Top Muscle Health Secrets to Boost Longevity and Reverse Aging—with Dr. Gabrielle Lyon

Mark Hyman, MD

Full Transcript

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Dr. Mark Hyman: Welcome to The Doctor's Farmacy. If you care about being healthy and strong as you get older, you're gonna love this podcast with doctor Gabriel Lyon, who's a great friend of mine, extraordinary physician who studied muscle centric medicine, a thing that you probably never heard about, but is one of the most important things I don't know about to age well. She wrote incredible call for ever strong, a new science based strategy for aging well. She's got a great podcast at Doctor Gabrielle Line Show.

Dr. Mark Hyman: Her website, Doctor Gabrielle Line is full of great information to help you optimize your health. And on today's podcast, we talked about some things that I think most people don't know about, which is the muscle that you have on your body being the biggest organ. We talked about its role in our metabolic health and our immune health in regulating blood sugar, in regular insulin, in our liver health, and pretty much our hormonal health, pretty much everything. Right? If you wanna live well, you need good muscle.

Dr. Mark Hyman: We also dove deep into how to build good muscle, what you need in terms of exercise, what you need in terms of diet. We talked about some of the science and the controversies in the space, and I think you're gonna love this podcast. So let's dive right in. Welcome back to The Doctor's Farmacy Gabriel. It's been such a pleasure to have you gone before.

Dr. Mark Hyman: And I know our listeners are just gonna love this podcast because we're gonna get deep into the muscle, into the trigger point. And the controversies and the questions about why we should be paying attention to muscle. You know, as I was thinking about preparing for this podcast, I realized there is no specialist in medicine that is dealing with the muscle. Like, there's, you know, a rheumatologist of the joints. There's, you know, physical medicine rehab.

Dr. Mark Hyman: It's more about rehab. There's orthopedics in terms of the bones.

Dr. Gabrielle Lyon: Come up with this. Musal centric medicine.

Dr. Mark Hyman: That's right. Muscle centric medicine, right, which is actually

Dr. Mark Hyman: a really important framework for understanding human biology that was sort of absent from our training. We never learned about muscle other than what the muscles were,

Dr. Mark Hyman: where they attached, and you know, basically like some

Dr. Mark Hyman: rare muscle diseases like rhabdomyolysis or, you know, autoimmune muscle diseases or weird muscular

Dr. Mark Hyman: dystrophy things. So it was like, it was kind of a non thing. Right? And we didn't learn about why it's important, what it does in the body, how it functions, how it's probably the most important organ, and yet we don't even have a specialty about it. Well, now we do it because you created it.

Dr. Mark Hyman: But it's I'm working

Dr. Mark Hyman: on it.

Dr. Mark Hyman: I gave important certified yet in muscle centric

Dr. Gabrielle Lyon: Working on it.

Dr. Mark Hyman: Working on it. Alright. A great

Dr. Gabrielle Lyon: new project

Dr. Mark Hyman: for it. That's good. I think it should be because because, you know, as as I begin to learn from people like you and other people about muscle, I began to realize that, you know, this is this is not just a bunch of muscles dragging your skill around and making you move your arms and legs and your body around. It's is a very dynamic organ, and it's probably the biggest organ in our body. I mean, I think dermatologists say the skin is, but You're also 40% of your body weight.

Dr. Mark Hyman: Yeah. It's huge. So this is the biggest organ in your body. It's not just for

Dr. Gabrielle Lyon: locomotion.

Dr. Mark Hyman: It's it's highly functional in terms of immune function, metabolic function, hormonal function. So I I wonder if we could sort of start by zooming out a little bit and and have you sort of explained to people you know, what the heck does muscle do beside make you walk down the street? Yeah.

Dr. Mark Hyman: I I think it's a great question. And also you framed up everything nicely with this concept that we have

Dr. Gabrielle Lyon: not thought about skeletal muscle,

Dr. Mark Hyman: as the largest organ in the body. We have it. Skeletal muscle.

Dr. Gabrielle Lyon: Even as an organ. That's that's right. And it is the organ of longevity. In the space now, we hear all about longevity, and one would have to recognize that the health and trajectory of how we age and how we live is directly related to the health of our skeletal muscle.

Dr. Mark Hyman: Mhmm.

Dr. Gabrielle Lyon: The other point that you made is when people think about skeletal muscle is they think about locomotion and activity and sports and you know, in the sixties, the, you know, muscle beach and American heart association with cardiovascular activity and aerobic type training, but the reality is skeletal muscle is a tool for optimal health. It is a tool that we have voluntary control over. And when we think about skeletal muscle, the obvious is there. Mobility, strength, power, flexibility, Yeah. Balance.

Dr. Mark Hyman: Which is all important. You wanna be able to move

Dr. Gabrielle Lyon: around a little bit?

Dr. Mark Hyman: Get up off the floor and tire shoes.

Dr. Gabrielle Lyon: You have to.

Dr. Mark Hyman: And that's my skin with my dad when he was seventy four, and he fell. He couldn't get up. And I had to, like, drag him up off the mountain. You know?

Dr. Gabrielle Lyon: Yes. But

Dr. Mark Hyman: that shouldn't happen. Like,

Dr. Gabrielle Lyon: It shouldn't happen.

Dr. Mark Hyman: It doesn't have to happen. The other important aspect about skeletal muscle is the framework of metabolic health.

Dr. Gabrielle Lyon: And I think in body building circles, people have talked a lot about skeletal muscle from a metabolic sync perspective. It's the primary site for glucose disposal. The carbohydrates that you eat, skeletal muscle is It's where you burn your calories. That's right. So also a primary site of mitochondrial function.

Dr. Gabrielle Lyon: Mhmm. No matter where you believe longevity or health begins.

Dr. Mark Hyman: You know,

Dr. Gabrielle Lyon: you've had tons of experts on this podcast.

Dr. Mark Hyman: Some might might say that it's about the mitochondria. Some might say that it's about, I don't know, sirtuins

Dr. Gabrielle Lyon: or some might say it's about inflammation. Give me someone else.

Dr. Mark Hyman: Microbiome.

Dr. Mark Hyman: There

Dr. Gabrielle Lyon: you go. Microbiome. Give me something else. Give me one

Dr. Mark Hyman: more thing. Oh,

Dr. Gabrielle Lyon: Yako Moto factors. Is that the right

Dr. Mark Hyman: thing? Yamanaka.

Dr. Gabrielle Lyon: Yamanaka. There you

Dr. Mark Hyman: go. You know, hormones. Okay. Stress. Perfect.

Dr. Gabrielle Lyon: The unifying organ system

Dr. Mark Hyman: is skeletal muscle with all of these things. If you want healthy mitochondria, you need healthy skeletal muscle. So so take a stand.

Dr. Gabrielle Lyon: And we we we know that that, mitochondria are

Dr. Mark Hyman: key to healthy aging and having plenty of them and having

Dr. Mark Hyman: them in good operating condition and having them souped up so they are very effective and efficient and to clean them up and to repair them at all really important. And a

Dr. Mark Hyman: lot of longevity strategies we talked about help us do exactly that, whether it's taking your lift in a or I love your

Dr. Mark Hyman: lift in a or exercising or whatever, but but, you know, the the real the real thing I want you to help explain is is

Dr. Gabrielle Lyon: not it goes beyond just having

Dr. Mark Hyman: enough muscle that's well functioning so you can be functional as you get older. Right? So you can do stuff. It's great. I mean, I wanna ski.

Dr. Mark Hyman: I wanna hike. I wanna put tennis, but but, Turner, I want you to unpack, like, scientifically besides the mitochondria because I think people understand that chondria is really the factories of energy production and their

Dr. Mark Hyman: keto longevity. Walk us through how the muscle plays a role in the

Dr. Mark Hyman: immune system, in hormonal health, in stress, and growth hormone and to repair all the things that we don't really think about that it does, but is essential for our health and longevity?

Dr. Gabrielle Lyon: I think it's a wonderful question. And there's a few ways to frame it. And quite simply, there's active skeletal muscle, and then there's inactive skeletal muscle. Inactive skeletal

Dr. Mark Hyman: muscle, we can think about from at rest. Meaning, you're

Dr. Gabrielle Lyon: still active, but, again, you and I are very active, but we're sitting here. At this moment, we are not active. Then there's also sedentary skeletal muscle inactive versus

Dr. Mark Hyman: sedentary skeletal muscle. Inactive skeletal muscle. Again, we are just sitting here, but we're still active on a daily basis. We have

Dr. Gabrielle Lyon: a lot of flux, which I'll get to. And then there's sedentary skeletal muscle. That is never healthy.

Dr. Mark Hyman: When you look at the data in PAVmed or you look at these large research, trials

Dr. Gabrielle Lyon: or cohorts and they define healthy sedentary individuals, skeletal muscle when it is sedentary is almost like a swamp.

Dr. Mark Hyman: So meaning if you don't usually exercise Correct.

Dr. Mark Hyman: And

Dr. Mark Hyman: you don't strength training, you don't do cardio, even though you're you're quote healthy, you're really not because your muscle's not healthy.

Dr. Gabrielle Lyon: You're not. And there is when you think about what skeletal muscle does.

Dr. Mark Hyman: So you're saying there's no such thing as healthy sedentary skeletal muscle.

Dr. Mark Hyman: So if

Dr. Mark Hyman: you're a sedentary person

Dr. Gabrielle Lyon: It you you, by definition, have unhealthy skeletal muscle. Right.

Dr. Mark Hyman: So, I mean, we exercise a lot. So we're sitting here. It's fine. That's that's

Dr. Gabrielle Lyon: We're inactive right now. But we're not sedentary. And I was looking at some of the definitions of what defines sedentary, and not surprising there is a lot of ways in which we can think about it. Is it a metabolic equivalent? Is it about how much we're burning?

Dr. Gabrielle Lyon: Is it about how many steps is someone having less than five thousand steps? There's a whole host of ways in which we can define sedentary behavior.

Dr. Mark Hyman: But at the end of the day, what is the outcome that we're thinking about? And I think by framing it up what skeletal muscle does, skeletal muscle is the

Dr. Gabrielle Lyon: primary site for glucose disposal.

Dr. Mark Hyman: The carbohydrates that you eat must go somewhere. Carbohydrates dominate metabolism. Yeah. When you have an excess of carbohydrates, they dominate metabolism. You must

Dr. Gabrielle Lyon: move glucose out of the bloodstream into tissues.

Dr. Mark Hyman: And that's why exercising helps with insulin resistance

Dr. Mark Hyman: and diabetes and blood sugar control because it sort of basically sucks up all

Dr. Mark Hyman: the glucose. And scientifically, there's 2 ways in which that happens. There is the insulin dependent action

Dr. Gabrielle Lyon: which affects for the science nerds, gluten for transporters to move glucose out of the bloodstream into cells.

Dr. Mark Hyman: And then there's the contraction related, gluten for transporters. So they're all gluten for transporters,

Dr. Gabrielle Lyon: but it doesn't require insulin when you're exercising.

Dr. Mark Hyman: So your if you're exercising, your body will take up glucose

Dr. Mark Hyman: and your muscles even without insulin to this sort of sideways pathway. Exactly. And so when

Dr. Mark Hyman: we think about why is healthy skeletal muscle important?

Dr. Gabrielle Lyon: Again, we're gonna talk about each of these different domains, but from a mass standpoint, skeletal muscle mass makes up 40% of the body. Insulin resistance is at the root of nearly every metabolic disease. Right? Yeah. Agree that It's

Dr. Mark Hyman: the central feature of aging, heart disease, cancer, diabetes dementia, infertility,

Dr. Mark Hyman: depression, the list goes on and on.

Dr. Mark Hyman: And there's really some seminal work by defranzo and some of

Dr. Gabrielle Lyon: these individuals out of Yale, Patterson, or Peterson. Pedersen is in Copenhagen, but some of these individuals that really highlighted insulin resistance of skeletal muscle first. Even if an individual is young, eighteen year old college student. No outside signs, outward signs of obesity

Dr. Mark Hyman: or anything. Yep. An inactive individual because of insulin resistance, because skeletal muscle is designed to

Dr. Gabrielle Lyon: move, like, healthy, sedentary individual without outward signs of

Dr. Mark Hyman: insulin resistance or unhealthy skeletal muscle Mhmm. Will begin to have a distorted

Dr. Gabrielle Lyon: metabolism very early on. Yeah. So what makes up healthy skeletal muscle? So if you go back

Dr. Mark Hyman: I mean,

Dr. Mark Hyman: by the way, 40% of kids are overweight.

Dr. Gabrielle Lyon: Not only.

Dr. Mark Hyman: Right? What And, probably another 40% are not that active. Right?

Dr. Gabrielle Lyon: And then adults adults with overweight or obesity. What is it? 75%.

Dr. Mark Hyman: 75%. 50% of Americans are not exercising. Now Only 50. I thought it was a lot less than Well, 75% are not actually meeting the criteria,

Dr. Gabrielle Lyon: which is a 150 minutes a week plus 2 days of resistance training. Yeah. So nearly 75% are not meaning that.

Dr. Mark Hyman: Yeah. That sounds more.

Dr. Gabrielle Lyon: But but there's a couple things to unpack here is when you think about why skeletal muscle. Why skeletal muscle? Because at the basis, it is at the root of these diseases of aging. And I know that I'm speaking in extremes and I apologize for that, but when we think about insulin resistance, because that is a primary driver, then we have to think about what happens to skeletal muscle. Yeah.

Dr. Gabrielle Lyon: Skeletal muscle is the primary site for

Dr. Mark Hyman: glucose disposal. At rest, it burns fatty acids. People think, well, muscle burns a

Dr. Gabrielle Lyon: ton of carbohydrates at it doesn't. It burns fatty acids. It Which come from Foods. Foods. But also

Dr. Mark Hyman: it can come from carbohydrate.

Dr. Mark Hyman: Right? It

Dr. Gabrielle Lyon: can come from absolutely. If you were to think very practically, what are some of the lab values of unhealthy skeletal muscle? I'm gonna lay it all out for your

Dr. Mark Hyman: listeners. High triglycerides?

Dr. Gabrielle Lyon: High triglycerides? What else?

Dr. Mark Hyman: High insulin.

Dr. Gabrielle Lyon: That's right.

Dr. Mark Hyman: High a 1 c.

Dr. Gabrielle Lyon: That's right.

Dr. Mark Hyman: High blood sugar.

Dr. Gabrielle Lyon: Yes.

Dr. Mark Hyman: Small LDL particles.

Dr. Gabrielle Lyon: There you go. Keep going. These are all

Dr. Mark Hyman: My APOB.

Dr. Gabrielle Lyon: These are signs of unhealthy skeletal muscle first.

Dr. Mark Hyman: Mhmm. And CRP inflammation.

Dr. Gabrielle Lyon: Exactly. When we have this large organ system that is generating low grade inflammation, this bag of tissue that's that's

Dr. Mark Hyman: generating low grade inflammation, then the it distorts metabolism. But then

Dr. Gabrielle Lyon: the other thing that happens

Dr. Mark Hyman: is

Dr. Gabrielle Lyon: we have to recognize that skeletal muscle, if skeletal muscle is a suitcase. Yeah. And let's say there's liver glycogen, depending on your size,

Dr. Mark Hyman: maybe you have a whole lot. Glycogen is the storage form of carbohydrates that we can store only about 25100 calories. So

Dr. Mark Hyman: and

Dr. Gabrielle Lyon: So for liver might be a 100, maybe 200, depending on the size of your liver, skeletal muscle might be

Dr. Mark Hyman: anywhere between, again, depends on the person, 4 or 500 grams of of glycogen. Now why does

Dr. Gabrielle Lyon: that matter? Because if an individual is sedentary, we know that the average American eats 300 grams of carbohydrates a day. Yeah.

Dr. Mark Hyman: A lot. Then we also recognize the metabolic function of muscle, which is glucose disposal, fatty acid oxidation, and it also utilizes branch chain

Dr. Mark Hyman: amino acids.

Dr. Gabrielle Lyon: One recognizes that there's nowhere else for these substrates to go.

Dr. Mark Hyman: I mean right.

Dr. Gabrielle Lyon: Distorts metabolism.

Dr. Mark Hyman: Right. They go to the organs too. I mean, something like that.

Dr. Gabrielle Lyon: But if it can't go to muscle,

Dr. Gabrielle Lyon: then it's actually just goes to fat.

Dr. Gabrielle Lyon: It goes to fat.

Dr. Mark Hyman: Right. Distral fat.

Dr. Gabrielle Lyon: Visceral fat

Dr. Mark Hyman: Belly fat.

Dr. Gabrielle Lyon: Belly fat, liver fat, muscle fat. And then what happens is now you have dysregulated metabolism.

Dr. Mark Hyman: And you

Dr. Mark Hyman: have a rib eye instead of filling it up. Exactly.

Dr. Gabrielle Lyon: It's exactly where I was going. So now you have fat that infiltrates. It's called myocyatosis.

Dr. Mark Hyman: That's a big word.

Dr. Gabrielle Lyon: I know. I do not know how to spell it. Don't ask me how to do it.

Dr. Mark Hyman: It means you get marbled muscle like a nice Wagyu rib eye steak, which maybe find to eat, but not to have as your body.

Dr. Gabrielle Lyon: And we also know from cross sectional imaging that it doesn't have to happen.

Dr. Mark Hyman: Yeah.

Dr. Gabrielle Lyon: When you see skeletal muscle that is like a fillet, it's typically exercise skeletal muscle.

Dr. Mark Hyman: What is one of the problems with

Dr. Gabrielle Lyon: skeletal muscle is that it is an organ system that requires flux to be healthy. What is flux? Flux is doing activities that deplete energy from skeletal muscle. Deplete glycogen, utilize these fatty acid biproducts. Flux of nutrients in and out.

Dr. Gabrielle Lyon: And out.

Dr. Mark Hyman: In and out.

Dr. Gabrielle Lyon: So the the funny part is, Mark, I feel like we're on a talk show because you and I have known each other. Every time I see you, I have to count another year. Sure. And it's pretty funny.

Dr. Mark Hyman: That's true.

Dr. Gabrielle Lyon: And one thing that I learned from you very early on, and for the listener, they might not know this or the viewer, however, they're consuming this, is I learned from you when you, I mean, over a decade ago, I would come to your clinic and I would listen to you talk to patients. And my whole point is is you always said Gabrielle. You have to simplify it. That there can be these very complex topics, but it has to be so someone at home

Dr. Mark Hyman: can think about it and take action. Yeah. Exactly. And so this idea of physical activity, you can I

Dr. Gabrielle Lyon: would argue it's never too early to start? Exercise. I wanna talk about exactly what that is. It's never too late

Dr. Mark Hyman: to start. It's never too early

Dr. Gabrielle Lyon: to build strength, and it's never too late to build strength. No. And why do we underestimate skeletal muscle because it's been very difficult to test it. It is very heterogeneous. It there are different fiber types.

Dr. Gabrielle Lyon: You know, the main 2 fiber types type 1, type 2, type 2 a, type 2 x, But the reality is these fiber types transition. And someone's like, well, why do I care about fiber types? Stated simply the big bulky fibers Mhmm. Type 2 fiber types. If you do not keep up with training and doing these things, these fiber types change.

Dr. Gabrielle Lyon: We I mean, both of our parents, you know, sorry, dad, but they get skinnier. Skinnier, flabbier. They do.

Dr. Mark Hyman: They shrivel.

Dr. Gabrielle Lyon: They shrivel. And they have a body recompositioning that happens. They gain body fat. They lose skeletal muscle all while their weight stays the same.

Dr. Mark Hyman: Okay. Right. So that's, like, what we call skinny fat. But but I wanna get back to kind of the the the sort of framework of muscle as an organ. Right?

Dr. Mark Hyman: We we sort of established that it's the sink for glucose Yep. For energy that it helps you prevent in some resistance if you use it properly through cardiovascular training and strain training.

Dr. Gabrielle Lyon: And it's 2 different things.

Dr. Gabrielle Lyon: How to do both of them?

Dr. Mark Hyman: And it's critical for maintaining your metabolic health. But there's so much else that it Yeah. So so tell us about the other hormonal aspects

Dr. Mark Hyman: Yeah.

Dr. Mark Hyman: Around sex hormones Sure. Cortisol around growth hormone because it it it it's not just a bunch of muscle cells moving your body. It's doing other stuff.

Dr. Gabrielle Lyon: Right. Let's talk about what we know. We know that exercise can increase androgen receptors. Exercise It's testosterone

Dr. Mark Hyman: receptor.

Dr. Gabrielle Lyon: Exactly. Testosterone receptors. You know, there's been data out there where they say, okay. Well, exercises increases IGF 1, of which is insulin like growth factor. These are transient.

Dr. Gabrielle Lyon: And the reality is as it relates to sex hormones, it is complex. People are different. I can't provide my patient with, a 100 grams of a 100 milligrams of testosterone and know that that individual is going to put on £3 of muscle. For example, But but the muscle itself

Dr. Mark Hyman: you know, we'd you you when you have unhealthy muscle, you also get the syndrome of screwed up sex hormones. Right?

Dr. Gabrielle Lyon: You do. Is it directly related to adiposity,

Dr. Mark Hyman: which is directly related to unhealthy muscle?

Dr. Gabrielle Lyon: I think that it is complex because skeletal muscle in them itself doesn't secrete, androgens. Right. But the sensitivity to the androgens can change. The dynamic of contraction and power and mobility, flexibility, the quality and the architecture of the tissue can change.

Dr. Mark Hyman: And some of it's downstream. Right? The downstream effect of losing muscle and gaining fat

Dr. Mark Hyman: Yes. Is as

Dr. Mark Hyman: a guy, your testosterone goes down. Yes.

Dr. Gabrielle Lyon: Now yes.

Dr. Mark Hyman: Goes up. Yes. You become, you know, more like a woman as a guy because your metabolic

Dr. Gabrielle Lyon: health secretes. Right.

Dr. Mark Hyman: And for women, it's a little bit different. They get other factors, but they can get, you know, all kinds of issues around hormonal dysfunction, like PCOS it may not be directly to the muscle producing these hormones, but it's really related to this overall syndrome.

Dr. Gabrielle Lyon: It is it is. It's related to overall the overall syndromes related to insulin resistance and metabolic dysfunction, which can be infertility, can be PCOS. Again, these things create downstream effects. So while we talk about skeletal muscle from the metabolic aspect, I think that we really have a good sense of that. When it also comes to the contraction of the tissue, this is where it becomes very fascinating.

Dr. Gabrielle Lyon: Skeletal muscle as an organ system releases something called myokines. 600 or so, myokines. They're always finding new ones. It is relatively a new science. Yeah.

Dr. Gabrielle Lyon: What are myokines? Myokines are what we consider peptide hormones, little molecules that are secreted by exercising skeletal muscle. Based on the duration and intensity of training. Mhmm. And really the the pioneering work out of this is is out of co of Copenhagen and Bente Pedersen.

Dr. Gabrielle Lyon: If you could get her on the podcast, I've been trying forever. You know, it's like the the one email, but anyway, she is think she's an immunologist as well as if she if you get her on, I I would flip.

Dr. Mark Hyman: Alright. We'll try. We'll try. So so so what is she found about these mild kinds? What do they do?

Dr. Mark Hyman: And how do

Dr. Gabrielle Lyon: they So these mild kinds are very fascinating. When we think about exercise, we think about the input and the health of exercise from the effort. Right? You you know, when we would go on a bike ride or exercise

Dr. Mark Hyman: or college. Right. Right. Right. But it's not necessarily just that.

Dr. Gabrielle Lyon: It's the influence of the contracting skeletal

Dr. Mark Hyman: muscle

Dr. Gabrielle Lyon: releasing these myokines. Again, these peptide hormones that travel, they act locally, they act cells next door, they act systemically. So, basically, the intensity and duration, for example, the most famous myokine is interleukin which is also a cytokine when released, which is an inflammatory molecule, when released from a cell of the immune system. Yeah. We've all heard about those cytokine storms.

Dr. Mark Hyman: Because your white blood cells will release that too. Right.

Dr. Gabrielle Lyon: They also release interleukin 15 and TNF alpha, all of which create an inflammatory condition.

Dr. Mark Hyman: So so these are what you heard about in COVID as cytokines, which are these inflammatory Exactly. Messenger molecules. And the ones that are specific to muscle are called myokines. Exactly. They're ones that are probably anti inflammatory and ones that are prone inflammatory.

Dr. Mark Hyman: Right? Yes. Based on the tissue of origin. And that's

Dr. Mark Hyman: fascinating, meaning the same

Dr. Gabrielle Lyon: peptide hormones or when released from the immune

Dr. Mark Hyman: system will have a pro inflammatory effect versus when released from muscle seem to have a

Dr. Gabrielle Lyon: dampening of that inflammatory seesaw. Now I think it's important to note that we are talking about things in black and white terms and extremes, and we recognize that that's not exactly how that works. But I think from a logical perspective, when we think about what is an application that we can do to make sure that we are getting enough stimulus to maintain health of skeletal muscle. I'm a geriatrician by training, and I always think, what is it that people have to do? And what happens is is that people don't necessarily train less as they age.

Dr. Gabrielle Lyon: They have less intensity in their training.

Dr. Mark Hyman: They don't work as hard.

Dr. Mark Hyman: They

Dr. Gabrielle Lyon: don't work as hard.

Dr. Mark Hyman: Because they're tired because it hurts.

Dr. Gabrielle Lyon: Who knows? Probably all of the the things because, you know, I coined the term muscle centric medicine And I focus a lot on skeletal muscle because I think that everything originates from muscle. It's just the way that it that it is in life is better this way, and that's just how it's gonna be. But I recognize that the reality is we talk about the health of skeletal muscle, but low skeletal muscle mass, which, by the way, we do have a a definition of that, in the way that we look at appendicular lean mass index, which no one should ever have to do unless you are diagnosing something if you're a physician, maybe. But The reality is is low skeletal muscle mass, maybe an early indicator of low bone mass.

Dr. Mark Hyman: Yeah. I mean, we talked about osteoporosis, but we don't talk about, of course, our osteopeno. We don't talk about sarcopeno very much.

Dr. Gabrielle Lyon: We don't. And you know that it became a disease, it got its classification of disease 2016.

Dr. Mark Hyman: That's amazing. I mean, because it it yeah. It I mean, it's something I've been looking at for almost 30 years. We had decks and machines at Canyon Ranch when I worked there and everybody got a DEX scan, and it was incredible to see because you see people who, you know, you think were muscular, but actually had a lot of fatty infiltration in their muscles. Or you see people who are you think they weren't overly overweight, but they were extremely over fat and under lean.

Dr. Mark Hyman: Yep. And so there's, you know, it just taught me a lot about, you know, kinda what meets the eye when you see someone doesn't always reflect what's really going on into the hood.

Dr. Gabrielle Lyon: And I think that if for argument's sake, for someone who's listening to this, an individual should really attempt to put on as much healthy skeletal muscle mass as they can. When I think about

Dr. Mark Hyman: too late for me.

Dr. Gabrielle Lyon: Never. And by the way But

Dr. Mark Hyman: there's something called and, you know, I think it's, let me just anabolic resistance

Dr. Gabrielle Lyon: There is something called the

Dr. Mark Hyman: anabolic resistance is this phenomena that happens at your age where it's harder to put on muscle?

Dr. Gabrielle Lyon: Well, it's actually a decrease in the we didn't talk about skeletal muscles and nutrient sensing organ. Yeah. We talked about skeletal muscle from the mobility strength, metabolic perspective, the immune function. And also, by the way, we should just mention brain function, contracting skeletal muscle. Let me let me back up.

Dr. Gabrielle Lyon: One other thing is individuals that exercise think it's really about the energy expenditure. It's not just about the

Dr. Mark Hyman: energy system.

Dr. Gabrielle Lyon: It's not just about that. It's also about this immune interface and these molecules that are released from skeletal muscle. There are 2 primary ones when I think about the health of brain function.

Dr. Mark Hyman: And, you

Dr. Gabrielle Lyon: know, I trained as a geriatrician, which is over the age of sixty five. I don't think you'd be my patient yet. No.

Dr. Mark Hyman: I'm gonna be 65 in November.

Dr. Gabrielle Lyon: But, anyway, not Can

Dr. Mark Hyman: I be a patient I'm 65?

Dr. Gabrielle Lyon: But, those individuals, when we think about exercise, so there's 2 other components that I I really have to mention as this organ system is that contracting skeletal muscle re releases irisn and caps sepsin b, which is a mouthful. I don't know how to spell it. But it stimulates brain derived neurotrophic factor.

Dr. Mark Hyman: That's miracle growth for the brain.

Dr. Gabrielle Lyon: In the brain.

Dr. Mark Hyman: Yeah. So, basically, just back up. So, basically, you're saying is when you exercise, your muscle releases these molecules, these peptides. That stimulate the production of something in your brain that increases your brain connections and new brain cells, neuroplasticity, neurogenesis.

Dr. Gabrielle Lyon: You should do this for a living. I mean, you're really good at explaining.

Dr. Mark Hyman: That's amazing. That's so cool.

Dr. Gabrielle Lyon: But The other thing is That's

Dr. Mark Hyman: why, you

Dr. Mark Hyman: know, that's why you see the studies where exercise reduces the risk of Alzheimer's, and it's really powerful.

Dr. Gabrielle Lyon: Or one is on the docket for for publication. Shout out to my girl, Louisa, Nicola.

Dr. Mark Hyman: Yeah. So, I mean, I think the data is really clear that this is a phenomena, but now we may be understanding the why underneath the findings we're having around longevity and Alzheimer's and dementia and cognitive function. Yes. Even depression and exercise.

Dr. Gabrielle Lyon: Yes. And I and I I think that there is another layer to that. Other thing that I wanna

Dr. Mark Hyman: mention is that exercising skeletal muscle that releases these myokines, there is a way that it actually helps

Dr. Gabrielle Lyon: with, fatty acid utilization and glucose station. So these myokines seem to interact with the organ system with liver and with adipose tissue for utilization of nutrients of the foods that we eat. So there is the exercise component, which is about energy expenditure. There's the exercise component where everyone thinks about energy expenditure, and then we think about healthy mitochondria, and then we

Dr. Mark Hyman: think about decreasing flux or increasing flux and decreasing the swamp pool in

Dr. Gabrielle Lyon: your muscle, but also the training component based on the duration and intensity of your training also affects the myokines that you

Dr. Mark Hyman: release that impact how you use calories. So this is mind blowing.

Dr. Gabrielle Lyon: So what you're saying is

Dr. Mark Hyman: basically exercise is not just helping us maintain our healthy metabolism because we are better able to uptake sugar, glucose, or

Dr. Mark Hyman: fats from our body, and we're a diet. But that actually the myokines, these messenger molecules

Dr. Mark Hyman: from the muscle, literally help instruct our metabolism and what to do and how to regulate the nutrients that we're eating and whether they become muscle or fat or something else.

Dr. Gabrielle Lyon: Mhmm. Right?

Dr. Gabrielle Lyon: And I'm gonna mention something else.

Dr. Mark Hyman: Yeah. Right. Yeah.

Dr. Mark Hyman: Get that.

Dr. Gabrielle Lyon: It is. You gotta I'm telling you to do this for a living.

Dr. Mark Hyman: And I

Dr. Gabrielle Lyon: have to mention something else, which I thought was so fascinating, is, again, when we look at a lot of these studies, we look at it with factors that we can control. For example, we look at calories in, calories out, macronutrient distribution. We look at all of these things, it's very difficult. We have to recognize that science is kind of a a science of confusion or unknowing. We're constantly learning it and thinking about things.

Dr. Gabrielle Lyon: And we are always trying to implement actions for specific outcomes. And why am I saying this? Because you've heard a lot about training in a low carbohydrate state. Right? Should I train fast?

Dr. Gabrielle Lyon: Should I have low carbohydrate? There may be some evidence to suggest that training in a low glycogen state called training low secretes more interleukin 6.

Dr. Mark Hyman: Which is bad or good?

Dr. Gabrielle Lyon: Which is good. So now it's not just about the energy expenditure. But it's also about these mild kinds and how you are leveraging your muscle to orchestrate these things.

Dr. Mark Hyman: Amazing. So so, basically, we're we're really in a new era of understanding muscle and its role in health longevity. Your book, forever strong which is an amazing book. Everybody should, for sure, get a copy, a new science based strategy for aging well, is is really kind of the

Dr. Gabrielle Lyon: First book of its kind,

Dr. Mark Hyman: actually. Download Yeah. Of of your research. In in in in Washington University as a student who had a fellowship in literally studying protein and muscle and aging. Right?

Dr. Mark Hyman: This is like where you came from.

Dr. Gabrielle Lyon: So Don't don't also forget that I spent 20 years and then can and continue to be let mentored by doctor Donald Layman Yeah. Who made some of these discoveries a surrounding anabolic resistance.

Dr. Mark Hyman: Yeah. So so there's a guy I love, and I don't follow many people on Instagram, guy's my hero, and his name's Alan Gustav. He's a French guy. I don't really know anything about him other than he has this amazing Instagram where he he's seventy eight or maybe seventy nine years old, and he is ripped. And he can do like Do you

Dr. Gabrielle Lyon: think he'd come on my podcast?

Dr. Mark Hyman: I had if he gets you could do it in French, maybe. I mean, he he could literally do 25 pull ups and does all these incredible feats of athleticism at seventy eight years old, which is just astounding to me.

Dr. Gabrielle Lyon: We should talk about that. Can we talk about that?

Dr. Mark Hyman: Yeah. Let's go.

Dr. Gabrielle Lyon: When I think about sarcopenia, which is a decreased muscle mass and function, people define that as a disease of aging. My question to you is when does cardiovascular disease start?

Dr. Mark Hyman: No. When your teenager?

Dr. Gabrielle Lyon: What about Alzheimer's even?

Dr. Mark Hyman: Can be 30, 40 years before you forget anything. Skeletal muscle dysfunction and skeletal muscle deficits begin very early on. And this

Dr. Gabrielle Lyon: sarcopenia idea to be a disease of aging, there are what I would consider young sarcopenic phenotypes, eighteen years old, even younger, especially with the alarming rates of inactivity Yeah.

Dr. Mark Hyman: In

Dr. Gabrielle Lyon: sedentary behavior. So let's talk about what's his name? Gustavo?

Dr. Mark Hyman: I like Gustavo.

Dr. Gabrielle Lyon: Okay. Let's let's talk about Gustavo. Seventy some years old, probably training like my husband, ripping out, pull up, after pull up, after pull

Dr. Mark Hyman: up.

Dr. Gabrielle Lyon: Here is the key.

Dr. Mark Hyman: If we were to go back and look at his muscle health over his lifespan, there's 3 sections. There's early life development, train early satellite cells that nourish Yeah.

Dr. Gabrielle Lyon: Musculoskeletal cells,

Dr. Mark Hyman: that require activity and stress to be able to be robust. Yeah. Then there's midlife, which is, you know, the

Dr. Gabrielle Lyon: time where you should really focus on peak bone mass, peak muscle mass. Yeah. And then there's later life, which is the maintenance of what you have.

Dr. Mark Hyman: Mhmm. Wait. Because I because I I actually was kinda snobby. Like, oh, gyms are smelly.

Dr. Gabrielle Lyon: You've been you've been saying that for

Dr. Mark Hyman: over a decade. They're like, you know, got a bunch of muscle heads in there. And I'm this skinny guy. It's kinda intimidating. And every time I lifted weights, it would hurt like hell for a while.

Dr. Mark Hyman: And I was like, this is dumb. And of course, I thought, you know, oh, you know, I could do yoga. That's play the strengthening and I ride my bike and I can ride my bike a hundred miles and I'm play tennis, you know, for 2 hours. No problem. And I and I really didn't start till I was 59.

Dr. Mark Hyman: And and I've noticed a tremendous change in my body, but What I kinda heard you say in the subtext was it's kinda late to start then. Like, can I make it up?

Dr. Gabrielle Lyon: The only time it's late to start is if you don't start.

Dr. Mark Hyman: Mhmm.

Dr. Gabrielle Lyon: And that's the reality of it.

Dr. Mark Hyman: Yeah. As soon as I took my dad when he was eighty 9, he couldn't get a bit of a chair. I said, down meaning a trainer. It was amazing to see the the gains he made even in eighty nine years old.

Dr. Gabrielle Lyon: Yep. There is a time where there's peak muscle mass that happens. Could that peak muscle mass be later? Could you potentially have been under muscled your whole life? And then all of a sudden, in your sixties and seventies get to a peak muscle mass?

Dr. Gabrielle Lyon: Maybe. However, what we see from aging data is that it may be more difficult to put on mass keep in mind, we don't have a great way from a population basis to measure skeletal muscle mass.

Dr. Mark Hyman: Yeah.

Dr. Gabrielle Lyon: We are using DXA.

Dr. Mark Hyman: Yeah. Yeah.

Dr. Gabrielle Lyon: Okay.

Dr. Mark Hyman: Yeah.

Dr. Gabrielle Lyon: But you can always build muscle. And, you know, I've thought for the longest time, two things. Number 1, you have to lift heavy to do anything worthwhile. I really did believe that, as you know.

Dr. Mark Hyman: Must be

Dr. Mark Hyman: hard if you're of injuries or you're older or you're looking to turn it strong.

Dr. Gabrielle Lyon: And it it's ligaments, it's tendons, it's not muscle.

Dr. Mark Hyman: Right.

Dr. Gabrielle Lyon: And so the best thing someone could do is never stop training.

Dr. Mark Hyman: Mhmm.

Dr. Gabrielle Lyon: That guy who is seventy eight, I guarantee you he never stop training. Yeah. Because we go through a series of catabolic crises where If you go on bed rest or if you stop training, it becomes very difficult to

Dr. Mark Hyman: To get it back. To

Dr. Gabrielle Lyon: get it back. It's not impossible, but it's difficult.

Dr. Mark Hyman: So sleeper health. It's fast to lose, easy, hard to gain.

Dr. Gabrielle Lyon: I mean, that's ridiculous. Sounds like money. So what can we do to maintain healthy aging and can you still build muscle?

Dr. Mark Hyman: Yeah.

Dr. Gabrielle Lyon: This is where when you're young, you're you're very much driven by hormones. We could say, you know, when I think about muscle protein synthesis, there's 4 inputs. Yeah. The 4 inputs.

Dr. Mark Hyman: So muscle protein synthesis in English means how you build muscle?

Dr. Gabrielle Lyon: Well, it's essentially a biomarker Yeah. For what we believe to be over time this way of of putting on tissue.

Dr. Mark Hyman: Yeah.

Dr. Gabrielle Lyon: For example, let's just say I eat 30 grams of protein. I stimulate muscle protein synthesis, but that doesn't mean I'm gonna gain a pound of muscle.

Dr. Mark Hyman: Mhmm.

Dr. Gabrielle Lyon: It's not a one to one ratio. You mentioned anabolic resistance. Anabolic resistance is the inefficiency or the decreased efficiency of skeletal muscle to respond like youthful muscle.

Dr. Mark Hyman: Yeah. So we need the same amount of protein or exercise same amount. You don't necessarily get the same gains.

Dr. Gabrielle Lyon: And there's, you know, there's a really long history history of where these discoveries came from, which I won't bore anyone, but if they're interested, I talk about all the time because it's very exciting to me. Yeah. Mark's like, continue on. We're not talking about the history of amino acids, but

Dr. Mark Hyman: that's good.

Dr. Mark Hyman: Other than 5. Yeah. I know that.

Dr. Gabrielle Lyon: But I

Dr. Mark Hyman: have an agenda for this one. I'm gonna get to it.

Dr. Gabrielle Lyon: But when we think about the amount of protein necessary to stimulate tissue and some of the earlier work by more looked at 5, 10, maybe it was 20 grams, 15 or 20 grams at that at that low level.

Dr. Mark Hyman: What they found is that younger individuals were able to stimulate muscle protein synthesis with 5105 grams of protein or 10 grams of protein Yeah. Or 15 grams of protein. Whereas an older individual, 60, had no, She need more protein as you get older. That's right. You need more protein.

Dr. Mark Hyman: Which is kind of paradoxical because people have less appetite as they eat less. Right? So what does that tell you? The quality of the food that you eat?

Dr. Gabrielle Lyon: If they have really nutrient

Dr. Mark Hyman: dense

Dr. Mark Hyman: after nutrient dense food. And what's so fascinating is leucine is one of those essential amino acids that is is nearly highest in protein sources in general. So even,

Dr. Gabrielle Lyon: you know, we, you know, there's different qualities of protein, but leucine tends to be high in all of those things, and you have to think from an evolutionary perspective, why across food sources, does leucine seem to remain high? And it's because that is a unique amino acid that does unique metabolic signaling for It's like this switch that turns on the muscle building. It's like if you put bunch of stuff in a soup pot and then you don't turn the heat on, you're not gonna make soup. So That so the loose the loose seed is like

Dr. Mark Hyman: the amino acid that sort of flips a switch

Dr. Mark Hyman: that starts to make the soup slash muscle. But you need all the soup Yeah. Pieces. So what is someone gonna do who's

Dr. Mark Hyman: never worked out before? And they're like, you know,

Dr. Gabrielle Lyon: I missed my prime.

Dr. Mark Hyman: Well, I I wanna I wanna I wanna get to the work, to the what to do. I have a

Dr. Mark Hyman: I I was

Dr. Gabrielle Lyon: trying to hit your agenda, by the way. So good to

Dr. Mark Hyman: hear you. I I have a

Dr. Mark Hyman: I I know. No. No. This is good. I wanna get to the what to do.

Dr. Mark Hyman: We're gonna get to what you should be doing, what kinda exercise you need, what you should be eating, where you should be eating, where you should be But but I just kinda wanna summarize because what basically we sort of said is that

Dr. Mark Hyman: muscle is this underappreciated organ that has been under studied that's been neglected in medicine Yes.

Dr. Mark Hyman: That is probably one of the biggest drivers of disease Yeah. As we get older. That,

Dr. Gabrielle Lyon: If not the biggest. If not

Dr. Mark Hyman: the biggest and that it's usually responsible for our metabolic health, our immune health,

Dr. Mark Hyman: and our brain health, and hormonal health, all related to functional functioning muscle. So that leads me to

Dr. Mark Hyman: the question of, you know, when I wanna know how someone's blood sugar is, I can measure their blood sugar or the a 1 c.

Dr. Mark Hyman: Right? What are the diagnostic tests that we can use to measure the amount, the quality of our muscle other than saying, you know, like, grip strength and how many push ups you can do and things like that. So A sit to stand test, or a metered walking test. Muscle quality is typically defined based on function.

Dr. Gabrielle Lyon: Functionality. I don't think it's a great it's a great proxy. It's

Dr. Mark Hyman: interesting because how we measure skeletal muscle mass, we have to think about a lot of the literature is population based.

Dr. Gabrielle Lyon: Someone will say, how much skeletal muscle mass mark should you have for optimal health?

Dr. Mark Hyman: Mhmm. I have no idea. I can tell you that if you have 30% body fat, that's probably too much. I have no idea how much skeletal muscle mass you should have. It is very challenging.

Dr. Mark Hyman: You are much

Dr. Gabrielle Lyon: taller than me. There's different body habitists. There are charts

Dr. Mark Hyman: that we have, quite frankly. I don't think they're great.

Dr. Gabrielle Lyon: But, I mean, are there diagnostics? Like, we have, MRI, a CT, ultrasound, and Texas scan,

Dr. Mark Hyman: do we wanna do a muscle biopsy? No.

Dr. Gabrielle Lyon: I've done lots of those.

Dr. Mark Hyman: We wanna measure their blood tests we can measure to assess our muscle health. I mean, how do how do we begin to sort of as a doctor, I'm thinking, how do I start to really assess this with my patients? Because really what I do now, is I look at all the biomarkers we talked about earlier that reflect poor metabolic health, like insulin glucose a 1c, blood sugar, you know, APO B, lipoprotein, fractionation, liver function tests, a whole bunch of uric acid, things that really help me to understand the person's metabolic health, he'll get their hormones, cortisol, stress hormone. I can

Dr. Mark Hyman: tell a lot, and I can infer that they probably have poor muscle. And and those are great

Dr. Mark Hyman: bar markers. And part of function health which is a company I co founded to help people get access to their lab tests, we do all that testing. So you can you can

Dr. Gabrielle Lyon: kind of sort of see the tea leaves of what's going on. But directly measuring it is tougher. So I'll send patients for a DEXIS scan.

Dr. Mark Hyman: Or we have an in body machine in my office at the ultra wellness center where

Dr. Mark Hyman: we actually measure that because we don't have a room for Texas skin.

Dr. Mark Hyman: Also, all of those are only okay. So the reality is Adexa, which is

Dr. Gabrielle Lyon: consider the gold standard, looks at bone and fat mass, and it extrapolates lean body mass. We use interchangeably lean body mass with skeletal muscle mass. They're not the same. So when you see that particular lean. Mass.

Dr. Gabrielle Lyon: Mass. That's not

Dr. Mark Hyman: skeletal muscle?

Dr. Gabrielle Lyon: It is, but it's an extrapolation.

Dr. Mark Hyman: It's not directly measuring skeletal muscle mass, and it tells you nothing about if there's fat infiltrate, it tells you nothing about the quality of that tissue at all. We really are behind, and that's the reality

Dr. Gabrielle Lyon: of it.

Dr. Mark Hyman: We are behind from a measurement perspective. But if someone's if someone's got, like, marbled fat You'll see it on a CT or MRI. Wait.

Dr. Gabrielle Lyon: Wouldn't you wouldn't you see that on the DEXY? Wouldn't wouldn't it show up as

Dr. Mark Hyman: because I because I I just remember a guy I saw when I was working at Canyon Ranch, and he was, like, a a weight lifter,

Dr. Mark Hyman: but he loaded up on carbs all the time. And he wasn't overweight. And we did the NexSys scan.

Dr. Mark Hyman: I was like, holy crap. This guy. I thought he was gonna be, like, 10% body fat. He was, 25, 30 percent body fat because all of his skeletal muscle was just marbled with fat. So there's a challenge there because there's something called the athlete's paradox.

Dr. Mark Hyman: And the athlete's paradox is they have

Dr. Gabrielle Lyon: fat and triglycerides within skeletal muscle that

Dr. Mark Hyman: they use for energy. And that's called the athlete's paradox, but they would have great

Dr. Gabrielle Lyon: metabolic markers. But you may see fat within those tissues. It's

Dr. Mark Hyman: challenging.

Dr. Mark Hyman: So the best thing today we have,

Dr. Mark Hyman: and we're gonna talk maybe about something new is is a DEXIS scan, a DEXIS scan, which is something that's not that expensive. It's low dose radiation. It's like flying across the country probably familiar to New York in terms

Dr. Mark Hyman: of radiation. And it's test for bone density too, which is important to check because

Dr. Mark Hyman: Especially if you have low muscle mass, you can assume you have low. And and bone density is a huge thing because it affects your your risk of, of all sorts of things as you get older, but, you know, hip fractures

Dr. Gabrielle Lyon: and

Dr. Mark Hyman: spinal fractures and,

Dr. Mark Hyman: you know, a lot of people suffer from it. And then you need to pick it up early because it's it's a project to fix it, but you can. But also the same machine will measure body composition. And so I I think, you

Dr. Mark Hyman: know, absent anything else, I think it's a great place to start. Do you agree? It is a great place to start, and you have to marry it with 5th

Dr. Gabrielle Lyon: the 5th vital sign, which really isn't a vital sign, but should be strength. Strength. So how do how do we measure strength? Great question. There are lots of charts on there out there that talk about how

Dr. Mark Hyman: much you should squat,

Dr. Gabrielle Lyon: how much you should bench press. These are, quite frankly, probably arbitrary because someone should just start and begin where they're at. And focus on improvement because we are not going to train for being better at exercise. You're going to train to be better at life. These are very good questions.

Dr. Gabrielle Lyon: So is it true that I should squat,

Dr. Mark Hyman: I don't know, two times my body weight? Maybe.

Dr. Gabrielle Lyon: If I have a a old training age, but should you squat. Twice your body weight, you don't really like doing squats.

Dr. Mark Hyman: And I

Dr. Mark Hyman: like doing squats. I love doing squats, but I don't can't

Dr. Gabrielle Lyon: do too many

Dr. Mark Hyman: because of my back with the heavy weight.

Dr. Gabrielle Lyon: Here's what I would and I talk about this in my book, but here's what someone should do. Someone should know How many push ups they can do even if they're on their knees. You're gonna have to push up off the floor. The the reality is you can't train to fall. The only way to get better at falling is to train fall.

Dr. Gabrielle Lyon: No one's gonna do that.

Dr. Mark Hyman: Not balanced. I mean, you can train your course so you don't fall. Like, I, you know

Dr. Mark Hyman: Yeah.

Dr. Mark Hyman: People are about to fall and they can't catch themselves.

Dr. Gabrielle Lyon: But the reality is people will say, oh, well, you've gotta train x, y, and z, you know, and you have to do ply metrics in case you fall. Like, those are all very challenging moves. And, very difficult to

Dr. Mark Hyman: tell an individual who is largely untrained to do and to actually see improvements from

Dr. Gabrielle Lyon: a metabolic perspective, from you know, they might get a little bit better at balance, but I think with time, which is finite, that you have to focus on the things that are really gonna move the needle. So you asked me originally, how do we test for healthy skeletal muscle? There's metabolic markers. The other thing that I would say The

Dr. Mark Hyman: ones that I mentioned are the other ones.

Dr. Gabrielle Lyon: Yes. And then I would say, are you strong? Can you lift how much do you think suitcase lift is?

Dr. Mark Hyman: Oh, because I'm where I'm traveling, but it could be, you know, anywhere from £30 to £70? Right.

Dr. Gabrielle Lyon: How much weight is one of those doors that individuals sit, at the emergency exit in a plane. £40. How many people do you think that sit there that can't lift £40? Yeah. You should test yourself and determine where you are on a strength continuum.

Dr. Mark Hyman: Yeah. So

Dr. Gabrielle Lyon: And that might not be an answer that someone likes because they're like, well, well, what is that? Well, that depends on where you start. That's like the

Dr. Mark Hyman: I was

Dr. Mark Hyman: actually I couldn't do 10 push ups on those 50. But now I can do, like, you know, 50. And when I was really training on, I could do more, like, 75 nonstop. But I read this paper in JAMA that says if you can do 40 push ups, the risk of having a heart attack is dramatically reduced. Right?

Dr. Gabrielle Lyon: I will say that study was, I think, all men, though.

Dr. Mark Hyman: Yeah. Yeah. Right.

Dr. Gabrielle Lyon: Because I can do way more than that.

Dr. Mark Hyman: Oh, boy. Okay. Let's go.

Dr. Gabrielle Lyon: Uh-uh. Yes. We can do the push up challenge. So that becomes under important to understand that picking a handful of exercises or movements that are safe. I don't even wanna say exercises.

Dr. Gabrielle Lyon: Squat push like a, you know, it could be a push. It could be a pull. Various activities where you measure your strength

Dr. Mark Hyman: and focus on improvement.

Dr. Gabrielle Lyon: If you are new to lifting, you might improve week after week. 1st 6 weeks, 1st 6 to 8 weeks might be neurological adaptation, getting your body ready, understanding the movements. After that, you

Dr. Mark Hyman: should begin to progress

Dr. Gabrielle Lyon: in strength. If you are an advanced worker outer, it's gonna take

Dr. Mark Hyman: a lot longer. It's Yeah. You know? But understanding that there's this

Dr. Gabrielle Lyon: idea where there should be progression. Yeah. And At some point, you'll reach a limit.

Dr. Mark Hyman: Right?

Dr. Gabrielle Lyon: I don't know.

Dr. Mark Hyman: I mean, you know, you're not gonna be able to bench press £5000. You're gonna you're gonna hit a limit. Right?

Dr. Gabrielle Lyon: Right. And the the changes might be incremental, that we can continue to build on, but then I would say, let's say you have maxed out in that movement, then you switch to something else. There should be a lot of skill acquisition that happens.

Dr. Mark Hyman: So some people need a trainer for, can they do it on their own? Can use body weight bands? You need heavy weights? You need machines? I mean, it's a I mean, part of the reason I I just never did.

Dr. Mark Hyman: I was I just didn't like going to the gym. I didn't like all the machines. I didn't didn't really know what to do. I was intimidated by it, and I'm sure a lot of people out there feel like that. You know, and I until I got a trainer who showed me the right form and the right, you know, body position and started with the right amount to wait to build myself solely over time, I wasn't really able to

Dr. Gabrielle Lyon: I'm excited to share with you a concept I guarantee you haven't heard about.

Dr. Mark Hyman: Okay.

Dr. Gabrielle Lyon: Which is

Dr. Mark Hyman: unusual because I know how many people contact you to send you things, and you've heard about almost everything. I learned this from a PhD. His name is Pat Davidson. Do you know

Dr. Gabrielle Lyon: who that He is a PhD in exercise physiology. He's very jacked

Dr. Mark Hyman: and very tan, and, I tease him all the time about this. But the reality is I think about how do we

Dr. Gabrielle Lyon: protect people as age? What do they have to do? I said, Pat, I have individuals that I see

Dr. Mark Hyman: them go to the gym, and I

Dr. Gabrielle Lyon: watch them train. I know that they're not training in a capacity that they need to be, even though they're doing fun stuff, like, ropes and bet, you know, battle ropes and and they're trying to jump on a a boseu ball and and all of these fancy feel athletic type things. Yep. But at the end of the day, they're not able to generate enough power. They're not able to generate enough force They're not focused on strength and or hypertrophy.

Dr. Gabrielle Lyon: Strength is obvious. Hypertrophy is is muscle growth. I would argue that if you focus on

Dr. Mark Hyman: muscle growth, you're going to get stronger. You're going to get more force. You're going to get

Dr. Gabrielle Lyon: more power. You're going to able able to do these things. He said Gabrielle, think about high ground activity. I'm like, that. But but that is high ground activity.

Dr. Gabrielle Lyon: Right. He said When

Dr. Mark Hyman: you're on a mountain,

Dr. Gabrielle Lyon: Exactly. I'm like, oh, there's Sherpa's here. Wait. What are we doing? I don't know what high ground is.

Dr. Gabrielle Lyon: And he said, focusing on muscle hypertrophy is the most important thing. If they build and target the growth of healthy skeletal muscle, they will get stronger. They'll have better

Dr. Mark Hyman: metabolic control. They will have a better ability to generate more of a

Dr. Gabrielle Lyon: VO 2 max. They'll be able to do everything better. And go back

Dr. Mark Hyman: to the basics. And so high ground activity, and people are gonna be like, wait. I I didn't think we should use machines. Our high

Dr. Gabrielle Lyon: ground is exactly that lots of contact. For example, a hack squad. A hack squad is, a squat that has a back rest. Your feet

Dr. Mark Hyman: are on something. Your legs are your arms are touching something. It's a lot of contact and a lot of feedback. So when you are able to

Dr. Gabrielle Lyon: engage in that exercise, you are fully focused on

Dr. Mark Hyman: the muscle of choice. Yep. And by choosing those type of things, and that is a,

Dr. Gabrielle Lyon: what we consider a compound movement, you are putting in effort in the right place. As opposed to going and doing bicep curls, which would be considered a low ground activity.

Dr. Mark Hyman: You are not supported. Maybe you're standing up. Maybe you're swinging your arms. Maybe you're instead of working your better to use these big machines

Dr. Gabrielle Lyon: is what you're saying? Yes. And it's called high ground training.

Dr. Mark Hyman: So you need to I need to buy these expensive machines and go

Dr. Mark Hyman: to the gym. But think about it. It has to matter enough. Could you do resistance

Dr. Gabrielle Lyon: training, body weight, and bands, and all of those things? Absolutely. Do we need to do that totally? But if

Dr. Mark Hyman: we are really serious about our health and wellness, we have to put some effort in to do those things. Yeah.

Dr. Gabrielle Lyon: And I get a lot of pushback when people say, well, do I have to go to the gym? No. You don't have to if you're certainly more advanced. And you know that you can move and and do things in a way that is safe because here's the reality.

Dr. Mark Hyman: Basically, I should get a trainer going to the gyms that you're saying.

Dr. Gabrielle Lyon: Yes. Until you learn.

Dr. Mark Hyman: How to do it myself? Until you

Dr. Mark Hyman: and another high ground activity. So people think about lunges or split squats. So that's one leg in front, one leg in back, but

Dr. Gabrielle Lyon: another way to do that would be one leg in front, and then have your foot back up against a block. So now you've got that work better?

Dr. Mark Hyman: Because now you've got your foot fully flat instead of a split squat in in the way that

Dr. Gabrielle Lyon: you're doing it, or, you know, like an assisted deadlift where, you know, a single leg RDL. Basically, what I'm saying is, when you increase contact, you are now training the muscle with the intensity, again, intensity declines as we age.

Dr. Mark Hyman: It doesn't have to be heavy. You do have to go to a level of fatigue because you're looking for stimuli. And what about

Dr. Gabrielle Lyon: what about these other kind of tools for people who

Dr. Mark Hyman: who have injuries or who, you know, sort of their hacks to get the intensity without the injury or hurting yourself, like electrical stim, which I think, or a blood flow restriction or these vaseper, cooler kind of things. Wonderful. What what how effective are those? Because I'm I'd rather probably, like, at my age, get a bunch of blood flow restriction devices or

Dr. Mark Hyman: electrical stim. So I don't have to hurt myself because I have a bad back, and I don't wanna hurt myself.

Dr. Mark Hyman: So is that is that as effective? I can't say

Dr. Gabrielle Lyon: you know, I haven't seen any data. You know, these this is very difficult to do over time.

Dr. Mark Hyman: Can't it's very difficult to follow someone in control for everything. You know, I've worked with a lot

Dr. Gabrielle Lyon: of special operations community. They use a ton of blood flow restriction and injury. Know a lot of physical therapists that use it. Individuals use it to

Dr. Mark Hyman: help with, rehabilitation, slowly loading up tendons. Again, it's not always muscle injury. It can sometimes be tendons.

Dr. Gabrielle Lyon: Yeah. It can sometimes be ligaments. How do we go in a slow progressive way to, eliminate the potential for injury. So, yes, do I

Dr. Mark Hyman: think a swimsuit is great?

Dr. Gabrielle Lyon: I do. Do I think blood flow restriction is great? Absolutely. Do I Does

Dr. Mark Hyman: that allow you to do the intensity without the

Dr. Gabrielle Lyon: It does.

Dr. Mark Hyman: The the It does. Fluid wrist command. Stim suit is it's different. It's different because it's When you get the muscle hypertrophy and the growth?

Dr. Gabrielle Lyon: You will. I I mean, again, I'm saying that as if I know everything about it, I'm assuming, yes. I've seen some data to support. Yes. I've also seen RABdo from it.

Dr. Gabrielle Lyon: Which means damage to muscles. Yeah. From electrical stim. Yeah.

Dr. Mark Hyman: From electrical stim. So also get that from just training. I've seen people with high muscle enzymes after training. Yeah. Absolutely.

Dr. Mark Hyman: Yeah. I think that the real magic Yeah.

Dr. Mark Hyman: Is going to be the interface

Dr. Gabrielle Lyon: with fitness professionals and medical professionals.

Dr. Mark Hyman: The true interface because we can't do what we do without that component. You know? And I have there's That's why I really you

Dr. Gabrielle Lyon: know, I don't know if you know this with function health, right, which I cofounded.

Dr. Mark Hyman: Be able to test all your biomarkers. We partner with Equinox because

Dr. Gabrielle Lyon: I didn't know that. Where's my invitation?

Dr. Mark Hyman: Well How

Dr. Gabrielle Lyon: come I like it later?

Dr. Mark Hyman: What is it?

Dr. Mark Hyman: It just gotta announce. Good. Yeah. I mean, you know, there's a membership and there's a whole thing, but the idea is that that, you know, you need to look under the hood and deal with the medical aspects, not just the training aspects too.

Dr. Gabrielle Lyon: Yes. I I fully agree with that. And then I think that the other thing is that people feel like strength training, resistance training is interchangeable. That they could go do a class or do something else. And I would say there's nothing more important from my perspective as a geriatrician than strength

Dr. Mark Hyman: training to really focus on resistance, exercise everything else. I love the idea of having a a great VO 2 max. Cardio. Which is cardiovascular activity. Here's how I prefer

Dr. Gabrielle Lyon: someone do it. Do high intensity interval training to compress the time because sometimes people can't manage the length of time it takes and the effect on joints or even the interest. Yep. You should do things.

Dr. Mark Hyman: How how long? Just practically Yeah. As we wrap up practically, how much time a week should people devote to strength training?

Dr. Gabrielle Lyon: The more intense an individual works the less time it takes.

Dr. Mark Hyman: So you could do once

Dr. Mark Hyman: a week super intense? I wouldn't recommend it. I don't think that's a optimal. I think if I were to design a new lifter or even

Dr. Mark Hyman: advanced lifter, I consider myself an advanced lifter. I trained 3 days And Full body. 20 minutes, 30 minutes from now.

Dr. Mark Hyman: 5 minutes. I a shout out to Carlos Mata. My my trainer, you should come in and, get some push

Dr. Mark Hyman: ups with us. But seriously, full body 3 days a week, very

Dr. Gabrielle Lyon: intense, We do push, pull hinge. Those are all actions. You know, someone could look that up. Mhmm. We do sled pushes.

Dr. Gabrielle Lyon: We do things that are dynamic and hard that continuously, challenge me. But for a beginner Yeah.

Dr. Mark Hyman: They are going to get the biggest bang for their buck. They're going to improve the most. Yeah. Yeah. And I saw that.

Dr. Mark Hyman: It was amazing, actually. 3 days a week, 2 days a week, full

Dr. Gabrielle Lyon: body. It's not about the time because you could go there and you could be on your phone.

Dr. Mark Hyman: The intensity. It is about the overall volume, the overall amount of work that you're doing. Lighter weights, more reps. Exactly.

Dr. Gabrielle Lyon: So that can be considered intensity? It could be as long as you're going close to Failure. Failure.

Dr. Mark Hyman: Yep. You

Dr. Gabrielle Lyon: know, and I never believed that until I started seeing the stuff out of McMaster University. I was like, no. You gotta lift heavy. You gotta but you don't. 2 days a week, full body, ideally, that's enough to to maintain if you're gonna, you know, 5 to, I don't know, pick a number 25 reps.

Dr. Gabrielle Lyon: Again, it's there's so many different ways to do it, right, which is amazing. Yeah. The only one way to do it wrong is to not do

Dr. Mark Hyman: it.

Dr. Mark Hyman: Yeah. That's a good line. Only way to do it wrong is to not do it. You should hear that out there because I I I was a late starter and I regret not doing this when I was younger. I really

Dr. Gabrielle Lyon: I tried. I tried to

Dr. Mark Hyman: I know. I was done.

Dr. Gabrielle Lyon: At least 10 years ago, I was like, Mark, you cannot be doing all this yoga. Yoga is wonderful. Yeah. But come on.

Dr. Mark Hyman: Yeah. Yeah. I know.

Dr. Mark Hyman: But by

Dr. Gabrielle Lyon: the way, it it is wonderful.

Dr. Mark Hyman: So

Dr. Mark Hyman: let's talk about the now we've talked about the the need for training and the amount and all that in varieties of kinds of things we can do in this. Oh, by the way, all of this is in your book forever strong. So people can check that out and check out your website, which is doctor gabrielleian.com.

Dr. Gabrielle Lyon: My YouTube, I have training programs.

Dr. Mark Hyman: I've programs

Dr. Gabrielle Lyon: check out your YouTube.

Dr. Mark Hyman: Definitely follow this lady. She's amazing and she's going places. It's like that

Dr. Gabrielle Lyon: doctor. It's

Dr. Mark Hyman: like that doctor. She's gonna go to the places you'll go. That's her. I'm

Dr. Gabrielle Lyon: going to the gym after that.

Dr. Mark Hyman: I'm going to the gym. Okay. Well, I'm going to a concert.

Dr. Mark Hyman: Really?

Dr. Gabrielle Lyon: Yeah. So Grateful then.

Dr. Mark Hyman: There you go. And the next piece I wanna talk about, and we talked about this when you're on last time quite a bit about protein and about diet and about diet and and and and muscle. And and I think, you know, your perspective has changed over time. We're learning things over time and I think, you know, the the the question is really when what

Dr. Mark Hyman: and how should you be eating to to optimize your muscle health?

Dr. Mark Hyman: Great question. Probably my favorite topic. Although I think that I I might eventually

Dr. Gabrielle Lyon: I don't know, talk about underwater basket weave basket weaving. Kinda killed that joke, but in the meantime underwater

Dr. Mark Hyman: basket. Protein is the most controversial macronutrient. It just

Dr. Gabrielle Lyon: is that way. And, I think that It it is, and it will continue to be that way. But what is the reality of why we need dietary protein? We need dietary protein because we need these amino acids. We often only hear people talk about protein as the building blocks.

Dr. Gabrielle Lyon: I would say let's scrap that and let's talk about dietary protein when it comes to each of these essential individual amino acids to different metabolic things in the body. Mhmm. They're not interchangeable. I'll just give you a few examples. Threanine is an essential amino acid for mucine production in your gut.

Dr. Gabrielle Lyon: I remember some of the first patients I saw with you, they all had quote

Dr. Mark Hyman: leaky gut. Right.

Dr. Gabrielle Lyon: Threanine for mucine production, arginine for nitric oxide production, which is

Dr. Mark Hyman: I'll dilate

Dr. Gabrielle Lyon: your blood vessels and inflammation. Right? You know, tryptophan for serotonin production for your brain, loosing for skeletal muscle stimulation. As you can see,

Dr. Gabrielle Lyon: They all do different things. They're not interchangeable. So then the next question is, well, that's confusing. How do I eat for that? I would say you're right.

Dr. Gabrielle Lyon: That does sound super confusing. And,

Dr. Mark Hyman: I think God Nature took care of it for us.

Dr. Gabrielle Lyon: We they did. First most important thing that someone understands is how much protein that they are getting, and that trumps everything.

Dr. Mark Hyman: If I were to say what is the protein hierarchy?

Dr. Gabrielle Lyon: That would be 1.6 grams per kg. Which is point 7 grams per pound ideal body weight.

Dr. Mark Hyman: Which is double with the RDA, which

Dr. Gabrielle Lyon: is the RDA.

Dr. Mark Hyman: Which is the minimum amount you need not to get a deficiency disease.

Dr. Mark Hyman: And

Dr. Gabrielle Lyon: that's point 37 grams per pound.

Dr. Mark Hyman: Or point 8 grams per kilo.

Dr. Gabrielle Lyon: Exactly. Which is also based on only high quality proteins. Yeah. That's not based on plant proteins.

Dr. Mark Hyman: They're not based on plant and you're saying

Dr. Mark Hyman: plant proteins are not high quality proteins. Based on, the

Dr. Mark Hyman: definition from digestibility and amino acid

Dr. Gabrielle Lyon: profile.

Dr. Mark Hyman: Yeah.

Dr. Gabrielle Lyon: It's just, you know, people get very offended by that. It is purely biological numbers. It's not oh, this is better. This is worse. This is purely based on the spectrum of amino acid.

Dr. Gabrielle Lyon: So the first most important thing is getting enough protein. And people will say, well, we get a ton of protein we get a ton of protein for what? Do we get a ton of protein to overcome

Dr. Mark Hyman: the minimum deficiency? Yes. But do we have enough protein with an appropriate amount

Dr. Gabrielle Lyon: of calories to maintain healthy aging and metabolic correction? And I would say, we have some work to do. The average individual, the average male gets about maybe 90 to a 100 grams of protein. Average female is probably around 70 grams of protein. And we know that in order to protect skeletal muscle that we're really looking at closer to 1.6 grams per kg, so 0.7 grams per pound or closer to 1 gram per pound ideal body weight.

Dr. Mark Hyman: If I'm a £180, you're talking about, like, a 150 grams per protein a day.

Dr. Gabrielle Lyon: That's reasonable. Now that's the first and most important aspect, whether it's coming from plants or animals, if you choose to and this is just protein. This is not talking about where you're getting your iron, or creatine or a B12, we're purely talking about protein,

Dr. Mark Hyman: not the other micro nutrients that are diminishing and we have

Dr. Gabrielle Lyon: deficiencies of, like, none of that. Yeah. And that are different in animal versus Right.

Dr. Mark Hyman: Planned protein.

Dr. Gabrielle Lyon: Plant protein has a lot of fiber and phytonutrients and lower protein quality. If someone wants to get their protein from plants, they are likely going to need a certain percentage more depending on the source. Maybe it's 30% more. Overall, calorie consumption is going to go up, but you can get enough of these amino acids necessary for muscle health. However, you have to be careful if you are older and you are not highly active, then if you if your idea is to eat whole foods and eat whole foods from plant based proteins and you have to watch total calories and, carbohydrates.

Dr. Gabrielle Lyon: Yeah.

Dr. Mark Hyman: I mean, you could you, you know, if you wanna get know, 4 ounces of chicken is a few hundred calories, and the equivalent of that in Kiena was, like, six cups, which has got, like, a 1000 calories.

Dr. Gabrielle Lyon: Correct.

Dr. Mark Hyman: So how do you manage that?

Dr. Gabrielle Lyon: Right. And the way in which you manage it is you choose, things like tofu or rice pea blend protein powders.

Dr. Mark Hyman: So you have to eat processed proteins in order to actually maintain the level of protein you need as you get older. Is that what you're saying?

Dr. Gabrielle Lyon: I would say that

Dr. Gabrielle Lyon: unless someone is very active.

Dr. Gabrielle Lyon: So unless someone was very active, then I would be concerned about the ability to dispose

Dr. Mark Hyman: of the carbohydrates and overall calories. I I would have certainly concerns about that just from a metabolic.

Dr. Gabrielle Lyon: So, basically, if you, like, run five miles a day and you

Dr. Mark Hyman: do all this stuff and then you eat more calories, it's fine. But if you're just an average person who's not doing that and you're trying to build muscle, the amount of protein you need is gonna kinda put you over the calorie limit and end up causing metabolic issues.

Dr. Mark Hyman: I mean,

Dr. Gabrielle Lyon: it it definitely depends. There's many ways to do it well. But what I would say is that understanding that the total protein intake is most important, understanding that that first meal of the day is critical because you're coming out of an overnight fast. There's only two ways to simulate skeletal muscle, and you have to protect it. And that is through resistance training and dietary protein.

Dr. Mark Hyman: Yeah.

Dr. Gabrielle Lyon: We know that when you are in an overnight fast, you are catabolic. The body is using liver glycogen and potentially pulling from amino acids from skeletal muscle because these processes protein turnover throughout the whole body has to be going on.

Dr. Mark Hyman: Yeah. You can't, like, you your body's a supplement repairing tissues and making new cells and proteins all night long. It still has to do that and you do that in a state by by using kind of recycling protein that's called a topic. It's a

Dr. Mark Hyman: good thing.

Dr. Gabrielle Lyon: You recycle proteins, you know, what it's, you recycle an enormous amount of proteins. You oxidize. You replace. It is a very dynamic process. Understanding that that first meal of the day is most important.

Dr. Gabrielle Lyon: I don't care when you have it, but coming out of an overnight fast.

Dr. Mark Hyman: So we

Dr. Mark Hyman: should be having, like, what, French toast to a muffin.

Dr. Mark Hyman: If you

Dr. Gabrielle Lyon: wanna complete

Dr. Mark Hyman: the story in a couple of bread.

Dr. Gabrielle Lyon: Yes. Yes. Exactly. But, you know, the evidence is is very interesting from a a satiety standpoint. So there's a skeletal muscle standpoint.

Dr. Gabrielle Lyon: You wanna hit between 30.50 grams. That's

Dr. Mark Hyman: In the morning when you wake up,

Dr. Gabrielle Lyon: And that's also the same amount.

Dr. Mark Hyman: The opposite of what we do in America is we don't eat protein for breakfast. We eat sugar for

Dr. Gabrielle Lyon: breakfast. Right.

Dr. Gabrielle Lyon: You know, I I've worked on some of these early studies and one of the it was 2 groups and one of the groups, they filed the food guide pyramid, which was 55% carbohydrates, the RDA of protein, and 30% fat. And the other and they were both isochloric. And then the other group was, let roughly 40 grams of, protein of breakfast. It was a 40, 30, 30 split, like the zone diet. So forty I yeah.

Dr. Gabrielle Lyon: Anyway, it was a 40, 30, 30 split.

Dr. Mark Hyman: And what we saw was that those that were isocaloric, but

Dr. Gabrielle Lyon: just adjusted The macronutrients. Macronutrients actually lost body fat. Maintained lean tissue. And with

Dr. Mark Hyman: exercise, there was this fantastic synergistic effect that the majority of weight that they lost was fat.

Dr. Gabrielle Lyon: So basically eating just to input that English, basically eating protein in the morning combined with

Dr. Mark Hyman: reducing carbs and carbs combined with exercise

Dr. Mark Hyman: at the most benefit. Yeah. Even eating the same

Dr. Mark Hyman: exact amount of calories. Yes. Right. That's amazing. So you switch from the standard American eating trajectory

Dr. Gabrielle Lyon: to a more balanced distribution. And this is kind of where we don't have time to talk about this one, but this is kind of where that whole 30 grams of protein three times a day came in. There's actually no evidence to support that.

Dr. Mark Hyman: So does it matter like you get saying you would need, like, I need a 150 gram protein. Could I have, like, a a 900 gram piece, a rib eye steak and that, like, and that gets me going for the whole day if I

Dr. Gabrielle Lyon: You'll probably do 70 I mean, I wouldn't suggest that because then you're stimulating tissue once a day, I and we've seen that. So there was some Did

Dr. Mark Hyman: you want it more evenly spread out, or did you, like, do you have to do it before exercise? Does it matter?

Dr. Gabrielle Lyon: It it matters.

Dr. Mark Hyman: After exercise, how long after exercise. So, like, yeah, just, like, people need to know, like, the calities of how do you Okay.

Dr. Mark Hyman: How do

Dr. Mark Hyman: you apply this to get the most benefit? If you are young science behind this.

Dr. Gabrielle Lyon: There is. If you are young and healthy, it really doesn't matter. As long as you're hitting your total protein target, it doesn't matter. I don't care when you get your protein. I don't really care kind to get your protein?

Dr. Mark Hyman: Do you

Dr. Mark Hyman: wanna share for backs when you're kidding me fine?

Dr. Gabrielle Lyon: I mean, I don't. Anyway, my kids don't, but, it doesn't really matter.

Dr. Mark Hyman: Yeah.

Dr. Gabrielle Lyon: As long as you're getting your total protein intake in, I don't care if you have it around exercise. I don't frankly, I don't care.

Dr. Mark Hyman: That's because there's a lot of hormonal activity in your younger that drives growth.

Dr. Gabrielle Lyon: Your tissue is highly anabolic. Yep. If you are more mature, if you have weight to lose, if you have underlying inflammation, then

Dr. Mark Hyman: understanding, first, the total amount of protein is critical, recognizing that that first meal of the day, which is where all

Dr. Gabrielle Lyon: the data's been, all the data is from to my knowledge is on that first meal of the day. Again, I worked on some of these early studies, and what we saw was changes in body composition

Dr. Mark Hyman: with, carbohydrates managed.

Dr. Gabrielle Lyon: That first meal of the day is critical. Second millidate, I don't really care about. It's just to get in that protein and and there should be some kind of a a one to one ratio of carbohydrates to protein. You don't wanna overshoot your carbohydrates for no reason. And then, arguably, one could consider that last million of the day being very important because now you're going into an overnight fast.

Dr. Mark Hyman: So what should that be?

Dr. Gabrielle Lyon: Same thing. Between 30.55 grams. But here's the thing. If you are

Dr. Mark Hyman: Protein also makes you feel full and it also takes more energy to burn protein in

Dr. Gabrielle Lyon: the body. It it stimulates muscle protein synthesis, which is a this is where the thermic effect of food comes in, thermic effect of feeding So fats, maybe 3% of the calories from fats are utilized, for the utilization of fatty acids. Carbohydrates might be It

Dr. Mark Hyman: takes energy to

Dr. Gabrielle Lyon: metabolize your food. Right. Protein can be 20%.

Dr. Mark Hyman: So I

Dr. Mark Hyman: need to eat a 100 calories of protein. 25 of those

Dr. Mark Hyman: calories or 20 goes into actually processing and metabolizing and breaking down and burning those calories. I actually believe.

Dr. Mark Hyman: So the net net calories less is what you're saying.

Dr. Gabrielle Lyon: And I believe that it's actually from the stimulation of muscle tissue and not the disposal

Dr. Mark Hyman: of urea or nitrogen, which are the byproducts of of protein. It is from the loosein stimulation

Dr. Gabrielle Lyon: of muscle. But what's Let's let me close out with some very practical things.

Dr. Mark Hyman: If

Dr. Gabrielle Lyon: you are young, I don't care what you're doing. You have 5 grams of protein in the morning in the afternoon. Doesn't matter as long as you're getting your total protein in.

Dr. Mark Hyman: Yeah.

Dr. Gabrielle Lyon: If you are older, and let's define older inactive, have

Dr. Mark Hyman: weight to lose, or under protein. You are protein deficient or you're eating a sub amount, then understanding that total amount

Dr. Gabrielle Lyon: of protein matters first Let's just shoot a high 1 gram per pound ideal body weight, but the evidence is perfectly fine with 1.6 grams per kg or 0.7 grams per pound body weight. You're gonna ask me, what is your ideal body weight? Pick the last time you felt great. This is Right. A human science, which is not a a perfect science.

Dr. Gabrielle Lyon: Yeah. Then, the first meal of the day should be between 30 grams could be higher if you wanted to eat twice a day. Let's say you needed 75 grams at that first meal. I don't care. Go right ahead.

Dr. Gabrielle Lyon: I just want to make sure that you're really hitting between 30:50. Now does it matter that's around exercise necessarily?

Dr. Mark Hyman: I noticed when I do my morning go away protein shake, which

Dr. Mark Hyman: my healthy aging shake that I wrote about in my book young forever, and I'm working out at home. And I have my routine. It's amazing to see the gains I have in muscle very quickly.

Dr. Gabrielle Lyon: Let's talk about why that is. This is one of the nuances that if you look at the international society for sports nutrition, they will say it doesn't matter when you eat protein. And I would say, I I appreciate that, especially if someone is young and healthy. When you are more mature, Mark, you're more mature.

Dr. Mark Hyman: Thank you.

Dr. Gabrielle Lyon: We have to overcome anabolic resistance. Yeah. How do we make your skeletal muscle respond like younger skeletal muscle?

Dr. Mark Hyman: You do that by resistance training and the synergistic influence of also the amino acids. The protein with the protein.

Dr. Gabrielle Lyon: Protein and the strength training if you look at the data, it looks like this is you've seen this in Bob Wolf's lab. You've seen this in,

Dr. Mark Hyman: Katsanos lab. Your muscle responds exactly like youthful muscle. So you wouldn't

Dr. Gabrielle Lyon: be able to tell the difference from a metabolic perspective. If someone is listening and they're like, well, should I train fast and go right ahead? But now after you've done your done training and you wanna take advantage of blood flow, Give yourself 30 minutes. And within that 30 minutes to an hour, because now your muscle is primed to receive nutrients, have your protein.

Dr. Mark Hyman: Can't be right after.

Dr. Gabrielle Lyon: Sure. Of course.

Dr. Mark Hyman: Or you

Dr. Mark Hyman: wanna you don't have to wait 30 minutes. No. But you shouldn't wait 3 hours.

Dr. Gabrielle Lyon: If you are young and healthy, I don't care.

Dr. Mark Hyman: Well, I'm

Dr. Mark Hyman: not gonna about me.

Dr. Mark Hyman: I don't

Dr. Mark Hyman: care about all these young people.

Dr. Gabrielle Lyon: For you. No. But for you, if we wanna keep I

Dr. Mark Hyman: joke because everybody's favorite radio stations, w I f m. What's in it for me? Asking for a friend.

Dr. Gabrielle Lyon: Asking for a friend, then for you, I would say that that would be a benefit. If someone wants to lose weight, if they have low grade chronic inflammation, this is a great way to help get nutrients to the muscle. Yeah. That second meal, I don't care so much about could it be 30 to 50 grams of protein? Sure.

Dr. Gabrielle Lyon: Does it have to be an even distribution? No. Could it be 20 grams of protein easily? That last meal of the day, I like making sure that there's 2 meals that are robust and protein because now you're stimulating that tissue Yeah. Going into an overnight fast.

Dr. Gabrielle Lyon: Is there evidence to support that, that meal is the key to metabolism? No.

Dr. Mark Hyman: But, like, you shouldn't be late. That's for sure.

Dr. Mark Hyman: Well,

Dr. Gabrielle Lyon: it'll affect. It'll affect

Dr. Mark Hyman: your sleep. It'll cause you to gain weight.

Dr. Mark Hyman: It's it's Now I'm

Dr. Gabrielle Lyon: gonna leave you with one more thing. Yeah. Because I think this is really important.

Dr. Mark Hyman: Okay.

Dr. Gabrielle Lyon: And that is if you fail to do the practical, the practical becomes impossible. If you fail

Dr. Mark Hyman: to do the practical, what we are talking about is very practical. If you fail to

Dr. Gabrielle Lyon: do these very simple things, resistance training, 2 to 3 days a week,

Dr. Mark Hyman: full body, having dietary protein. I don't care where that's coming from. If you're older, yeah, you know, combine it with resistance training.

Dr. Gabrielle Lyon: If you fail to do these very practical things, you will find, as you age, the practicality of your life becomes impossible.

Dr. Mark Hyman: That's

Dr. Mark Hyman: right. I mean, that's really the message here. I mean, the title of your book is really forever strong, a new science based strategy for aging well. And and the idea is that strength is important as we get older because without it, we lose function, without function, our lives decline, and we withdraw, and we become old.

Dr. Mark Hyman: And so that's why I like to watch this guy on Instagram because he's like crushing it, and

Dr. Mark Hyman: he's almost eighty years old. And the average eighty year old, we don't think of as somebody who's that ripped in that fit. But the body is capable of that, and it's now exciting that we have the science and that you've done so much of the work and you've written about it. It's really tremendous. And I think I think for people listening I think the message is clear.

Dr. Mark Hyman: Your muscle is an important organ. Pay attention to it. Make sure you work out and resistance training, and make sure you're eating up protein. And that's it. And it's not that hard.

Dr. Mark Hyman: You want the details for sure. They're gonna be in the show notes. We're gonna link to Gabriel's work and heard amazing podcast, which is called the Doctor Gabrielleian show.

Dr. Gabrielle Lyon: Hard to find. I know.

Dr. Mark Hyman: And her great website, which is Doctor Gabrielleian, her book, young, forever strong, young, forever. That's my book. And,

Dr. Mark Hyman: And

Dr. Gabrielle Lyon: by the way, our titles had nothing to do with each other. The you know, the teams work on these things well before they come out.

Dr. Mark Hyman: Yeah. For sure. And and you know what? I I always learn so much from you. It's really tremendous.

Dr. Mark Hyman: I know how passionate about this topic and you've done a hard work and you basically are probably one of the few physicians I know who actually understands muscle, which is kinda interesting because it's like the biggest organ, and we've completely neglected it. So no longer no longer and and everybody needs to pay attention to this beautiful woman who is doing incredible work, to change our thinking about how we need to move and eat and be healthy as we age. So thanks for being on the show.

Dr. Gabrielle Lyon: Thank you so much for having me.

Dr. Mark Hyman: Thanks for listening today. If you love this podcast, please share it with your friends and family. Leave a comment on your own best practices on how you upgrade your health and subscribe wherever you get your podcasts and follow me on all social media channels at Doctor Mark Hyman. And we'll see you next time on The Doctor's Farmacy. I'm always getting questions about my favorite books, podcasts, gadgets, supplements, recipes, and lots more.

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