pounds of lean tissue. One of these dexas was wrong. Six pounds of lean tissue in five months. I mean, is that possible?

She probably did gain some.

Would that be expected to. I mean, we'll know, I guess when we repeat it at the one year mark from the beginning, because maybe it'll plateau. And this would be this remark, remarkable adaptation out of the gate. But it struck me as a lot of lean tissue.

But I mean, if you want to gain 8 pounds of lean tissue on a DEXA, it could be a lot of water. Yeah, take a Dexa, jump off, drink a gallon of water and jump back on and you'll have gained eight pounds of lean tissue.

So that's my point. There's the hydration artifact and all these other things that could be doing it.

Yeah, she probably did gain some. Most people's lifestyles aren't that volatile that you see that difference. So she probably did gain some. But in terms of muscle protein synthesis and how much you deposit muscle, people say, well, if you only need 50 grams to meet your requirement, in terms of being a positive nitrogen balance, because that's how that's determined, is nitrogen balance.

Can we dismantle the RDA? In a minute.

It'll kind of get to that. People say, well, just throw 10 grams of amino acids on top of that. 10 grams of protein on top of that. I mean, you're there. That's not how it works. You're assuming that every single amino acid after that just goes straight to lean tissue.

You've already mentioned the thermogenic effect. How much of that is actually coming from the protein itself being inefficiently metabolized versus a stored energy source. Do we know that?

I would say it's more about the oxidation of the protein and where it's going, but I'll get to that in a moment. The thing to keep in mind is that in order to maximize your deposition, to get that 5 to 10 grams, you need to maximize protein synthesis. Synthesis. But to maximize protein synthesis requires a disproportionate amount of total protein. So in order for you to maximize protein synthesis, we think it's around 1.6 to 2.4 grams per kilogram of body weight.

Sorry, say that again. 1.6 to 2.4grams per kilogram of lean body weight or total body weight.

The meta analysis on this was total body Weight. But if you want to say lean body mass, then you could pump it up to, like 2.2to 2.8 grams per kilogram of lean body mass, and you're pretty much at the same number, unless you're, like, obese or super lean. And people will, like, quibble about that. And I'm like, listen, just get in the ballpark.

Yeah, exactly.

Which kind of winds up with that old one gram per pound of body weight number. You need a disproportionate amount of protein to maximize the deposition. It's just kind of an interesting fact. And the other thing people will say is one of the ways that protein is assessed or needs are assessed is what's called the indicator amino acid method. Or they also look at direct amino acid oxidation. But usually the indicator is kind of the one that's the gold standard. But if you look at direct amino acid oxidation, I did this. I pulled up a bar of direct amino acid oxidation, which basically is like, if you feed a certain amount of protein, if you're feeding increasing levels of protein, and you look at the oxidation levels of a specific amino acid, it'll be kind of flat. And then you'll hit an inflection point, and it'll go up linearly. And they've said, okay, that inflection point right there, where you start increasing amino acid oxidation, that's obviously wasteful. That's extra protein. You don't need any more than where that inflection point is. And then if you look at what actually increases muscle protein synthesis, it's right at where amino acids start getting oxidized.

And do you think that that's just an association?

I think it's an association.

You don't think that that's causative?

No, I don't think it's causative. I think it's more if you think about it from a teleological perspective of evolution. And to me, and this is one thing Don Layman was great about, he would always ask me, why do you think this is happening? From an evolutionary perspective, it would make sense that at the same amount of protein that you can start using it for energy, that you could also start building extra tissue. To me, that actually kind of makes sense. You've got such a surplus that now you can begin to build more lean tissue.

And did you say that on average that was going to occur at roughly 2 grams per kilo?

That's gonna be the higher end of that linear bar.

So maybe even two and a half.

You're probably gonna see amino acid Oxidation. I don't know the exact number. I could find it if I dug through enough stuff, but probably around one gram per kilogram of body weight. Protein intake, something around there.

Oh, I see. So you even start to see that at such a low level.

Oh, yeah.

Once you pass the rda, you'll probably just start to oxidize amino acids.

So you really got to think about protein as you've got to throw in a lot more to get out what you want.

So it's just a very inefficient system.

Correct. Which works to your advantage because, again, that wasteful, futile cycle is wasting energy. You're expending more energy.

And is that all through gluconeogenesis, Lane, all of that oxidation, is it going to the liver to make glucose?

It's been a while, so forgive me, I could be wrong. There is, I believe, some direct amino acid oxidation in terms of you have to deaminate it first, but after that, there's some pretty quick ways to oxidize some of those intermediates, and some of them can enter the Krebs cycle directly.

That's right. Yes, yes, yes. We do see some paths for amino acids to enter.

Think about ketoglutarate.

Alpha ketoglutarate. Yep, exactly.

So that's a direct, I believe, from glutamate. There are these places. I think it's like 60% of protein is gluconeogenic.

That's right. Not all of it is.

Yeah, there is some specific ketogenic amino acids. If I was still in grad school, I would know this.

This is a Dom d' Agostino question. He would know this. Right.

I think one of the branch chains is actually ketogenic. There are pathways to both. But that's the beautiful thing about metabolism is, like, nothing is actually wasted. If it's given off as heat or something like that, it's because there was a reason for it. If it's metabolized into glucose, it's because there was a reason for it. It's one of the beautiful things. In fact, one of the pieces of artwork I want to get in my office is the chart of metabolism. It's just such a cool thing to look at. And almost as a scientist, I could look at that and go, you know, I could believe there's a God just from, like, how beautiful that is. You know what I mean?

This is actually great background. So let's go back to our woman. You got her in the gym. She's there three days a week, 45 minutes at a time. We're doing two days lower body, one day upper body to start. For the first six weeks, the goal is don't get hurt, don't get too sore, build up the habit of doing this thing, find some enjoyment, get the tissue resilience. You're probably overly degrading muscle and not so much synthesizing. So don't expect to actually add lean mass. When you do your intake assessment on her, you find out she, let's say she weighs 135 pounds, so that's what, 60ish kilos. And you find out she's eating 50 grams of protein a day. You can probably think better through how many calories she's probably getting on average. But let's say she's getting 2,300 calories per day, of which only 200 is coming from her protein. How do you change her macros with obviously the most important being the protein?

I think one of the biggest things that I really work on people, especially with like our app, Carbon Diet Coach.

Tell me what the app is again. I've seen it on Instagram.

Yeah, it's called Carbon Diet Coach. So basically it's if people feel like they have a little bit more independence or they can't afford a one on one coach. So basically the app is a nutrition coaching app. If you put in your metrics, it will give you macros to follow, has a food tracker. And then every week you check in with the coach, which is an algorithm, and it will adjust your macros based on your progress. We've had thousands of awesome testimonials, so it's pretty cool to see. But one of the big things we'll get, especially from like gen pop, is how do I hit these protein recommendations? And when I go in, most of their protein sources are really fatty cuts of meat. That's one thing. And so I'll say, okay, one, pump up your portion size, but let's select.

Leaner cuts of meat because you're not necessarily trying to increase their calories, you're trying to basically keep them almost isocaloric but shift more to protein.

Absolutely. And sometimes even like in her case, I wouldn't necessarily recommend it because she's already kind of slightly small. But if people do have a little bit of excess body fat, especially if they're new to training, they can recomp. Absolutely can recomp. Lose fat and gain muscle at the same time. And in that case that might be a place where I would do it just because it sounds like she has a little bit more body fat than she probably should for her body weight.

Let's assume her height is such that by BMI she's totally fine. She's at BMI of 25, but we would love to see her be at 22% body fat in two years instead of 35% body fat in two years. I'd like to see her have 10.

More pounds of muscle and that's pretty reasonable goals. And so one of the things I would say is, okay, let's look at the portions of. If you are eating meat, let's look at the portions of meat you are eating.

What's your protein target for her?

A lot of it's going to be one. What can I get her to eat?

Starting from theoretically exceptional.

Yeah, I would probably say if we could get you at like 120 grams.

About a gram per pound, almost.

Yeah, it probably could be a little bit less. 110 doesn't have a lot of lean body mass, so probably 100, 110 is going to be just fine. Anywhere in that range is going to be just fine.

And then your strategy is what, how much in shake? How much in.

Yeah, first thing is breakfast. So breakfast is where most Americans are very low in protein because most breakfast foods either don't eat breakfast or it's a banana or it's cereal or it's oatmeal or whatever.

Oh, and sorry, I'm going to just keep making shit up to be funny. She says, But Lane, the thing that has been so helpful for me is I do time restricted eating. I do just two meals a day, lunch and dinner.

So first thing I would say is, okay, why are you doing time restricted eating?

And she'll say, because it really helps me maintain my weight.

Thing I would say is, okay, you can probably still get the vast majority of the benefits of time restricted eating. Just throwing down a lean protein source or a shake in the morning, you're getting in, boom, another 25 or 30 grams of protein. You're stimulating protein synthesis and protein itself. High protein diets actually mimic some of the things that go up during fasting. I would say that protein acts a little bit differently. And one of the things I said to people, if they are trying to increase or maximize lean body mass, but they want to do time restricted eating for the benefits of, of satiety and lifestyle, cool, do that. But throw in a protein shake in the morning just because it's not gonna mess up any of those things and it's gonna help with lean body mass.

If she said, I mean, maybe I'm saying this now, but just what about mtor? MTOR is responsive to amino acids. And of course, I'm gonna argue you're not getting much MTOR suppression with an overnight fast and skipping breakfast. But what about low IGF and all of these other things? Aren't these the important pillars of longevity? Isn't all this extra protein you're making me eat at odds with that?

Let me answer that question after I get to how I'd add more protein. I was talking about somebody about this the other day, and so many people mess it up. The next thing I would do is, okay, let's look at lunch. Where can we get more protein? If it's not a shake or anything like that, let's pump up some lean protein in the sandwich or let's add it to a salad or, you know, whatever it is. I don't want to fundamentally choose, change how she's eating. If the calorie amount is okay, I want to make small changes that aren't going to feel disruptive to her current lifestyle. The minimal disruption of the current lifestyle. In fact, the research shows that in terms of dietary adherence, the less you can change, the better they will do because it's already close to their current lifestyle. Then if we get to dinner, which is where most people get about 65% of their protein, again, assuming we've got 20, 30 grams at breakfast, 20, 30 grams at lunch. And again, people say, well, how many shakes can I have? Hey, if you like having shakes, there's nothing wrong with shakes. Absolutely nothing wrong. Go ham. Like, there's nothing wrong with it. And then at dinner, obviously, okay, if they've been having fattier cuts of meat, which a lot of people, they have a rib eye. And again, I'm not saying you can't have those things, but again, if calories are a consideration, rib eye, T bone, those sorts of things. Okay, well, let's move to like a sirloin or a filet or chicken breast. You can get pork chops that are really lean too, that are very tasty venison. I was at a place called Steel Bok here in Tampa, and they had a venison ribeye or something like that. I think it was a venison rib eye. Amazing. It was like 4 grams of fat per serving. Amazing. By simply changing the cuts of meat, you can pump up the protein, reduce the fat. Your calories kind of stay about the same. I like to use shakes. Wherever somebody just says, hey, I just don't have. Especially as people get older, they tend to Consume less protein and have less of an appetite for protein, especially like the mastication. As people get older, they just don't like having to chew as much. And so shakes can be a really, really useful tool. And even if somebody's having a carb heavy breakfast, typically like a cereal, something like that, there's such good ready to drink shakes out there right now. Instead of milk on your cereal, just put a protein shake, a vanilla protein shake and boom, you've got 30 grams of protein instead of eight now. I mean, Peter, I'm sure you can speak to this compared to when I started like in the late 90s, early 2000s. I mean, literally I got a can of unflavored protein from GNC one time. I was like, oh, I can do this because it was cheap and I was a college student and I could not do it. It was like chalk. It was literally like chalk.

When I was in high school, there was this brand called Sheckley, I think. Yep, yeah, it was, it was pretty bad.

But boy, and the protein bars, again, not the best tool, but again, what are we replacing it with? So if you're having a protein bar instead of like a really burger or something like that, great alternate substitute and there's some great tasting ones out there now. Now your question about MTOR and IGF1.

Before we wrap up her. The biggest change you've made is you've doubled her protein intake, which in reality is almost an isocaloric switch. It's a rounding error in terms of how many additional calories you've had. Are you paying attention to what percentage carb versus fat in this woman, given that our primary goal is going to be hypertrophy over the next couple of years.

So the research on hypertrophy leads me to think as far as carbs and fats go, it mostly doesn't matter as long as you're not at the extreme of either. If you are very, very low fat, it can impair testosterone levels. Now they've not really shown like an impairment of lean mass accrual, but they haven't really measured it either. And I would say that if it impairs testosterone enough, you may get an impairment of lean body mass. As far as how much fat that is, it's very difficult question because they've done it as a percentage of calories, which to me is almost useless because obviously if 10% of calories, if you're eating 5,000 calories is still probably enough fat. And as you have more calories you can also create fat or spare fat from oxidation by using more carbohydrates. So first off, it's a calorie amount issue as well. But I would say if you're getting at least 20% of your calories from fat, you're probably safe and is an absolute floor. 40 grams of fat again, I'm guessing. So please don't be dogmatic about these numbers to those who are listening. But then also like a ketogenic diet does appear to impair lean body mass accrual, probably through a few different mechanisms. Even though carbohydrates aren't stimulatory for muscle protein synthesis, they do inhibit muscle protein degradation and fat doesn't appear to have the same effect. It's probably an insulin effect. Insulin does inhibit muscle protein degradation.

It's almost impossible to be on a ketogenic diet if you're actually generating sufficient ketones. And that's your metric for saying you're ketogenic with the amount of protein that we were talking about anyway, because for someone your size, it would be very difficult for you to get high levels of beta hydroxybutyrate with the amount of protein that you, you would need to be in that positive nitrogen balance anyway.

Correct. The other way that it probably impairs lean body mass accrual is through just effect on training because resistance training is anaerobic for the most part.

So her glycolytic capacity goes down.

Yeah, the research shows that if we're talking about ultra endurance or even endurance in terms of under 65, 70% of a VO2 max, ketogenic appears to be just fine. But once you start getting over that 65% VO2 max, there does seem to be a significant impairment in performance. So there was a couple of 12 week studies looking at lean body mass accrual and showing an impairment with the ketogenic diet. My guess is it's one, through not inhibiting muscle protein degradation as much and two, just through not performing as well. And they did show lower strength accrual as well in the ketogenic diet group.

So your fat to carb ratio in her, given that we're not going to go to any extreme, I notice in your programming some of the stuff that you've written about, you talk about, look, here is where you customize it based on how you respond to carbs. So some people carbs really increase their appetite, they create brain fog, all sorts of things. If you're in that camp, you're going to push to a lower carb variant here. If you're someone who Tolerates carbohydrates very well. You could easily be on a higher version there. That becomes the secondary fill after the primary bucket of protein is established.

Absolutely. Protein and calories, most important. Two things. How you distribute your carbohydrates and fats should be based on what you could adhere to and what you enjoy. I could argue brain fog or appetite that it depends on the type of carbohydrate. A lot of it might be possibly placebo as well, just based on things that have been said in the media. Regardless, if you know that you just prefer a lower carb diet, then there's absolutely nothing wrong with doing it as long as you're not getting to the extreme end of a low carb diet. And even then it's a balancing act, it's okay. You know what? I really, really enjoy the ketogenic diet. My goal isn't to be the biggest, most muscular person I possibly can be. Well, you can still gain lean body mass on a ketogenic diet. This is where nutrition communication really requires nuance. Because what somebody might hear what I just said is Lane saying you can't gain muscle on a ketogenic diet. I'm just saying you can't gain as much, but you can absolutely gain muscle. Same thing with intermittent fasting. You can absolutely gain muscle in intermittent fasting. Are you going to build as much? Probably not quite, but again, it depends on what your goal is. If your goal is, my primary focus is muscle mass, then I would say, okay, protein, calories, and making sure you have enough carbohydrate as well. But if your primary goal is maintaining body composition, if you put on a little bit less muscle mass, but you like being low carb, then do it. So it's really going to boil down to, for this individual lady, what do you like best? And then even for some people, when you know, if they get overwhelmed by, like, protein, carbs, and fats, I'll say, hey, hey, just track your calories and track your protein. That's it. Those are the big buckets. And then if you want to get more granular, you can, like, I get granular because I want to make sure I'm kind of getting a consistent amount of carbohydrates and fats because I don't want my performance to fluctuate very much. And I also don't want my body weight to fluctuate a ton because I use that to track various metrics in our app. For most people, calories and protein, two huge buckets, and you're getting 90, 99% of the benefits. Now I want to come back to your what this person might say about MTOR and IGF1. I've heard these things are bad. I know David Sinclair has brought a lot of stuff and saying, you know, I really try to limit MTOR and IGF1 and it will never cease to amaze me how many scientists do not understand the difference between a short term truncated acute response to a stressor versus dysregulated signaling that persists indefinitely. And what I mean is when you look at MTOR elevations that lead to cancer and whatnot, those originate at what I would say mostly insulin resistance. So you're having elevations in insulin, you're having elevations in insulin signaling through akt, which can then transmit to mtor. It's like this chronic low level pushing.

That button as opposed to a pulsatile.

That is a big difference between a dose of protein that causes MTOR to rise, go back down in a natural rhythm. Also tissue specific, we're talking about in skeletal muscle, not liver, not brain, necessarily those sorts of things. IGF one, same deal. And what I will say is where are all the resistance trained people that are getting cancer by the droves? Because if you want to talk about amplitude of response from mtor, resistance training dwarfs what protein does. If we look at the meta analyses on cancer incidents amongst resistance trainers and there's getting to be some now we see lower levels of cancer in people who resistance train. So what that tells me is there's a difference between these two signals.

And I want to point out something there because I think it would be very quick to say, but Lane, there's a healthy user bias there, blah, blah, blah, blah, blah. I don't think what you're saying is that that proves that lifting makes you live longer. I think what you're actually saying is no, it's the contrapositive. It demonstrates that lifting doesn't increase MTOR to the point of it being detrimental to your health. That can be asserted, I think, from.

That observation or that it's also tissue specific. That's part of it. Let's use a different example. So let's look at exercise in general. Peter, if you got educated medical school but knew nothing about exercise, this is.

One of my favorite discussions.

You know where I'm going with this and I told you I'm going to do something that's going to make you elevate your heart rate, elevate your inflammatory markers, elevate your reactive oxygen species, raise.

Your blood pressure, increase Hepatic glucose output.

What would you say to me about that?

Yeah, of course I'd say, yeah, this can't be good for you.

Don't do that. And what does exercise? It does all those things. Why is exercise good for us? Because that is a short term stressor. I mean we use the term hormesis if you want. The body responds to and it actually acts kind of like a vaccine. I realize that's like a really triggering term for a lot of people right now, but it's like a vaccine, right? It's a controlled dose of a stress that your body can handle. And I kind of look at protein. I wouldn't say protein's a stressor necessarily, but again, it's this acute response versus a chronic hum. Your inflammatory markers, people who deal with elevated inflammation, it's not actually super high elevations, but it's just all the time. That chronic pulse on that, that is the problem. That is the issue. Again, they might say, well, there's healthy user bias there. And I would say, well, so what? Okay, so you're saying that people who have high rates of IGF1 and MTOR who are healthy. Okay, well show me them getting higher incidence of cancer. You can't. You can't. Because all these things are tied together. Because people who have high levels of mtor activation and IGF1 typically have insulin resistance. They have poor dietary habits and poor lifestyle habits. So I would say, okay, that's a fair point. There's confounding variables, but all these things are tied up together. You can't really separate them. Am I saying that MTOR plays absolutely no role? No, but again, it can be cart before the horse sort of thing. Like people say, well, rapamycin is an MTOR inhibitor and that's a cancer treatment drug. And I would say yes, but do you think it's a good idea to do chemotherapy to prevent cancer?

It's not even really true because rapamycin is not really. I mean, it's never really been a particularly successful cancer therapeutic used constitutively, which is how it would be used. I think rapamycin does have significant longevity benefits in basically all models that aren't humans. So the extrapolation would be pulsatile. Rapamycin is probably beneficial, but in that application it's not really being taken to constantly suppress mtor because remember, if you took it all the time, you're suppressing MTOR Complex 2 and MTOR Complex 1. So I agree with that point actually completely, which is that tissue specificity and Time course are very difficult things to infer from the outside, which is sort of the meta view of all things equal. You know, IGF levels have a J curve with mortality and therefore very, very high levels of IGF must be problematic. And high protein increases IGF and therefore must be bad.

And I think it's important to also understand the following, and that is, I think I might have missed this on the last show, but I think we have this idea that like there's this perfect diet out there that's going to be the one diet that's going to reduce cancer and cardiovascular disease and mortality and all. And the fact is that there's probably trade offs for everything. I know there's people out there that will say that protein increases cancer. Well, there's a ton of confounders to that. Like somebody saying, well, there's healthy user bias, sure, but there's ton of confounders to people who eat high protein. Most protein in these meta analyses, looking at cancer, I mean, you're talking about high protein is above 70 grams of protein per day or 1.2 grams per kilogram of body weight. Okay, well, where do most people, most Americans eat high protein by definition of the rda, but where is it from? It's from burgers and hot dogs and like a bunch of processed meat. What does the cancer incident say about people who have high protein but an overall healthy diet? And there was a really interesting cohort study out of Alberto and 100,000 people where they said, okay, we're going to look at meat intake, and I think even red meat intake, specifically, we're going to look at low, medium and high levels of red meat intake, but also with low, medium and high levels of fruit and vegetable intake. And because here's the big thing is most people who eat high levels of meat and protein eat low levels of fruits and vegetables. What they found was that at the highest levels of meat intake, but also with the highest levels of fruit and vegetable intake, there was no difference in cancer incidence between the lowest level of meat intake and even with the highest level of fruit and vegetable intake, it's not an issue.

In other words, it's a marker for overall diet quality.

Bingo. I don't want to extrapolate too much out of one study, even though it was a large study. But what that would seem to suggest is that overall diet quality is the big rock that we're looking at here. And you can achieve good diet quality on a whole host of different diets. I mean, you can have a ketogenic diet that's very poor quality diet. You can have a ketogenic diet that's very high quality diet. You can have a plant based diet that's very low quality and you can have a plant based that's very high quality. You can have intermittent fasting that's low quality and so on and so forth. A lot of it boils down to like, what are the food choices you're making on balance, are you getting enough fruits and vegetables and minerals and micronutrients? And even then it's so interesting every time we try to say, okay, well fruits and vegetables have these benefits on health that we see pretty consistently. So let's try and take out these isolated micronutrients and give them in a supplement. We're always disappointed with the results and it just seems to be a little bit of mother nature's kitchen. Kind of have to eat the whole food to really get those benefits. Again, if the MTOR story were true in terms of dietary protein, we would have expected in that study to see a linear increase in cancer, especially at each level of fruit and vegetable intake. But we didn't. What we saw was more of a linear inverse association with fruit and vegetable intake is what we saw.

So let's now talk about a different example of a person who comes to you. So now let's just use a male instead of a female. Last one. And let's talk about a 40, 50 year old male. So they have a training background, but they are also realizing what you said earlier, which is, hey, I'm going to start losing muscle mass at a pretty good clip once I'm in my 50s and certainly by the time I'm 65, it really starts to nosedive. So the aha moment is I need to build up as much of a reservoir as possible. So there's a person who says, look, I've always been an athlete, I've always done X, Y and Z, but I've never really thought about muscle mass. I want to start thinking about it now. Maybe I've got a decade to pack as much on as possible before I'll go into that. Just maintain it as long as I can mode. Okay, so this is a person who, they're lifting weights three days a week, an hour at a time. They squat, they deadlift, let's say they do a whole body split every day for those three days. And let's say their DEXA scan is 20% fat. So they're probably 25th percentile actually for a 50 year old. And now they Come to you. And they say, lane, okay, I want to go all in. I want to know, can I be 10% body fat? So they're not trying to be a bodybuilder. They want to be 10% body fat in two years. And let's just assume that their BMI is 25 as well. No, let's say it's not. Let's actually. They say their BMI is 27. So they're technically a little bit overweight and they've got a little extra body fat. How are you going to change their training? How are you going to prescribe nutrition?

Yeah. So let me ask a question back. Have they been training consistently up to this point?

Yeah, they've been training relatively consistently. But when you look at it, you realize they're not really in a progressive overload mindset. They've become a little comfortable in their training. If you dig under, you'll notice that they haven't really increased the weight in anything they're doing in five years.

The first thing is looking at the resistance. Training is. Okay, just what you said. All right? You're doing three sets of ten on everything. And you slap a plate on and you slap two plates on, and you do the same thing you've been doing. Adaptation is never comfortable. So what you're trying to do to grow muscle, you're trying to induce adaptation. Muscular hypertrophy is an adaptation to a stressor placed on the body. In this case, the stressor is volume and mechanical load. So either you need to increase the weight, the repetitions, or the number of sets, and doing so is going to be uncomfortable. Your body is going to tell you it's uncomfortable. Even my own coach is coaching me for nationals this year for powerlifting. It's so funny. I was starting to kind of have this linear effect coming back from these injuries I've had. Then one week had a dip in performance, also was feeling really beat up, and he just responded. One line said, adaptation is never comfortable. It's so true. It really is. And we talked about this sort of thing. So just mentally gearing this person up for the idea that, hey, you've been comfortable. We're going to go start doing some things that are uncomfortable. And whether it's those particular exercises he's been doing, it sounds like he's been doing big compound movements, so probably going to keep him on that. I would like to get video feedback to see what his form is like, especially with injury considerations as we age and pain. So getting some feedback on those, making sure that he Is getting the requisite amount of load, progressive overload. And also at this age and with trying to push now, it's also about knowing when do we build in some tapers so that he can actualize those gains and recover as well as well. Because here's the thing about adaptation. At a certain point, if you've been training for long enough and you're old enough, the amount that you need to cause adaptation versus what is going to cause you to overreach is going to become closer and closer and closer. When you first get into training, you need almost nothing to adapt. You come in and do one set of leg extensions, you will get an adaptation from that. If you do it consistently for several weeks, been training five years, one set of leg extension is going to do absolutely nothing. It might maintain what you have. That's it. And so if you want to push adaptation, you have to push harder, which is going to create more of a recovery deficit. Recovery capacity is going to increase as you get older and have a greater training experience. It's not going to increase as much as the amount of stress that you're going to have to apply to adapt. So again, I think having built in tapers is really important and whether you do them responsively in terms of okay, this person has been getting week to week, we've seen he's adding five pounds. Oh, this week we had a dip in performance. Now maybe we reactively do a taper. That's possible. Or whether you build them in systematically to try and get ahead of that curve.

Either way can work in the latter lane. What is the typical duration of a build cycle, taper cycle?

It's probably going to get progressively closer together the more advanced you get. My situation's kind of unique. So I get my kids week on, week off. And we have noticed that the weeks I get my kids, I get less sleep, I have a little more stress, My performance goes down a little bit. I track bar velocity as well.

How do you do that? What equipment do you use for that?

I use a device called REP1, which is a accelerometer and it's available for purchase by private individuals. It's about $400. So it's nerd stuff if you're really dialed in. If I don't push the weight, I can try and look at the speed and see comparatively okay compared to last time. Did I move the same weight faster or slower? When we look at my performance in terms of strength, RPE speed, all those measures consistently show that on typically on weeks that the kids Are with me, I'm just not quite as good. I'm about 90 to 95% of the good. So we've actually built in micro cycles.

Of tapering, sort of a push week, a slightly back off week at one week at a time.

Yeah. Now, overall, through these micro cycles, we're trying to walk up the volume and the progressive overload. And then after probably four to eight weeks, we'll do a much bigger taper where we pull back on everything, but we do micro tapers in between.

So for this guy, for this guy.

Probably four to eight weeks.

Okay, so you'd say, look, I'm going to guesstimate that, split the difference for six weeks, I'm going to push you and then you're going to back off how much and for how long?

So I like to back off the volume and also the intensity a little bit. So whereas maybe we're up to a 7, 8, 9 RPE on most sets. And when I say RPE, we're talking about rate of perceived exertion. And an easy way to think about it is if it's a 7 RPE on a set, then that person could have done 3 more reps before they hit absolute failure. So most RPEs to me for advanced people should be close to 7 or 8, with a few sets pushing into a 9. And very rarely should you push to a 10. There's quite a bit of literature out there to show that you get basically the same hypertrophy training close to failure that you do going to absolute failure. Failure. It's not necessarily that failure is bad. It's just the amount of recovery deficit it creates, the amount of taxation it creates is disproportionate to the stimulus. So what we really want to do is maximize hypertrophy and stimulus while minimizing fatigue. Yes, sure, you can get a similar stimulus by going to failure and maybe even just a little bit more. But if it then causes you to have performance decrements the following week or not be able to push as hard overall, we have to think about this as an overall training program and not just isolated workouts. I'm very purposeful. When I tell people I go in to train, I don't go in to work out. Working out is just an isolated workout. And I've had so many people with big egos who say, well, I couldn't possibly not train to failure. First of all, I've watched them. They're not actually training to failure. I know what actual muscular failure feels like. On a squat, for example, a Free bar squat. I've seen this on Dr. Mike Israel's Instagram too, because he talks about training shy of failure a lot as well. And people will say something like, oh, you train like a wuss. This isn't that hard. What I want to say to them is I have done probably one of my most impressive squat sets is I did 480 pounds for 14 reps, and I've done 405 pounds for 21 reps before I couldn't move afterwards. First off, it probably took me five minutes just to get my breath back, just to breathe enough to, like, be a functional human. After that, then as far as, like, going to do another set first off, when I hit that 480 and I grinded out that leg last rep, that 14th rep, I was so fatigued I couldn't rack the right side of the barbell because for whatever reason, I'm a little bit lopsided. It sits just a hair lower there. I could not fully lock out my glutes and lower back and I couldn't rack it. And there was actually somebody had to run over from across the gym to help me rack it, even though normally it's no problem. And then I laid down for five minutes just trying to get my breath back. And then when I got up, if you told me I had to go squat 480 again, I'm telling you I couldn't have gotten a single rep even after resting 10, 15 minutes. There's not a chance in hell. So you're telling me if I stopped two reps shy of that, that that would have felt easy? You're insane.

Or that it would have failed to produce bingo benefit. Yeah.

And actually with compound movements specifically, you don't have to get as close to failure to get the benefits with compound movements.

By the way, I feel so much better hearing this. Today was a deadlift day. And this cycle I'm doing trap bar, which I actually don't like very much, but I did sort of my trap bars and then I was supposed to go to hip Thrusters after, and I was not feeling great. It just didn't feel like it was going. So I was like, you know what I really miss doing Sumo deadlifts. So I went and did Sumo deadlifts and they felt great. But on the very last set, I added a bunch more weight on, and at the sixth rep or eighth rep, I was like, I feel really good. But something tells me if I try to get to 10 today, I'm going to push just a Little too much. So I sort of bagged it at 8. And afterwards I was like, I'm really proud of myself. I didn't do something stupid. Because today's one of those days. Because, you know, to deadlift two different deadlifts on one day and it's at the end of the workout. Those are the moments when you make mistakes. And that was probably. Truthfully, I think I probably had four reps in me left. So that might have only been a 6 or a 7 RPE, but you still get benefit.

Absolutely. And the research shows that what was popular a few years ago was kind of the effective reps hypothesis. I don't know if you've heard of this.

No. What's that?

Basically, the idea is that the majority of the stimulus that you get for muscle growth is in the last five reps before failure.

Oh, yes.

So whether you're doing 20 reps means you need to get to at least 15 reps to really get a similar stimulus. And in terms of volume and progressive overload, you really need to think about volume in terms of just number of hard sets within a 5rpe. But the research shows that that's much more accurate for isolation stuff than it is for compound. So compound lifts are kind of their own beast. You can train at a sub 5 RPE and still get maximal EMG recruitment and quite a bit of hypertrophy. Whereas with isolation you pretty much have to take it close to failure. And then the other thing I would say is that exercises are not equivalent. That's a big thing. It's like, all right, let's do a 5rpe on a squat and then a 9rpe on a leg extension. I'll tell you, the 9rpe on leg extension, I can do that all day.

I was just about to say that is infinitely less painful.

Exactly. Versus a big compound movement that requires core and stabilization and breathing and creating intra abdominal pressure. All that kind of stuff factors into fatigue. So for this individual.

Yeah. So tell me about sets and reps here. So let's assume he's much more interested in hypertrophy than strength. He's not going to powerlift. What's the rep range you're going to keep him in for compound movements and for isolated movements?

Variety is the spice of life. The research shows that from one rep to 30 reps, you can build very similar amounts of muscle.

So this is amazing, right, because the conventional wisdom says, oh my God, if you're doing fewer than, I don't know what the number is that they would Say if you're doing fewer than six reps, there's no hypertrophy. It's all strength. That's what conventional thinking would say.

There are benefits to being in that hypertrophy rep range of 6 to 15 reps. That's kind of the traditional. Here's the benefits and downsides. One of the nice things about the 6 to 15 reps is you can accumulate quite a bit of metabolic fatigue. You can use relatively heavy loads. You can get quite a bit of volume in that rep range. If you're doing really heavy weights for low Reps, say under 5 reps, you are going to induce more.

You functionally would have to double your number of sets just to get the volume right.

Probably not, because it's more about the number of hard sets. But doing a hard set of five is not the same thing as doing a hard set of 10.

10, you have fewer of them in you, presumably, Right?

Probably. There's probably a greater fatigue effect. But some people, again, like me, if you told me I couldn't train under 5 reps, I'd be like, ah, I'm just gonna be bored. I don't like doing high reps. I get bored for me. And the same thing with clients. Again, adherence is number one. So if he says, oh, I'm not worried about creating strength, but I really like lifting heavy weights, okay, we're going to find a way to incorporate that. But it might be where, hey, we're touching one set that's under 5 reps, and the rest are going to be 6 to 10 on these compound exercises. And then on the isolation exercises, you know, we'll go 15, 20, just for some variety and whatnot. But really the research, at least in the short term, and when I say short term, I mean like 12 weeks. We don't see differences in hypertrophy between anywhere from low reps to up to 30 reps, as long as the number of hard sets are equated. So really, it says do what you like, do what you enjoy.

What is that sweet spot for hard sets? If we just pick 10 reps, so then we can do the math and go up or down.

So the sweet spot is what maximizes per body part is probably about six to 10 sets in a session. They don't really see improvements above 10 sets. Now, this gets a little bit complicated because if you rest longer, each set actually becomes more effective as a stimulus for hypertrophy, presumably because you perform better and you can use more weight and do more reps on that individual set. So the number based on the meta regressions out there, and I think James Krieger did a really good one. The number seems to be like if you're resting more than three minutes between sets, six sets. If you're resting like one to two minutes, it might be more like 10 sets. But again, the other thing to keep in mind is you don't have to just jump to 10 sets immediately per body part. That's a lot of sets you should probably use what is ever allowing you to adapt at the time. If you're somebody who is relatively new to training, you start doing 10 sets per body part. One, what's going to happen once you plateau? That's a lot more sets you're going to have to add on top of that. And two, you're probably going to outpace your recovery capabilities. When people tell me they're going to do, I know you talked about covering squatting and deadlifting every day. What I would say is you better be in very good physical condition to do that. And even then there is an expiry date on that.

And I've talked to people who have done this. To be clear, I've never done this. I look at the people who have tried it in awe. I'm not willing to give up so many other things I do exercise wise to just make sure I squat and deadlift every single day. But what I noticed that they're doing is they're being very clever. Every day is not a crushing set of that, right? I mean, some of those days it's a very, very low volume, low intensity that functions effectively as a recovery day where they're basically working on the muscle memory in the form. So for example, in the case of this guy, if he says, lane, I'm willing to train as much as you need to tell me to. So even though currently I'm doing three 60 minute workouts a week, if you tell me I need to be in there five days a week with two rest days and that should be two hours a day, I'm willing to do it. Where would you say again, let's assume that his form is decent, you're not concerned about overuse. Where would you want to put him.

If he's not looking to powerlift? If he says, I don't really care about exercise selection, just pick whatever. Probably not going to be doing a lot of free squatting and deadlifting, even though that's my personal love, because those do create a very high recovery debt. And not just that it's very mentally taxing when my Wife Holly moved over and she's a phenomenal athlete. Went to the junior World Games as a track athlete, won the natural Olympia two years after she started lifting weights. I mean, just incredibly genetically gifted and hard working person. But she would look at me doing like triples on squats and then resting 10 minutes between sets and say, why are you resting so long? That can't possibly be that difficult. Meanwhile she's over there doing sets of 10, she's slapping a plate on each side, doing sets of 10 and resting a couple minutes. And I said, well, you'd have to really do a powerlifting meet to understand. And then she did one and then she was like, yeah, the amount of intense mental focus it requires when you have that much weight on your back and you know this could literally kill you. Now obviously you have safeties and spotters and whatnot, but just strapping £600 across your back, I mean, there's a reason your adrenaline spikes. So after that she understood. But that's a lot of recovery debt to create for something that you could get a similar stimulus by doing a hack squat or a leg press or that sort of thing. As long as you're working through a full range of motion. That's the other thing very important to work a muscle at a long muscle length. In fact, there was actually a recent meta analysis that came out looking at partial range of motion, but partial range of motion at different muscle lengths and found that while partial range of motion at shortened muscle lengths does not produce the same hypertrophy as full range of motion, partial range of motion at lengthened muscle lengths produce similar hypertrophy as full range of motion.

So let me make sure I understand that, lane. So let's just use a bicep because it's easy at the lengthened part of the bicep. When you are straight armed, you're saying a partial rep from straight to say 90 degrees is more effective than if you just do the top of the bicep. And let's assume you do the same range, but because at the shorter range you're not seeing presumably as much adaptation or recruitment by the muscle.

Presumably, although the bicep might be a little bit different because you would actually have to be on like an incline bench to truly get the stretched range of motion, because otherwise in a traditional dumbbell curl, the top end is actually the more difficult component of the rep, whereas if you pre stretch it now, you can make that bottom part a little more difficult. Difficult. So, but if we think about something like a squat, like A partial range of motion squat. If you're doing a partial range of motion in the bottom half, that is not going to be easy. So I think it's more about working the muscle in the difficult regions. But the stretch component does seem to be important. So what I would say is I really am a big fan of like, something like a hack squat for leg development, if you don't care about being strong on free squats. Because if you get a good machine, you can take it through a really full range of motion. You can really get a good stimulus for the quadriceps and some of the rest of the leg muscles. And it's not crazy fatiguing. So something like that. A leg press. There's also, like really good pendulum squats. I really like a good pendulum squat, if anybody's ever tried that.

What's that?

So it's kind of like you sit in a seat, it's on an arm. So if there's a pivot here and the weight is loaded here, and you get in here, hopefully I'm displaying this. And then as you go down the weights here, basically, as you get lower.

Are your hands loading in front or are you loading?

Yeah, yeah, they're right here. As you're getting lower, it gets a little bit easier because of the pendulum. And then as you get higher, it gets harder, which actually works on your strength curve, because the hardest part of the squat is near the bottom and the. The easiest parts near the top. So I really like those two because those are exercises you can really work through a nice full range of motion and create a lot of stimulus. And like I said, I think full range of motion or training in that stretched position is very, very important. And so I usually like to have two main exercises. For a big muscle group like that, you probably don't need it. You probably could just do hack squats for five or six sets, that sort of thing. But people like variety. And I would keep Those between a 6 and an 8 RPE, most likely, and then go to a leg extension and leg curl and those sorts of things. Well, I'd probably do an rdl, some sort of rdl, because it's not as fatiguing as a deadlift, but you're still activating similar muscles, once again, keeping that between a 6 to 8 RPE.

Are you going to coach that with obviously one leg? Are you going to do IPSI or ISO grab on the kettlebell?

I would probably do a barbell, honestly, and do both legs. If we felt like there was some imbalance or Something like that. Or they just wanted some variety. You could do single leg. If muscular hypertrophy is the primary goal, you can create more stimulus using both legs at the same time. Then doing some isolation stuff. Low rest periods, higher reps, 10 to 20 repetitions, going to a little bit higher RPE, you know, like a 9, an 8 or 9 RPE, I think those are fine. And then if somebody said, you know, I just got to take a set to failure, it's part of my credo. I came from the 80s bodybuilding. I said, great, take the last out of the last exercise of an isolation to failure and go nuts, do something like that. And that might be how I build out a leg session. The bigger compound exercises, a little bit lower reps, maybe five to 10. Then as we progress through more isolation, going into the higher end of the rep range and maybe taking some a little bit closer to failure.

And is he going to do this two or three times a week?

So frequency, interestingly, I think that the meta analyses so far haven't been sensitive enough to pick it up. But what it says is that for legs it doesn't matter. One time a week is enough, but for upper body, two times a week, I think probably multiple times, times a week for both is beneficial.

Your pH3 program is about five days a week, right?

So it's five days a week, three days of squatting, two days of deadlifting, three days of bench pressing, and also accessory on those days as well. What I will say is, for the most part, frequency is more of a tool to distribute volume than it is an individual hypertrophy stimulus. But it does seem to me that it would make sense. And again, a lot of people, scientists have gotten in trouble saying, well, this just makes sense. But it would seem to me that if you have a muscle protein synthesis response, especially in trained individuals that's only 16, 20, 24 hours, that multiple doses of that are probably better than just doing one dose and thinking you got it all. So again, I think part of that's just we don't have enough studies yet and we don't have the sensitivity to detect that. And also the studies are so heterogeneous in, in terms of the population that's used, their training status, the type of exercises that are used, how RPE is measured, how intensity is measured, how volume is measured. It's really hard to get good meta analyses of these sorts of things. The amount of hypertrophy research that's come out in the last 5 to 10 years is literally an explosion compared to pre2010, I think I read one meta analysis on hypertrophy from resistance training in the entire time I was in graduate school.

Are there a couple that we should link to in the show notes here that are if someone's going to say, look, I'm willing to wade through two meta analyses on this. Are there a couple you'd recommend?

Some of that would be some of the stuff that's been done by James Krieger and some other folks that really kind of looks at all right, like set number and volume and those sorts of things. But for this guy, I mean, really putting out an actual program day to day is difficult just because it's A lot of it boils down to personal preference in terms of how I'm going to program it.

And presumably you'll get feedback. Right? So you might say this is what we'll start with, but we're going to modify it after this first cycle. Let's talk about his nutrition now. Let's pretend that you assess him so I forget what I said he weighs. Let's make up the weight. He's 175 pounds, he's 180 pounds. I don't know, whatever. And I think we said he's 20ish percent by DEXA, low 20s. And let's say he's eating 120 grams of protein a day. So right off the bat you're going to say, hey, you're a little light on protein. This guy is going to be willing to eat anything you say, where do you want him? Do you want this guy at 180 grams a day, 200 grams a day?

What was his body weight again?

Let's say 180.

If he likes protein, I would say you're not having any downsides to having 200 grams a day. And that's a nice number to shoot for. So I would probably start somewhere around there making sure his calories are adequate as well for facilitating recovery and enough carbohydrate and whatnot.

In this guy's case, because he really wants to gain lean mass. How do you think about cycling him in terms of making him hypercaloric? I mean, where are you trying to put his energy balance? How much weight do you want him gaining?

Since he's been training for a long time and he's older, the likelihood that he's going to be able to gain lean mass without at least some body fat is probably pretty low. I get this all the time from people. I want to gain muscle and lose fat at time the same Same time. Well, if you are subject A, the lady who'd never trained before. Absolutely. I mean, you heard me. I was like, yeah, we can recomp her, no problem. She's going to gain some muscle and lose some body fat. When you've been training for a long period of time, you have to have everything lined up just to gain ounces of lean body mass. Part of lining that up is also a slight caloric surplus. There is a new meta analysis that came out that showed that an energy deficit, it's not quite the same thing, but they did show an energy deficit impairs lean body mass accrual. It makes sense because we do see in an energy deficit decreased rates of basal protein synthesis. So it makes sense. I mean, if you are in an energy deficit from mechanistic perspective, it activates AMP kinase which hit with an inhibitor rimtor. It makes sense. And it also makes sense from a teleological perspective that if you don't have excess energy, this remodeling is extremely energy expensive. Why would we want to create more of it if we don't have the energy to support it?

So a protein sparing fast isn't necessarily going to save you from losing lean mass. It might be better than a carb fast. In other words, if you're going to eat a thousand calories a day, you're probably better off having them be as much protein as possible. But just because you have 200 grams of protein in your diet, if the calories are exceptionally low, you're probably losing lean mass. Is that how I'm hearing you?

A day of an energy deficit is not something I'd really be worried about.

No, no. But I'm saying, let's say somebody took this approach and said, look, for two weeks I'm going to go 1,000 calories a day, virtually all protein, in an effort to get as lean as possible without losing lean mass.

You might be able to not lose lean mass, but the likelihood you would gain lean mass is very, very low for somebody who's been training for a while. It's one of those things that the more advanced you get, the more things you have to have lined up correctly to continue to push. Especially if you're drug free and you can do it in sprints, you can do it in different sections. I went from I was in the 230 pound class back in 2019 and then I just started to drop back down to my original weight class of 200 pounds, 5 pounds. I did that over the course of about a year, but that was Taken in sprints, I would do fat loss sprints, for example. So I would do like two or three weeks of like a pretty aggressive deficit, like 750 to 1,000 calories a day.

And I'm sorry, this is for powerlifting.

Yeah, that was for powerlifting.

And what body fat is your performance at its best because you obviously don't want to be powerlifting. At 7% body fat, I'm still pretty good at 7. Really?

Still maintain pretty well? Yeah, I still maintain pretty well. Maybe not quite as good. I can still perform well at 7, but if I have a couple days where I'm not dialed in, I'll start to feel it. I'm right on that edge. I'm teetering on that edge at seven. On calipers, that is. So I did it over the course of the year and I did it in sprint. So I would do three weeks, lose like target, trying to lose five, six pounds. And then I would go to maintenance for like at least as long. And I kind of built that into my lifestyle. I really like that for a lot of clients, actually, a lot of our team biling coaches use a lot of what we call diet breaks where the people are eating at maintenance. So it's like, okay, vacation coming up, diet break for two weeks. Everything looks like it's going to be normal for three, four weeks. Boom. Let's do a fat loss sprint. So coming back to building muscle, I'll do sections of. Okay, I'm overfeeding in this slight caloric surplus for about eight weeks. Okay, we gained three pounds of body weight. I'm going to maintain for a little while just to make sure it doesn't get too out of hand in terms of body fat level. Now I've kind of got adjusted this. Now I'm going to do another six to eight weeks. But what I'll tell people is if fat loss should be slow, at least for people who are well trained, if fat loss should be slow to retain lean body mass, then weight gain should be snail's pace.

What's a rule of thumb for this guy then if he's going to gain five pounds of total body weight, of which we're going to hope, three is lean, two is fat. Is that a good goal?

Yeah.

How long would you want him to take to gain five pounds?

Probably at least 12 weeks.

Okay, so he's doing that once a.

Quarter, but it might be something more like where it's six months, but there's 12 weeks where we get him up £5 and then we say okay, let's trim a little bit of this fat back off that we put on. We lose three pounds, then we do another gaining cycle. What tends to happen is the composition gets a little better each time. Now, this is completely anecdotal, my coaching experience, but when you put on weight, and we see this in studies for trained people, it really depends, but it's somewhere around 50, 50 lean mass to fat mass, sometimes even 40, 60 if you're. If you're really well trained. So 40 lean 60 fat.

Wow. So the implication, by the way, is when you're gaining weight, you're getting fatter by body composition because you're presumably starting out at less than 50% body fat.

Well, it depends on the training status and a whole host of other factors.

So that's an important thing for you to tell this guy, which is, hey, if you're going to be rigorously following body comp, don't be disappointed if your body fat goes up in that cycle.

We're playing the long game here. It's like investing. You're taking money away from you now in this immediate moment that you could have. So hopefully you have more money later. The good thing is that when we lose body fat for resistance training, we tend to lose mostly from body fat. So if we're doing this cycle over time, hopefully each time it gets a little better. Now, there are limits to this. Eventually you butt up against your genetic limit. Of probably your genetic limit. What I always say is you never really know if you're at your genetic limit. What I always tell people is I show them this picture of me at 21 years old where I'd been resistance training hard for three and a half, four years, where most people say you hit your genetic limit somewhere around there. And I show that picture, and I show a picture of me now at age 40. And I mean, the difference in my leg musculature and my overall musculature is enormous. But if you had just gone year by year, you would have seen very little difference. And so what I'll tell people is you might think you're at your genetic limit, but you're probably not. It's probably more like an asymptote. You're familiar with an asymptote?

Yeah, yeah.

You never really hit like a hard cap limit, but the gains become so minimal that it's almost not measurable. Yeah. I think when it comes to this kind of person, one really focusing on, okay, making sure that they can do a lot of resistance training because it is going to take Quite a bit of a stimulus to get them there. Focusing on stimulus versus fatigue. So doing high stimulus, low fatigue movements so that they can accumulate enough volume without overreaching all the time. Because if they can train for 12 weeks without needing a taper versus six weeks, I mean, that's more stimulus. And then putting them in a very slight caloric surplus. And when I say slight caloric surplus, I'm talking about 100 to 200 calories a day over their maintenance. And now what does that look like? Well, that means that you're going to have weeks where you don't gain anything. Anybody. I don't know if you've ever done this, Peter, like try to do a super lean gaining phase. What tends to happen is people get really frustrated because the weight comes on so slow that they end up just throwing down a bunch of calories so that they can say they gained the weight and it doesn't go well. And what tends to happen is weight gain comes on in chunks. Just like weight loss tends to happen in chunks, weight gain tends to happen in chunks. You can be stable, stable, stable, even though you're in a calorie surplus and all of a sudden, boom, your weight's up two pounds randomly and it's sticks. And we don't have all the explanations for why it happens that way, but just know that that's normal for those listening. And again, don't look at, oh, I gained two pounds from the past three days. It's not going down, it's staying. Look at the fact that you've been doing this for four weeks now and you gained £2 on average. So you're right in line with what the goal was. So you want to look at that monthly month to month average in a gaining phase and say, okay, am I hitting my milestones in terms of the overall rate of progress? And try to not worry too much about those little things.

I don't know how we did this. Again, we're at this point where I've got through about a third of what I wanted to talk about. But nevertheless, there is one other thing I wanted to talk about, and it actually feeds really nicely into this case study of this, this man and this woman, which is that of kind of the most important supplements or the supplements we most hear about and what is their utility for the purpose of hypertrophy training. So let's start with the most common of these, which is protein. We talked about it already. You alluded to the fact that this woman might not be able to get enough protein in Actual food. So you might talk about shakes. So where does whey protein stack up in the hierarchy of proteins and should we be looking at other sources?

Top of the list. Whey protein, high in leucine, high in branched amino acids, high in essential amino acids, generally tastes good, generally well tolerated. I will say if it's a straight whey concentrate, a lot of people have difficulty tolerating a straight whey concentrate. But a blend of concentrate and isolate is what most proteins out there are and most people can tolerate them well.

What's the source of protein in whey? Where does it actually come from?

In wheat, from cow's milk, if you centrifuge off the fat. So if you centrifuge off the fat and then you take what's left over, you precipitate out the casein, the non soluble fraction of cow's milk, the soluble portion that's left over is whey. So it's called whey. And mostly consists of proteins called lactalbumins. It's just a very high quality, easy, digestible, very bioavailable source of protein. In terms of muscle protein synthesis, it's the tip tops. It always scores the highest. In our research, it was always the highest. It was no statistical difference from egg, but when we did it versus egg, it was always just like a little bit better. So my guess is if you had a high enough subject number, you could maybe pick out some statistical difference.

Is there a brand that you favor or are there brands that you think are the best brands to go for?

Incoming Shameless plug. So I actually have my own supplement line called Outwork Nutrition. Outwork. Outwork. Okay, we have a whey protein isolate. The reason we didn't isolate, a little bit more expensive than like a concentrate isolate blend. But there are people with lactose intolerance, there are people with a sensitivity to the lactalbumens and so an isolate is generally well tolerated. Some people with really high sensitivity to the lactalbumins can't tolerate nisolate. And, and if that's the case, they could probably do a hydrolysate which is a little more expensive and doesn't taste as good, but still a good option for those that have really sensitive gis. Like I said, an isolate is generally tolerated well by people and ours is called outward nutrition build. So it's just low carbohydrate, low lactose, low fat, high protein, high leucine. So I think our leucine content's over 11. I think it's actually 12%, which is very high. And then the carbohydrate content, depending on vanilla or chocolate, is like 1 to 4 grams. And then the fat content is less than a gram of fat. In fact, the vanilla is zero.

Are there any other brands that you would say, hey, I trust that brand? One of the things that I think as we talk about supplements, you always.

Get, there's a bunch of good ones.

Yeah. What would be three other brands that you would put in your body Legion.

They make good stuff. And I think, you know, some of the big companies, Optimum has been doing protein for years and most companies are sourcing the same stuff. To me, a good company is somebody that markets responsibly. But then another one, eas has been making stuff for years and they make stuff that's very, very third party tested, all that kind of stuff. There's a bunch of good companies out there. What I would say is make sure nobody's using a proprietary blend. Proprietary blends are usually just a way for people to hide stuff. Two, make sure that nobody is doing what's called nitrogen spiking. So what you can do to pump up the protein and nitrogen content of some of these proteins is add individual amino acids that have nitrogen that are actually lower cost than just the protein itself. They actually put creatine in some of these. Not that creatine isn't good. Creatine does work, but you're not taking away protein necessarily to get creatine. You take creatine to get creatine. And they do that because it's actually cheaper. It pumps up the protein content.

And how would you know that when looking at the label?

Oh, it's on the label. For example, like I think they spike with glycine too. So like if you look on the label, it might say whey protein sweeteners, preservatives. Oh, glycine. Well, that's nitrogen spiking. So I would make sure that companies aren't doing that. And to me personally, I mean, even if company makes a good product, if they make insane claims, I mean, I would love to say that our protein is the most anabolic protein on the market, but the fact of the matter is it's a high quality whey protein isolate at a competitive price point that tastes really good and you could get another whey protein isolate that would build just as much muscle. So I'm not going to claim that. The ethical side of me says just look for something that's promoted responsibly. Yeah, those other companies are just fine and I would recommend them so let's.

Look at a subset of that. Is there utility in using branched chain amino acids specifically in workouts where these are typically coming as far lower doses? Right. There's only three branched chain amino acids and they're typically giving you five grams per serving. Any utility in the in workout bcaa.

So this was something that I've changed my mind on and I will tell people like my PhD specifically is on leucine. I mean it's right back there, it says leucine right on the COVID you know, is one of the words. And I used to say, hey, I think supplemental branch chains are useful. I can't support that anymore. If you're getting enough total protein in it doesn't seem to be a benefit to supplemental branched chain amino acids. The only thing I would say that there might be something is they may reduce muscle soreness, but it's never been compared straight up with like a comparable amount of whey protein. So it's possible that that's just a protein effect. The only case I could really make, besides maybe soreness, is also for people who just cannot get high quality protein in. So for example, if you're a vegan and you say I don't want to take whey protein and I can't take XYZ and my stomach doesn't tolerate these proteins and I want to pump up the quality of my meal, then supplemental branch chains could make an impact. And we actually did a study in our lab where we looked at whey protein versus wheat protein. We saw that whey protein obviously had a much bigger response in muscle protein synthesis compared to wheat.

That's obviously gram per gram, right?

Gram per gram. Yeah, we isonitrogenous but when we added leucine to match the leucine content of the whey, we actually got the exact same response. So if you are somebody who's plant based and you're concerned that you're not getting enough high quality protein, you could actually add supplemental branched amino acids to your meals or your protein and you would pump up the protein quality doing that. But obviously the best outcome is just getting it through diet or shakes. And then if you have to add supplement of branch change, you can any.

Role for supplementing leucine specifically. So if someone says, lane, I'm buying your brand, I'm consuming it, I'm just going to add 5 grams of leucine every time. And by the way, leucine tastes horrible.

Horrible.

It's literally one of the worst tasting things on the planet.

No, I just don't think there's a benefit to it. I wish there was. I did my PhD thinking I'm going to find the secret anabolic trigger and just get enough protein.

You mentioned it already. Creatine monohydrate, very popular. Back in the day when I was a kid, it was 30 grams a day loading and then a maintenance phase. I think these days people are kind of just doing 5 grams a day every day.

What you're looking to do is saturate your phosphocreatine stores in your muscle cell and you can do that through loading or you can do it through maintenance phase. If you do it through loading, it'll saturate in five to seven days. If you do it through maintenance, it'll take about three to four weeks. Downside to loading, more GI discomfort, more bloating, more just overall discomfort. But you get saturated faster. Downside to maintenance, just takes a little bit longer to get the benefits, that's all.

What are the main benefits of creatine? Are they on the strength side, the hypertrophy side, the recovery side?

All above. It increases lean body mass, increases strength, exercise performance, and we're actually there's possibility that there's cognitive benefits as well. Interestingly we're finding out. But I would tell people, do not get caught up in the hype of these other forms of creatine. Creatine monohydrate has been shown to saturate the muscle cell 100%. You cannot get more than 100%. And the other forms of creatine are simply in existence to remove more money from your wallet. I use the comparison of big screen TVs. My first big screen TV I bought it was 42 inches big screen LCD screen. I bought it in 2008 and it was $1,000. What would that go for? Now? You could probably get it for 200 bucks.

100 bucks? Yeah.

Yeah. Here's a stick of gum. Can I have that 42 inch screen TV? Sure. Why? Because everyone makes them and there's such a competitive market that the margins are this big. So what does everybody have? Everybody has creatine in their supplement line. The margins are so thick, thin. Nobody makes money on straight creatine. They have to come up with other forms of it to justify charging you more. And you hear things like, well, our creatine doesn't bloat you or our creatine doesn't cause water retention. Well, I would tell you that the water retention hydrated cell is an anabolic cell. The water retention from creatine is inside the muscle cell, which is a good thing. And there's research studies to show this that it does not increase extracellular water, that it's actually intracellular water. So are you saying that your creatine is not anabolic then? And then you have things like buffered creatine. You don't need to buffer creatine. Creatine is stable in stomach acid. And then there's creatine ethyl ester which has actually been shown.

So there's just a ton of marketing nonsense.

Yeah. Creatine trimalate.

Do you make a creatine supplement?

We have a supplement called recovery and creatine is one of the ingredients there. So there's five grams of creatine monohydrate.

Is that a daily thing? Someone should have even on their non lifting days.

Probably don't need to take it on your off days from lifting.

If you're doing cardio on a non lifting day. Do you benefit at all from creatine there?

There's no real studies to know. What I would say is it's very cheap. You're not really missing out on anything by having an extra dose. So I would say take it daily. If your budget is really rail thin, then take it on the days you train.

Any other brands that you respect and just trust that they're not doing any nonsense. There's basically the same look for the no claims in the trusted brands, no.

Crazy claims, no pushing other forms of creatine is better. No proprietary blends. One of the best ways to know the great thing is there are a lot of good companies out there that are marketing more responsibly now.

Okay, last one. Nitric oxide or these nitric oxide boosters. I remember this was one of the things that got so much attention. I want to say like 10, 15 years ago. Truthfully, I don't know how much attention it's got now. But I did see a paper about it recently which is what made me think about it again.

Nitrates and nitrites do appear to enhance exercise performance. Beetroot juice and those sorts of things and sources of nitrites. So there was a recent meta analysis looking at this and the effect size was actually pretty impressive for power.

It was like 5% or something. It was huge, wasn't it?

Yeah, yeah, yeah, yeah. Really impressive. 5%, which I mean that's the difference between first and last. If you're talking about the Olympics. The. The effect size was a 0.42, which isn't considered a large effect size, but it's approaching a modest effect size, which for supplements is really impressive. I mean that's on the order. I don't know offhand creatine effect size in the meta analysis, but it's got to be close to that. What I will say is a lot of supplements appear to not have in them what they say they have in them in terms of these nitrates. The other thing I will say is like something like citrulline malate, it can be recycled into arginine and then into nitric oxide. So citrulline malate or citrulline specifically actually increases blood nitrate levels more than arginine itself. So it actually increases nitric oxide more than arginine. And arginine is the direct substrate. That's because citrulline is actually much more bioavailable, whereas arginine is mostly extracted by the splanchnic tissues, the gut and liver. So you're actually better off taking citrulline, which is in our pre workout of course. So there's another shameless plug. But really if you're looking at citrulline specifically, 6 to 8 grams at a.

Dose and this is more to increase performance than hypertrophy, is this going to.

Yeah.

Presumably if your performance goes up, you have more stimulus, you might see the gains there.

There is some evidence that citrulline can actually stimulate mtor, but I'm not sure it's enough to actually create create hypertrophy on its own.

So were you consuming something besides water or electrolytes in the workout? You've obviously got a pre workout. So the citrulline would be before obviously the whey would probably be after. Where's the creatine falling post or pre?

The timing doesn't seem to be real important. There does seem to be a little bit better response to after. Not sure why because it really to me with the mechanism it shouldn't be matter because it's a long term thing. But that's actually why we included the creatine in our recovery product and not the pre workout for a couple of reasons. One, it's not an immediate effect from creatine, so you might as well take it post. Might be a little bit better effect post. So there you go. And then in the pre workout specifically there's a couple of things in there that are already semi gut irritants for some people and creatine can be a gut irritant for people and we didn't want to compound those two too much. So that's why we Kind of separated it from our pre workout. But there's a lot of pre workouts that do have creatine in it and especially when you pair it with a large dose of caffeine, it can just really give people a lot of GI discomfort if you're not careful.

So then in workout, are you drinking something?

I usually just people are going to laugh, but I'll like a Gatorade zero or something like that. You know, in water. I've looked at the intra workout stuff. If you're working out for 2, 3 hours at a time, maybe it's useful to get some glucose and carbohydrate in to maintain performance. But I think bodybuilders or weightlifters tend to overestimate, like how difficult their workouts actually are. You only need to worry about glycogen resynthesis, the speed of which if you're somebody doing multiple events per day. If you're a bodybuilder, you're going to be 24 hours to your training in any way. You're going to resynthesize that glycogen as long as you didn't get enough total carbohydrates. So I'm not real huge on intra workout nutrition. As long as we're not talking about really long workouts or we're not talking about multiple sessions per day.

Well, Lane, I've taken us way past our time, but as always super enjoyable. Can't wait to do it again. There's a lot of stuff to follow up on here, so the show notes we'll have a ton of the detail we've talked about and offline you and I can connect and make sure we've got the links to some of the things we spoke about. So thanks again man. Appreciate it. And congrats on being by the water.

Thanks Peter. I appreciate it man. Really enjoyed it.

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