Muscle Is the Key to Longevity (Not Fat Loss) with Dr. Gabrielle Lyon

Mark Hyman, MD

Full Transcript

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Dr. Mark Hyman
It's amazing to me how ignored this is in medicine, and it's such a critical part of health. We have this epidemic in this country of not only obesity, but sarcopenia. And you put together a hypothesis, which is that maybe it's not that we're over fat, that we're under muscle.

Dr. Gabrielle Lyon
From the seventies to roughly early two thousands, muscle wasn't even thought of. Then we started focusing on body fat percentage. Now as we continue to transition, we're looking at bioimpedance, and now we're beginning to think about overall muscle amount, but it doesn't end there. The real important marker is the intramuscular adipose tissue. It's the quality of the muscle tissue.

Dr. Mark Hyman
Doctor Gabrielle Lyon is a board certified physician with advanced training in nutritional sciences, geriatrics, and metabolism from Washington University in Saint Louis. She is redefining health and longevity by placing skeletal muscle, the organ of longevity, at the center of aging, disease prevention, and human performance. So let's get into the protein thing because, you know, this is a hot topic.

Dr. Gabrielle Lyon
Number one, age. The older you are, the more protein you need. Period. Number two, physical activity. The more sedentary you are, the more protein you need.

Dr. Mark Hyman
Really?

Dr. Gabrielle Lyon
Yes.

Dr. Mark Hyman
I think building muscle is probably one of the best ways to lose body fat, but also to break your metabolism, lower inflammation, improve your cognitive function.

Dr. Gabrielle Lyon
Improve your immunity.

Dr. Mark Hyman
Up your sexual function. I mean, pretty much everything. More muscle, better sex.

Dr. Gabrielle Lyon
Now we have everyone's attention.

Dr. Mark Hyman
Gabrielle.

Dr. Gabrielle Lyon
Hi, Mark.

Dr. Mark Hyman
Hi. Welcome.

Dr. Gabrielle Lyon
Yeah. So great to see you.

Dr. Mark Hyman
Good to see you too. We've been buddies for a decade plus. We were chatting. I remember you used to come to my house and hang out and kinda shadow me in my clinic and see patients with me. And, you know, you've kinda taken your whole career and exploded it in in this whole field of muscle centric medicine.

And I remember you used to come see me, and you'd like, Mark, you've gotta strength team. Mark, you gotta train. You gotta train. I'm like, ugh. I bike.

I bike tennis.

Dr. Gabrielle Lyon
Oh, I'm gonna just do yoga.

Dr. Mark Hyman
I do yoga. I'm like, whatever whatever. And I I always didn't like I mean, look, I'm a tall skinny guy, so I get intimidated by going to the gym. There's all these guys with big muscles, and I just feel like I'm I used to do 10 push ups, and my chest would hurt for a week. And I'm like, this is for the birds.

And even though I know as a doctor that I needed to do it, I didn't really start until I was 59. And it was it was actually you that got me really going on this. You you really put a bug in my ear about this and how important it was and started teaching me about the importance of muscle as this neglected organ. Think about it. Yeah.

Where is the muscle specialist in medicine? You've got a neurologist. You've got a cardiologist. You've got a rheumatologist. You've a gastroenterologist.

Where's the muscleologist? Well, hopefully,

Dr. Gabrielle Lyon
we're creating a new generation of thinking about it and doctors. Right now, think about it. We have physical medicine and rehab, but that's the movement side. Yeah. What about the dysfunction that actually happens to skeletal muscle?

I mean, skeletal muscle can get Alzheimer's.

Dr. Mark Hyman
Mhmm.

Dr. Gabrielle Lyon
Skeletal muscle can become dysfunctional from an immune perspective. It is its own organ system.

Dr. Mark Hyman
And it's like the huge organ. Like, you got lots of muscle. But you got the biggest organ?

Dr. Gabrielle Lyon
It is. It's the largest organ system in the body. And Yeah. Arguably the most important organ system, of course, depending on whatever your specialty is. We actually just published a paper looking at the importance of muscle mass, strength, and sexual function.

Dr. Mark Hyman
More muscle, better sex.

Dr. Gabrielle Lyon
That's right.

Dr. Mark Hyman
They're saying.

Dr. Gabrielle Lyon
Now we have everyone's attention.

Dr. Mark Hyman
I mean, it's amazing to me how ignored this is in medicine, and it's such a critical part of health. And, you know, we have this epidemic in this country of not only obesity, but sarcopenia. And you put together a hypothesis, which I find very interesting, which is that maybe it's not that we're over fat, that we're under muscled.

Dr. Gabrielle Lyon
That's exactly right.

Dr. Mark Hyman
And that the muscle is the key to health. It's not just losing weight because you can lose weight and still be fat. We call that

Dr. Gabrielle Lyon
skinny fat. That's right.

Dr. Mark Hyman
Thin on the outside, fat on the inside.

Dr. Gabrielle Lyon
So you

Dr. Mark Hyman
lose tremendous amounts of muscle as you lose weight as well as fat. And so this is a big problem for people, and they end up having metabolic issues. But you're talking about a way to kind of rethink medicine from the perspective of muscle, not just as this thing that moves around your limbs and

Dr. Gabrielle Lyon
No.

Dr. Mark Hyman
Body parts. But Right. It's actually an organ that has all the extraordinary functions that we're just learning about. And And that I didn't even know about. I didn't learn about it in medical school.

So kinda take us through, like, what is muscle? Why is it important? What does it do other than just move your bones around? And and why should we be focused on it as a key organ of longevity?

Dr. Gabrielle Lyon
First of all, skeletal muscle is the largest organ system in the body. Dermatologists we've always heard that it's skin, but, actually, skeletal muscle makes up roughly 40% of our body weight. Yeah. And as you can imagine, the health of your tissue for you now, it might be 50. For me, it might be 30.

But regardless, it's a large portion of our body. It's the most important organ system that we have because it is the focal point. And I'm gonna break down as to why that is. Mhmm. So skeletal muscle, by the way, is something that we prime our bodies for when we're young, and it is pliable, and it's never too late to build.

So before we talk about all the functions, let's just pause. What other organ system do you have direct voluntary control over?

Dr. Mark Hyman
You exercise, your heart will get better.

Dr. Gabrielle Lyon
But you can't say heart beat 73 beats a minute.

Dr. Mark Hyman
No. I can't do that. Well, I can meditate and get it slow down.

Dr. Gabrielle Lyon
But you can say, I'm gonna contract my bicep, or I'm gonna contract my quad. Yeah. It's the only tissue that we have voluntary control over. Yeah. There's skeletal muscle.

There's cardiac muscle in the heart. There's smooth muscle, say, in the uterus, but skeletal muscle, we have voluntary control over. Now what are the other functions of muscle? Obviously, for the architecture of our body, the building, the strength, the power, but also from a metabolic perspective. When we think and listen.

When I was in your clinic, when I would go to your clinic and I would listen to you talk about diabetes, obesity, cardiovascular disease, and Alzheimer's, these are not diseases that are separate. Yeah. Many of these diseases are caused by metabolic pathology. And to say that simply, dysregulated glucose, Right? Abnormal blood glucose, triglycerides, elevated levels of insulin.

So all of these metabolic syndrome Yeah. Which are actually not caused by fat first. They are caused by dysfunctional muscle first. Dysfunctional muscle is in part at the root of cardiovascular disease, Alzheimer's, which is type three diabetes of the brain, type two diabetes, insulin resistance. So just the list goes on.

Dr. Mark Hyman
So tell us, like, what is functional muscle and what is dysfunctional muscle?

Dr. Gabrielle Lyon
And before, you know, it's interesting because we're talking somewhat in absolutes, but it's not in absolutes. Right? So is the liver does the liver play a role? Is it fatty muscle? Right?

So this is a complicated organism. And so for the physicians listening, I wanna make sure that it's not just comes across as black or white. Right? Functional muscle is the following. Typically, muscle quality is defined based on strength, which is a little kind of misleading.

Right? How many push ups can you do? How strong are you? How fast can you walk? Functional muscle is strong muscle.

Dysfunctional muscle is weak. Dysfunctional muscle looks like a marbled steak over time. Yeah. You get fat that is infiltrated into muscle tissue. And also

Dr. Mark Hyman
You get a Wagyu rib eye instead of a filet mignon.

Dr. Gabrielle Lyon
Yes. And we're gonna talk about this in terms of imaging because I think we're at the precipice of something new. Our muscle that is dysfunctional has less mitochondrial efficiency. You and I talk about exercise as mitochondrial medicine. Mhmm.

Pushing exercise, whether it's resistance training or high intensity interval training or endurance training, all of this is medicine for your mitochondria. So there is the functional aspect of muscle, strength, power, mobility, balance. Then there is the metabolic component.

Dr. Mark Hyman
That keeps you active and functioning as you get older. Yes. Like, I I noticed that I when I started doing strength training, I just felt more solid in my body. I felt more stable. And I when I was younger, used to, like, hike on a trail and just jump from rock to rock.

And I noticed I was maybe a little more tentative, but as soon as I started strength training, I'm like, oh, my body's like my core is strong. I can bounce around on my legs. And was a really interesting phenomenon to notice.

Dr. Gabrielle Lyon
Yeah. And also, when you think about what's important for you is how do we get injury prevention? You know, you and I see patients, and we think, okay. Well, as we go through life, is there this inevitable decline? And I would say no.

And this inevitable decline as we see our parents get thinner or more frail, you know, this is this kind of

Dr. Mark Hyman
It's expected.

Dr. Gabrielle Lyon
Expected. But, really, that's not how aging happens. Aging happens in what we call a catabolic crisis model. There are discrete moments of inactivity that decrease muscle mass very rapidly and strength. Yeah.

Now with that, there is this relationship with muscle mass and glucose regulation. Mhmm. So oftentimes, as people are losing muscle, their blood sugar goes up. Yeah. Their insulin goes up.

And so now we are at a point where there is metabolic dysfunction, which becomes dangerous because we all know that glucose is toxic to the cells if it remains elevated. I mean, we have a disease for that. It's called type two diabetes.

Dr. Mark Hyman
You know, I was thinking about these these weightlifters, these, like, power lifters. And these guys are kinda overweight. They got big guts, they're big guys. And, you know, are sumo wrestlers. Are these guys these guys have a lot of muscle.

They do. They're trained muscle. Mhmm. And are they are they metabolically healthy?

Dr. Gabrielle Lyon
I made a mistake really early on in medicine, and I think what's so cool about medicine and learning is that we can change our opinion.

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
And when I was at WashU doing my fellowship in geriatrics and nutritional sciences, there was a lot of talk about fit and fat. I didn't believe it was possible. Yeah. It didn't make sense to me. Yeah.

Because I was thinking, okay. So there is adipose tissue subcutaneous, a certain body fat percentage of over 30%. Well, how can that be healthy? And you know what I found? Yes.

They can. And you know why? It's actually the intramuscular adipose tissue that matters. Uh-huh. So let's talk about this.

Dr. Mark Hyman
In other words, they don't have marbled fat.

Dr. Gabrielle Lyon
Correct. And this is where I think the future of medicine is going because we are going to be you know, in the seventies, we were very focused on the obesity epidemic. Yeah. In the seventies. And it was that the nutrition outpaced our ability to kind of manage that caloric intake.

Mhmm. Exercise wasn't even brought into the picture. Do you know why? Mm-mm. Because our physical activity didn't change during that time.

It was still the same. I mean, it was lower, but it was still the same. So the input, it was input versus output, and people really started focusing, and the experts started focusing on overall calorie consumption. Yeah. Finally, up until around 2000, muscle came into the picture as a metabolic organ.

But from the seventies to roughly early two thousands, muscle wasn't even thought of. But how did this then frame how we currently think?

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
Well, there was BMI, which we know body mass index body mass index is just thought of in terms of overall size. Right? There's this you know, you do this little formula, and someone like my husband who's very muscular would have a high body mass index, which would mean he's unhealthy.

Dr. Mark Hyman
Yeah. He ripped, but he looks

Dr. Gabrielle Lyon
bad on paper. Exactly. Then we started focusing on body fat percentage. Right? And then after body fat percentage, if you're 30% body fat or more than, you know, you're either overweight or obese.

Now as we continue to transition, we're looking at bioimpedance, and now we're beginning to think about overall muscle amount. Mm-mm. But it doesn't end there. This is just the beginning. The real important marker, and again, we're at the beginning of all this, is the intramuscular adipose tissue.

It's the quality of the muscle tissue.

Dr. Mark Hyman
And where can you see intramuscular fat tissue? Is it on the MRIs?

Dr. Gabrielle Lyon
MRI. Yeah. MRI. I was talking early on about maybe a year ago, was talking to Jonathan about this.

Dr. Mark Hyman
He's my cofounder.

Dr. Gabrielle Lyon
Cofounder of Function. And I said, Jonathan, listen. You're doing these early detection screening tests, but this is amazing. And then the next iteration is actually going to look at not just body fat percentage and not just muscle mass, but actually the quality of muscle.

Dr. Mark Hyman
Yeah. Well, we know through function and imaging, Ezra offer intramuscular

Dr. Gabrielle Lyon
Which is why I'm so excited about it because I believe

Dr. Mark Hyman
body composition this is the

Dr. Gabrielle Lyon
way of the future.

Dr. Mark Hyman
Yeah. And now it's available to everybody. You don't even need a doctor. You just go to functionhealth.com and sign up, and you'll also see all your metabolic pathways and inflammation. Everything else is affecting your muscle.

Yes. Hormone levels.

Dr. Gabrielle Lyon
Yes. And if we were to think about that from the listener or the viewer, that means the simple act of engaging in resistance training improves intramuscular adipose tissue Mhmm. Whether your body fat percentage or muscle mass changes. When you make the choice to exercise and be physically active, you're improving the quality of your tissue in the immediate. Yeah.

And that becomes really empowering. I was interviewing on my podcast one of the world leading experts in PCOS, polycystic ovarian syndrome. So someone who's listening to this, if they're struggling with fertility, this is the number one cause of infertility in

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
Young women. Mhmm. And I said I said her name is Doctor. Melanie Cree. She's in Colorado.

She's MD PhD. And I said, well, what is the body fat percentage where we're seeing all these problems? Because in my mind, as physicians, we think, well, there's a certain cutoff. So for example, we know how much protein someone should have. We know what their blood glucose levels should be.

We know or we should know what should their percent body fat be where they have these problems. Right? Like, we should know that. And she looks at me. She goes, Gabrielle, it has nothing to do with body fat percentage.

Has everything to do with the intramuscular adipose tissue. Yeah. And that really determines how someone responds.

Dr. Mark Hyman
So if you do a DEXA scan, you can't tell that? No. Yeah. So only an MRI can really help you get this information. MRI,

Dr. Gabrielle Lyon
CT, or ultrasound, but ultrasound is obviously that would just be one body part. But I say all this Mhmm. To then bring it back to the conversation of GLP ones, obesity, and now sarcopenia.

Dr. Mark Hyman
Before we jump on that, I wanna just finish summarizing the features of good body muscle. Because it's not just that it moves your skull around or it's got less fat, It's actually a metabolic sink for sugar. It actually regulates hormones. It regulates inflammation. Mhmm.

You talk about this thing called myokines, which I'd love you to unpack.

Dr. Gabrielle Lyon
Sure.

Dr. Mark Hyman
So so help us sort of understand the broad range of functions that's besides just moving around your bones and walking around

Dr. Gabrielle Lyon
Yes.

Dr. Mark Hyman
That that they this plays and why it's so important and why it's so important to have healthy quality muscle, not just the amount that look at you know, you can

Dr. Gabrielle Lyon
look the mirror. It doesn't matter. It does matter to an extent, but it really is the quality of that tissue. If we were to think about the quality of the tissue from a metabolic perspective, at rest, people don't actually realize this, but at rest, the body muscle primarily burns fatty acids for fuel. So at rest, if you're metabolically healthy, your muscle is burning primarily fatty acid.

Dr. Mark Hyman
Fat.

Dr. Gabrielle Lyon
Fat. If your diet is too high in carbohydrates, you can force muscle at rest to then burn and utilize glucose, but this is not ideal. So when we think about

Dr. Mark Hyman
During activity, your muscle sucks up a lot of shit.

Dr. Gabrielle Lyon
Ideally, yes. But you don't want if we're just sitting here hanging out at 0% v o two max, don't wanna be burning glucose. We wanna be burning fatty acids. That's how it was designed. But if you overwhelm the system and if you are constantly eating you know, if the RDA is a 130 grams of

Dr. Mark Hyman
the

Dr. Gabrielle Lyon
carbohydrates, which is on average 300 grams of carbohydrates, we are creating an environment that we are forcing muscle to respond to. So number one, at rest, empty muscle. Right? So activity allows you to burn muscle glycogen. You use muscle glycogen.

Dr. Mark Hyman
That's a storage form

Dr. Gabrielle Lyon
of sugar carbs in your

Dr. Mark Hyman
muscles that you know, it's about 2,500 calories. You can

Dr. Gabrielle Lyon
You empty the tank. Yeah. So if we think about what muscle does, if we think about it as a suitcase now I don't know about you, but I think you're kind of a heavy packer. You yeah. You're definitely a heavy packer.

At least you were last time I I saw you.

Dr. Mark Hyman
That's where I'm going all along.

Dr. Gabrielle Lyon
So listen. I gotta tell you. When I when you have your place in Lenox, and I remember we were running out. I was going in one direction back to New York City, and you were going on a trip. And you had this massive suitcase, and you know what you're doing?

You're putting your supplements in. Not even just the little pill case. I mean, whole bottles were going.

Dr. Mark Hyman
Yeah. Yeah.

Dr. Gabrielle Lyon
And it was absolutely hilarious. Now why does this matter? If you think about your muscle as a suitcase, and let's say you're going on a trip for four days, and you instead of going on a trip for four days, you pack for fourteen, like Mark and all the supplements in the world. You're stuffing all this stuff in the suitcase, meaning glucose, and you didn't exercise it like clothes, then all that stuff spills out. It has no place to go.

And so muscle, it's really important that you do activity to empty the suitcase of muscle so that when you eat carbohydrates, you have a place for it to go.

Dr. Mark Hyman
Not your belly.

Dr. Gabrielle Lyon
But Not your belly. But but the reason I say this is because there's no such thing as a healthy sedentary person. There's no statement. There is no such thing as a healthy sedentary person. So when we are talking about the metabolic role of skeletal muscle, we have to talk about it from an ideal standpoint, which is healthy muscle burns fatty acids at rest.

But if we are living in reality, we know that most people are eating way too many refined carbohydrates and grains. We know that most people are eating roughly around 300 grams of carbohydrates, meaning that most people that are also inactive have unhealthy sedentary muscle. And so what does that look like in blood? Or if someone goes and gets a function test, what does it look like? Or or whatever.

And it is the following. You have elevated levels of blood glucose. You have elevated levels of triglycerides. Mhmm. So you are now mismatching your nutrition for muscle health, and you have elevated levels of insulin.

So there are two sides to the same point. There is muscle that is unhealthy, meaning it's full of muscle glycogen. It has not been turned over. It hasn't been emptied. We get fat that then infiltrates into muscle over time, making muscle itself less effective, both metabolically and from a strength standpoint.

So this is this is totally not ideal.

Dr. Mark Hyman
So that's the metabolic part. You get you kinda screwed up glucose metabolism. You get more insulin resistance. You get more prediabetes. It's sort of a vicious cycle where you have not enough healthy muscle to actually regulate your metabolic health.

But then there's other parts, like the immune immune part and the hormonal part of muscle. So talk about those.

Dr. Gabrielle Lyon
Yeah. And this is also really fascinating with aging because there are changes that seem to happen with muscle as we age. And that is it becomes more resistant to things like amino acids that stimulate muscle. It becomes so there are immune cells within skeletal muscle, and those become less robust. Mhmm.

Skeletal muscle that is not moved can then become atrophied. And, also, there's a a nerve relationship, so it becomes less responsive. There's a denervation that happens. And all of these things are thought to be as normal parts of aging, potentially, I don't necessarily agree with. Mhmm.

Because what we see is when you increase activity, like we're talking about resistance training, nonnegotiable three days a week, plus some kind of cardiovascular, you can improve skeletal muscle to then respond and look like youthful muscle. And that's that's fascinating.

Dr. Mark Hyman
At any age?

Dr. Gabrielle Lyon
At any age.

Dr. Mark Hyman
It's so interesting. I went through this horrible catabolic state

Dr. Gabrielle Lyon
I know.

Dr. Mark Hyman
Last year.

Dr. Gabrielle Lyon
I came and saw you. Remember?

Dr. Mark Hyman
Yeah. Barely remember. I was so high on narcotics.

Dr. Gabrielle Lyon
Well, anyway, did I came and saw you. There was great music playing.

Dr. Mark Hyman
Do remember. And I lost 25 pounds No. Of muscle because I didn't really have any body fat. I was already, like, at 10 or 12% body fat. And so I just lost my skeleton I know.

And my muscle. And I was worried. You know, I was 65. Didn't know if I could build it back. Didn't know how my body would respond.

You know, I know all about this phenomenon of anabolic resistance, which is as you get older, it's harder to build muscle. And you know what? I just doubled down on everything that I knew to do, which was strength training, no testosterone therapy, which was made a big difference because of my hormones were just in the tank after the surgery. Oh, yeah. 100, 200 or something.

Unbelievable. I had I used creatine.

Dr. Gabrielle Lyon
Mhmm.

Dr. Mark Hyman
I used high doses of protein.

Dr. Gabrielle Lyon
A lot of protein. Say high, we should talk about that.

Dr. Mark Hyman
Yeah. So had, like, fifty grams for breakfast in a protein whey protein shake. I would put in creatine. I would put in Mitopur, which is something we're talking about. A molecule that helps build mitochondrial help and reduce inflammation.

And I was just deliberate in the gym every day for an hour. And though I couldn't do anything at first, all I could do was lay on the floor and or I actually couldn't even get on the floor. I was laying on a massage table, and I would put a band around my knees and just open my knees back and forth, and activate my glutes. Like, that's all I

Dr. Gabrielle Lyon
But that was enough to then begin to stimulate Yeah. The tissue. And and I just wanna say something because

Dr. Mark Hyman
I could do, like, I could do, like, 10 pound weights. Now I'm doing, like, you know, 50 pound weights.

Dr. Gabrielle Lyon
I mean, you're strong. Yeah. And you'd mentioned myokines, which I think is important.

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
And myokines are these proteins that are released from skeletal muscle based on contraction and duration of exercise. Now they were discovered in the February, early two thousands, in Copenhagen by an exercise. She's actually an MD who also is an immunologist. Really, Ben Henderson. Pedersen.

Pedersen. And there are thousands of different myokines. But what is so interesting is when you contract skeletal muscle and we're just thinking about you had an injury, we'll call it an injury or a catabolic crisis. But when you went to go contract that skeletal muscle, the myokines that were released did a number of things. So number one, stimulates bone as we know.

So it's not just the pulling, but also helps stimulate BDNF in the brain, which is brain derived neurotrophic factor. Also, it secretes interleukin six, which people always think about as this cytokine storm from macrophages and other cells. But when released from muscle, it helps balance the inflammatory response. And so there's this pleiotropic effect. There's this positive effect when these myokines are released from muscle.

They do things we don't even know about. And so that's this idea of exercise as medicine. And by being able to dose exercise appropriately, we should be able to get these responses that are beyond just the responses by improving blood flow. Yeah. Right?

So there's the muscle mass and strength. You're on the ground doing your clamshells to try to then stimulate and engage your glutes, which is really important. We know better leg strength means better mobility, better activities daily living, but it also means better cognitive capacity.

Dr. Mark Hyman
Yeah. Definitely helped. For sure. So really, it's such an interesting thing. You've got all these different functions of muscle, most of which have not been ignored, most of which I certainly never learned about in medical school.

Doctors don't know how to assess sarcopenia or loss of muscle. They don't know how to treat it. They don't know Mhmm. The first thing about it. It's kind of amazing to me.

And I remember when I worked at Canyon Ranch in the nineties, we had a DEXA machine. And everybody would get a DEXA scan. And I was like, this is really fascinating. And we looked at bone density, obviously, but we also did body composition. And back then, nobody was looking at body composition.

And we were seeing, you know, all kinds of interesting things that that people didn't know about in terms of where the distribution of fat was, where loss of muscle was, increased body fat. And it was such an incredible tool. But now with the imaging through Ezra, thecom the company that's part of Function, we can now get sophisticated MRI assessments Mhmm. To see where you're at. And then you can track it longitudinally over time to see what your interventions are are doing to help.

And, you know, one of the things that I think you pioneered is this idea of muscle centric medicine we talked about, and and not just sort of at an abstract level, but how do you actually apply this to your life? And your new book, The Forever Strong Playbook, which everybody should get a copy

Dr. Gabrielle Lyon
And you agree you're gonna do the training program. Why don't we start you on that?

Dr. Mark Hyman
I am.

Dr. Gabrielle Lyon
And we'll do a before and after. Let's just see what happens.

Dr. Mark Hyman
If I follow your your six week program to build my muscle

Dr. Gabrielle Lyon
Yes.

Dr. Mark Hyman
I'm gonna get even more ripped.

Dr. Gabrielle Lyon
Okay. But it's also not fair because kinda genetically, you're also very lean. But why don't we do that? Why don't we do a body composition assessment before Yeah. And strength assessment before, and then do this for six weeks and do strength assessment after?

And we'll talk about it on my podcast.

Dr. Mark Hyman
I love that.

Dr. Gabrielle Lyon
And we'll talk about the results from Ezra on my podcast.

Dr. Mark Hyman
I love a challenge.

Dr. Gabrielle Lyon
And I know you do. So let's

Dr. Mark Hyman
I mean, I'm obsessed. Like, I I I honestly I have to be honest. I hated strength training. I I hated the

Dr. Gabrielle Lyon
remember last time I tried to get you to to gym, you know what you said we were gonna do? You wanted to go for a bike ride instead.

Dr. Mark Hyman
I know. I'm like, I but now, it's like I'm addicted.

Dr. Gabrielle Lyon
Well, it's nonnegotiable.

Dr. Mark Hyman
It's now it's nonnegotiable. And even if I'm traveling, I'll go to the gym. I'll bring my little bands if I can't get things. I have, you know, all these

Dr. Gabrielle Lyon
Let's talk about a few of the the the practical strategies that people can do, which is why I wrote this book. Now there is this concept of progressive overload. Okay? Progressive overload is increasing the amount of weight necessary to get a particular outcome for strength or hypertrophy. We'll just put it all together.

But the reality is it's about progressive stimulus. And the reason I say progressive stimulus is because, again, you are traveling. And there are many people that are listening to this podcast that say are in perimenopause or menopause, and the last thing that we want them to do is to injure their shoulder Yeah. Which maybe they presented with frozen shoulder or injured listen. You know, I've had a bazillion injuries.

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
The reason I say it's progressive stimulus is if we take a step back, muscle strength outpaces tendon strength.

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
And it doesn't mean if you are listening to this and you are new to training, it doesn't mean you just have to lift heavier. Heavy is relative. Yeah. One to two reps in reserve, meaning with good form, there's mechanical failure, and then there's technical failure. Right?

You want the muscular failure, the mechanical part. You don't want the you don't want your form to be all over the place if you're supposed to do a squat, but you're lifting it with your neck. That's

Dr. Mark Hyman
wrong. Right.

Dr. Gabrielle Lyon
And so what are some of the foundations of a great strength training program that is nonnegotiable and everyone can do? I mean, that's three days a week. It's full body. It's all about how you progress over time, and the progressions could be reps, could be tempo, could be adding more volume. There's all different ways to improve muscle health that's not just lifting heavier.

Dr. Mark Hyman
Well, it's interesting how you say that because I was in a bike accident and limited, but, you know, I didn't stop training. A lot of people when they have an injury, they go, well, I'm just gonna chill and take this chance to just watch Netflix and lay in bed. You know, but I have like a broken ankle, a broken foot, you know, kinda banged up pretty bad. And I just was like, I'm not letting this stop me, and I I can't lose the progress I've made. And so, you know, I I'm working with someone who's helping me adapt to it.

But I'm also using these things called blood flow restriction. Let's

Dr. Gabrielle Lyon
talk about that.

Dr. Mark Hyman
And yesterday, we were in the gym, and I was like doing like 10 pounds with these things on. And I'm like, normally, I can do like 25, 30 pound curls. And I was like, you know? And so you can do things without hurting your tendons as you And get and to deal with this this injury risk and make your risk for injury a lot less, but get as much or more benefit.

Dr. Gabrielle Lyon
Blood flow restriction is something that we've been using in our clinical practice forever. And let me just highlight blood flow restriction. Yeah. So blood flow restriction was originally used in rehab, and we use it a lot. A lot of the soldiers use it for rehab for injuries.

And what it is is you'll put a cuff on and there's various cuffs. I use a a Bluetooth cuff called Saga. Have you ever heard of them? I don't

Dr. Mark Hyman
know katsu.

Dr. Gabrielle Lyon
Okay. Katsu. So this is that's like a

Dr. Mark Hyman
like a Japanese

Dr. Gabrielle Lyon
Yeah. That's a very

Dr. Mark Hyman
speech.

Dr. Gabrielle Lyon
It's a very advanced cuff. And what it does is it occludes the blood flow. Yeah. Meaning, it will calibrate to a certain millimeter of mercury. And then Kinda

Dr. Mark Hyman
like a blood pressure cuff.

Dr. Gabrielle Lyon
It's it looks like it feels like a blood pressure cuff, but a little bit more robust. Yeah. And what it does is it allows you to train at a fraction of the weight that you would normally train to get the same stimulus.

Dr. Mark Hyman
Mhmm.

Dr. Gabrielle Lyon
So what does that mean? So you had just said that you do 30 pound curls. You could pick up a five pound weight. Yeah. And it would signal to the body because, again, your blood is partially occluded, and it sends growth factors.

And there's very standardized ways of doing it. And doctor Jeremy Lenneke, who is one of the world leading experts on blood flow restriction, he was on our podcast, and he just gave a master class in how to use blood flow restriction very particular for outcomes. Right? So it's it's not this kind of just haphazard use. It's what percentage are you including?

What exercises are you doing? What is the injury that you're trying to work on? And it's it's, you know, obviously, I'm I'm not they're your guys' doctor or neither is Mark, but this can be very safe and effective. Yeah. I used it when I tore my hamstring.

I still use it. I travel with these blood flow restriction bands when I don't have access to a gym as well.

Dr. Mark Hyman
That's right. As you guys do body weight stuff, and it's it feels like heavy weights.

Dr. Gabrielle Lyon
Yes.

Dr. Mark Hyman
I mean, I I I get this incredible pump in my arms. I look my arms look almost as good as yours after I'm after I'm done with my workout.

Dr. Gabrielle Lyon
But it's extraordinary. And also for more advanced aging people Yeah. It's great. And, also, if you don't have a ton of room like, let's say, you know, you're someone is on bed rest or someone is injured. By just simply inflating that cuff, even by doing a partial push up or even pushing against the wall, some kind of muscular movement actually has, again, just profound effects from injury and also maintaining muscle and blood flow, which is, again, really important.

Dr. Mark Hyman
Let's get into kind of the details a little bit. Because clearly, muscle, as as you've laid out, is is such a neglected and important part of our long term health. You call it the organ of longevity. I agree. Think, you know, if you look at all the things you could do I mean, when you're younger, you have a lot of trophic factors and hormones that keep you kinda going.

When you get older, those change, and you end up, you know, having the dwindles, we call it, in medicine.

Dr. Gabrielle Lyon
I never I wait a second. I never heard of the dwindles.

Dr. Mark Hyman
You never heard of that? No. No. You're a geriatrician.

Dr. Gabrielle Lyon
I know. We didn't we never called it the dwindles. That is definitely not a geriatric word. That is a Mark Hyman word. It's like,

Dr. Mark Hyman
It's like, you know, you say slow, gradual decline, you dwindle in your ability to function.

Dr. Gabrielle Lyon
Dave never heard of that either, the producer. Oh,

Dr. Mark Hyman
well, anyway, maybe I made it up. But it's something that you kinda notice. And like you said, what we see in our aging population, we think is another part of getting older, which is this decline in ability and function than than doing things. And and the truth is that that's not inevitable. Now it takes a lot of more input and work and dedication and diligence, and I wanna really get into what does it actually take.

Because, you know, people can hear this and go, well, I'm not gonna go to the gym every day, and I'm

Dr. Gabrielle Lyon
like No. They're not. They're gonna hear this, and they're gonna go, you know what? This is the new standard because this is more impactful than any medication I could ever take.

Dr. Mark Hyman
It really is. I mean, you're losing body fat's important, but I I would argue with along with you that I think building muscle is is probably one of the best ways to lose body fat, but also to wreck your metabolism, lower inflammation, improve your cognitive function, to improve your

Dr. Gabrielle Lyon
Improve your immunity.

Dr. Mark Hyman
Up your sexual function. I mean, pretty much everything. Your immune everything.

Dr. Gabrielle Lyon
And, also, we have a direct mechanism. So one of the things that we have to understand is that, you know, in medicine, we have to ask, okay. So what is the mechanism of action? So for example, muscle mass and sexual function, which we published with my colleagues at Baylor, we have a direct action, and that is what does muscle do? Muscle, strong muscle improves endothelial function.

Okay. Improves all vascular health. Strong, healthy muscle mass improves n o two, which is vasodilation. Strong, healthy muscle helps improve metabolic risk factors, helps control blood glucose, helps control fats, and it's under voluntary control. And you had said something that

Dr. Mark Hyman
Sounds like a good ROI.

Dr. Gabrielle Lyon
There's also twofold. We just have to become more strategic at the inputs that we put in. Meaning, what does that mean in terms of inputs that are valuable? You know, as we age, you'd pointed out, when we're younger, our system you know, it's this this idea of mTOR. We've all people have heard about this, but, anyway, it's this protein kinase.

It's this growth fact. It's this growth perpetuator.

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
And when we think about it, it's in all tissues. So mTOR and I'll get to why this is even important, not to get too caught up in the weeds. But mTOR, which is responsible for muscle protein synthesis, is in all tissues. The signaling of our muscle decreases the efficiency, becomes decreased to inputs like protein. And so when we're young, we're highly anabolic.

You know, you've met my son, my little one. He's training for the seal teams. He's four. He's highly anabolic. He could have five grams of protein, and it would still stimulate his muscle because he's growing.

He's driven by growth factors and insulin. Yeah. But when we're done growing, then this input has to change. And this input would then be resistance training, calories, hormones, carbohydrates, and the balance between all of them changes. So we have to get Protein.

Well, protein is right. The amino acids. And that's probably the most important. The most important is the resistance training input, the mechanical input, and then the protein input. Yeah.

Primarily, leucine.

Dr. Mark Hyman
So so let's get into the protein thing because, you know, this is a hot topic. Still. You know? Yeah. Fat was the boogeyman, and then carbs are the boogeyman.

Now lack of protein is the boogeyman. Lack

Dr. Gabrielle Lyon
or just protein in general?

Dr. Mark Hyman
And and and yet there's this sort of bias that too much protein is bad for you. We certainly learned that in medical school. You know, that it can stress your kidneys, that it that you don't need it, that your body waste it, it turns into calories or energy, turns into glucose if you eat too much. And and and what you're saying is we we need far more protein than than most people think. And that, you know, you've got guys like Chris Gardner who I know well, I respect him.

He's a he's a top Stanford scientist, but he's very, very strong in his opinion that that we don't really need that much protein, that, you know, you can get all the protein you need from, like, grass. And I think that there's some challenges with that. And I think especially as you get older, there's challenges with that. I think the RDA, which is the recommended dietary allowance, was designed for preventing deficiency diseases like protein malnutrition, not necessarily optimal health. So when people talk about point eight grams per kilo protein per day, which is, you know

Dr. Gabrielle Lyon
Point three seven grams per pound.

Dr. Mark Hyman
Pound, which is a, you know, a third basically a third of a Yeah. Gram per pound. It's really so you don't get a a disease. It's not for optimal health or muscle building, or it doesn't even adapt to what you need as you get older. So how do you how do you help people understand the right frame for protein about what we need, when we need what, how to eat it, when to eat it?

Dr. Gabrielle Lyon
Probably my favorite question aside from one on my kids. Now I wanna just touch on Gardner and the episode that he did with Andrew Huberman because we did a response video to that with doctor Donald Lehman, who is one of the world leading protein researchers, who's trained me for over twenty years.

Dr. Mark Hyman
But, yeah, don't know you noticed, but I did a debate with Chris Gardner on the Diary CEO, and they haven't published it because it's so it was so controversial.

Dr. Gabrielle Lyon
I would really encourage people, and I will send it to you. I would really encourage people to listen to that episode Mhmm. With Don Lehman. Again, Don is not out

Dr. Mark Hyman
of It's on your podcast.

Dr. Gabrielle Lyon
It is on the podcast, and I will send you

Dr. Mark Hyman
a few podcast. Link. Podcast.

Dr. Gabrielle Lyon
We're to a show on us. But I am gonna send it to you because it's it addresses each statement that because, again, you know, it's it's fascinating to think that how we're communicating science now is like this, which is incredibly valuable. You and I are sitting down, and we are talking. But you and I have both been in medicine for a long time. Arguably, you more than longer than me.

Thank god.

Dr. Mark Hyman
Got a few more miles on the You

Dr. Gabrielle Lyon
and I know that we would sit down, and there would be grand round. And then there would be you know, for me, it would be like experimental biology where you have these world leading experts have discussions, and they would come together. And I I just say that because, typically, science is not debated on platforms. So for example, we would take a look at this study, and we would say, okay. This is the

Dr. Mark Hyman
It's sort of sequestered to the halls of academia, not in a public forum, which is now where what's happening, which I don't think is a bad thing. I think it's a good thing.

Dr. Gabrielle Lyon
It is, but it creates a lot of confusion.

Dr. Mark Hyman
It does.

Dr. Gabrielle Lyon
For example, Chris Gardner talking about how we're getting too much protein. You know, his many of his fundamental statements were incorrect. And so put that aside. Encourage people to listen to that. Let's talk about where we are in terms of protein and where that information come came from.

Now in the seventies, early seventies, there was the McGovern Committee, which then informed the dietary guidelines.

Dr. Mark Hyman
That's right.

Dr. Gabrielle Lyon
The McGovern Committee was written do you know who was written by?

Dr. Mark Hyman
I think I do.

Dr. Gabrielle Lyon
A staff writer in their early thirties that had an economic degree.

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
This person wrote the documents that then informed the dietary guidelines, which arguably we have barely changed.

Dr. Mark Hyman
Yeah. And they were they were actually better when they first came out. And then the industry got involved. They made them change a lot of things because they were basically talking about eating less starches and carbohydrates, but then actually they made them change it.

Dr. Gabrielle Lyon
For whatever. But we just have to understand that that nutrition is an interesting aspect of medicine because, you know, it's it's not like endocrinology or not like gerontology. Nutrition has a lot of inputs from food supplier, from industry, from politics. Mhmm. Okay?

So this then changes and informs the public. So the the dietary guidelines have a a list of recommendations. For example, it's 10% saturated fat. Anything more than 10% saturated fat is considered unhealthy.

Dr. Mark Hyman
Working on that.

Dr. Gabrielle Lyon
But let's just frame frame this out appropriately. And then the protein recommendation is point eight grams per kg. Then the carbohydrate recommendation is a 130 grams of carbohydrates per day. Now let's look at just the fat component. By making 10% saturated fat or more unhealthy, that weaponizes food for all for almost all animal based foods.

For example, an egg, one single egg that has a total of six grams of protein has, I don't know, 16% saturated fat. Maybe it has, like, half a gram. Yeah. Right? Six grams of fat.

There's tons of high quality protein, choline, fat soluble vitamins, b vitamins. But because it, as a food, has 16% saturated fat, now this is considered unhealthy. Let's take one more example. If my husband who runs marathons is eating 4,000 calories a day, his saturated fat intake can be 44 grams.

Dr. Mark Hyman
Because?

Dr. Gabrielle Lyon
Because of the 10% because of the dietary guidelines, which we're gonna circle back to protein because, obviously, protein is the most essential and important macronutrient in the world.

Dr. Mark Hyman
The most important. And but people don't realize this, but there there is the only macronutrient we need in large volume. So we need no carbohydrates that are essential.

Dr. Gabrielle Lyon
And only four grams of essential fatty acids.

Dr. Mark Hyman
And we need very low amounts of essential fatty acids, but you need, like, literally multigram

Dr. Gabrielle Lyon
You do. Every day, and here's why. We'll get to that. So 10% saturated fat or more is considered dangerous. However, in medicine, you and I both know that there is a dose and a poison.

Is it forty four grams like my husband on a 4,000 calorie diet, or is it 14 or 16 if I'm having a 1,500 calorie diet? So the question is, what dose of saturated fat is then detrimental for human health? We don't have good evidence for that. The next one is protein. So protein, you'd mentioned that protein is set at the RDA.

You said that it was intended to prevent deficiencies. Now I'm gonna ask you a question. What health outcome is related to nitrogen balance? So the dietary guidelines of protein point eight grams per kg is based on nitrogen balance studies tech technique from the early nineteen hundreds for agriculture to determine what was the minimal amount of protein needed for animals to grow. Mhmm.

Based on nitrogen balance. What health outcome is related to nitrogen balance?

Dr. Mark Hyman
I always say it's muscle mass, but I think that's not the answer because it's too obvious.

Dr. Gabrielle Lyon
There's no health outcome that we know of related to nitrogen balance. And so rather than asking the question, is the RDA enough? A better question is, is the RDA a relevant number? Yeah. And the RDA is an irrelevant number.

Dr. Mark Hyman
Why?

Dr. Gabrielle Lyon
Because it's based on nitrogen balance studies with no health So

Dr. Mark Hyman
how do how do we look at the upper limit or the you know, like, I mean, there are certain populations, like, you have kidney failure, you have to be careful with protein intake. But aside from that

Dr. Gabrielle Lyon
But it's not based on an RDA number. No. And this is the thing is that rather than reevaluating and reorienting ourselves to, you know, the indicator amino acid number or some other way of thinking about protein, we've anchored in on the RDA, and then we argue about the RDA as if it's a really relevant number. It's not. Point eight grams per kg is based on a nitrogen balance study, which is arguably irrelevant.

Dr. Mark Hyman
I mean, I don't know if you've single handedly done this or who else is on the bandwagon here, but now protein is in everything. It's like everybody's talking protein.

Dr. Gabrielle Lyon
Right. And we you and I know we've been having this conversation. I've been having this conversation for twenty years. And it's great that it's caught up, and then it's getting the visibility it deserves, and there should be good evidence and guardrails. So point eight grams per kg while people are talking about the RDA is an irrelevant number.

We know, again and I've sent this to you not

Dr. Mark Hyman
So what we should be what should we be eating?

Dr. Gabrielle Lyon
Well, the data would suggest beyond point eight grams per kg, the data suggests anywhere from 1.2 to 1.6 grams per kg, which could be on the lower end point seven grams per pound up to one gram per pound target body weight. But how do we make our protein decisions?

Dr. Mark Hyman
You mean your ideal body weight?

Dr. Gabrielle Lyon
So if you're three No.

Dr. Mark Hyman
You're target hundred what if you're three hundred pounds Target

Dr. Gabrielle Lyon
body weight.

Dr. Mark Hyman
Like, what you ideally would like to be?

Dr. Gabrielle Lyon
Yes. You can

Dr. Mark Hyman
say If I'm I'm one eighty and I wanna get to one ninety with muscle, I have to eat a hundred and ninety.

Dr. Gabrielle Lyon
But let's let's let's frame this out a little bit. And I make this very easy to think about in the book. The book doesn't have a ton of numbers, which is interesting because we always calculate the macros and calculate the calories.

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
I made this playbook so that it's visual. And the visual component is one third of your plate should be protein. One third of your plate should be fruits and vegetables. The other third is complex carbs or starchy sugary carbs that you earn, which we'll talk about. But the protein conversation is really important.

Point eight grams per kg is irrelevant number based on nitrogen balance studies. All of the data coming out largely for the last twenty plus years is 1.2 will always perform better in a number of ways than point eight grams. Okay? Higher protein 1.2 to 1.6, so double the RDA. What happens?

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
Improvement and retention of lean body mass. I didn't say muscle because we haven't really been testing muscle. Lean body mass. Better regulation of blood glucose. Better regulation of triglycerides.

So when when I was running a weight management clinic at WashU and also in our practice, in order to tell if someone is following their nutrition plan, we watch their triglycerides.

Dr. Mark Hyman
Yeah. Of course.

Dr. Gabrielle Lyon
Right? A 140 grams of carbohydrates or less, we typically see an improvement in triglycerides by 20%.

Dr. Mark Hyman
So Those are the things that are most highly correlated in an acute way to the amount of sugar and starch you eat.

Dr. Gabrielle Lyon
But it's actually related to muscle health. So if muscle is healthy, you have more flexibility. So these indications of metabolic syndrome, elevated levels of blood glucose, elevated levels of triglyceride, elevated levels of insulin. They're not a reflection of metabolic syndrome. They're a reflection of muscle health.

Now we talk about protein as if it's one thing. Protein is 20 different amino acids, nine of which are essential, but they all have different biological pathways, and there's biological needs that are different. So for example, as we age, glutathione. Glutathione production goes down. We might need three times more protein in methionine as we age than we do when we're younger.

Dr. Mark Hyman
Thionine is one of the building blocks that

Dr. Gabrielle Lyon
we Right. So it's one of the Yeah. The amino acids. When you are eating for muscle health, all of those amino acids, essential and non, fall into line. And, you know, someone's listening to this, okay.

Protein is protein. Why do I need protein? Well, you need protein for a for everything in the body, but it's not just protein. It's these amino acids. It's these individual amino acids that you need.

Leucine is important for muscle health.

Dr. Mark Hyman
Right amount.

Dr. Gabrielle Lyon
For muscle health.

Dr. Mark Hyman
You're the one who taught me that leucine was the rate limiting amino acid for turning on the switch that starts you to build muscle.

Dr. Gabrielle Lyon
Yes. But you need all of the amino acids to build muscle, which is, you know, if we begin to just unpack what does that look like. So 20 different amino acids, nine in which are essential. You must eat them for a number of reasons. The first thing is understanding that we don't need it just for muscle.

The body turns over, recreates itself four times a year.

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
On a daily basis, protein turnover is between 250 to 300.

Dr. Mark Hyman
Meaning, you are you are metabolizing your own body's protein and recycling it

Dr. Gabrielle Lyon
and Everything.

Dr. Mark Hyman
Reusing amino acids that were formerly a different protein.

Dr. Gabrielle Lyon
Correct. And at night, you are in a catabolic state. But it's not that it's turned on and off. You've got enzymes that are degrading. You are constantly requiring these proteins.

It takes it from muscle. So it's not just that low muscle mass is detrimental for mobility. Low muscle mass is detrimental for healthy aging. And we cannot meet our turnover needs with the kind of diet that we have right now.

Dr. Mark Hyman
So we need more protein. So people should be focusing on point seven to one gram. And that's for everybody?

Dr. Gabrielle Lyon
For everybody. And the way in which you do it is important. When you're young and under 40, it doesn't matter what you do. Protein distribution and timing doesn't matter.

Dr. Mark Hyman
Meaning when you eat it.

Dr. Gabrielle Lyon
When you eat it. How much you eat at once. But as you get older, you have to learn how to make protein decisions. And there are a handful of steps that you follow to make a protein decision.

Dr. Mark Hyman
Tell it to us.

Dr. Gabrielle Lyon
Number one, age. The older you are, the more protein you need. Period. Number two, physical activity. The more sedentary you are, the more protein you need.

Really? Yes. Because we were talking about mTOR, which, you know, is mammalian target of rapamycin, this protein kinase complex. But can

Dr. Mark Hyman
you build muscle just by eating more protein without exercising?

Dr. Gabrielle Lyon
Not really.

Dr. Mark Hyman
Not really. That's what I thought.

Dr. Gabrielle Lyon
You know, people will say that, but if you go back well, number one, the other thing that we have to recognize is that the studies and the literature out there, it takes a long time. If you think about sarcopenia, it's in a span of a decade. You're losing 4% or more of muscle That's a very slow decline if you think about it. Can you imagine trying to look at these twelve week studies and try to get a sense of the input of 1.2 to 1.6 grams per kg? It's this stuff is not very sensitive with the tools we have.

We're not taking someone's muscle and then stripping it down. Right? So we have to understand that low protein intake is over a lifetime. Right? These effects are over a lifetime.

So the protein decision is the older you get, the more you need. Number one, your age. Number two, activity. The less active you are, the more protein you need. Because if there's two main ways to stimulate muscle as you age and becomes less sensitive, it's the mechanical input as resistance training, and then it's the protein input.

And then your metabolic health. Right? So the next choice would be how do you determine how much protein? Well, you know, you want to begin to limit carbohydrates if you're metabolically unhealthy, and you wanna increase dietary protein. Because ultimately, if we match our diet to our muscle health, then we will be able to live a long healthy life.

Dr. Mark Hyman
What does it look like? Because people go like, god. That's a lot of protein.

Dr. Gabrielle Lyon
But why do they think that? Because we've been taught

Dr. Mark Hyman
Right. But what what does it look like when you eat it? Like, lunch, dinner.

Dr. Gabrielle Lyon
So Very simple.

Dr. Mark Hyman
This morning, I had a protein shake, which was 50 grams of

Dr. Gabrielle Lyon
Great.

Dr. Mark Hyman
Whey protein.

Dr. Gabrielle Lyon
Amazing.

Dr. Mark Hyman
And put in ten grams of creatine.

Dr. Gabrielle Lyon
You're like rock star. Your brain function is amazing, and you threw a little urolithin a in there, and look at your

Dr. Mark Hyman
I did. I threw urolithin a in there too.

Dr. Gabrielle Lyon
You're doing amazing. I did. So there's a a couple ways to do it. The first meal when you're coming out of an overnight fast is the most important. People talk a lot about fasting.

And at some point, if we believe that muscle is the organ of longevity, I don't really care when you have breakfast, but recognize that after an overnight fast, you are in a catabolic state. Right? And you're not just your muscles, but you've got enzymes and and everything else is repairing and rebuilding in your body. That first meal, your body is primed for nutrients. Doesn't have to be at 8AM.

It could be at 10AM. Between thirty and fifty grams of protein is ideal. Okay? What does that look like? It could be a 15 gram a 50 gram protein shake.

It could be

Dr. Mark Hyman
It's actually double what the says on the label. Says it says two scoops is 25. I put in four scoops.

Dr. Gabrielle Lyon
Well, I love that.

Dr. Mark Hyman
But it's a lot of smoothie. Mean, I'm a big guy getting habit, but it's a lot of

Dr. Gabrielle Lyon
So let's talk about another let's talk about something that I do. Yeah. Right? So for me, I might have a scoop of a whey protein shake, which is has about 20 grams of protein, two and half grams of leucine, but that's not enough for me because, you know, I'm burning the candle at both ends, and I'm I'm training hard. So I'll add in a scoop of essential amino acids.

Dr. Mark Hyman
You can you supplement with amino acids?

Dr. Gabrielle Lyon
I do. And but I do it very strategically and for a very important meaning. So I know that you use body health. Yeah. So do I.

Dr. Mark Hyman
Perfect. Aminos was a big part of my recovery too. Yeah.

Dr. Gabrielle Lyon
And so there's great evidence for recovery and also for people who, say, want to control their calories. You have a base of protein, and and maybe it's 20 grams. And then you add in a scoop of essential amino acids, and now you bump up what your body's used.

Dr. Mark Hyman
Jacked up a little bit.

Dr. Gabrielle Lyon
Yes. And they there's a lot of data out there on this, especially looking at the aging population, which I think is really impressive. Yeah. When you're young, you can get a max muscle stimulation at, you know, 14 grams of protein. But 14 grams of protein for you and 14 grams of protein for me won't it won't stimulate our muscle.

But by doubling that amount or by adding these essential amino acids, you now can create a robust response that's critical for aging well.

Dr. Mark Hyman
So you may have protein shake with some extra amino acids. What if you don't want a protein shake? What's breakfast?

Dr. Gabrielle Lyon
Eggs. You

Dr. Mark Hyman
need six eggs to get 30 grams

Dr. Gabrielle Lyon
of protein. That's right. So do three eggs plus essential amino acids. I've just solved it. Also, what about Greek yogurt?

Greek yogurt is easy. The minimum you wanna hit is 30 grams.

Dr. Mark Hyman
And what is that? Six ounces, eight ounces?

Dr. Gabrielle Lyon
Yeah. So it's a a cup of yogurt. We'll have, like, 20. And then you could have turkey sausage, chicken sausage. If you are vegan or vegetarian, then I highly recommend essential amino acids and then some kind of multivitamin.

So what do you do? Again, if you're vegan or vegetarian, it could be tofu. You know, the majority of plant protein comes from wheat in The US diet. Yes. And wheat is a very poor source of these essential amino acids.

So we're really talking about improving pro we're talking about improving nutrient density.

Dr. Mark Hyman
Protein quality.

Dr. Gabrielle Lyon
Protein that's exactly right. Protein quality.

Dr. Mark Hyman
So what would be lunch?

Dr. Gabrielle Lyon
So for me, actually, and also from a dosing perspective Mhmm. Lunch doesn't matter from a protein amount. Yes.

Dr. Mark Hyman
And why?

Dr. Gabrielle Lyon
Because we don't have a ton of data. It does it have to be 30 grams of protein, or is your muscle still primed? The way I think about lunch is that that's the place where you just get your extra protein. The most important part about also these meals is balancing carbohydrates. So for lunch for me is so lunch today is gonna be I prep all my food on a Tuesday, by the way.

Prep all my food on Tuesday. Lunch for me, you might laugh at me, is gonna be protein waffles made with cottage cheese, almond flour, and some blueberry compote.

Dr. Mark Hyman
Blueberries. You're eating blueberries now? Of course. I couldn't even let you eat.

Dr. Gabrielle Lyon
I know. Yes. See, I've I've evolved. So the protein waffles are amazing. So that is one of it's a recipe that I put in the book.

So all recipes in the playbook are easy.

Dr. Mark Hyman
Great recipes in this book. And there's great images of exercise. You've got a little avatar cartoon of you that is really great. And it's it's like, wow. This is something I actually could follow.

Because I was like, alright. Well, I wanna vary something. I don't wanna do something like travel. I don't wanna do my trainer. Like, what do I do?

And this is really, really great.

Dr. Gabrielle Lyon
So And let's talk about dinner. Dinner is the

Dr. Mark Hyman
next I often will have, like, a couple of cans of sardines for lunch. That's, like, almost 50 grams. Yes. But if I need a 180 grams of protein a day, that's a lot of protein.

Dr. Gabrielle Lyon
But for who?

Dr. Mark Hyman
Well, I'm saying saying, like, if I have 50 grams for lunch or breakfast and I have a couple cans ready, that's 50 grams. So I need another 80 for dinner.

Dr. Gabrielle Lyon
Yes. And so but here's the other part is the more active you are. So protein decisions, it's a u shaped curve. And if you think about a u, at the top is the worst of all worlds is if you are an older person who is sedentary. Mhmm.

This is the worst of all worlds for muscle health and metabolic health. Yeah. But as you become more active than, you know, say, like, you're moderately active, your protein need goes down. Mhmm. So you offset the amount of protein you're eating with your physical muscle activity.

And then as you move into the more elite activity, which I'm not doing and you're not doing, the more protein you need.

Dr. Mark Hyman
So dinner would be what?

Dr. Gabrielle Lyon
For me, it's a lean steak. Six ounces.

Dr. Mark Hyman
Why lean? Why why low fat?

Dr. Gabrielle Lyon
Because I keep my I actually do better with carbohydrates. If I were to allocate how I want my food to be, I do much better on a higher carbohydrate diet than on a higher fat diet. It's just personal choice. Mhmm. Carbohydrates and fats are interchangeable as fuel sources.

Dr. Mark Hyman
I mean, you mean you don't mean like like flour or sugar. Right? You mean like a sweet potato? Or

Dr. Gabrielle Lyon
No. I just eat ice cream for dinner. I'm just kidding. No. I don't.

Dr. Mark Hyman
I mean No.

Dr. Gabrielle Lyon
No. I

Dr. Mark Hyman
don't. Let's be specific because I think people hear that, and they're like, oh, carbs are interchangeable.

Dr. Gabrielle Lyon
I But also, how do we think about carbohydrates?

Dr. Mark Hyman
Big bowl of pasta. Or

Dr. Gabrielle Lyon
We talk about how much protein someone needs in a day in a twenty four hour period, close to point seven to one gram per pound, but carbohydrates should be thought of as a meal threshold. We never talk about that. People do not talk about that. Just like protein has a meal threshold, carbohydrates should be thought of as a meal threshold. Are you ready for this?

The average American is eating 300 grams of carbohydrates a day. That's three glucose tolerance tests a day. Okay? But how do we recreate

Dr. Mark Hyman
four because it's seventy five grams in a glucose tolerance test.

Dr. Gabrielle Lyon
How do we re that's really funny. How do we recreate that? So for me, dinner is around 40 grams of carbs. Yeah. 40 to 50.

Okay? Anything above that for someone who's listening who is sedentary begins to distort metabolism. Mhmm. And I cover this in the book. Yeah.

It's something called a carbohydrate threshold. Carbohydrate threshold is how many grams of carbohydrates can you have at a meal before you begin to distort metabolism? Mhmm. What the choices are, again, one third is protein. One third is fruits or vegetables, fibers, carbs.

One third is more complex carbs. Is there a place for pasta? There is if you're training hard. Right? There's a place for pasta.

Yeah. But for me, you know, I like potato. I like white potato.

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
I like resistant starch. I might make the rice. I mean, I eat rice. Yeah. But again, I eat I also train.

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
And I am not grazing all day long.

Dr. Mark Hyman
The thing is you're you know, what people don't realize is there's this concept of metabolic flexibility.

Dr. Gabrielle Lyon
Correct.

Dr. Mark Hyman
If you're a diabetic and you have a can of Coke, your blood sugar will at 300. If you or I have a can of Coke, our blood sugar won't go above normal because we're metabolically able to handle the same sugar load because we're trained and we're our muscles and our tissues are more sensitive to insulin, and we can actually regulate our blood in ways that people can't, given the same exact dose of carbohydrate or in the form of carbohydrate. Yes. That's really important. I want to kind of shift gears a little bit.

I think this is fascinating. I think, you know, we covered a lot, but I want to talk about some of the sort of added things that I that I do, and I know you do. I mentioned creatine, and I think there's a lot of increasing data on creatine. I've Oh, been using it for long For

Dr. Gabrielle Lyon
cognition. For

Dr. Mark Hyman
cognition. Yeah. Muscle. Muscle building. It's a mitochondrial Mhmm.

Cofactor. And I use a lot of mitochondrial therapies for my own health because I've had mitochondrial issues. And one of the things that I've started using is something called urolithinane, which for those of you who know, we've talked about a little on the podcast. But essentially, it's a it's a molecule that's what we call a postbiotic as opposed to a prebiotic or a probiotic. It's a molecule that's made from using microbiome converting certain plant chemicals, ledge gas and others from pomegranate, walnuts, berries, into this molecule.

Problem is most of us have taken antibiotics. Most of us I mean, I do I do talks, I like have a thousand people. Mean, who here has never taken antibiotic? Like, maybe one person will raise their hand, or maybe nobody. And so we've all kind of messed up our gut and and and have trouble making this.

But this molecule is is found to have some really extraordinary properties around muscle quality, strength, longevity, muscle function Inflammation. Inflammation, immune health, mitochondrial function. So can you kinda walk us through what the research is on this compound? I mean, they're talking about grip strength and things like thing that kinda blows my mind about the research on this is that even without exercise, it seems to improve your fitness and strength, which Yeah. Seemed a little bit weird to me.

But but it seems to be true based on the data, including v o two max, grip strength, things that are highly correlated with longevity.

Dr. Gabrielle Lyon
Now urolithin a is a postbiotic that the majority of people cannot make. And this comes from these ellagitannins, from walnut, pomegranate. And let's say you could make it, it would be, I don't know, six, four cups of pomegranate juice. It's a lot of sugar. But the reality is is this urolithin a compound is so fascinating.

And and the company that we are both talking about is timeline because I don't I don't recommend actually other forms of urolithin a because I think it should really be tested.

Dr. Mark Hyman
Yeah. They spend they spend, like, a $100,000,000 researching this stuff. It's it's crazy. And it's published in JAMA and major medical journals. It's

Dr. Gabrielle Lyon
It is.

Dr. Mark Hyman
Not like a like, there's a lot of crappy supplements out there. There's a lot of hype and promotion. This is one of those things where, you know, you and I focus on where is the data? Where's the evidence? How good is it?

You know, where is it?

Dr. Gabrielle Lyon
I I mean, I'm a huge fan. And we had Anurag Singh, which is one of their immunologist scientists on on the podcast. And there's some really cool stuff that urolithin A is responsible for. What does it do? Its primary role is in mitophagy, and that is the removal and degradation of old mitochondria.

Yeah. And, you know, when you think about muscle and you think about urolithin A, the house of our mitochondria, the majority of our mitochondria

Dr. Mark Hyman
Is in our muscle.

Dr. Gabrielle Lyon
Is in our muscle. And one of the things that urolithin a does is it really helps with this turnover process. And the other fascinating thing about urolithin a that

Dr. Mark Hyman
It cleans up old damaged mitochondria and helps build new ones.

Dr. Gabrielle Lyon
Yes. It does. And the other aspect in terms of energy and metabolism, I think that we're gonna start to see emerging data. So we know that it helps improve strength and endurance. Again, grip strength.

I think there's also evidence for its use in individuals that are going through chemotherapy. Interesting. Because it helps with this muscle metabolism component.

Dr. Mark Hyman
Mhmm.

Dr. Gabrielle Lyon
And it's just it's a really extraordinary compound. One of the things that we hear in our clinic is that people's energy improves. I think that there's also going to be some emerging data on cognitive function. It's also I think a paper just came out in was it in JAMA on immune function and urolithin a? They just published another recent paper, and it's we typically recommend a thousand milligrams Yeah.

A day.

Dr. Mark Hyman
That's what I take. Yeah. And you can take it in gummies. You can take it in powder. You can take it in pills.

Yeah.

Dr. Gabrielle Lyon
It's pretty extraordinary. It's a pretty extraordinary compound that we definitely recommend.

Dr. Mark Hyman
And I think, you know, what what I like about it is that, you know, it's it's sort of a phytochemical. Mhmm. Sort of comes in nature, or sort of if your microbiome makes it. But it works on the mitochondria. And the mitochondria are are tricky because they're very delicate little organelles inside our cells that convert food and oxygen into energy, or ATP, that runs everything in our body.

And it's it's sort of the the foundation of our health. And most age related conditions are mitochondrial diseases. In fact, sort of aging itself is a decline in mitochondria. You see a two year old running around like a jackrabbit and a 92 year old sitting on the couch doing nothing. Yeah.

The difference is their mitochondria. And our ability to improve our mitochondrial health as we get older is partly related to exercise, strength training, muscle quality, cardiovascular fitness, both muscle strength training, also to things that we can actually influence by reducing our level of inflammation and toxins and infections and all the things that potentially affect it. But there are a lot of mitochondrial therapies. And it's something that has not been really well utilized in medicine at all. And what happens is that as we think about chronic illness, whether it's dementia, or Parkinson's, or obesity, or diabetes, or even cancer, autism, you know, mental illness, depression, bipolar, schizophrenia, the list goes on.

These are all mitochondrial diseases. Mhmm. And you and I went to medical school. And I think we had our first year, we learned biochemistry, and we learned about some mitochondria and histology, and like, that was kinda it.

Dr. Gabrielle Lyon
Yeah.

Dr. Mark Hyman
There's no like, how do you evaluate mitochondria? How do you test them? How do you treat them? How do you optimize their function? And as someone who at 36 years old got walloped with chronic fatigue syndrome as a result of mercury poisoning, my mitochondria, like, were in bad shape.

Like, my CPK, my muscle enzyme, were 600.

Dr. Gabrielle Lyon
Really?

Dr. Mark Hyman
Yes. Mhmm. For years and years and years. That's a sign of mitochondrial injury. Basically, damage.

Dr. Gabrielle Lyon
Yeah.

Dr. Mark Hyman
And I could feel it.

Dr. Gabrielle Lyon
Like Rabdo. Now I'm not at 600,

Dr. Mark Hyman
Mhmm. What's that?

Dr. Gabrielle Lyon
Rabdo. You know, as I was just thinking

Dr. Mark Hyman
rhabdomyolysis, but it was like

Dr. Gabrielle Lyon
Of course.

Dr. Mark Hyman
It was some degree of muscle dysfunction. I mean, when you get on a statin, that causes muscle injury. It's a mitochondrial toxin. And it actually leads to these muscle pain syndromes and also elevations in this muscle enzyme that I had. Mhmm.

But it's but what I'm saying is that I got to really learn, okay, what are my mitochondria? How do they work? And I started applying this in medicine. And so urolithin A is a really powerful mitochondrial nutrient. But there's many others.

CoQ10, carnitine, creatine, ribose, and acetal cysteine, all the b vitamins, and magnesium. There's a lot of things you need to actually produce energy. So it's important really to understand how do they take care of their mitochondria. And so this is one incredible tool. And I I think it's it's of of all the sort of longevity

Dr. Gabrielle Lyon
I agree with you.

Dr. Mark Hyman
Wellness supplements is I believe. It's quite it's quite unique, and it's part of my daily staple, actually.

Dr. Gabrielle Lyon
Same. I'm very careful about the it's actually in this book, by the way.

Dr. Mark Hyman
Yeah. I know. You wrote about it in the book. Was gonna say that.

Dr. Gabrielle Lyon
I did. Because it is something that with all the velocity at which information spreads, how do we begin to make choices that actually can move the needle? And I think that urolithin a is a a great one. Absolutely. And I think we're gonna start to see it be more involved in what I would love to see is how it actually helps those with chronic illness that are going through therapies like chemotherapy.

Dr. Mark Hyman
Well, we have so much more to talk about. Is there anything else before I hit the quick fire questions at the end here that you wanna share about what you're doing, what's important, what's in the book?

Dr. Gabrielle Lyon
I think the big takeaway is what many of the diseases that we're seeing now are a mismatch for muscle health. And if we don't become careful, we're going to trade an obesity epidemic for an epidemic of sarcopenia. And we have an opportunity to not recreate history. And it's happening right now in a way that we've never seen before with the use of GLP-1s. And then also with now the more liberal discussions on hormone replacement and specifically the anabolic agents, this is this is the time.

Dr. Mark Hyman
And we're learning a lot. Yeah. Yeah. Yeah. The GLP one thing is interesting.

I mean, you're it's not black or white. They're not good or bad. They're like any other tool. And when they're applied properly, they can be helpful. When they're applied improperly, they can be extremely hard.

Dr. Gabrielle Lyon
And they can help with the intramuscular adipose tissue. Yep. And, again, the next conversation that I would love to see as we begin on this journey just in general on reorienting ourselves to muscle health is that anabolic agents beyond testosterone or these myostatin inhibitors, what else do we need to do that affects muscle health? And and I will say one last thing regarding this is that a patient can go to their doctor and say, I want a medication that's gonna help me lose fat. And the doctor probably doesn't think twice about it.

But if a patient goes to their doctor and says, I want a medication that's going to help me build healthy muscle, it's a completely different story. Two organ systems, yet two completely different biases.

Dr. Mark Hyman
But what's the answer to that question? Which part? What drug can I take to build muscle?

Dr. Gabrielle Lyon
There are anabolic agents that are FDA approved that we have to have more conversation about that have to be more involved in the conversations just in general. And that is

Dr. Mark Hyman
are using testosterone more.

Dr. Gabrielle Lyon
Yes. And this is the path this is the path forward.

Dr. Mark Hyman
Yeah. As a mother and a woman, what are the top three things that you do personally to support as long as you have it?

Dr. Gabrielle Lyon
I spend time with the people I love.

Dr. Mark Hyman
Oh, that's a good one.

Dr. Gabrielle Lyon
Just like you, I'm very community oriented. I I care about relationships, and so I do that.

Dr. Mark Hyman
It's true. You reach out to me, and I really appreciate that. Stay connected. Mhmm. I think that's an important part that we neglect.

You know, we can eat well and exercise and take all our supplements. But if you don't build community connection relationships, the quality of your life is less, your longevity is shorter.

Dr. Gabrielle Lyon
And consistence consistently, it's not transactional for me. I'm a relationship person.

Dr. Mark Hyman
So that's that's one thing. What are the other two?

Dr. Gabrielle Lyon
I always train.

Dr. Mark Hyman
And you mean it's train training?

Dr. Gabrielle Lyon
I do.

Dr. Mark Hyman
Three times a week.

Dr. Gabrielle Lyon
Yes. And if I train hard enough that if I miss a training session let's say it's impossible. Let's say and it's usually not. But let's say it was. Let's say my flight was delayed or I was in the airport, and the best that I could do is push ups in the airport, which I will do and on the plane.

I did go to Australia and did push ups in the yeah. But whatever. People are like, that's a crazy person. I make it count when I'm in there.

Dr. Mark Hyman
The crazy people are the only ones that change the world, so I'm with you on that.

Dr. Gabrielle Lyon
Okay. Great. I train hard enough that I'm not dependent on the next workout if it's if for some reason I'm traveling. Yeah. But resistance training is a nonnegotiable, and people will say I don't have time, but you don't have time not to.

Yeah. I train with my kids.

Dr. Mark Hyman
There's a there's a slide that I use using my talk. And then this this guy was like, you either have a choice. You wanna be wanna exercise one hour a day or be dead twenty four hours a

Dr. Gabrielle Lyon
day. That's funny. That's that is awesome. And we make training a family affair. You know, I walked down

Dr. Mark Hyman
I see that in your video.

Dr. Gabrielle Lyon
I walked downstairs, and my son was on the treadmill sprinting. I'm like, Leonidas, it's 8PM. This is this is way bad time. He's like, mom, I gotta get my training in. This is my second training session of day.

Gotta get it done.

Dr. Mark Hyman
I love that.

Dr. Gabrielle Lyon
I mean and so it's not I'd rather have them decide on the good habits rather than try to break bad ones.

Dr. Mark Hyman
Yeah. And what's the third thing?

Dr. Gabrielle Lyon
The third thing that I do for longevity? This is a a toss-up. Obviously, the obvious answer is my nutrition.

Dr. Mark Hyman
Yeah.

Dr. Gabrielle Lyon
But I think the not so obvious answer would be spending time with my husband and really talking about the family and the landscape of how we wanna go through life. So spending time on the standards of how we're raising our kids and

Dr. Mark Hyman
Your values. Yeah. Yeah. That's beautiful. Mhmm.

Your mindset and values of how you approach life. That's beautiful. Amazing. Alright. Quickfire questions.

Fasting for women.

Dr. Gabrielle Lyon
Sure.

Dr. Mark Hyman
When does it help? When does it hurt?

Dr. Gabrielle Lyon
If you're trying to get pregnant, I typically don't recommend fasting. Again, there's nothing magical to fasting. It's calorie control. It allows for gut rest. But, you know, if you're more mature and older and wanna maintain muscle, don't recommend it.

If you decide you wanna do it, I train fasted.

Dr. Mark Hyman
Mhmm.

Dr. Gabrielle Lyon
It's totally your own choice. Choose your own adventure.

Dr. Mark Hyman
And, you know, twelve hours is minimum. Like, people think that's a fast, but it's not. It's normal. But people eat all night, and then they wake up and eat. And I'm telling you, you eat in the middle of the night.

So, yeah, just at least twelve hours. Artificial sweeteners, good or bad?

Dr. Gabrielle Lyon
Not gonna like this. Not dead yet.

Dr. Mark Hyman
Not dead yet. Because what is the evidence that they're actually okay for your health? What the evidence that they're not? Because I think Yeah. It's controversial.

Dr. Gabrielle Lyon
So I would say things like Splenda might not be great for the gut microbiome. And there's Sugar alcohols. Right. So Suzanne Devcota is someone who I look to to answer those questions. I'm I'm certainly not a a microbiome expert.

But I think, for example, artificial sweeteners when used in moderate doses, you know, not abusing it is, you know, the data doesn't say that it's terrible for you. But, again

Dr. Mark Hyman
It doesn't depend which one because they're not all crazy. Like, is it monk fruit or or, like Monk

Dr. Gabrielle Lyon
fruit is is no problem.

Dr. Mark Hyman
Or stevia.

Dr. Gabrielle Lyon
Or aliolus is no problem.

Dr. Mark Hyman
So aspartame or erythritol or xylitol or other sugar alcohols, melatonin. Those can be problematic.

Dr. Gabrielle Lyon
It depends on the kind, and it depends on the dose, and it depends on the person for sure.

Dr. Mark Hyman
A little bit of sebia or monk fruit or

Dr. Gabrielle Lyon
I have no so I don't have problems with those. So this is, again, this is just my personal opinion. I'm okay with it.

Dr. Mark Hyman
I think one of the things that we're we have to understand is is the way it affects the brain. Because it does it does keep you lit in the areas where you don't wanna be Which one? All of them may increase, you know, your your sweet perception, which causes your brain to light up Mhmm. And to crave more. And so it's it's I think there's a there's a probably a craving cycle that it activates, but who knows?

How about caffeine? Good? Bad?

Dr. Gabrielle Lyon
All of it. So I the people that should not use caffeine is if you're pregnant, they don't recommend two hundred milligrams or more. And, you know, listen. If you have a genetic perhaps you're a slow metabolizer, then maybe it's not great for you. But, otherwise, I think caffeine has been around for a long time, studied for a long time, and can be used well.

And I drink a lot of caffeine. People make fun of me. They're like, you're five one, a hundred and ten pounds, and you drink more caffeine. You drink you drink enough caffeine to kill a draft horse. And I would say that this

Dr. Mark Hyman
is true. And it doesn't affect your sleep? No. That's amazing. Your fast metabolizer.

Yes. How about menopause? What's the number one thing women going through that need to know?

Dr. Gabrielle Lyon
Be

Dr. Mark Hyman
strong. Be strong like forever strong?

Dr. Gabrielle Lyon
Yes. Strength is a responsibility. Strength will take you through that time. Physical strength begets mental strength. It's a lever that you can pull that you have control over.

You have to be strong. No amount of hormone replacement is going to be a solution for being strong.

Dr. Mark Hyman
It does help balance your hormones. It helps balance blood sugar and insulin. Helps balance

Dr. Gabrielle Lyon
It's a nonnegotiable. It's the new Everything about of longevity. It's just it has to happen.

Dr. Mark Hyman
What about cold exposure? Good or bad for women? Cold plunges?

Dr. Gabrielle Lyon
I love it. I do it every day.

Dr. Mark Hyman
No downside?

Dr. Gabrielle Lyon
Nope. No. And that's I have protocols

Dr. Mark Hyman
in the book. I've been hearing hearing in the, you know, in the the misinformation Internet cybersphere

Dr. Gabrielle Lyon
that The mechanistic there's the mechanistic data. So when I told you that we just published this paper on sexual function and muscle mass, there has to be a mechanism that then is related in humans. So there can be mechanism, but the mechanism doesn't necessarily translate or hold up. You know, for example, we like urolithin A because we know that there's a proven mechanism translates over to humans. We like essential amino acids because there is a mechanism.

We know how this works. Translates over to human. The idea of cold exposure being different for men or women at this point, there might be mechanistic ideas, but I have not seen that translate over at all. And I think that cold exposure has been used for lifetimes. I have cold exposure protocols in this book.

We are very acclimated to our perfect environment. It's not ideal. We want hormesis. It's way of stress. Same with heat.

Dr. Mark Hyman
K. We've got a cold plunge out back.

Dr. Gabrielle Lyon
I can't wait. I would do it in a heartbeat. You give me a bathing suit. I'm not wearing yours. I will do it

Dr. Mark Hyman
in a heartbeat. Alright. Creatine is something everybody should take or you'll read?

Dr. Gabrielle Lyon
Yes. No. I think that it's again, is there something that everyone should take? No. But creatine is I I it's been around for a long time.

I think there's a lot of positive. The other thing that I think is really valuable too we didn't talk about is ketones. Ketones. Exogenous ketones? Yes.

Dr. Mark Hyman
And Taking ketones that are preformed, you can then you

Dr. Gabrielle Lyon
can Exogenous ketones. Beta hydroxybutyrate. Yes.

Dr. Mark Hyman
Tell us about why.

Dr. Gabrielle Lyon
Because there's just more and more evidence from a brain perspective, cognitive perspective, you name it. It just seems to improve performance. I I think there's a ton of benefits. Mhmm. I talk about that in the book as well.

Okay. If I could just make a a product myself, I would definitely that would be it.

Dr. Mark Hyman
Not being in ketosis from a diet, but adding supplemental ketones.

Dr. Gabrielle Lyon
No. For brain function. Right? For the ability of neurons and and cells. I mean, from a because, damn, we talk about brain fog all the time and mitochondrial health.

Dr. Mark Hyman
Amazing. Amazing.

Dr. Gabrielle Lyon
T Jones are another one.

Dr. Mark Hyman
Well, Gabrielle, you know, we've known each other a long time. I've seen you grow, evolve, develop your career, be a spokesperson for a new kind of thinking about muscle health. And just I mean, the whole idea of muscle centric medicine, I just think, is brilliant. And your new book, Forever Strong Playbook, is out. Everybody needs to get a copy.

It's the playbook for you if you wanna stay healthy long time and be functional and feel good. Where can people learn more about your work and what you're doing?

Dr. Gabrielle Lyon
Well, you can go to my Instagram, doctor Gabrielle Lyon. My website, doctor Gabrielle Lyon dot com. We have a medical practice called Strong Medical. And we have been around for a while, and we just have tremendous, tremendous patience and results. Also, my podcast, which you'll be coming on, the doctor Gabrielle Lyon show.

I have a newsletter. I have a YouTube, Twitter. Did I miss anything? I'm also a part time travel agent for my kids.

Dr. Mark Hyman
Amazing. Well, Gabrielle, keep up the good work. Make sure you take care of yourself. And thank you for all the wisdom you've given us.

Dr. Gabrielle Lyon
Thank you.

Dr. Mark Hyman
If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Doctor Mark Hyman. Please reach out, I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to The Doctor Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Doctor Mark Hyman for video versions of this podcast and more.

Thank you so much again for tuning in. We'll see you next time on the doctor Hyman show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health where I am chief medical officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests.

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