Is Muscle the Key to Longevity? With Dr. Gabrielle Lyon

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A couple of years ago I had the good fortune of meeting an amazing doctor who was focused on bringing something new out to the world called Muscle Centric medicine. And it really is all around this idea that muscle is the organ of longevity. And I am so thrilled now that she's put this into such a super scientific and actionable book too called Forever Strong. I am talking about Dr. Gabrielle Lyon. I have her with me today. She is a board certified family medicine doc. She completed research and a clinical fellowship in Geriatrics and Nutritional sciences at WashU St. Louis. She did her undergrad training in Nutritional sciences at the University of Illinois. And that's where she met Dr. Donald Layman, who's also mentored her for the last two decades who was key in discovering the trigger for muscle protein synthesis. So this is a very exciting interview where we talk about again, muscles as the organ of longevity, why that is and then what you need to do to protect muscle as you age so that you can play full out at 100. So that is what we're going to be unpacking. You will want to have a notepad as you go through this one. I've also got great notes. I've got some really cool freebies from Dr. Lyons, so you can grab all of that@jjbirgin.com Lyon and we will be talking about protein, animal versus vegetarian protein, the quality of protein, how much you need and when you need it. We'll be talking about resistance training, the different types, what you should be doing and why muscle is so key important. So stay with me. I'll be right back with Dr. Gabrielle.

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Dr. Gabrielle Lyon, I am so excited to be talking about muscles with you.

What's up, my friend?

First of all, I'm so thrilled about you having your book Forever Strong coming out. I am just like, this is going to send a ripple that is going to make a movement and your whole muscle centric medicine, all of that. It is so mission critical. So thank you for doing the work. And that's what I want to dive into today is I'd love to just even start with muscle centric medicine. What the heck is this?

It's really interesting. Muscle centric medicine is this concept that muscle is the organ of longevity.

And that's really your line.

Oh, yes.

Have you trademarked?

I have trademarked it, yes. I had a very good mentor since starting out in my career. So this concept of muscle centric medicine is this idea that muscle, skeletal muscle specifically, is the organ of longevity. And often when we think about skeletal muscle, we think about looking good naked, looking good in a bikini, which, jj, you do. But it's so much more than that. It truly is the center of the universe as it relates to blood sugar regulation, as it relates to aging. Well, as it relates to triglyceride levels, cardiovascular disease, you name the diseases of Western society. And skeletal muscle is really at the center point of it.

I've just got to throw you massive props because the reality is that this, for most people hearing it is new information that when people think of muscle, they think, oh, it. You know, it protects your bones. Oh, it allows you to do a lot of stuff. They don't think of muscle for all the other things. And I'd love you to really unpack the endocrine organ part of all of this. It's just starting to come to light. Yeah.

It's so fascinating, this idea that skeletal muscle, which makes up 40% of the body, is an endocrine organ. What's an endocrine organ? An organ that secretes hormones that travel throughout the body. It acts systemically, it acts locally. And you're thinking to yourself, well, skeletal muscle, what does that have to do with being an endocrine organ? Skeletal muscle is the largest endocrine organ in the body, which means that when you contract skeletal muscle through resistance training, through cardiovascular activity, that contraction of skeletal muscle secretes hormones or peptides called myokines. You're thinking, what's a myokine? Myokine is that secretable peptide from contracting skeletal muscle, and this travels and interacts with the brain and the bone and the liver, identifying skeletal muscle as an endocrine organ, which is so fascinating. And again, that's just one aspect of what makes skeletal muscle an organ system. Are you ready for some more?

Let's go.

Jj, you've spoken about this kind of way in terms of body composition. Skeletal muscle truly is your metabolic disposal unit. It is the site for carbohydrate disposal, meaning the carbohydrates that you eat goes largely to skeletal muscle. Fatty acid oxidation. People really care about cholesterol. They care about fatty acids in their bloodstream, they care about triglycerides in their bloodstream. All of this in some form or another, is leveraged by skeletal muscle. Skeletal muscle uses fatty acid as a energy form. Some other underappreciated roles of skeletal muscle. Skeletal muscle is your body armor. If you get sick, God forbid, if you get sick, cancer, have any kind of very extreme or even non extreme illness, your body will pull from the amino acids of skeletal muscle. In fact, data shows it increases survivability in nearly all cause mortality. Your ability to survive, nearly everything is based on the quality of the health of your skeletal muscle.

You know, one of the things I remember when my son Grant got hit at 16, and he was a big like football playerish guy, right? And he went from £200 to down to 150. But like two things really mattered to help him get through that. One, that he was on fish oil before he got hit, that protected his brain, but that he came in with a lot of muscle mass. And by the way, as soon as he got rid of his feeding tube, which he did himself, he's a stubborn kid. I started him on cranking as much protein as possible and also using a very specialized amino acid blend because I knew that he was getting very catabolic. And you know, he was 16. He can recover from those things. But talking about muscle as the organ of longevity, what happens as we start to become, you know, 35, 40, 50, 60, and we're sedentary or we do have a hospitalization, a fall, et cetera. In terms of muscle mass, muscle is.

So fascinating in that we talk about it as an endocrine organ. The other components we talked about are the metabolic components. The one aspect that I didn't mention is that skeletal muscle is a nutrient sensing organ. And you're thinking, well, what does that mean? Skeletal muscle has the capacity to sense the quality of the diet. And it does this through sensing the amino acids, in particular the essential amino acids. Why is that important? Because in order to maintain skeletal muscle, you need really two things. You need the influence of resistance or the influence of exercise, but you also need the influence of foods, in particular dietary protein. And you had mentioned, well, what happens as we age. What happens as we age is the sensing ability, the efficiency, the capacity for skeletal muscle to utilize protein decreases. But the good news is, if you get your protein Dosing right, you can get your older tissue, your more mature tissue to respond like younger tissue. And you do this by simply increasing dietary protein, both the quantity and the quality. So again, skeletal muscle functions as a nutrient sensing organ. And as we age, this phenomenon of anabolic resistance happens. And again, that's this concept of decreasing protein efficiency which can be overcome through the action of, number one, improving dietary protein and number two, resistance training.

So there's so many things to talk about here. The first one you just talked about anabolic resistance. As we age, I think it's a very important message to get out. It's like, when are the guidelines going to shift and show something related to age? It's so clear that there is a difference. You know, in the teens and twenties and being more hormone driven to build muscle, and all of a sudden this shift, and yet we don't change the protein requirements that are so clearly wrong. It's crazy. But also the big shout out to you, your amazing mentor, Dr. Donald Lehman, and all the work that you did to discover this leucine trigger. So I'd love for people to understand this idea of how muscle protein synthesis happens, how we do muscle protein breakdown, muscle protein synthesis, and how mission critical that first meal is. And it's why I don't think we should wait till noon to eat. I'd love you to really talk about that leucine trigger and how we make sure that we get up in the morning and we are not catabolic and not breaking down.

Let's talk a little bit about this muscle protein synthesis first. The concept of muscle protein synthesis is really a biomarker of metabolic health. It is the physiological or metabolic process of incorporating amino acids. There are 20 different amino acids and there are certain essential amino acids that are necessary for stimulating this process, this metabolic process called muscle protein synthesis. Muscle protein synthesis is again, a biomarker of muscle health, which allows for the incorporation of amino acids for muscle health, which is very interesting. Now, I want to highlight something because I think that there's a lot of confusion in this space about what muscle protein synthesis is the actual accretion or the building of skeletal muscle. It is not a one to one ratio. So you don't eat dietary protein and put on muscle mass, but what happens is you eat dietary protein, you trigger the process of muscle protein synthesis that impacts contractile proteins. And the other one is mitochondrial protein, which is typically influenced by aerobic exercise. Now, the thing about muscle protein synthesis is when you don't stimulate it, then over time it becomes More difficult to really maintain the health of skeletal muscle. Which gets into kind of what you were speaking about is this fasting. But before we go into that, I wanna just go down another layer of muscle protein synthesis and what it does. So we've talked about how muscle protein synthesis is this ability to trigger skeletal muscle to create a metabolic process. This incorporation of amino acids is leveraged through a complex called mtor. Again, we're not going to go too deep into the weeds, but it stands for mechanistic target of rapamycin, which is kind of the hot topic in the longevity space. The discovery of MTOR signaling actually quite frankly isn't that old. We're talking about potentially in the 90s and at that time it, you know, as all discoveries, they look at fruit flies and C. Elegans and then we start to move it to humans. And Dr. Donald Layman was the first person to discover this meal threshold. What does that mean? The way in which we eat protein now that we all take for granted. He discovered in his lab as it relates to triggering muscle protein synthesis based on a protein meal, which is incredible. And that is kind of the backstory of muscle protein synthesis as it relates to dietary protein feeding, especially for women perimenopause or nearing menopause. Very critical for maintaining body composition.

Yeah, because if you wake up in the morning, you are in muscle protein breakdown, correct?

That's correct.

And now you're gonna have like your skinny latte. Like let's just walk through like someone says, okay, well I'm just gonna have a skinny latte or maybe I'm fasting. So I'll just have, I'll have black coffee and I'll wait a while or I'm gonna go have a healthy morning muffin. And what happens when they do that and they don't get that optimal protein dose?

It's really a missed opportunity because when you are in an overnight fast, the body still has to main blood sugar regulation. The primary way it does this is obviously it depletes liver glycogen. This is how it typically maintains blood sugar regulation. But over time, just as you mentioned, there is this protein. It's actually a protein turnover and it's this catabolic process that's happening. Skeletal muscle is incredibly dynamic and what happens is muscle breaks down and in fact we're almost always in this state of ebb and flow of muscle protein synthesis, which by the way is much easier to measure. In studies. It's very difficult to measure rates of protein breakdown. That being said, that is One reason why muscle protein synthesis is always at the forefront. When you wake up and you've been fasting for 12, 14 hours and then you continue to fast, you are doing your metabolism a disservice because that is the opportunity coming out of an overnight fast to have a protein bolus, a protein dose. And in fact, all the studies are based on that first meal. Muscle protein synthesis in the literature is based on that first meal. And that first meal is the most important as it relates to amping up muscle protein synthesis, essentially turning on the machinery. This is the way that you protect yourself over time from sarcopenia, which is the destruction of muscle mass strength that we see in older individuals.

As I hear this, it must have been so exciting. Were you in the lab at the time when he discovered this?

It was very exciting. So when he discovered this, this was with Tracy Anthony. So it was the group before me, and they were doing studies in rodent models, but after rodent models, they moved to humans. And so, yes, I was involved in. Listen, is it cool to collect urine and deliver food and measure all the things? And also your name never gets on the paper, which Don And I, again, 20 years later, we go back and forth, but undergraduates are never allowed the literature, which is, you know, it's kind.

Of like it is what it is. But how did they know? Because they were doing whatever they were doing for feeding. How was he able to determine it was actually the leucine and how much leucine was required to be that trigger to turn on muscle protein synthesis?

I think that that is a great question and we'd have to ask Don on that. And the way that he thinks is very forward thinking and very integrated. And I don't remember all the details, but I do know at the time people were not thinking about muscle protein synthesis or leucine being a trigger. Quite frankly, I can't tell you how he determined the amount, but one of the things that he did see was that the minimum amount of leucine was around 1.8 grams. So you will see some triggering effect. And, you know, the listener's probably thinking, well, well, what is that? And a 1.8 gram leucine trigger would be something similar to 15 grams of protein and then a more optimal triggering. And again, this is triggering a metabolic process that is believed over time to help with muscle accretion and really accruing more skeletal muscle and also maintaining the health of the skeletal muscle you have. So I think it's important to highlight the fact that while we're targeting muscle protein synthesis, the outcome that we're looking for is very applicable. So while this sounds like a lot of biochemistry, the applicable outcome is protecting skeletal muscle health at all costs. And the applicable outcome is how are we going to protect it? And it's super easy, quite frankly, which is amazing. Dietary protein dosed appropriately and resistance training as we age, done appropriately, so that ultimately we can all look as jacked as JJ.

Ah, who just turned 60. So here's what's interesting though, in looking at all of this, because unless again, we go into a cadaver, how do we really know the quality of the muscle, how much muscle? I mean, I've been using DEXA because I think it's the closest thing we have. And then having people correlate at home by using a bioimpedance scale, so at least they have some semblance. Like I am on a mission to get people to get rid of the scale because it's just doesn't give you the information that you need whatsoever. But how are you having people look to determine their skeletal muscle mass? How do you determine the quality of that? Like, is it a ribeye or a filet? How are we doing this?

You bring up a really good point. I believe that skeletal muscle should be the next vital sign, which it is not. The traditional way that a muscle mass has been determined is through dexa. That's an extrapolation. After they've looked at body fat percentage, they extrapolate or estimate the rest of lean body mass, which, by the way, lean body mass is everything else. It's bone, it's blood, it's everything other than fat mass. Now, from my perspective, how do we know the quality of the health of the skeletal muscle right now, unless you are getting a CT or MRI or even potentially an ultrasound, but an ultrasound is not quite as sensitive. You will not know from a practical perspective looking at the health of your skeletal muscle. You won't, I believe eventually we will get there. It is not the standard of care yet. So then the next question becomes, if we can't visually see the health of our skeletal muscle, what are other markers that we could potentially leverage to begin to paint the picture of skeletal muscle health? Well, I'm so glad you asked. The ways in which we can think about skeletal muscle health are really twofold. When we think about skeletal muscle as the organ of longevity, we think about skeletal muscle from a metabolic profile. We think about blood sugar regulation, meaning your fasting blood glucose. How stable is it? How high or how low is it from a Metabolic perspective, we think about where are our triglycerides? Where is that number? We also think about skeletal muscle health from a perspective and zone of fasting insulin. For me personally, in my clinic, I like to see it less than 5. And really when you take all of these things into account. So just to summarize it for everybody, the way in which we metabolically think about skeletal muscle health, this is fasting blood sugar, fasting insulin, triglyceride levels, and I think that's it. The top three.

This is huge because most people would never think, oh, you know what, I should look at those things to see the quality of my muscle, not realizing that one of the fastest ways to start to fix insulin resistance is to do resistance training.

That's right. And so that is the metabolic side. And you know, in my book I talk about the other biomarkers, whether it's apob, just, you know, other biomarkers, but really for simplicity's sake, that's really the top three that I'm thinking about.

Yeah. And in her book, it's Forever Strong. You must buy this book. This is a must have book. I was so fortunate to be able to read it early. And this is like one I'm going to push out everywhere. It's like required reading and then required doing.

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The next aspect of skeletal muscle health we have to think about is how strong are you? And someone could say, haven't ever trained? I don't know. But this is a responsibility to know exactly how strong you are. And again, this could be when we say strength metrics, it could be pushups. And I outline exactly what I want. But you should know how many pushups you can do. You should know how many sit ups, you should know how many squats, you should know how fast you could run a mile or an equivalent. And also thinking about strength, where is your baseline strength? Wherever it is, it can always get better. And this is collectively what we think about as it relates to skeletal muscle health. Another component of skeletal muscle health, which often isn't really discussed, is this idea of energy. Skeletal muscle as the organ of longevity, making up 40% of your body Mass is the site for the majority of your mitochondria. If you, your skeletal muscle looks like a marbled steak, you're going, doc, gee, how do I know if my skeletal muscle looks like a marbled steak? Your skeletal muscle looks like a marbled steak if you are sedentary. There's no such thing as being healthy sedentary, even if you're skinny. If you have abnormal blood markers of any of those things that I had described and or if you have not been training and are weak, then chances are your skeletal muscle looks like a marbled steak. But the good news is it is always fixable. This is something that absolutely can be transformed.

So let's talk about how to fix it because that's obviously the key thing here. And so someone listening who's like, okay, I've been walking, I've been doing some pilates, I follow a, you know, vegetarian diet. I eat some fish here and there's. But I'm willing to do whatever it takes to change things because I recognize that at 50, my risk of all cause mortality is going sky high here because I don't have the grip strength, I don't have the gait speed, I don't have what I used to have. And I want to make sure that I can play full out at a hundred. Where would you start then?

The first place that I would start would be through nutrition. And here's why. Nutrition is something that everybody does. 100% of people eat. This is a non negotiable. It is also jj, the longest relationship anybody will ever have. It will outlast a relationship with your kids. It's longer than the relationship with your spouse, longer than the relationship with your parent. Eating is something that 100% of us has to do, so we need to get that right. Whereas is exercise a more potent stimulus to muscle health? It actually is. But only 24% of Americans are meeting.

Exercise requirements and the exercise requirements are lame. Just FYI everybody.

But by the way, 24% of people are meeting that. Yeah, the lame ones of Americans don't even work out. So what are we going to do to optimize muscle health? Well, we're going to optimize body composition. And you had mentioned something early on this podcast and it was that the protein requirements have not changed. The initial protein requirements were set out in 1943 and it was basically protein as a percentage of total energy intake and it was between 10 and 12%, which that in and of itself is abysmal. Then finally in 1968, they decided that the Dietary Recommended Allowance as the minimum to prevent deficiencies, was going to be instated at 0.8 grams per kilogram, which for people who don't want to do math, which by the way, I don't hate anybody, but for not wanting to do math, equals 0.37 grams per pound body weight. That means if you are 115 pounds and you multiply that by 0.37, your recommended minimum amount of protein is around 45 grams a day. That's disgusting.

Yeah, it's like literally that's what I eat for breakfast.

So this is really important to understand that the current dietary recommendations are really based on how do we prevent deficiencies.

Wasn't it based on like poor science, based on nitrogen balance too?

It was based on nitrogen balance studies. It was based on, so proteins, typically proteins, and then there's non protein nitrogen, but protein has nitrogen. This is one way in which they look at turnover of tissues. And these requirements were really based on 18 year old men. And the whole point was, how could we optimize our soldiers? I don't want to go down this rabbit hole, but I did put a lot of history in this book because history is starting to repeat itself. There was a time where dietary protein was like the thing, and this was during World War II when they said, listen, we have got to feed our soldiers the best quality foods. Don't eat meats or butter and all these animal products, we need to ship them to our soldiers and we should stay and build victory gardens to allow for all the high quality, nutrient dense foods to go to our soldiers, which we are seeing a reiteration of now. Self imposed rationing, which is fascinating.

Wow.

Self imposed rationing. But anyway, back to your question. If you are going to design a diet and we know that the minimum is 0.37 grams per pound, what is a more optimal number? The evidence suggests and is very clear and compelling that you are looking at double the RDA. So anywhere between 0.7 to 1 gram per pound body weight is closer where you should be. And people at home are thinking, oh my gosh, that is like so much protein. Protein is a very unique macronutrient. It is essential. It is the primarily the only essential macronutrient. We do have an essential need for fatty acids, but that need is very low diet.

And you'll get it with your protein.

Yes, right.

As long as you're eating real protein and not weird stuff.

So if you are deciding to design a diet that is going to bulletproof you and make you in the best shape of your life as you age, then the major consideration is dietary protein for the fundamental need of protecting muscle health. And the way in which you are going to do that is, number one, think about the hierarchy of dietary protein and that is your total protein per day is most important. And I recommend again, 0.7 to 1 gram per pound, ideal body weight. If someone says, I don't know what my ideal body weight, I would say the last time you felt amazing. Pick that weight. You're gonna pick that weight and you're gonna design a program around that. The next question is, how do we design? What are the strategies and what are the protocols that we are going to put into place to put together a nutrition plan that is going to really optimize body composition. We care about muscle and we have to focus on what we have to gain instead of what we have to lose. And the reason it's interesting, I feel, and I've talked to Don about this ad nauseam, is the initial research came out with this even distribution of dietary protein, which would be 30 grams three times a day. Doug Patton Jones and Dr. Don Layman and a handful of others put a lot of science behind this. But the reality is it's that first meal that is really shown to make an impact, but the even distribution is not evidence based in the way that people think it is. So it's that first meal that matters. And that first meal should be a minimum of 30 grams higher, upwards of 50 grams of dietary protein. That second meal no one really cares about. And there's actually no evidence to support what that meal should be. You know, and I'll just tell you this, jj, is that the machinery that has been turned on from that first meal, we don't actually know how long that stays upregulated. It might be four hours, it might be five hours, but nobody really knows. So again, that second meal, you know, with machinery that mtor machinery, that muscle protein synthesis that we were already talking about, does that second meal really matter? But by the third meal, we can make an assumption that this meal is very mission critical, as you say, because you are going to be going into an overnight fast and that becomes very important to then protect muscle mass. So to bring this all around, total protein goals of between 0.7 to 1 gram per pound, ideal body weight, making sure that that first and that last meal are optimized for dietary protein. I say optimized for dietary protein. I am not including in here plant based proteins. If you choose to have a plant based Protein, you will likely need more total protein. That could be upwards of 35% more. It depends on the source. If you are eating whole foods. But the guidelines that, RDA guidelines that does not include plant based type proteins. So that is just something that I.

Think that's so big. Hold on, like you just dropped a big bomb. I did not know that. That the RDA did not include plant based protein when here they are pushing plant based protein. Yeah, I know, Wowie wow.

The problem, right? Because you know a little bit of one, yes, you know, 40% of women over the age of 65 are not meeting the minimum requirements for protein. People keep talking about how we're eating too much protein, but actually the NHANES data doesn't support that. So NHANES data for the people listening is just the largest data set. It's the collective population. The reality is, you know, women might be getting around, I don't know, 50 grams of protein a day, maybe a little bit more, whereas men might be getting 90 grams of protein a day. This is not overeating. This is barely meeting the minimum requirements.

Are not really the right requirements for someone especially 60 plus when you really start to accelerate muscle loss. So those minimum requirements are the minimum requirements that were for 18 year old guys back in the 60s.

Right.

So it's completely irrelevant really. Like it's not relevant. So that doesn't even make any sense. You threw that bomb out there. Of this being based on animal protein. I think it's important to unpack. Cause I literally got a DM on Instagram about this and I was like, oh, of people just wanting to do this all plant based. And I remember hearing something, I think it was from Dr. Donald Layman saying we eat a more plant based diet now than we ever have. Like it's now like 80%, whether it's.

Refined grains or oils or whatever it is, plant oils, only 30% of our diet comes from animal based products. I'm also going to blow your mind on something else, which is some new emerging research, is that the lower your protein in your diet, the more you require it to become from animal based sources. So one of the things that we're talking about so heavily here, largely because time and we could have this conversation for hours, but it's not just about the macronutrient protein, it is about the whole food matrix. And if you are going on a plant based diet, there is no way for you to be able to make up some of the other needs. These low molecular weight molecules, these other molecules that are in animal based products. If you eliminate a full food group, you could eat all the plants that you want. And yes, you will meet your protein need, but you will not necessarily meet the other physiological needs of the body.

You look at this, Gabrielle, and you go, all right, if I was going to be solely plant based, I'm going to have to become a very good biochemist, like a very good biochemist. And I look, okay, if this is a religious thing and you're committed to it, all right, now we have to get really, really solid on so many things. I mean just Even look at B12, look at carnitine, look at iron, look at all these nutrients and then just the amino acid balance and it just, there's so much stuff besides not overloading yourself. And I'd love you to do the chicken breast quinoa thing, not overloading yourself with carbohydrates in order to get there.

When we think about protein, it really, you know, we talk about it as one macronutrient. But protein is made up of 20 different amino acids, nine of which are essential. And the essential nature of them is different. The needs of the body, whether it's leucine, lysine or methionine, these are all key amino acids in the quality of the diet. And what happens is that an animal based product is different in this amino acid profile than a plant based protein. And the concept of how do we design a diet around high quality foods? We really have to think if you're going to be eating whole foods, then the way in which you're going to be doing that is leveraging definitely animal based products in your diet. There, there is no way around it. Unless of course you want to be drinking shakes and heavily supplementing. That is an alternative. But again, over the long term strategy, the question becomes why?

Yeah, to me all those things are supplements. It's like called supplement for a reason. You know, I love me some protein shakes, but that's not the foundation. The foundation's real, like whole food. And then you use those things as needed.

So basically let's put this into perspective. So the perspective would be, you know, there was, remember that whole push about quinoa being high in protein and people were really saying that quinoa is a superfood. So people are saying, well, you don't have to eat protein, cuz you'll get your protein from quinoa. Well, it will take 6 cups of quinoa and over a thousand calories to equal one small chicken breast. If we are purely talking about the amino acid profiles.

Yeah. And that's why you've got to look at not just total protein gram. You got to look at the amino acid profile. And for years these things about, like beans are high in. In protein. I go, no, they're high in carbs. Nuts are high in protein. No, they're high in fat. You can't be high and high. You only get to be high in one thing.

Right, right.

And if something's 10%, it's not high. It's high if it's over 50%, but if it's under, no longer high. And the other critical thing is looking back to the initial protein recommendations of this 10 to 12% protein, which I think the Food Guide Pyramid is probably pretty close to, and then the rest is carbs and fat, which is what we know is an obesogenic formula.

That's right. Yeah. We did a terrible social experiment which was called the Food Guide Pyramid, that really created an epidemic of obesity, which, by the way, continues. And the reason it continues is because, again, we are fighting the wrong battle. Obesity is not at the core of this. What we are fighting is a muscle problem. We are fighting a midlife muscle crisis, not an obesity problem.

And that's why we have to change how we do this. I had to go into the doctor yesterday and they put me on the scale. And every time I go into a doctor's office and they put me on a scale, I'm thinking, this is the stupidest thing ever. How is it that we still are putting people on a sc. Least use an inbody. At least do something to start to unpack what this weight is made up of and give people some legitimate thing. Because if I'm 140 pounds and 40% body fat, I am not metabolically healthy. If I'm 140 pounds and 20% body fat, as a woman, I am. You can't look at weight. You've got to unpack it as to what the weight's made up of.

That's right. And I'm going to tell you something else that's going to actually be coming out right now. It is purely used in research. And this is for the listener and for JJ. I'm going to tell you this.

It's.

It's D3 creatine. Because creatine is only found in skeletal muscle. And basically what they're going to do is individuals are going to take a pill, it's going to be able to look at the amount of muscle mass someone has based on this creatine tagging. So the. The amount of creatine in the urine, I'm oversimplifying it, but it's called D3 creatine, and it's a way of tagging the creatine and then seeing what comes out. And this is going to be the first time ever that there is a direct measure of muscle mass.

Well, the fact they're even trying to find a direct measure of muscle mass is the exciting piece of that puzzle, right?

It is.

Okay, so we talked nutrition, and I know we're going to also give a link to your Lyme protocol. So if you're listening, you're going, okay, I need to do this. We got it. And you get the book. So you're going to get Forever Strong. You're going to get lion protocol. You can get that immediately while you're waiting for two days for your book to come. But let's talk on the other side, because diet is. Is the smaller piece of it, but it's the mission critical. You're not gonna build muscle unless you have the building blocks from protein. Then you have resistance training. That's right.

Resistance training, by the way, is the non negotiable. Any exercise is better than none. So, you guys, I've known JJ for years, and this girl, she does not miss a training session. If you're going to show up at one of our events, you better be ready to rock and roll.

You know what's exciting, Gabrielle, is literally early on, I was in grad school, and I was the deviant because all of them were doing research because Precor was sponsoring us. So everyone was doing these 30 minute aerobic studies. And I'm like, taking everybody and going, you have to lift weights. If we lift weights, we're going to change your interest rate. Like, it will fix everything. Because the whole message in grad school was you don't lift weights until you've lost the weight. Which is, can you imagine the worst advice, you know? So I would take people on field trips to Gold's Gym in Venice because then the women were like, but we're gonna get big. I'm like, let me take you to this gym. And you will see that unless you're gonna kick yourself with steroids, that is not happening. I feel like finally, 40 years later, this whole message is getting out there because, like, resistance training, to me had been my mantra for so long. People are scared to eat protein. There's all this weird stuff about my kidneys. I'm like, oh, my gosh. There's the same thing with Resistance training. And you know, I have never, in 40 years of doing this, I've never had a woman get bulky lifting weights. Never. I've never seen it happen. So let's unpack the resistance training side of this.

Yeah, let's define what resistance training is. It's really anything that is movement other than, I suppose it could be body weight over time, but it's movement against something per se. When we think about resistance training, it's exactly that. Like when we think about resistance in life, it's this idea of getting stronger or moving muscles against something that is generating a force. For example, if you are lifting a weight, a bicep curve curl, if you are doing some kind of body weight squat, your body weight could be a form of resistance training. There's many ways to do resistance training. The more untrained you are, the better your results will be with limited activity. For example, if you are doing yoga and Pilates, will you get a stimulus for skeletal muscle early on? You will. Will that be enough to build a body like JJ's? It likely won't because at some point you will have to progressively overload that tissue. Again. There are many different ways to do resistance training appropriately. From a medical perspective. Why do I care about resistance training? You'd ask me about unhealthy skeletal muscle. And one of the things I failed to mention to you is that one of the things that makes skeletal muscle unhealthy is this lack of flux, meaning it's lack of glycogen utilization, which is simply the stored glucose, and lack of utilization of fatty acids, intralipids, intramyocellular lipids. When a skeletal muscle is static and sedentary, substrates or byproducts of glucose, all of this stuff builds up. Resistance training does wonders. It's like metabolic magic when you begin to contract skeletal muscle. And we'll get into kind of like what a plan would be or what a baseline plan is. But I think understanding from again, a medical perspective, not a athletic perspective, why resistance training is so important really can bridge the gap between the two. And that is these myokines like Interleukin 6 and Irisin and capthepsin B create really positive anti inflammatory effects in the body. The other aspect of doing resistance training is you are utilizing substrates, you are emptying out your suitcase. If you think of muscle as a suitcase, you are dumping out your suitcase. And this creates healthy skeletal muscle. The other thing that's so critical about muscle is that we care about insulin resistance. And when you have exercising skeletal muscle you can move glucose out of the bloodstream into muscle tissue without insulin. You care about resistance training because you can move blood glucose out of the bloodstream into skeletal muscle without requiring insulin. This is incredible. And in fact, I don't even know any other way to do it. Utilizing insulin, it's like an emergency mechanism. You don't want to have to make a ton of insulin. And so it should be a fail safe mechanism. But the idea is that you are not constantly pushing up insulin. You don't want to be taxing your pancreas, you don't want to be doing this strategy. What you want to be doing is you want to be eating in a very particular way where you are not over consuming carbohydrates and you are exercising to really leverage quality of movement as well as blood sugar regulation. So again, skeletal muscle as a blood sugar regulator. Now how are you going to do that? Super easy. There's a million ways to skin a cat. Basic recommendation. Two to three days of resistance training. Evidence would suggest that it doesn't have to be heavy weights all the time. I personally love heavy weights, but it can be lower weight, more volume, and.

I hate that so much.

I know, I actually really hate that too. And I wish I could say no, ladies, get up in there and you need to be lifting heavy. But I will tell you that you do stimulate tissue differently. The molecular stimulation of heavier weights versus lighter weights does stimulate tissue differently intracellularly, which again, I think that there's a lot of argument and a lot of stuff still in the space coming out, but it is something to consider. However, you don't have to be lifting heavy to get impact, but you do have to be putting in effortful training. There is a mind muscle connection that must happen and you do have to improve.

You know, it was interesting when I was in grad school, there were very tight ranges and you're gonna laugh cause you know how different this is now. It was like 1 to 5 for strength and 8 to 12, maybe 15 for hypertrophy. And then after that it was endurance. And it's like, yeah, no, it's way looser now. And so someone who's afraid of injury can do those longer sets. They could do two to three sets of 30. I just personally find that to be. I just hate it. And the other side of it too is if you look at what we lose as we age, we lose those type 2 muscle fibers. And so we're losing muscle size, but we're also losing strength and power. I think that once we get past that initial training stimulus of let's start to get strong again. We have to focus on those three elements and especially the power side of it, because I think that's how we really protect ourselves as we age, is to incorporate some power movements that most people think, oh, I can't do that. I'm older. I'm like, that's what you do. Because when you can do things in the gym, you're protected. People don't get injured in the gym. They get injured in life. You go in the gym to train for life, so you don't get injured. You can run away. Like, you can run out if you need to grab your kid running out in the street. Or you, like, catch yourself from the fall. You do that with some of the power training you can throw in. What do you think of that?

Yeah, I think that that is important and wise and protects people because again, if you fall, you actually do have to be able to catch yourself and do some kind of explosive movement. It's true. I think it's very wise. I also think it's underappreciated.

Yeah. Just when I started to look at the statistics of what we lose as we age, I'm like, holy smokes, it's power. And I'll tell you a funny story, Gabrielle. I was in the kitchen a couple years ago, and I was trying to unscrew something, and I'm always the lid taker offer. Like, I'm the lid taker offer. And all of a sudden I couldn't unscrew something. And I'm like, you know, trying to find my husband or son to unscrew it. And I go, what is going on here? And the minute that happened, I was like, okay, what do I need to do here? I'm going to start some farmer's carry, carry things around, do some hangs. Like, I've got to get my grip strength back. I'm like, oh, no, no, no, no, no. Maybe just throw a couple of those statistics out. I know we talked a little bit about them before. Just kind of impress upon people how important this is as we age, because your whole book is forever strong. And why is it so important to focus on maintaining and building strength as we age?

One of the things that people think about aging that is wrong is that it's a linear decline. Aging is anything but a linear decline. What aging is is a series of catabolic crises. Aging is a series of catabolic crises where you'll have an injury or you'll get an illness. And when I Say injury, Maybe you have a hip replacement, or maybe you get the flu or maybe, I don't know, tag in anything in that X, Y and Z. And what happens is you go on bed rest, which is the number one treatment. When people go into the hospital and you lay in bed for a week, that is a catabolic crisis. You can lose an exponential amount of both strength and muscle mass in a week. Now, what do people say that they lose? People will say, oh, we lose 1% muscle mass per decade or per year. I don't agree with that. I think it's wrong. I think that it's probably much higher. And what happens when we get a catabolic crisis? It becomes very difficult to regain that lost skeletal muscle mass, and it creates a whole host of complications. Because I told you earlier that skeletal muscle is the organ of longevity. And with that, it has its metabolic profile and its strength profile. But as you shrink the quality and quantity of that tissue, you no longer have good blood sugar regulation, you no longer have good cholesterol levels, you no longer have good insulin sensitivity. All of these things happen, and it happens suddenly. It's not a slow linear decline. And that's why making sure that you have healthy skeletal muscle going into more mature years is critical. It's critical for the trajectory of the way in which you will age. And it's never too late to actually put on skeletal muscle mass. But the best thing that you can do is you maintain it. It's the best thing that you can do. I remember just recently looking at some of this data. I don't want to give you numbers, I'm going to butcher, but I was looking at some of William Evans's data, and one of the things that they were talking about in this catabolic crises model, which came from Doug Patton Jones, was that the amount of muscle and strength a younger individual will lose is, like, not much. It might take them 30 days to lose what a more mature person will lose in a week.

Oh, boy. And then they can get it back in, like, probably a week, where the other person look at a muscle, they.

Look at a muscle, they look at a weight, their back being jacked and tanned while the rest of us, oh, boy. Are really struggling.

So I know we're right up against it. And I just want to thank you again for, gosh, putting this book together. I am so thrilled. This is the book I've been most excited about, so forever strong. And when you go to jjvirgin.com lion and that's spelled L, Y, O N you're going to get a couple cool things. You will get a link to get the book. You will also get a link to the Lion Protocol 2.0 so that while you're waiting for the book for two days, you will actually be able to get into immediate action to start to make sure that you are prioritizing protein in your diet and knowing what you need to do resistance training wise. And then you're just gonna love this book. It is fantastic, well written and again, it's a book that you're gonna wan and then make sure you implement.

And we have tons of freebies by the way. I have a full exercise library I.

Know, I'm so excited about. It's sitting in my email right now. I'm very excited about this and I'm excited that you're coming over to do workouts in my new gym that we can record. So all that stuff we will make sure like you get the book. You are going to have access to so much cool stuff that like the book should probably be like $2,000.

There's a lot of great stuff, a lot of great stuff happening and a lot of great work went into this book. It took two years to write and about 20 years to put together. 20 year mentorship to put together to make it very user friendly. I didn't want to put a book out there that was going to be so scientifically dense that it was going to really be missed. I am going to be training up physicians. We do have a physician training program for providers that will be different. But this book is for your mom, your sister, your brother, anyone in your life that is aging or needs to really age well. That is who this book is for.

And it's a great balance with the science and the action. So you struck the perfect balance again. It's forever strong. Jjvirgin.com Lion L Y O N and thank you so much, Gabrielle. Amazing. Another amazing interview. I just can't get enough of you.

Thank you.

Be sure to join me next time.

For more tools, tips and techniques you can incorporate into everyday life to ensure you look and feel great and more importantly, that you're built to last.

And check me out on Instagram, Facebook, YouTube and my website, JJ virgin.com and make sure to follow my podcast so you don't miss a single episode@subscribetoj.com See you next time.

Hello listeners, this is Anne Bogle, author, blogger and creator of the podcast what Should I Read next? Since 2016, I've been helping readers bring more joy and delight into their reading lives. Every week I take all Things Books and Reading with a guest and guide them in discovering their next read. They share three books they love, one book they don't, and what they've been reading lately, and I recommend three titles they may enjoy reading next. Guests have said our conversations are like therapy, troubleshooting issues that have plagued their reading lives for years and possibly the rest of their lives as well. And of course, recommending books that meet the moment. Whether they are looking for deep introspection to spur or encourage a life change or a frothy page turner to help them escape the stresses of work, school, everything, you'll learn something about yourself as a reader and you'll definitely walk away confident to choose your next read, with a whole list of new books and authors to try. So join us each Tuesday for what Should I Read Next? Subscribe now wherever you're listening to this podcast and Visit our website whatshouldireadnextpodcast.com to find out more.