Mark Bell's Power Project - Gabrielle Lyon - Focus On MUSCLE GAIN Instead Of WEIGHT LOSS For Optimal Health || MBPP Ep. 826
Episode Date: October 26, 2022In this Podcast Episode, Dr. Gabrielle Lyon, Mark Bell, Nsima Inyang, and Andrew Zaragoza talk about how muscle is medicine. Dr. Gabrielle Lyon believes one highly overlooked aspect of weight loss is ...the importance of muscle gain. Follow Dr. Lyon on IG: https://www.instagram.com/drgabriellelyon New Power Project Website: https://powerproject.live Join The Power Project Discord: https://discord.gg/yYzthQX5qN Subscribe to the new Power Project Clips Channel: https://youtube.com/channel/UC5Df31rlDXm0EJAcKsq1SUw Special perks for our listeners below! ➢https://www.naboso.com/ Code POWERPROJECT for 15% off! ➢https://thecoldplunge.com/ Code POWERPROJECT to save $150!! ➢Enlarging Pumps (This really works): https://bit.ly/powerproject1 Pumps explained: https://youtu.be/qPG9JXjlhpM ➢https://www.vivobarefoot.com/us/powerproject Code: POWERVIVO20 for 20% off Vivo Barefoot shoes! ➢https://markbellslingshot.com/ Code POWERPROJECT10 for 10% off site wide including Within You supplements! ➢https://mindbullet.com/ Code POWERPROJECT for 20% off! ➢https://eatlegendary.com Use Code POWERPROJECT for 20% off! ➢https://bubsnaturals.com Use code POWERPROJECT for 20% of your next order! ➢https://vuoriclothing.com/powerproject to automatically save 20% off your first order at Vuori! ➢https://www.eightsleep.com/powerproject to automatically save $150 off the Pod Pro at 8 Sleep! ➢https://marekhealth.com Use code POWERPROJECT10 for 10% off ALL LABS at Marek Health! Also check out the Power Project Panel: https://marekhealth.com/powerproject Use code POWERPROJECT for $101 off! ➢Piedmontese Beef: https://www.piedmontese.com/ Use Code POWER at checkout for 25% off your order plus FREE 2-Day Shipping on orders of $150 Follow Mark Bell's Power Project Podcast ➢ https://lnk.to/PowerProjectPodcast ➢ Insta: https://www.instagram.com/markbellspowerproject ➢ https://www.facebook.com/markbellspowerproject ➢ Twitter: https://twitter.com/mbpowerproject ➢ LinkedIn:https://www.linkedin.com/in/powerproject/ ➢ YouTube: https://www.youtube.com/markbellspowerproject ➢TikTok: http://bit.ly/pptiktok FOLLOW Mark Bell ➢ Instagram: https://www.instagram.com/marksmellybell ➢https://www.tiktok.com/@marksmellybell ➢ Facebook: https://www.facebook.com/MarkBellSuperTraining ➢ Twitter: https://twitter.com/marksmellybell Follow Nsima Inyang ➢ https://www.breakthebar.com/learn-more ➢YouTube: https://www.youtube.com/c/NsimaInyang ➢Instagram: https://www.instagram.com/nsimainyang/?hl=en ➢TikTok: https://www.tiktok.com/@nsimayinyang?lang=en Follow Andrew Zaragoza on all platforms ➢ https://direct.me/iamandrewz #MuscleIsMedicine #GabrielleLyon #PowerProject
Transcript
Discussion (0)
Paparazzi family, how's it going?
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What are we going to talk about for four hours?
We'll see.
We'll figure something out.
You'll see.
I didn't sign up for this.
I can't work under these conditions.
Keep flipping this back and forth.
I'll pay attention to once it runs out.
Yeah.
Flip it again.
Yeah, that's what we'll do. is that an hour when it runs out?
it's supposed to be
give or take
we'll see because I started it fairly close to when you flipped it
so whenever you guys are ready
what's going on Gabrielle Lyon?
hi it's so nice to see you
how you doing?
I'm doing great
so you've been on the show before
we talk about you on the show a lot
even when you're not around.
All good things, right?
They are good things.
Yeah.
Give us a little background, even though you've been on the show before and people should
already, I mean, come on, these people should know who you are.
But I think it's worth noting that you've been in the field, you've actually been physically
meeting people in person for a long time and that you had a,
and still I believe have a business in New York City where you meet people and stuff. I just think it's fascinating and that that's a very tough thing to be able to figure out how to even get
started with. So explain away. So I am a physician and I have a concierge medical practice. And I say
that loosely because we do service all kinds of individuals.
And yes, I have been in the field of medicine for quite some time.
I did my medical training.
Then I went to do a residency in actually, I don't know if you know this, two years in
psychiatry.
Oh, I did not know that.
At University of Louisville.
Louisville.
Louisville.
Yep.
You notice I said that correctly. Oh, I did not know that. nutritional sciences, obesity medicine, and geriatrics. And didn't you study under the same guy that Lane Norton was kind of mentored by?
And he has now still mentored me to this day, two decades later.
His name is Dr. Donald Lehman.
I did my undergraduate in human nutrition, vitamin and mineral metabolism at the University of Illinois.
And after that undergraduate, I did additional training, a two-year fellowship in nutritional sciences at WashU.
And Dr. Lehman is like Dr. Muscle, Dr. Protein, right?
He is one of the OGs of protein metabolism.
In fact, we all talk about leucine as this trigger for mTOR.
It was out of his lab and some of his graduate students discovered that. So him
and his graduate students made that contribution to science. And some of the theory is that you
could have leucine a couple, a handful of times a day and like keep muscle mass on or something
like that, right? And still be in a caloric deficit or something like that? Yeah. Essentially
leucine is what stimulates this cascade of events known as muscle protein synthesis.
And I think it has been very valuable, especially to your community.
And of course, as we think about aging.
So long story short, I did that training and started seeing patients.
In New York City, I opened up a practice in 2015 and saw patients in person, including many people that you know and maybe even some of your family members.
Absolutely.
Which has been amazing.
And over the last two years now, we're largely remote.
However, I do travel and see patients in person.
I love it.
I think, you know, one of the things that we've been talking about more recently and something that we're kind of obsessed with is, you know, how do we get some people to kind of take that first step?
Because there's people that are they have challenges.
Maybe they were abused when they were children.
And now nowadays they're obese and they have had many medical issues and now they need kind of like a medical intervention.
And yes, it'd be great for them to go to the gym.
We all love lifting. It'd be great for them to walk and do all those things. But some people are,
they're like not ready for it. So what are some like first steps that somebody,
or when you meet somebody and you start kind of walking them through how they're going to like
get better? I know there's like medical intervention, like all kinds of things.
You can use pharmaceuticals can assist
and stuff like that too, right?
Well, the first thing I am going to tell you
may be somewhat surprising.
Individuals oftentimes, more often than not,
do not have a great relationship with their provider
where that person feels not only like family,
but also a friend and someone they can count on.
And above and beyond any intervention,
the first thing that needs to be established is a relationship. I would tell that person to be
open-minded and forget their experiences that they had previously with their provider because
ultimately that's what the sticky point is. It's actually not the action.
Because when you have a teammate, you're willing to show up for that teammate.
If you have a coach, a trainer, a coach, you're willing to show up for that coach.
Many people that are in a point of being stuck in their life have had very bad experiences with the medical profession previously.
And or they might just have a stigma.
Absolutely.
Associated with like, I don't want to go to the doctor.
They're just going to tell me that I need to exercise and that I'm fat
and they're going to be rude and mean and make me do stuff I don't want to do.
Right.
Therefore, the first step is actually finding a provider
and an individual you connect with and trust above and beyond anything
and knowing that you connect with and trust above and beyond anything and knowing
that you can count on them.
Along with that, though, a lot of people will go to a doctor.
My mom has gone to a doctor before and he's told her to eat less protein, eat less meat.
And with her, with all the information that she's gotten over the years of watching Oprah,
all the information that she's gotten over the years of watching Oprah, Dr. Oz, right? There seems to be this effort to get people to eat less meat and get more plant-based protein. Then when
you go to your doctor and then they tell you, you probably should try eating less meat too.
You wonder, why is there such a divide between some of the information that we're getting
from people in the fitness space and then the medical space seems to be spitting in that.
That is a great question.
And the first thing that I would say and bring up
is that it's very hard to be good at everything.
What I mean by that is physicians are trained in medicine.
They are typically not trained in nutritional sciences,
which is essentially, you know,
it's somewhat of a difficult position,
but I also believe that physicians shouldn't be required to be trained in nutritional sciences.
And the reason is, is because it takes a lot of effort and education, right? I did seven years
of nutritional training. I don't expect my husband, who is going to be a reconstructive urologist, to also be able to be in that domain and put attention, time and attention to that.
Reconstructive urologist.
Guy's a total loser.
He's going to be building some dicks.
Yeah, totally.
Yes, he is.
What an amazing human.
Hey, listen, I got something for you.
Can he fix it if it ain't broken?
Like, can you make it better?
He still got his training going.
Hey, listen, I always joke that muscle is the organ of longevity.
And Shane, my husband, always says, listen, there's another organ of longevity.
Let's go.
So the concept that a physician is giving nutritional advice is challenging to me because it in one hand is incredibly necessary.
They're the primary intervention point.
The flip side of that is where are they getting their information?
And the challenge is typically, not all physicians,
but typically physicians are not trained to look at nutritional science research.
It's very different than medical interventions.
There's a lot of nuances.
It's a whole different space in and of itself.
The difficulty is the individuals in charge perpetuate a narrative to eat less meat, not because of good evidence, but because of some of the fundamental beliefs at the top.
Which typically is to eat more plant-based, to reduce red meat consumption, because it's somewhat of an anti-animal narrative.
Might be also an effort to just lower calories.
Quite possibly. However, if that were the case, a good choice would be having a discussion about
increasing lean meats and decreasing overall processed foods. Something simple versus saying
that individuals should eat less red meat.
It's amazing the impact that that can have. Just what you just said right there.
You didn't say to completely get rid of processed foods, which would be amazing if people could
figure that out. But that's hard. You and I, just during your stay here, we're talking about like
cookies and donuts. Which, by the way, Mark is eating under the table. You said carrot cake.
It was weird. I was like... I may or may not have had that yesterday.
Yeah.
I don't know.
He took me for a run and then we worked out all day.
She's like, I deserve carrot cake.
I don't know.
Anyway.
Carrot cake.
People don't have, they don't have to.
Vegetable.
Yeah.
Right.
Yeah.
You get a lot of fiber from the carrot.
Right.
And the beta carotene.
It's got to do something.
We got to be able to fit carrot
cake into the diet. Anyway, you didn't say that they need to completely cut it out and you
mentioned increasing the protein. What happens when people increase protein?
There is something called the protein leverage hypothesis. You guys are familiar with that and
it's that an individual will eat their protein need in terms of there's
this biological drive for these amino acids, which is what make up protein, that they will continue
to feed until they meet that need. So one of the things, the theories is as you increase dietary
protein, your hunger mechanisms kick in and you eat your amount and you no longer are driven to continue to consume.
When you have a more optimal protein diet, your hunger is under control.
Your muscle is fed well, right?
Your blood sugar has a potential to remain stable.
Of course, assuming that calories and carbohydrates are in check.
to remain stable, of course, assuming that calories and carbohydrates are in check.
So you might potentially eat a Give Me S'mores Ben & Jerry's and not be satisfied or filled because you don't have, there's not much protein in there.
Right. And also it's affecting blood sugar.
We got an issue with Ben & Jerry's.
Yeah, yeah. An easy strategy for a listener who is really struggling to make the change or do good dietary interventions would simply be, let's say they are having difficulty managing their hunger, would simply be to increase dietary protein and have that be their initial food that they're eating, the initial macronutrient.
the initial macronutrient. I guarantee you, if you eat a chicken breast or you eat two chicken breasts, it's going to be very difficult for you to then switch to Ben and Jerry's and eat the
whole thing. Just not going to want to do it. It's going to make it harder, yeah.
Just curious about this, because if there are any plant-based listeners that are listening to this,
is there validity to the idea that, are there any drawbacks of eating too much protein? Are
there any real drawbacks of eating meat? Because we do have some listeners that are plant-based and they comment, but is there any validity behind those beliefs or is it more so the morality aspect that people, like that's where the point is?
have never seen any randomized control trials to say that eating red meat is an issue.
It is a highly nutrient-dense food, and the food matrix, it has creatine, B vitamins, zinc,
selenium, highly bioavailable. That's not to say that a plant-based individual couldn't be healthy.
Of course, they can be healthy with a lot of knowledge and supplementation, adding iron and creatine and things of that nature.
Yeah.
So, no, I do not believe that red meat is bad for you.
In fact, I believe it is one of the most important foods for us as humans.
Yeah, we were discussing this the other day that it might be one of the greatest evolutionary things that humans have ever done was to evolve to eat ruminant animals.
Yeah. and to be
able to raise them. It's because a cow will take stuff that we can't eat and it will filter it for
us. And then we get to eat the cow and get all the benefits without all the stomachache of trying to
eat grass. Right. It's an upcycler. It's a upcycler of nutrients. It's interesting. You know, Mark,
we've been, and I don't know how long you've been
in this space, but I assume for a long time, 10 years ago, nobody was arguing about this.
You remember that? There was never an issue with whether someone was plant-based or should we eat
red meat. I suppose some of the more fringe groups were, you know, saying. You're 100% right. I
remember Paula Quinn would talk about, you know, eating elk and venison and all these different things. all these different things and it would be a recommendation and no one was like, hey, well, what if you want to eat plants? No one was asking that.
Isn't that interesting? That makes me think, where did this come from and who stands to profit from increasing these narratives? Because it never existed before.
increasing these narratives because it never existed before.
I have a question about that for both of you guys, because like thinking about that 10 years ago, we would have never been in the discussion. Like in terms of the popular discussion,
the popular discussion was Oprah, Dr. Oz, those types. Right. And then there was barely any
internet people or podcasts that were actually talking about this at scale. But now you have
all these different sides that are coming at it.
And maybe just because there's so much discussion,
there is so much debate.
Yeah, more people have a platform.
More people have a platform.
Yeah, I think there's more diversity.
Like there's more, you know,
I think there's room for people
to choose to eat different ways.
Like I believe that.
However, I think for me, I like to eat
meat. That's what I like to do. I can understand why some people may choose not to eat meat.
However, I agree with Dr. Lyon where I, I don't think that there's anything bad that meat does.
I think it gets a bad reputation, uh, due to people eating like the standard American diet,
which may include some meat, but it also includes
the bun. It includes fried food and it includes a lot of processed foods. And so
it's the same thing with the oils. You know, we've gone down the rabbit hole of the oils and it's
just like, just try to limit processed foods. You don't have to really worry about these
vegetable oils. I also agree with you. I also agree with you. Because having some of it, like, okay, we can get crazy about it and say,
I don't know, man, having some of it might be pretty bad. But at the same time, it's like,
for me, I'm kind of like, fuck that. I kind of want to have some of that sometimes just because
I want to. I want to. I view it as entertainment. I enjoy to eat junk food here and there.
And so therefore I want to make the decision just to be able to do it here and there.
And also the evidence isn't so convincing.
There's multiple different seed oils.
Flax seed is an oil.
And I think that we have to be very careful when we make absolutes.
And we assume that the human body doesn't have the capacity that it does it does
it's highly capable so actually to clarify because like this is it's so interesting because in that
carnivore space there are people who are like seed oils are the devil in your opinion it's it's not
in the hierarchy of importance for people becoming healthier seed oils is not up there. It's not even in my top five. Wow. Okay.
Very good to know. It seems like if it was a huge concern, it seems like we would know more about it, right?
Like it's been, people have been like digging around in this for a while and I would agree
with you.
Like I think it's not a place for anybody to start, I don't think.
I don't think it's a, I agree with you.
I don't think that it's a starting point.
to start, I don't think. I don't think it's a, I agree with you. I don't think that it's a starting point. The key is really determining calories first. Calories do matter. Optimizing for dietary
protein, reducing processed foods and training. Let's talk more about calories because you have,
I think you're one of the very few people, I haven't really heard anybody really speaking
from this perspective. And you're not afraid to, because you're a
doctor and because you have this knowledge, you're not afraid to prescribe maybe some
things that are kind of outside the box to help people kind of have a little bit more
muscle mass on them to come from the side that we talk about quite often on this show,
which is the calories being burned, the calories out rather than just the calories in. So what
are some strategies that you have? Yeah. I think that this is two part. Number one, I have no issue with addressing and
treating obesity. Okay. Do I think that it is a primary issue? I don't. I think really muscle is
the primary driver for all things or at least a major contributor to things like insulin resistance and diabetes.
So with that in mind, in my practice,
we really focus on body composition and optimizing for skeletal muscle.
Ways in which we do that are you obviously optimize for hormones,
and that is testosterone.
I think that that's very valuable.
I think the data would support that.
Also optimizing for women the full spectrum of hormone replacement if and when they need it. In addition, there are a lot of tools like the things like incretins. There's a lot of talk about ozempic and succenda, things that affect gut hormones and improve insulin sensitivity. All are very valuable.
and improve insulin sensitivity, all are very valuable.
I believe that individuals shouldn't spend a lifetime suffering.
If an individual cannot get a hold of their diet and body composition,
it's not about how long can you suffer.
It's let's treat, and then as we are treating,
we will leverage your habits, your nutrition, your training.
Someone like my mother, for example, right?
Like she was on a walker.
She was already kind of like,
she was already like fairly defeated,
even though, you know,
we tried to give her some hope here and there and she tried some stuff.
It's tough for that person,
even if their children are into fitness,
for that person to turn the corner
and just all of a sudden
wake up and have this like awakening, like I'm going to start walking and I'm going to do this.
Their mind is not there and you have to figure out a way to meet them halfway. And so maybe
some of the suggestions you're talking about, some of these pharmaceuticals might
induce some new change or new attitude that might help you to start to head in the right direction. I think that's absolutely correct. And people don't know this, but I had a really nice
relationship with your mom. Yeah, I appreciate that so much. Thank you.
And she would have been a perfect candidate for that kind of intervention. You know,
we have to be able to address individuals in a way.
It's interesting.
So we say, OK, do this, do this, do this.
And then we wonder why it doesn't happen.
Come on, you got to do it.
We love it.
We love to go to the gym and lifting and all that shit.
It seems obvious.
However, they're up against a lifetime of an inner monologue, an experience, a self-worth.
People will, you know, I've been in practice for quite some time and people will only be as healthy, a self-worth. People will, you know, I've been in practice
for quite some time and people will only be as healthy as their self-worth.
Repeat that, please. That sounds amazing.
People will only be as healthy as their self-worth. And they hit a ceiling. And I've
seen this so many times where an individual has lost weight, begun to really gain the body of their dreams, what they have always hoped for, and suddenly completely sabotaged themselves.
In my experience, it's their capacity to be worthy of health and fitness, to truly believe that they are worthy to feel good.
And individuals that have not addressed that worth, which is something that we have to do
in practice, if an individual does not address that worth, they will never reach their full
capacity. So this is going to be so general because every individual has their own specific things. But in a general idea, how do you help people address that worth?
Because you were mentioning that there are potential hormone implications in this, right?
And we've been having this conversation because with individuals who are obese, for example,
if they're a man, their testosterone is typically going to be lower because they're sedentary
and they're not active.
And there's all these things working against them.
So they're already in a state where they don't feel good.
Testosterone is wanted.
They're not feeling good.
And there are some people in the audience that mentioned like I was obese and I got on HRT and it made me feel better to have the motivation to actually take action on all these things that you guys are talking about.
Right?
Yeah.
So maybe along with that, how do you help are talking about, right? Yeah. So maybe along with that,
how do you help address an individual's worth?
Yeah.
The first thing is bring it to their attention.
If I see an individual who's struggling in my practice
or they come to me,
one of the first questions that I ask them is,
do you feel worthy?
Do you feel worthy to go on this journey
we're about to go on?
And oftentimes they have never thought about it before.
It's always subconscious.
And when you do not illuminate the subconscious, you will continue to repeat it.
And you will play it out.
And a good provider has a responsibility to set the stage for capacity of growth.
to set the stage for capacity of growth.
In medicine, we're trained very algorithmically.
Okay, so your testosterone is low here.
I'm going to give you 150 milligrams.
You're going to take this weekly.
Your HSCRP inflammatory marker is here.
Let's do X, Y, and Z.
What is missing from that equation is the mental framework in which the person is is functioning
from and that has to be equally addressed in terms of where their belief systems are
and i think somebody that gets excessively heavy um maybe if they're still young maybe they're able
to uh work in a similar way to what they're used to from when they were younger. Maybe they can still move around okay. But I think for individuals that
start to get a little older that are heavier due to lack of muscle, due to lack of strength,
they're not going to be able to do some of the things that they did when they were younger.
And that must have a massive impact on your self-worth.
Totally. And an injury. So you have to plan for it, right? You become robust and you begin to train yourself and you become very aware of your thoughts and you
begin to execute when you don't feel like it. And again, this is where hormone replacement,
you know, if an individual, depending on levels that are low, yeah, you have to fix that.
And this is also a good place for other pharmaceuticals. For example, like I had
mentioned, semaglutide, depending, obviously, someone has to meet
that criteria in addition to really understanding that there's that internal narrative.
Is your mind, because you love to lift and you love to exercise yourself, is your mind
almost a little bit like, I really just kind of need to figure out a way for this person
to get jacked?
Absolutely.
More often than not. I believe
that that is the key to longevity. And to get them in a frame of mind to where they are interested
in that and to where that helps make them feel good. Well, jacked and tan. Right. Yes. And if I
can get them hungry enough and I can, you know, you have to find the lever that is that person's
sweet spot to potentiate an outcome. Do you believe everyone has that? I do. I've seen it. Again, this is where
practice comes, you know, they call it a medical practice for a reason.
A good physician will be able to diagnose and recognize disease.
I believe a great physician can diagnose and recognize people and the archetype of the person and leverage that.
Yeah.
Is this where that psychiatry background came in?
Because I think of typical physicians and with all the things you're talking about in terms of assessing the way somebody thinks about themselves, if you're not classically trained in that, you're just going to look at the numbers.
And when somebody needs to get help, it doesn't seem like people like you are common within that field.
Am I incorrect or is it just they need to seek the right person?
I mean, I can only speak from my perspective and I've met very fine physicians.
I know I have a wonderful physician in my practice.
He's a former military, Brian Stepanenko.
He should definitely come on.
He deals with special operations and other individuals. And I would say a very caring physician, that's their responsibility.
And so is it common? I hope so, because it's actually what really moves the needle for people.
So a lot of times, again, your thought process is to like help the person get
jacked. That kind of starts with muscle. It does. So it starts and actually ends with muscle.
So something like testosterone could be really beneficial, but I would imagine like the person
needs like, I don't know, maybe your experience is different. Does a person even need resistance
training or does a couple of weeks of testosterone just help add a little bit of muscle mass even without hardly any training? They need to train. They need to train. Potentially those that have
been fit in the past may have a response that is better without any kind of significant training,
but you do have to train. You do have to stimulate that tissue. I'm also curious about this because
we've been having this discussion a lot. Testosterone is something that is being used a lot, very liberally, especially within younger males.
And I wonder, are there any – we know the benefits or some of the benefits.
Are there any potential drawbacks of long-term use for some individuals that, you know, that are maybe just using it. And this is
outside of individuals who are obese, who are in these situations where it's like maybe very
necessary. Is there anything people really need to be thinking about? I think age of use is very
important to consider. One of the things that is, you know, I believe that you should optimize your
testosterone when you are young to your fullest capacity.
I don't even believe that individuals should be thinking about it in their 20s.
I mean, it just, again, it can shut down your own testosterone production.
It can cause infertility.
There are things that there can be issues with.
Not everybody.
And oftentimes they will recover.
But it also sets the standard,
the standard of not being capable, not being able to do and generate your own testosterone and
feeling naturally. And I think that that mentally can be a huge drawback. That being said, I am
absolutely in favor of hormone replacement, especially testosterone, TRT for individuals
who need it. There should be no reason that they shouldn't have it. And again, in society, especially testosterone, TRT for individuals who need it.
There should be no reason that they shouldn't have it.
And again, in society, I mean, listen,
I was with Mark yesterday.
The guy did not stop moving, right?
His testosterone is probably 25,000.
I don't know.
Probably.
But we don't live that way.
We're very sedentary.
A lot of individuals have excess visceral fat, excess abdominal obesity, things that can drive estrogen up, testosterone down, sleep apnea is huge. All that being said, you know, I think that you should do the things that you can when you are young and not make that transition because typically once people go on testosterone, they don't come off. In your practice for, you know, you've had it for many years.
Have you seen any changes with females that are coming to you? Are there different problems today than there were maybe when you started your practice? And do you have access to some
better strategies today or better drugs or better pharmaceuticals to assist with some of maybe
what today's women are, today's females are dealing with?
Yeah, this is a very challenging conversation because there are drugs that are very, well,
first we have to say when women are coming to me, the standards are very liberally set
right now.
So the standard for, say, obesity is at a certain level, right?
So, for example, a woman would come to me and say,
I'm not happy with my body composition,
but she might not be identified as obese.
So drugs that I think that she would be very –
a great candidate for her, I may have some restrictions to use
because she does not qualify as the medical
standard of obese, which is really interesting. The medical community and the responsibility of
a physician is to practice within guidelines. What does that look like? Is there some sort of
percentage or body index? It's right. So they have to be, you know, again, it depends on body fat
percentage. Typically, I don't use BMI.
If an individual has 30% body fat, okay, then you can consider certain kinds of medications.
But what about an individual that comes to me and is like, you know, I just cannot lose
these 10 pounds.
And, you know, part of me would be like, wow, you know, we should really initiate pharmaceutical
therapy, but it's not within certain guidelines.
And so that becomes a challenge.
So I am seeing, so one of the questions that you asked,
which is a very astute question, is am I seeing things differently?
And I would say, yes, I am not seeing things differently
within the patient population.
I see things differently with the amount of restrictions
that physicians have.
And that is a challenge.
So do you have, because actually I think Dan Garner has mentioned this,
and a few other people have mentioned this on the podcast,
how, for example, the guidelines for a normal testosterone range have gotten lower over the years.
And I'm wondering too, is it the same thing for if an individual's obese, has it,
have they loosened up the reins on that?
They haven't loosened up the reins in recent years.
But the testosterone phenomenon is actually very true.
And these are challenges that I think that we're going to continue to see.
Are there differences like with some of the psychiatric medications?
And are there differences like with some of the psychiatric medications?
Have they, in your opinion, have they advanced much or does it seem like it's – I mean I know that's not your main area of expertise.
But does it seem like with a lot of these people it just helps more to help them with their body composition and the mind follows after or how do you kind of see it? Well, I think that, first of all, I think there's nothing wrong with pharmaceuticals.
My practice philosophy is an integrative philosophy. I will use natural means when I can
and I will also use pharmacological agents because I do think that a practice is the best of both
worlds. For example, I will use metformin. I will use semaglutide. I will use Monjourno. I will use these medications that will help with insulin sensitivity and weight loss. And I also will use medications like Welbutrin and Effexor, these top-down effects. I think that there's a benefit for all of them. Again, an individual, I do believe that individuals should not struggle.
One thing I noticed with you in my communication with you and my mother's communication with you, I remember you're the first person that will say, I need to point in this person's direction.
And I always admired that from you. That's a really great trait because you're like, yeah, I know a ton about this, but let me send you off to somebody that's a specialist in
this actual field and that's a great trait to have thank you when people are good at what they do and
it's not about the person they care more about the patient and you cannot again you cannot be a
specialist in everything and if someone is that way then they're not a specialist because a true specialist knows what it actually takes.
And also, it's about the patient. And if the patient comes first, there are things that I
don't know. And not only that, if I'm unsure, even though I've been practicing for over a decade,
why would I not communicate with someone who is a niche specialist in this area?
For example, I take care of a lot of military operators.
I take care of a lot of SEALs, a lot of SEALs transitioning out.
They go away on deployments.
They come home.
I am not an infectious disease doctor.
I will screen all of them for infectious disease.
They all get significant stool tests, unfortunately, that I will send to Nigeria or some kind of infectious.
See, sends are shit to Nigeria.
I mean, listen.
Take exception to that.
Your ass will do that shit.
But it's really important to.
Picture it like being dropped out of a plane or something.
You are lucky.
You are very lucky.
The reason I bring that up is because, yes, there's a certain amount of knowledge that is required, what to look for, what to really think about.
And then you do a deeper level of testing.
Once you get those results, you have to send it out.
You have to, you know, medicine should be collaborative.
Just like your guys' industry.
You know?
Even if you guys were
doing pedicures in the back and looking at your feet
and I don't know what's happening.
It's gotten weird.
It's gotten really weird around here.
I can't work out under
these conditions. There's nothing wrong with pedicures.
Actually, you both should
probably get some. I've had them before.
They're great. I need another one.
They got rid of some
really awesome calluses I had.
You would need a sledgehammer. I saw you.
You need a drill.
Like a scene in Dumb and Dumber.
That's a good scene.
What about, and I know it probably
takes several steps to get there, but
testosterone prescriptions for like depression and that sort of thing.
It's not the primary.
That's a great question.
It's not a primary indication.
At least, you know, I haven't looked at, I have not seen it as a primary treatment.
But of course, low testosterone can influence depression.
So you do have to treat in entirety the whole person.
Yeah. So this is, again, it's interesting that you mentioned that we're on this discussion again,
because we've been seeing comments from, again, a few people in our audience
had depression and then they chose to get on TRT. And then that was the thing that,
and I'm not saying this as like, this is why you need TRT. Because I think that,
well, I know that habits, getting sun, getting sleep, exercising, nutrition, all of these things
can impact your testosterone and your hormones. But a lot of people, especially younger men,
that's been the thing that they're turning towards. So, I mean, how do you look at that?
I think it plays a huge part in my, in my patients will say, man, I haven't been on testosterone.
I'm feeling depressed.
Yeah.
And they will say it.
I'm really feeling this.
I don't feel motivated.
I feel low.
I don't feel like myself.
And these are people who were on testosterone?
Yep.
Have you noticed an impact on men and women?
I do.
I'm so glad you asked.
I think that women, one of the things I do see with women is their testosterone are low.
And their free testosterone is very low.
And when they go on testosterone, they have more energy.
Their sex drive improves.
And I think it's under, their orgasms improve.
I feel as if it's under-
I feel as if it's undertreated and under-discussed, for sure.
Why do you think so many women are suffering from many of the same things? I feel as if it's undertreated and under discussed for sure.
Why do you think so many women are suffering from like many of the same things? Like I have some female friends and it seems like a lot of prescribed thyroid medication.
It seems like a lot of autoimmune disorders.
Like what has this always been the case or Or what has maybe triggered some of these things, if you know any of that?
Autoimmunity.
When you think about autoimmunity, we should just briefly explain the body is attacking either the thyroid hormone or the
thyroid itself, has seemed to increase over the last decade. Why do we believe? I certainly can
offer my opinion. I believe that we are up against a much more toxic environment. And this may be a little surprising.
When I say toxic environment,
I mean that I believe a lot of autoimmunity.
So there's a genetic component and there's also an environmental trigger component.
The environmental trigger component,
I often believe comes from gut infections,
whether it's parasites or something happening.
There you go again with your worms.
I know, I'm sorry, but I've you go again with your worms. I know.
I'm sorry, but I've just seen it.
So crazy.
I know.
But hey, the proof is in the pudding.
I get people better.
The proof is in the poop.
Yeah.
Nice one.
Nice one.
The reality is, is we have a entire human race to feed globally.
Hear me out.
Which means we are getting food
from all over the world.
So now what's happening is
whatever is on that food
that we might not be exposed to here in the U.S.
is coming here.
People are getting it.
Whether it's sushi being shipped or
I don't know.
Yeah, there's a lot of meat companies
that you can order from
and it's from like Australia or something. Okay. And
fruits and vegetables that are coming from
other countries that are now coming
here. So now we are exposed to
say, helmets
or worms that we
I mean, typically you'll
find them everywhere, but perhaps the burden
level of what we're getting and
Mark is laughing. Well, the worms that
Nsema has are next level
because he has a,
he does a sushi sous vide out of his trunk of his car.
It's quite impressive.
I will say I never recommend anyone eating sushi.
Or anything from Nsema.
So you don't even mess with sushi at this point.
Again.
When I cooked for her yesterday,
she's like,
I like my meat cooked
a little bit more than that.
And I was like,
okay.
And again,
this is just from clinical experience
over the years.
You asked about autoimmunity.
When we start to see things
introduced from all over,
and listen,
you'll hear people say
they go out of the country,
they get sick,
I have this GI stuff,
and subsequently
they may develop Hashimoto's
or some kind of
autoimmune condition.
I, of course, am making this very black and white.
It doesn't necessarily just mean it is.
There's a predisposition.
There's environmental toxins.
There's all kinds of things.
But that is one of the reasons why I believe that we are seeing more autoimmunity.
And another thing, and I don't know how much this contributes to this,
but iodine, iodine's effect on the thyroid.
We are using iodinized salt.
There's a lot of iodine in skincare products
and iodine in things that potentially it shouldn't have,
and the iodine is really affecting the thyroid.
Do you think there's maybe some negative side effects of perfumes and makeup?
I do.
Because there's like a lot of stuff.
I remember, I just don't even really look at it anymore, but I remember like.
When you were wearing perfume and makeup.
Yeah.
Just last year.
When I was using a lot of blush last year.
No, I remember like when my wife first moved in with me and I remember like, or we moved in together, just like how many different like bottles of stuff she had like in the,
uh, in the, in the shower.
And I was like, what the fuck is like, where's the soap?
Like, is there soap somewhere?
It's like the cell volumizing something or other and this other thing.
And these products just aren't, you know, you look at the ingredients, you're like,
holy crap, like there's a lot of ingredients here.
So like, I think makeup and perfumes and shampoos and conditioners, they must have like maybe some toxins in them or something like that.
I very much believe that over a lifetime, these things can be very toxic.
And it's different for every individual.
Some individuals have more of a capacity to be able to detoxify than others.
to be able to detoxify than others.
And if an individual is predisposed to having issues,
then you add on more of these environmental toxins.
It's a real problem.
And you might be able to find alternative brands that don't have some of the parabens
and some of the other things.
I agree.
You know, ultimately,
I feel as if everything is going to cycle through.
They're going to say,
now it's parabens, it's these things,
and then they're going to have natural products
and the natural products are going to have put in whatever it is.
So ultimately the more natural an individual can be, the better, even though I, listen,
I use makeup all the time and I have no issue with it, but I try to use a quote clean brand
at the moment. But again, being cognizant of this stuff is really valuable. And if you're
going to offset it with what you're eating.
Yeah.
Right.
Right.
And other lifestyle habits.
Yes.
Since we're on this topic and hopefully we can get to what women should be looking at in terms of their potential labs.
But I have a few friends who have been sending me a lot of information on birth control on both sides of it.
birth control on both sides of it. Obviously, we know how it can be so important, but it is literal. It is the changing of hormones and potentially a 13, 14 year old girl.
Right.
What do you think people should be thinking about? Because we know why it's necessary.
It's very tricky. It's very difficult. These are very difficult conversations.
Yeah. So, I mean, if you can kind of
just educate us
on some of the drawbacks
and some of the things
people should be understanding
on how it can impact
someone negatively
and positively,
but it's a tough subject.
It's a very tough subject.
Yeah.
I would say overall,
birth control is considered safe
and has been used
for a very long time.
Safe does not mean optimal.
That being said,
what are the drawbacks?
Is it,
is a 13 year old girl going to get pregnant or not?
These become very difficult conversations.
Do taking oral birth control pills affect an individual over a period of
time?
Can it impact gut microbiome?
Does it shut down hormones?
Yeah. These are all potential risks.
I really feel that an individual has to think long and hard about it.
And again, the biggest issue is pregnancy and then affecting subsequently that individual's life.
So, you know, from a medical standpoint, it becomes very difficult to weigh out.
Now, as a young woman progresses, do I think that there are other options other than oral birth control?
I think a Mirena, which is an IUD, whether it is a hormonal IUD or a copper IUD are much better.
Again, this is just my professional opinion,
and it's different for everybody,
but I would much rather see people use an IUD.
Tell us more about your book.
I don't even know if these guys know that you wrote a book.
Yeah.
And the book is coming out in a couple months.
When's the book come out?
Well, in a while.
It will go on presale February 2023.
Oh, yeah. coming out in a couple months. When's the book come out? Well, in a while. It will go on pre-sale February 2023. But the book doesn't
come out till September
2023.
It's this whole COVID. I know.
Tell me more about the book. What's going on with the book?
So the book, the working title
right now, which may change, and I'll
tell you, I know that this is coming out in a week, but the
working title is Forever Strong.
Love it. And it is the concept of the revolutionary science of muscle from a health perspective,
not a fitness perspective, and nutrition for extraordinary health at any age.
And I believe this book will change the world.
I think it will shift the concept of obesity to understanding these diseases that we are seeing are really of skeletal muscle in origin first.
And we must protect muscle, build muscle, focus on muscle for overall health and wellness.
And that's where everything starts.
This is where a lot of these diseases start, right?
Well, I believe.
Like diabetes and stuff like that? If you were to put it in PubMed, you would probably get 10,000 different answers.
What I am sharing with you is where my perspective comes from.
And I'd love to share the story where these concepts originated.
This muscle-centric concept that I talk so frequently about was born from my fellowship.
Again, I trained in protein metabolism.
I trained in nutrition in my undergraduate.
And mentors are really important.
We were talking about how important mentorship is.
They really shape your capacity to think in multiple domains
and also with a scientific integrity.
Being trained by Dr. Donald Lehman and still mentored by him,
we focus a lot on protein, dietary protein, metabolism, weight, body composition. Then I
was inundated with medicine, which is brutal. Medical school is not fun unless you ask my
husband. He might think it's fun. Then, of course, residencies and then a fellowship.
And it was in fellowship when I went back to my nutrition roots that I was doing.
So part of my responsibilities as a fellow, so a fellow is post-doc work.
So after you now are a board-certified physician, you then can elect, if you are somewhat crazy, to go back and do additional training.
And so when I went back to do additional training,
my responsibilities were twofold.
They were obesity research and geriatrics.
So I did obesity research,
and then I was responsible for end-of-life care,
geriatrics, worked at a nursing home,
was responsible for running a weight management clinic
and a dementia clinic.
It's part of a fellow's responsibility.
I was working on a study where we were looking at body weight and obesity and brain function.
Okay.
So the working premise was that diabetes, there's type 3 diabetes in the brain, and that the brain becomes insulin resistant
and really Alzheimer's secondary to obesity,
you lose your memory.
So the wider the waistline, the lower the brain volume.
And Mark, you know me.
I am somewhat of a very loving human.
Don't tell anyone.
I'd much rather prefer them think I'm just like some asshole.
But I have a tendency to be- A softie.
Yeah. I'll hug you and tell you your armpits smell or whatever. And I became very
invested in these participants through this study. And there was one woman,
and she was a mother of three. She had always struggled with 15, 20 pounds.
there was one woman and she was a mother of three. She had always struggled with 15, 20 pounds.
And she was really kind. She always put everybody first. We know women like that. Always put everyone first, put her family first. And I imaged her brain. And she was in her late,
she might have been in her early 50s and her brain looked like an Alzheimer's brain.
And I knew that in the next decade, what was in store for her, and it crushed me.
And I felt that I had failed her, that the medical society had failed her.
And she was just a representation of all the other patients that I had seen.
And her life was going to be destroyed. That she, I knew what was in store for her.
It was at that moment that this concept of muscle-centric medicine was born.
That it was really, the one thing that all these people had in common wasn't that they were all obese.
It was that they all had low muscle mass.
They all had some kind of impairment in their muscle. And because we had told her to lose weight and fix her obesity,
she had been doing her best on a treadmill, on a hamster wheel that was going to ultimately
lead to her destruction and crush her family. And it was at that moment that I realized
we as a narrative, as a medical field, as a society, as a culture, we have gotten it all wrong.
And that is one reason why it's so difficult to fix because we are trying to fix a problem by asking the wrong question.
We don't have an obesity epidemic.
An epidemic is something that kills people swiftly.
We have a midlife muscle crisis.
We have a muscle disease.
And that's what we need to fix.
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So a big aspect of that
in our realm is changing the
messaging from, okay, losing weight to
building muscle.
Building muscle.
Insulin resistance, diabetes.
It starts
in skeletal muscle first.
I believe that muscle is the organ of longevity.
And then if we care about all these diseases of aging,
you must prioritize skeletal muscle first as a primary intervention,
not as a secondary intervention.
And what else is really important is if I could take what you guys do
and bring it to the medical field and we use
muscle as medicine and we combined physicians on understanding that fitness is above and beyond
performance, which I think that you've gotten to this point. It's not about performance. That's
great. When you're athletic and you're in your 20s and you're, you know, looking to hit PRs,
and you're looking to hit PRs, that's great.
I am talking about muscle as a primary intervention for disease.
And the real magic is going to come when the fitness industry and the medical industry collaborate and collide and change the messaging.
And I think some of the stuff that we did yesterday
is a really nice example of stuff that nearly anybody can do.
I realize there's people with limitations,
but the pulling of the sled forward and backward,
people could use whatever weight is appropriate,
or maybe they just start walking forward and backward
without any extra resistance.
Some of the twisting and some of the other maneuvers that we did,
those are all things that nearly anybody can do.
Pick appropriate weights.
Absolutely.
Right?
And in the contraction of skeletal muscle, you're improving insulin sensitivity.
You know, you used to walk and do all that stuff.
And not only that, the other flip side of muscle that really isn't discussed is muscle is an endocrine organ.
When you contract it, it secretes proteins.
It secretes myokines.
It interfaces with the rest of the body.
It interfaces.
It affects immunity.
It affects nutrient partitioning.
It's not just the exercise event in and of itself that is what is so valuable.
It's what happens when the skeletal muscle, which is muscle.
Everybody, all your listeners know what muscle is, the tissue that's under voluntary control.
When you secrete skeletal muscle, it secretes these under voluntary control. When you secrete skeletal muscle,
it secretes these myokines.
Or when you contract skeletal muscle,
it secretes myokines.
We've all heard about BDNF.
What about the other hundreds of myokines
that go throughout the body
and have very specific roles?
When I'm out on a run,
I see so many different kinds of people.
Sometimes there's people that are a lot bigger than you would think out there running and out there trying to figure it out.
When I go to the track, it's the same thing.
And there's some guys there, I haven't seen as many older women, but there's some older guys that I'll see at the track that are just out doing their
normal thursday like oh it's thursday you got to do my sprints because they know that they need it
like they know that it's they know how important it is and they're like in their 60s and they
couldn't be any happier and i'll jog and do some of my stuff and they'll like fist bump like they're
all excited and i think i think maybe sometimes people's interpretation,
you mentioned this about going to the doctor,
and this would be a good thing for people to lose with their mindset,
getting into fitness or going into the gym.
You know, forget your, you're going to have to forget your kind of preconceived notions
of what's going to happen.
The likelihood that someone's going to make fun of you is extremely low
I guess it could happen
but I personally, I've never seen it
but I understand where people are coming from
they feel that because they feel
they feel they're not worthy of starting this journey
and they feel out of shape and they feel fat
but I really would like to encourage people like you would be surprised.
And same thing with something like jujitsu.
I think people have it in their head like, man, I don't know anything about this.
People are going to be so like they're going to.
I mean, I'm sure you can walk into a place where they do jujitsu where maybe they would be mean.
But usually people are like, Oh, this is your first
day. Like this is, you know, and yes, maybe they want to mess with you a little bit and stuff like
that. There's some stuff that's like, uh, just part of like the camaraderie of a community.
Uh, but for the most part, people are really pumped that you're there. So when someone sees
you out for a run or for a walk, um, most likely you're not going to run into somebody that's going to have
a negative thing to say about you. And you're out there doing this positive thing for yourself.
And there's so many different versions that while I would love to see everyone lift, I do think that
for people that are just starting and for people that are maybe very disconnected to a lot of
movement from when they were younger, going out and going for a walk, there's actually some strength and some power involved in that that you might not even think about because going uphill and stuff like that.
And again, you just might be like not in the best shape.
Movement is all valuable.
And remember when you were, I don't know if you still do it, but the 10 minute walks?
Absolutely.
Do you still do it because you're 10-minute walks. Absolutely. Do you still do it? Because you're still running.
That's very valuable.
And that is if someone eats a meal, you can immediately utilize skeletal muscle to push that glucose into muscle.
It's a way to leverage what you have control over physically.
And Seema, we were talking earlier off air about this dietary, this whole narrative about how you should restrict dietary protein.
I was just about to ask you. Let's go.
And I think that that's probably the one biggest mistake that I have seen in my career over the last, I don't know, five years. It's really picked up, maybe five, seven years. Like mTOR thing?
Yeah, like apparently, literally I'm quoting what he said.
David Sinclair literally said that low mTOR predicts longevity.
And on your side of things, you're like, well, no, muscle.
But let's talk about mTOR.
So mTOR is mechanistic target of rapamycin.
It's in all cells. It's essentially been maintained over an entire human span.
Mechanistic target of rapamycin is the key.
It is a key trigger for this muscle protein synthesis.
There's multiple ways to stimulate mTOR, right?
So insulin stimulates mTOR.
Amino acids, particularly leucine, is this stimulatory mechanism of mTOR, right? So insulin stimulates mTOR. Amino acids, particularly
leucine, is this stimulatory mechanism of mTOR. mTOR is exquisitely sensitive to different stimuli
depending on where it is. So let's talk about mTOR in skeletal muscle. mTOR in skeletal muscle is exquisitely sensitive to protein.
Specifically, mTOR, say, in the pancreas or liver is more sensitive to insulin.
Right?
Mm-hmm.
So the concept that mTOR is universal and overall you should decrease mTOR makes no sense.
mTOR is in skeletal muscle very beneficial, stimulated by dietary protein, by resistance exercise, by insulin.
Maybe that's why protein has this phase one insulin response potentially.
mTOR is also stimulated by excess calories, excess carbohydrates, insulin, excess calories.
So if you want to make a bigger impact, then why wouldn't you reduce insulin stimulation through dietary carbohydrates?
Because then you are decreasing mTOR stimulation in liver,
pancreas, all these other tissues.
That would make much more sense to me than saying, no, no, it's dietary protein that
is stimulating mTOR in skeletal muscle.
Oh, wait, but also resistance exercise stimulates mTOR in skeletal muscle?
So someone has to explain to me so I can understand why the segment would be, okay, well, it's the dietary protein issue.
When excess insulin and excess carbohydrates and excess calories would be much more potent and impact potentially in a negative way.
Not only that, you know, the big thing was like mTOR and cancer, right? mTOR
is driving cancer. Well, cancer is a disease of the genome. And I just want to take a step back
and think about it. So this is a disease of the genome. Also, what kind of cancer are we talking
about? Are we talking about breast cancer? Are we talking about colon cancer? Are we talking about prostate cancer?
Do you know what one of the biggest risk factors for all those cancers are?
Obesity.
Oh.
Yeah.
So again, explain to me why taking a mechanism, a Vemtor, and saying we should reduce dietary protein to improve longevity, how that's going to work.
Not only that, what improves survivability across all cause mortality in cancer?
Anyone?
Skeletal muscle.
So muscle.
So one of the biggest killers in cancer is cancer cachexia, which is this highly catabolic state.
And we've seen individuals with cancer and it destroys their skeletal muscle.
Cancer cachexia, the body can only lose so much muscle before you die.
So again, explain to me where this is coming from.
And just show me one randomized controlled human trial that alone stimulating mTOR with dietary protein that is going to stimulate muscle is going to decrease longevity.
I mean wouldn't there be so many – I mean I know we've had some bodybuilders recently pass.
But like wouldn't so many athletes like – people have been increasing their protein since the 70s.
So like wouldn't we see like their lives?
I mean if that was the case, people that eat good amounts of protein,
I mean would probably die fairly young and you're not really seeing that.
Correct. And the idea – again, we are talking about health span and we're talking – bodybuilders, athletes are actually at the extreme end.
So there's bodybuilder, athletes.
These are also at the extreme end.
Now, the other extreme end from a physiology perspective is aging, the geriatric population who have lost skeletal muscle.
We know what happens to those people.
And they fall. they break a hip,
they're sarcopenic, which means low muscle mass strength, function. What also rides along with a decrease in muscle mass are blood sugar problems, all the things that we're worried about.
So again, how do we protect skeletal muscle?
You protect skeletal muscle two main ways.
You train and you eat dietary protein.
Break protein down and eat a bunch of it.
Right.
And the idea is very unidimensional.
It's very narrow-minded to say we should reduce our dietary protein to reduce mTOR signaling.
very narrow-minded to say we should reduce our dietary protein to reduce mTOR signaling.
That's like saying you should reduce resistance exercise because resistance exercise stimulates mTOR. We have to make sure that the primary outcomes that are required for overall health and wellness are the primary outcomes.
Muscle determines a big part of longevity in terms of prevention and protecting people.
What about like centurions?
I think they're called that, right?
Is that people that live to be 100?
I forget.
Am I saying that correctly?
I don't know.
They're doing all kinds of things.
But I know.
But a lot of times they're very small.
So maybe there's, I don't know, maybe there's some truth to like,
just because it's such a smaller person, maybe there's just like less protein i don't know maybe but maybe it's not
a protein issue yeah maybe and again why don't we also qualify or quantify what is longevity
so you're going to do protein restriction but you know what you're going to be bedridden for the
last five to ten years of your life. You are not
going to be able to walk. And if you break a hip, you're done. But don't worry, we're going to keep
you alive. The alternative is you're going to optimize for dietary protein. You're going to live
six months less and you're going to be jacked in town. I mean, you know, I'm teasing and this isn't,
you know, I don't want the listener to be like, oh my God, she's making these,
you know, black and white statements. I really, this conversation, it really is for the audience.
And the goal is to bring transparent conversations and perspective back rather than blindly listening
to what we are hearing. Again, the other thing we always have to ask is who stands to profit?
Why are we having these conversations?
I'm a trained geriatrician.
I'm trained in the end of life.
There is nothing worse than seeing an individual who has fallen and broken a hip and cannot ever walk unassisted again.
Yeah, and do you want to be built like
David Sinclair?
He's a fine scientist.
He's a fine scientist.
He's not Jack the Tan though, right?
He's a fine scientist and I think
that we all want to do
the best that we can for
the world.
However,
there is a certain responsibility that comes with what are the
other, you know, what are the unintended consequences of the statements that we are
making? This whole protein and cancer, give me a break. Yeah. It does seem though, like you
mentioned the elite athlete and the, you know, the bodybuilders on this side.
When, I think when some people hear us talking about muscle and all of that, you know, immediately they're like, well, look at these bodybuilders dying.
Like we're not talking about the bodybuilder who is on this cascade of other things to help them try to be that big who's competing.
I mean, oh, sick.
We've already passed that.
Who's all natural? Yeah. We were joking, right? Oh, yeah.
But we're not talking about that. We're talking about somebody who maybe you're working,
maybe you're using your body, maybe you're doing some resistance training, but you maintain that,
you maintain protein over years. It's a very different type of individual and that can lead
to some longevity. Absolutely. And I want to bring up something else that I think actually,
I have a podcast.
Did you know I have a podcast?
Yes, we do.
I'm aware.
And my first episode, I try to hear both sides, right?
The moment you stop listening to other information and other scientists is the moment that you should just hang it up, right?
the moment that you should just hang it up, right? My very first guest on my podcast,
which I'll just give you a plug here. It's a very creative name. You might not guess it.
It's called the Dr. Gabrielle Lyon Show, was Dr. Tracy Anthony, and she is an expert in protein restriction. She is a expert in protein restriction, dietary protein restriction.
in protein restriction, dietary protein restriction. And we had a long conversation about these mechanisms that you're talking about. Sinclair and these other longevity experts are
talking about. Now, this is a woman who is not on Instagram, or if she is, maybe it's a picture of
pancakes, you know, but she's actually in the trenches doing research. So she has funding and
grants, and she's just pumping out papers.
And one of the things she said is that you have to think about what your goals are.
And for protein restriction, it's typically done in rodent models. And those rodent models are in a germ-free, stress-free environment. And we have yet to see that protein restriction over the long term
is beneficial for humans. She did say, however, protein restriction done cyclically
may increase autophagy and ways in which you can regenerate cells.
And there may be some benefit to targeted protein restriction.
And she said, what does that mean?
That means it could be one meal every, I don't know, two weeks where you do protein restriction.
So we have to quantify when we talk about protein restriction.
Can it be
used? Does it have a positive impact? Yes, it likely does because it generates stress for the
body. It allows the body to upregulate, you know, Mark was talking about how he likes to eat junk
food and maybe once in a while it will create stress in the body that his body can overcome.
Did I get that? Yeah. So does protein restriction have that same impact? Yes. Should you do it all the time?
Probably not. But can it be done? For me personally, every three months, I may go through
a period of protein restriction for one week. What does that mean exactly? What does that week
look like? For me, it is mostly fruits and vegetables. It's very low protein for about
four or five days. And I feel great.
When you say low protein, is that like what half of your body weight?
No animal products, no animal products, just fruits and vegetables. You know, it's essentially one of the methionine restriction is one of the amino acids, right? That's where kind of all the
longevity, much of the longevity discussion comes from. And I'll do it. I'll feel great.
It also makes you hungry for those foods again, right?
Which might be nice for some people.
They might be tired of eating their steak and their whatever it is.
They might be exhausted from eating.
And I bring this up because I think it's very dangerous when things like this are discussed
and in terms of saying we should just globally restrict our protein intake.
I think that's Walter Longo too, right?
It is Walter Longo. He's got the five-day fast.
And I've done that before.
And unfortunately, there was a paper.
And again, these are fine scientists.
Paper Levine was the first author.
And it talked about protein and increased cancer or something like that.
I don't remember the title, but it was
published in Cell. And at the time, Walter Longo was on the editorial board. And this paper in Cell,
so Cell is not traditionally a nutritional science journal. And the way in which we look
at nutritional science is a bit different than the way that we would look at medicine or certain
kinds of studies. And again, these are very fine scientists.
This paper that came out, which really is what perpetuated this discussion of protein
restriction.
I mean, it was, you know how when this topic of cholesterol came out and dietary, and it
took like 20 years to unwind and you still go to the doctor and they're like, you know,
lower, you don't eat eggs.
It's going to increase your cholesterol.
So we're still there, right?
And it was these one concepts that just like all the shit slides downhill.
This paper did the same thing and it talked about increased dietary protein, cancer IGF-1.
Again, the issue is it took mechanistic data and then it took large epidemiology, took like groups of studies. So it
was not a randomized control trial, took mechanism and then it took groups of individuals and somehow
magic happened and it came out with this paper. It would have never, in my opinion, been published
in a normal nutrition journal because that's not the way nutritional science works.
It doesn't quite work like that.
And so this paper and actually a handful of world-leading protein experts put the statistics through and said these are all these errors.
You are recommending essentially lower than the RDA, which is putting people in somewhat of a protein deficit and the unintended
consequences of the paper that you're putting out, not only that, your statistics don't match
your conclusions. Those with higher protein actually did better and had more survivability.
They did not publish it. They refused to publish it in the journal. It is available online. You guys should link to it. I'll send you a link. It is available. But that is an example of subsequently what we are up against.
And again, it's challenging. And the reason I bring this up is because the unintended consequences
of the narrative of who is that going to impact? It's going to impact my parents.
of who is that going to impact?
It's going to impact my parents.
I don't want them to further perpetuate sarcopenia or loss of muscle and in their midlife
further reduce their dietary protein
when we know unless you are you guys
doing feet and whatever you're doing
and pushing sleds and Andrew
and God knows what you guys are doing.
The general population, I mean, I was exhausted yesterday.
I was like sitting out there, my feet out there,
I'm like, where's my carrot cake you know for the rest of the normal population
it is not gonna happen right you guys are living the dream in the Kabbalah dream I was like god
we're shark tank get me the fuck out of here but um you know uh the rest of the world is up against some really significant narratives.
And that's what I'm talking about.
And so we have to understand what are the outcomes that we want?
How can we filter through this information?
And it's very challenging to do that, which is one of the reasons I think Lane does an incredible job when he, you know, really talks about, you know, the studies and just is a fine scientist too to kind of
balance the narrative.
But the unintended consequences of these large discussions with social media, I believe that
with this go plant-based, further restrict dietary protein, we are going to see an epidemic
of osteoporosis from the millennial
population that we have never seen before. This is what I believe is going to happen.
Dietary protein is really important for building bones. Can you do it on a plant-based diet? Yeah,
of course. But again, now you are up against, if you care about mTOR, you know, you are up against
elevated levels of carbohydrates, right?
So if you are going to go plant-based and you are going to eat whole foods, you are going to consume a tremendous amount more potentially of carbohydrates.
How are you going to control for those calories?
These are concepts that we really need to think about.
And again, when you're young, you know, you can go in the back and eat your Twinkies and you're okay.
But as you get, you know,
we all did that in high school.
At least I did.
You eat Twinkies?
You ate a lot of things.
A lot of things, yeah.
But I know you don't eat that now.
I've never had a Twinkie.
Really?
Yeah, never.
I think I have one from like 1982
in my bag,
but I guarantee it lasts
and still probably tastes the same.
You know, I don't know.
My mom jokes
were getting to me down the road.
When you were here years
ago, you whipped
out a steak out of your pocket.
That's right. Wait, seriously?
And I was like, this lady's unbelievable.
I wouldn't put it past me.
Yeah. Pretty much whipped out a steak
out of her pocket. Yeah, ate it in the break room, I remember.
Oh, yeah. Yeah.
It was great.
That was fucking cool.
But like no fork or anything.
She just like started chomping on it.
It was pretty awesome.
You're welcome.
I'm very refined.
And then when I saw you in New Jersey.
I was there at the Bell family reunion.
I was really very upset that you didn't invite me this year.
You didn't plan your reunion around me.
I know.
I apologize. Where's Andy? But then, you know't invite me this year. You didn't plan your reunion around me. I know. I apologize.
Where's Andy?
But then, you know, you have two children and you whipped some more steak out of your pocket and just started shoving it in their face.
Technically, it was a bag.
I didn't typically keep it in mind.
My pants are way too tight for the pocket.
There might have been a bag.
There might have been a bag.
I think I forgot diapers, too.
I was like, mom.
Oh, remember that?
Yeah.
Man, motherhood
so we so we went you know i love the bells i feel like their family poor mark can't get rid of me
it's like a whole thing and uh so we brought my kids and one child so i have a three-year-old
and 18 month old now but when we were there it was two years ago because last year we were in
san diego and i think these are little children
andrew you can appreciate this i drove i forgot diapers i don't even think i had wipes and we
where were we we were like we're like at the end of the island right and like both kids shit
themselves and i'm just like oh my god yeah i think like one of my family members went out and
got they did right got diapers i, like mother of the year here.
Yeah.
I don't even think I had to change a clothes.
I'm like, where's my child?
Yeah.
My family's used to like kids running around all over the place.
So we were like, ah, kids shitting their pants.
Yeah.
I'm like, I shit my pants too.
It's fine.
And just throw them in the water and let the ocean wash them out.
Yeah.
No, I don't know where we're going that, but.
But how do you, but how do you eat? That was what, that's what I was going to get to. Exactly. I don't know where we're going with that. But how do you eat?
That's what I was going to get to.
How does the fam eat?
Well, we do eat a protein-forward diet, a lot of red meat.
We use certified Piedmontese.
Again, it's lean.
It allows for calorie control.
We don't eat a ton of fat, although my husband, he's an eating machine.
He commits carbicide every day.
He's under the table eating pancakes.
Like, no, I'm not.
I'm good, honey.
I'm good. I'm like, honey. I'm good.
I'm like, why do you have chocolate chip pancakes over there?
Or like Leo, my 18-month-old, will come in.
I'm like, what are you eating?
It's like ice cream.
Something he got from his dad.
Yeah.
No, I swear.
He's like, I didn't do it.
I eat – and I'm a tiny person, relatively. And I eat about, just to give people an idea of, I'm on five feet of boosters underneath this.
I'm about 5'1", 108 pounds, tiny.
And I eat about 120 to 100, yeah, about 120 grams of protein a day.
I also eat a lot of fruit.
And that would be the majority.
I hate vegetables, not because I'm against them, unless you can sneak them in my food. I'll eat a lot of fruit. And that would be the majority. I hate vegetables, not because I'm against them,
unless you can sneak them in my food.
I'll eat it, but I love it.
A salad maybe?
I mean, it's kind of gross, but if someone makes it for me, I'll do it.
I eat a lot of red meat.
I would say that that's probably the primary food intake,
not for any particular reason other than I think it is a nutrient
superfood.
Hey, those Piedmontese hot dogs were good, weren't they?
They were good.
Yeah.
And also-
With their cheese and mustard on them.
That was great.
They were chopped up.
Don't everybody-
Don't let your minds wander.
I totally missed that.
I mean, your dad jokes were terrible.
So yeah, so red meat.
We eat a lot of ground meat.
I do like cilantro.
I like herbs.
I think that that's very valuable.
Jalapenos and cilantro.
And then again, a lot of fruit.
And actually I've been throwing prebiotics in there, stuff for prebiotics like kombucha or sauerkraut, which I believe is the next frontier is going to be the gut microbiome.
And how dietary diversity impacts the body. And really, you know, it's
interesting. Some people, and I've thought about this a lot, and there's been a few proof of concept
studies where we think about a protein, we think about there's, you know, 20 amino acids typically
for humans, and nine of those are essential. Of those essential, there's the branch chains.
And it's the essential amino acids that really determine protein quality.
And you and I all know people that seem to do well on a lower protein diet, right?
And cognitively, we've just talked about how low, how dietary protein is the fountain of youth and the foundation for health.
dietary protein is the fountain of youth and the foundation for health.
But I cannot discount the fact that, you know, I have some friends that are vegan and they seem to do phenomenal and they don't seem to be wasted away.
And as a provider, I'm thinking, well, how is that possible?
Well, there are some interesting findings that have not been done in humans, but seem to be relevant.
Oh, your body will like fill in the amino acids or something.
Isn't that amazing?
This guy, he is the best.
Do you guys realize what a good memory Mark has?
Oh, yeah.
I mean, he just looks like a meathead knuckle dragger.
Actually, this is from Ron Knox, but actually he is very smart.
You know that, right?
Yes, we do.
It's just like, it's the, what's the word?
Like, not an oxymoron, but I don't know, whatever it is.
He's way smarter than I am.
I know you're joking.
Let's just keep going.
I'm joking.
No, no, he is.
He is smart.
So, you know, and I have a great guest who actually is coming on my podcast who should definitely come on here.
She is the head of Cedars-Sinai, the Microbiome Institute.
Her name is Suzanne Devkota.
Okay.
She's an amazing scientist.
And I will make the introduction.
She's also beautiful and just an amazing human.
Is she into poop too?
Totally.
Totally.
Fucking knew it.
So she worked on a study also with – she came out of Don Lehman's lab, also worked on a study.
Don Lehman contributed to this.
And what they found was that those – that there is a way in which the gut microbiome can scavenge.
And actually they can – it can generate – the bugs can actually generate some of the essential amino acids that can then
be utilized by the human. What I am saying, and again, I am saying this as if it's in humans,
but really these are rodent models. What I'm saying is that there is a potential
that the body, depending on what you are feeding it, can begin to generate,
because of the gut microbiome
essential amino acids so you could get away with less protein for a period of time for a period of
time again this is all and therefore some of those amino acids might have to be taken off the
essential list isn't that fascinating i mean it will never move them over to the non-essential
but it will but i mean this again we have no way of qualifying who – I mean, we're not there yet.
But this goes to dietary diversity.
While we're talking on this podcast about very important fundamental recommendations of what we can say for 80 percent of all people, dietary protein, if not more, is going to be a critical macronutrient.
It's going to determine their muscle health.
It's going to help with their body composition.
It's going to improve their satiation, their willpower.
There is a chicken breast threshold, unlike the donut threshold, right?
Like it's just not going to happen.
But there may be some future developments.
And I just say that because it is important to have somewhat of a balanced conversation, but we're not even there yet. And I don't even know how we got on this
from diapers to this. But to add, to kind of see if we can get some practical aspects from that,
you mentioned how you have kombucha, sauerkraut. What are some ways that people can potentially
be ahead of the research just in case it ends up panning out.
What can people do right now to add some of that diversity that you're talking into their diet?
I love this question.
Well, I have a couple thoughts on this.
Number one, this is a very savvy group.
This audience has likely been listening to you guys and hearing a lot of experts come on and you guys do a great job at interviewing i mean mine is terrible but you guys are doing okay with us like you're
all right thank you um i would say number one despite what you are hearing in the media if
you have already not experimented with a higher protein diet everybody should do that higher
protein diet first meal of the day,
I don't care when it is, restrict carbohydrates. Perhaps utilize your carbohydrates in and around
training and think about it as a meal threshold of carbohydrate, 50 grams or less, which is a lot.
But this is, again, for the listener who perhaps is not experimented with their own body. So being
protein forward,
understanding and thinking about carbohydrate in a meal threshold amount, 50 grams or less,
would be a great place
and don't have carbs that first meal.
Again, there's nothing magical about it,
but it will have the potential to start your day off right,
balance your blood sugar, prioritize protein.
Okay, the second aspect of that is I would then also experiment with every three months
potentially trying a protein restriction for four days.
Just see.
See what their experience is.
Fruits, vegetables, methionine restrictions.
And so have a vegan experience.
See how you do for four days. The other thing that I would say is adding
in prebiotics. So on the label, you will see kombucha and kombucha will tell you about all
the probiotics and all the colonies. I don't think that that is where the magic is. It's actually the
compounds that the bacteria utilizes. So it's not actually the probiotics. It's the the compounds that the bacteria utilizes.
So it's not actually the probiotics.
It's the prebiotics and the components that we don't even know enough about.
Adding in kombucha, adding in like sauerkraut, adding in any of those kinds of prebiotic fibers, polyphenols.
You know, there's a compound called in pomegranates called urolithin A.
People could take urolithin A. It's new. It's very much on my radar. I began to, I began to begun, that's my English, begun to, I mean, listen, can't be good at everything,
begun to use it. So these kinds of compounds and these polyphenols, which again, swing back from
the strictly carnivore group because they're missing all these.
And again, nutrition biodiversity is individual, right?
So those are a couple of the recommendations that I would give people to stay ahead of is to really think about the polyphenols, the colors, potentially add in urolithin A, you know, go through periods of calorie restriction.
Yeah.
Supplements or hormones that you might utilize yourself?
Testosterone.
You use testosterone?
I use, yep, low-dose testosterone.
I told you she's not natural.
You guys fucking didn't believe me.
I was like, there's no way.
She's so jacked.
He's joking.
I'm 108 pounds.
I'm not that jacked.
You do look muscular, though.
You look great.
Thank you.
And the truth is I had two babies in two years.
So I always had muscle.
I've trained my whole life.
It probably didn't grow.
I probably lost muscle.
So you asked me what are some of the things that I have used.
So I have cycled through metformin, which I don't really use anymore.
I have also utilized semaglutide.
Can you just tell people what metformin does for people?
Yeah.
So metformin is something that's been used for a very long time and it just essentially improves insulin sensitivity.
And it is from – I think it's from some lilac plant.
So it was utilized and it's it's from some lilac plant. So it was
utilized and it's been around for at least 60 years. And it's typically used in diabetics.
There's typically also now discussed in longevity groups too, because it decreases mTOR. And then,
of course, you'll hear the negative aspects where it's like a mitochondrial poison,
right? But again, the dose can potentially make the poison.
And you utilize it, but you don't use it anymore. I don't use it so much for myself anymore. You know, again, I'm pretty lean right now. I don't really need it. I'd say you're very
lean. You got abs and everything, veins, all of it. Oh, God. Yeah, you don't need to be much
leaner than that, I don't think, right? No, not at all. And so I've used that in the past.
I've also used semaglutide, which is a GLP-1 agonist.
It also improves insulin.
Kardashian drug.
Okay, perfect.
You know, it's interesting.
It's been around for a very long time.
I have friends that are endocrinologists that have used it in their practice for over a decade.
It's only recently been approved for weight loss.
So this is an example of what I was talking about earlier is before it was able to be used for weight loss, it would have been considered, quote, like an off-label use.
And you have to be very careful with how you are prescribing drugs.
But as it goes through the rigmarole of FDA approval, now these things can be utilized and would be considered a safe standard of care. You know, of course, I'm not giving anyone medical advice on the show.
But I'm just bringing attention to the fact that there are restrictions in utilization of these things.
So, and I've used progesterone to sleep.
I don't really use it now.
Right now, I really focus on training.
I train heavy three days a week.
I'm just getting back into CrossFit.
Thought I'd try my hand out for some injury.
It's about that time.
Now that I'm done being pregnant, I might as well
give the old
potential injury a go.
I will probably,
I'm also planning on picking up Jiu-Jitsu.
Nice.
Yes.
So that is going to be on the docket
for the next two weeks.
It'd be fun family, you know, fun family thing to do.
What does semaglutide do and whose radar should it be on?
Like, is this something that maybe should be on the radar?
I mean, we talked about you're very lean.
Should this be on the radar of some folks that just want to, they just want to lose weight and they are stuck? I believe it is one of the best drugs that I've ever seen.
You know, there was phentermine, people use phentermine, which is a stimulant. It can affect
your heart. Although, you know, phentermine can be safe. Again, there's other, there's
stimulatory effects that affect your appetite. A GLP-1, a GLP agonist, a GLP-1 agonist essentially affects gut hormones.
And what it does is it improves insulin sensitivity. So you are able to, your insulin
that your body makes is more effective. So you're able to move glucose out of the
bloodstream into the cells. The other thing it does is it slows gastric emptying.
From my perspective, it resets hunger.
We are way over consuming food.
We just are.
I mean, we just, can you imagine?
I think about this all the time.
As I was eating raspberries in the room,
I was eating raspberries in the room.
I have this thing where I'll order Instacart before,
actually my assistant's amazing.
Hi, Alexia.
You better be listening to this podcast.
She will order the, you know, like I'll have water and I'll have raspberries.
And so I was eating these raspberries.
And I was thinking, God, you know how long it must have taken someone to actually pick these?
You know, have you ever picked raspberries?
I have not.
Okay, so you go, you pick them and like half of them fall off.
And you're like, this is a total
waste.
And then you got to pick another one.
And that whoever picked it must have taken them an hour to actually pick that.
Yeah.
I go, you know, I am saying this.
They don't pick them that way, but.
They don't?
No.
Machine.
Well, I mean, but they, we used to.
Dog, I had a cotton joke I was just so ready to go with, but I was like, no.
It still takes a lot of effort.
It still does.
Okay, but we were probably designed to put in that effort before we were able to eat that food.
If we were designed to put in that effort, I mean, think about not a peanut, but I don't know, almond.
Can you imagine if you had to crack all those almonds?
God damn.
Wait, what?
Or like a walnut or something?
What's an almond initially like before you...
It's like terrible.
It's like a...
Just imagine a bigger one,
but just...
You would eat...
Yeah, I'll pull the picture.
You would eat like three of them
and you'd be pissed.
But wait,
how do you pick them?
Is there almond trees?
Do you have to go...
I mean, do you realize
how much effort...
This is all getting back
to the big picture
of semaglutide.
And how we're
overeating everything.
If you had to actually
put in the effort
of what you were consuming,
the energy output would be greater.
They're a pain in the ass to open.
See?
First of all, and not only that,
can you even eat it raw?
I mean, raw almonds are,
I mean, no offense to anyone,
they're gross.
You need some salt on there.
Definitely.
But you know how long it probably took to pick
and then crack open?
And how much water it takes to fucking water an almond tree?
I can't even.
I can't even.
By the way, we cannot eat ourselves out of climate change.
I'm just going to go on record as saying that.
You cannot eat yourself out of climate change.
Back to semaglutide.
Semaglutide can regulate hormone hunger.
Hormones like the GLP-1 agonist and hunger.
We are hungrier than potentially we should be. We are overeating in a way that we
are having access to food that is, it just would take much more effort. And that's why I love
samoglutide. I think anyone that has, you know, and I say this very cautiously, I have seen it
work very well for individuals with binge eating disorder, individuals that absolutely cannot control their hunger. And of course, it has side effects. Nothing is without major side
effects. We must have that discussion. You can get pancreatitis, you can get inflammation of
the pancreas, you can get massive nausea and vomiting. It's almost like being pregnant but
different. There's a like being pregnant but different.
There's a black box warning if someone has a multiple endocrine neoplasm, all these things, right?
I don't want to go down this other rabbit hole, but I just want to lay something at your feet.
But do you promise me we're not going to go down this rabbit hole?
Depends on what it is.
Mark, I'm not going to bring it up.
I need to have your word. It depends.
If this is about the penis pump,
then right.
This is not about the penis pump.
Okay,
go ahead.
We can be mature maybe?
I think.
Okay.
Okay.
Just,
you ready for this?
So,
physicians can prescribe
anti-diabetic medications,
anti-obesity medications
without an issue for the most part, okay?
We are now talking about we are treating a symptom of fat, no problem.
However, physicians cannot legally prescribe anabolic steroids, which would actually be perhaps a treatment
in skeletal muscle first. Now, I'm not saying it's right or wrong. I am just
laying this at the feet of the listener to think about the fact that physicians, you know, everyone, you know, you can prescribe
metformin, you can prescribe semaglutide, you can prescribe Fentanyl, you can prescribe all things
that are downstream in obesity, type 2 diabetes medication, body fat medication. But if you
believe what I am saying, that muscle is the organ of longevity.
Why is it that physicians cannot legally prescribe responsible doses? I'm just saying,
I don't know the answer to this. Responsible doses, very low doses of something that could
stimulate, and I'm not talking about testosterone, I'm talking about whatever the other things are.
You know, there's medications that are used for burn victims.
There's medications that are used for osteoporosis and post-surgery and chronic kidney disease, you know, and then subsequent anemia.
So there are indications for use of some anabolics, but very few.
And it's not accepted as a standard of care.
Weird, right?
You promised not to say anything.
I didn't say nothing.
This is his line.
But isn't that interesting?
Yeah.
It's just conceptually interesting that we can treat obesity, but we can't really treat muscle other than testosterone.
That's all. Can I ask you this real quick? Because when you mentioned semaglutide,
you mentioned that it could reset hunger. And a few years ago, I think it was maybe 2018 or 17,
I started and even you started at the time doing some time-restricted feeding. And there
was a point where like we, even by myself, I was doing some fasting every day. I'd fast for
20 hours, time-restricted feeding, 20 hours, eat for four hours. Over time, I am not too crazy with
it now. I have some days where I, most days I still don't eat in the morning. I'll eat most of
my food later in the day. Some days if I don't feel like the morning. I'll eat most of my food and later in the day. Um,
some days if I don't feel like it, I'll just eat breakfast and go through the day. Right.
But I know what my hunger used to be like. I was never obese, but I had the appetite of somebody.
I could kill you in an eating competition. And I always felt that at that time I was counting
calories and I was never able to have true control over my hunger.
The thing that helped me was getting used to not always eating when I felt hungry.
And because of that, nowadays, I have control over my hunger.
I don't count anything.
I eat when I want.
I still eat healthy. But I actually have control over it because of the practice of time-restricted feeding over time and getting
used to not always eating in response to hunger. Now, I'm curious what your thoughts are on that
because I've seen a lot of Lane and how he's talked about fasting. And a lot of people talk
about fasting as some type of magical thing. We still know that it is calories in, calories out
is the big thing. You could fast and binge eat and it might not make a difference if your calories are over where you need to be. But within practice, I see that as
being something that could train a person to not always respond to hunger. So how do you feel
about the practice of time-restricted feeding? And then potentially, can it fall in line with
any of the things that we're seeing as far as longevity is concerned?
I believe, and again, this is clinical practice, that fasting can be very valuable.
It can be very valuable in retraining hunger cues.
It can also be very valuable in gut rest.
Individuals that have frequent GI upset or irritable bowel, you're not continuously feeding them.
And that can be very beneficial.
I believe that also when you eat, you know, you do, you know, there is some circadian rhythm to our biology just in general.
Does this mean it's going to change body composition?
Perhaps no, but it does allow you for calorie control.
I do believe that it does allow you to retrain and not respond to hunger. You become very good
at tolerating the experience of hunger. Typically, people experience hunger as an emergency.
Before you are able to gain control of your physiology, whether it's mental or physical,
to gain control of your physiology,
whether it's mental or physical,
hunger is an emergency.
And if you do not cross that bridge,
if you do not get that under control,
you're going to have a very difficult time with any kind of,
unless you're a sumo wrestler,
where you probably,
you know, Mark last year,
no, I'm just kidding.
Unless you are a sumo wrestler,
these things, you know,
it's your responsibility
to regain control of your hunger.
And we live in a very obesogenic environment.
We live in a very soft environment.
Time-restricted feeding, fasting can be valuable.
Is it a magic bullet?
Absolutely not, right?
Can it be potentially damaging for older individuals who I see are really into fasting these days?
From a clinical perspective, absolutely.
Those individuals, for example, my father, when he goes through periods of long, and he's 70-something,
he didn't kill me because I don't know, he's 72, 74, he gets really pissed.
But when he goes through long periods of fasting, I mean, he loses muscle.
So when you say long periods, too, is he going multiple days
and eating very minimal food? Yes, he easily could go two days without eating.
But routinely, he won't eat all day. He's onto this new thing where he's not going to eat all
day. He's going to eat one meal. That is not ideal for body composition. And it's not ideal
for an aging individual. In the fitness space and in kind of the longevity space, it's really divided.
Fitness, you know, we think about being jacked and tan and in your college years, you're in the gym, you're weightlifting.
Some of us are still doing that.
And really it's about protein and performance and all that stuff. And then you kind of move, transition over to, okay, longevity.
And then after longevity, you know, there's like the paleo crew, CrossFit.
And then what about the conversations for the older individual?
Who is targeting?
Where are they getting their information?
Who is providing information to, say, 50, 60,
70-year-olds? Nobody really, right? I mean, unless there's someone who's really doing it,
they are then getting their information in the domain of midlife. You and I talked about,
can you span midlife? Yeah, but where this whole fasting thing has taken off, the older population
who is really interested in health and wellness, the information out there is not targeted
to them.
So they are broadly taking the information that is provided, protein restriction, do
your fasting, do some more yoga, do your stretching.
All of this is valuable.
But is it valuable to an older population?
What are the unintended consequences of that?
So I don't know.
So along with that, I'm curious, like someone like your father who's older, as people get older, their appetite does go down.
So when he's trying to do this one meal a day, if he were getting in enough calories, is he getting enough calories? That's my actual question.
Like,
yeah.
And he is.
Yeah.
But even so,
it's still obviously not the best thing for him to do that one meal at his
age.
I believe that there's controversy in this particular,
on this particular topic.
People will say that protein intake over a 24 hour period is what is most
important.
Is that true?
Yes, and.
Yeah, it is.
24-hour period is true.
You do need it.
Is my father going to go into protein deficiency?
No.
However, is it optimal for an older individual who perhaps is not lifting the way that he used to?
Probably because he's lazy.
Only if he's listening, which he will listen.
But is it optimal?
It's not.
He could have a leucine sandwich, right?
No, he needs all of it, right?
You need all the amino acids.
You need the full spectrum of amino acids to really stimulate that tissue. For the aging population, no, one meal a day is not ideal. Two meals, I'm happy with two meals at 50 grams of protein or higher to then really stimulate that tissue twice a day. Again, it is also about maintaining the integrity of muscle over a period of time and young tissue is not
the same as older tissue why can't you just throw in a fucking grilled cheese sandwich and some soup
midday isn't that what old people eat not my dad oh like tomato soup i don't know i was looking
forward to that when i was older yeah maybe not tea and toast no damn yeah uh i was hoping that
you can give me and everyone listening some ammo
um because when i when i tell my parents that i eat 10 eggs a day and then well that's breakfast
and then i go home and i eat a gigantic steak my mom watched my dad get well he she wasn't
physically there but he had open heart surgery because uh he had clogged arteries and the doctor
said it was because he had high cholesterol.
And so when they're like, wait, you have how many eggs a day and you eat steak?
Like, oh, my God, your cholesterol is going to go through the roof.
Right.
And I'm like, but I mean, I check my labs and everything is in range, whatever that means.
But like what is like the like go to rebuttal when it comes to people saying like you can't have all that steak because your cholesterol is going to be all crazy.
Let's talk about cholesterol and dietary guidelines.
Did you know that cholesterol recommendations were taken out of the dietary guidelines?
When?
2015.
Okay.
So dietary cholesterol was the recommendation was taken out of the guidelines to restrict dietary cholesterol in 2015.
Yet we still have this narrative that refuses to die.
So there's that.
The next aspect of the cholesterol issue I think is really – there's a couple of things to unpack here.
Does someone have familial high cholesterol?
And is it really just about the cholesterol numbers, familial high cholesterol? Again, you know,
my very good friend, Dr. Michael Twyman, cardiologist, it's really good to interface
with a cardiologist, get imaging, see the whole picture. It's not just about numbers. It is about,
you know, what is your ApoB? You know, do you have LP little a that is elevated? There are
multiple things that need to be addressed. What are your, what is your carotid? You know, do you have LP little a that is elevated? There are multiple things
that need to be addressed. What are your, what is your carotid, you know, what do your carotids
look like? What is your clearly scan or your calcium score look like? All of those things.
Now, from a dietary perspective, dietary cholesterol has very minimal impact on blood
level cholesterol. The other aspect of this is saturated fat. And I think that that's
where people talk about this red meat saturated fat issue. For the majority of people, when
calories are in check, saturated fat is not going to be an issue. Notice I said when calories are
in check, saturated fat is not going to be an issue. There are some individuals that seem to struggle with high levels of saturated fat in their diet.
Are they the majority?
Probably not.
Could it easily be measured?
Yes.
This is where understanding is keto good for you?
Are high-fat diets good for you?
Give yourself a couple months on the diet.
Take your blood.
Do the rest. Take your blood, do your imaging, see if in fact you tolerate it or you don't. And this is largely,
again, some people genetically don't tolerate it. And that would be a very easy way for
individuals to determine what is good for them. So the reality is, is saturated fat an issue?
When calories are controlled, likely saturated fat is not an issue.
Got it.
Yeah, and I would imagine, I mean, I guess the body can be confusing sometimes.
All kinds of people, unfortunately, die from heart disease.
But isn't something like your waistline,
like a pretty good,
like in someone like Andrew's case,
like if he was saying he's eating 10 eggs a day and his waistline,
his face is growing every time we see him,
then there would be probably a pretty good concern. Like,
oh man,
like,
you know,
maybe he's got a couple other things in his life that aren't together and he's
gaining weight and his body doesn't know what to do with this excess energy.
Absolutely.
It is an excess energy issue usually, most of the time.
And then, so kind of going back to the muscle being like the skeletal muscle being like the beginning and the ending of it all.
Yeah. I don't know exactly how much your markers will improve when you lose, what is it, like 10% body fat, right?
10% of your body weight is usually what they say, yeah.
Is there anything similar to that as far as like muscle gain?
Like X amount of muscle you might start seeing these markers kind of get a little bit better?
That is a great question. I believe that, well, I don't have the answer to that,
how much muscle you can gain, but what we would see is an improvement in body composition.
You would also see an improvement in insulin regulation. So assuming that you are putting on
skeletal muscle, you are exercising, and I've thought a lot about this. I did create a new
model for obesity. And when you think about resistance training, you can think about
resistance training. You can think about strength. In particular, I think about hypertrophy. So if
we think about muscle as this organ of longevity, we have to think about muscle as the storage
capacity for the body. Makes up 40% of your body weight.
For you guys, probably like 90%, but for the rest of the population, it makes about 40% body weight.
This is the place where you store glucose.
The dietary, you know, when Mark is eating his carrot cake, this is where his glucose is going to store.
So from an aspect of hypertrophy training, this can be beneficial as we are growing muscle.
We are creating an increase in storage capacity, glycogen storage.
How much muscle will do that?
Again, muscle is not easy to put on.
And I think that there is probably a genetic component.
If you do everything right, I've seen numbers where if you are untrained, a guy could put on two pounds of muscle in a year.
You know, naturally, I think that that's two pounds of muscle a month.
Oh, thank you.
I was about to say.
I hope you would correct me because, listen, this monster is only lasting so long.
You're falling under the table.
Two pounds of muscle a year and untrained?
Right.
So two pounds of muscle a month, you know.
But, again, I'm sure that there's muscular potential, which is different for everybody. So then you've got this increase in glycogen storage capacity. That would be one thing. And then let's say you are doing some kind of endurance training and you're improving your mitochondria function. You're now improving oxidative capacities. So you're improving energy. So that would be another thing. Would this, you know,
and then would the exercise in and of itself to get to the muscle, which contracting skeletal
muscle would be secreting myokines, which myokines can help lower inflammation. And we,
one marker of inflammation would be HSCRP. So they're all the, is it the muscle that we put on?
so they're all the is it the muscle that we put on yes is it also the act of building the muscle so those are some thoughts deep thoughts over here yeah and then like what it um obviously
it does matter but like differences in male and female like because i know like typically just
due to testosterone a man will develop muscle quicker But does that mean that a female might not have to
like have the bigger number? You know what I mean? Like, can she get like a little bit less
muscle but still gain the benefits of kind of rebalancing the fat?
Absolutely. Absolutely. I know that there's a lot of new studies that have, you know,
I haven't read, you know, I haven't read some of the newer studies on the sex differences,
but I will tell you from clinical practice,
well, women, everybody benefits from hormones.
If they need it, everyone benefits from hormones.
Everybody can improve.
And I will say that in terms of body composition,
muscle, is there a percentage of muscle
that's going to improve body composition?
Hard to say.
Something to still be determined.
And again, we also don't know how much muscle is optimal.
We don't actually have those numbers yet.
And you work with a lot of military.
And you and I talked briefly a little bit about CTE.
Is there much that can be done with CTE from a pharmaceutical perspective? So CTE is chronic traumatic encephalitis or something.
Maybe, Andrew, you can pull up what CTE is.
It's a chronic brain injury that progresses over years.
And football players can have it.
It's from a lot of trauma.
A lot of military guys get it when you see randomly where someone seems like
they had this great life and all of a sudden they kill themselves completely out of character.
This is typically what one would hear about when they hear about CTE.
CTE, there is no, and it's actually also only diagnosed on autopsy.
Wow.
Andrew, what does CTE stand for?
Encema.
Can you pronounce that?
Is it chronic traumatic encephalitis?
Yeah.
Encephalopathy.
Encephalopathy.
I can't read.
And then what about something like-
No charge, guys.
No charge.
And what about something like PTSD?
I'm sure there's strategies and there's people you can go to.
For sure.
So let's talk about chronic traumatic encephalopathy.
And can you spell that?
I can.
I mean, it could be related to your new theory of obesity.
This is, and I'm sure that you have military operators that are listening or people that have had a lot of head trauma.
And CTE is something that, again, is a chronic brain injury,
creates a lot of brain inflammation.
I will say if someone knows that they had it, they used to play hockey,
they used to play football, they used to do all the crazy things.
Maybe they were dirt biking and fell on their head a couple times.
If you feel that you have weird mood changes, they should definitely seek help.
They should definitely seek help.
So there's that.
Is there treatment for it?
We don't know that there is.
Can you treat post-concussive syndrome?
Can you treat brain injury?
Nearly all the operators that I take care of do have some kind of brain trauma.
And so it's just traumatic brain injury.
Hyperbaric oxygen therapy is really important for that.
There are things that you can do.
Hyperbaric oxygen, you sit in an oxygen chamber.
They should be a hard chamber.
There's a lot of discussion about hard versus soft chamber.
Hard chamber, you dive and it's very – lots of hours.
It could be two hours a day for a series of 40 to 80 treatments.
And then there's transmagnetic stimulation.
So typically, so for example,
my husband who was a SEAL for 10 years
would be awake but really tired.
And he was awake,
but his brain was showing the sleep waves
because of all his brain trauma.
So yeah, he's better now, but there's treatments for those
kinds of things depending on the severity. And of course, nutrition and omega-3 fatty acids,
hormones can help actually as well.
And this is actually rewinding back to the hormones for women, because you mentioned you
were on low-dose testosterone,
but we didn't really talk about maybe what women want to be paying attention to as far
as labs are concerned specifically.
And then also along with that, because we're only going to be able to give so much information,
where should women go?
Because I feel like maybe if they go to try to get labs done or they just go to a hospital and they get labs done, it doesn't seem that there's as much attention paid to that side of things, to the women's side of things when it comes to labs or HRT, unless I'm incorrect.
So where should they go for resources on that topic?
Yeah.
Also a great question.
I don't know if I have the answer to that. I will say for women
who are really savvy, there's North American Menopause Society. And that is typically for
providers where they would look at, you know, what are the current recommendations, but what is
available, whether it is estrogen and testosterone or progesterone, there's just information there.
So that would be a good
reputable place to go. So that's North American Menopause Society. As far as a provider,
there's a few things to look for. Number one, are they a physician that can legally prescribe
medication? I think that that's important. So there's a lot of experts in the space. There's
a lot of people with different expertise.
I think it's very important to understand, are you going to an MD, DO, or are you going
to a different kind of physician?
Who is it that you are seeing?
Then finding someone who's actually seen that person is really important because then they
can make an introduction.
Again, there is relationships.
And I know that this is a bit esoteric, but I will then talk about what they should look for in their labs.
So finding someone that you trust and that somebody else trusts.
Reputation is everything, and you will know how that person has been cared for.
Then the other aspect of hormone replacement is there's actually a great book out there called um oh god i can't remember the name
uh never mind some estrogen book estrogen matters thank god it came to me can you imagine i'm like
there's a great book on estrogen um estrogen matters and one of the things that women are
afraid of is hormone replacement it's interesting men that there used to be that men were afraid of
testosterone but not really, right?
The biggest restriction was the provider, right?
It's true.
Like everyone's like in the back, you know, you're in high school.
Hey, do you want testosterone?
I mean, I don't know if, of course, this is hearsay, but for women, it's true, but it has been just scarier historically because of the Women's Health Initiative and does estrogen cause breast cancer?
Is progesterone a problem?
And then, of course, testosterone is kind of just for dudes.
Understanding that there's some pretty significant flaws with interpretation and that these things had been considered scary, which are no longer,
we can nearly all agree. And I think much of the medical community sees the benefit in hormone replacement. So reading estrogen matters. If you are a female listening to this or you are a guy
who has a female partner, I would recommend you do that. Then the next thing is understanding where are you? Are you young and not in menopause?
Are you perimenopausal?
Are you postmenopausal?
And the definition of menopause is you have not menstruated for a year, right?
So understanding getting your labs.
Labs to look for would be a full female hormone panel. Anyone listening could be LH, FSH, estrogen, estradiol, sex hormone binding globulin, testosterone, free testosterone, and thyroid.
And I'm sure I missed one or two, and progesterone.
So you get a sense of actually looking at hormones in their entirety would be really important.
And then understanding how does a person feel?
So can you treat labs?
Yes.
Should you?
Yes.
But you also have to treat the person.
So if a person has testosterone that is, quote, within normal range, but the individual is saying, like, I have really hyposexual desire disorder.
I'm just not going to say that, but no sex drive,
really low libido,
really low testosterone.
You know,
you should probably consider treating it.
Of course,
going through the risk,
benefits,
side effects,
and alternatives,
you should consider treating it.
Yeah.
I don't know if that answered your question.
That did.
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in the description as well as the podcast show notes. And Merrick does have a female panel.
I just wanted to know if like, like what they should like, what they should be paying attention
to. They got it. Actually, I've seen their panel. They've done a great job. Sick. Eric has done a great job.
What do you want for your children?
You got two cute, adorable kids.
What would you like to see for them?
I have a three-year-old, and her name is Aries Hunter.
She is a little alpha dog.
And I have a son who is very musical.
His name is Leonidas Michael, and he's 18 months.
Strong names.
Yeah, they're going to be real wallflowers.
And I tell them five things every day.
I say, you are strong, you are kind, you are courageous, you are worthy, and you are loved.
And I have been telling them that since they were born.
So this is what I want for my children.
To know those things and to contribute to society and humanity.
And also to know that and embrace challenge.
As soon as they get old enough,
they're going to be like,
Mom, can you please stop?
You tell us this every day.
Every day.
But you know the cutest thing
is when she repeats it.
Oh, that's great.
And to see her repeat it,
she goes, I am strong.
I am kind.
I am worthy.
You know, I am courageous.
Yeah.
And she's like this.
We can program individuals with a little bit of fortitude from early on.
And if we pay attention to our children, the way that we pay attention to our nutrition and our health and our own internal workings and our own internal architecture,
we can change the world, you know, above and beyond muscle, right? In through the next generation.
Yeah. You mentioned, you know, and being somebody that has talked to so many people over the years
about their problems basically and help them navigate those problems.
You were like,
I just want to be out of the way when it comes to like creating a problem.
And I want to be,
uh,
encouraging and be supportive.
And,
uh,
you know,
they still like the fact that you're supportive and encouraging,
like that might be their trauma.
You know,
mom was always paying the ass cause you were too supportive or whatever, because kids will make up whatever.
But I really think that's a great principle for parents to follow.
Like not necessarily that you're just trying to be like a great parent.
There's so much that's required with that.
so much that's required with that. Being around and being very conscious of the different things that could come your children's way, like all those things are important, but simply not
contributing to the bullshit that you hear so many other people talk about with their own childhood
is a great way, is a great like model for for parenting I think. Yeah. I think it's really – and it's not that we are soft or easy on them even though they're little.
We have a – we're a military family and my husband is actually really pretty strict, believe it or not.
And the kids aren't totally coddled and we don't want that for them.
We want them to be capable and strong.
Yeah, and a lot of thought goes into it.
You know, and I think that that translates over to my medical practice,
and, you know, medicine is a modality to get to people.
I actually really love people.
I mean, surprisingly.
And medicine is the modality that i use to help provide people what they want for
themselves and i think that that's really important um to be able to do that how has your how do you
guys find time for each other because it sounds like your husband's extremely busy as well
he's really into house it of, what is it called?
House of Thrones?
Game of Thrones?
Game of Thrones.
House of the Dragon.
Yeah.
Okay.
Okay.
Whatever it is.
How to Train Your Dragon.
That's a good one.
Part two.
That was a good one.
That was a good one.
So he's really funny.
He's a professional teammate, I think, by training and trade.
So he's really into connecting.
So he wants to,
and I'm actually the opposite.
I'm really busy.
I'm like,
honey,
please.
I'm so busy.
So he is very into stopping what we're doing and just like,
let me just stare into your eyes.
It's hilarious.
And he's just really into connecting.
So I think from,
so you don't have to think about it much.
He takes care of
he's like all I'm like honey god
out of my face already
I mean I love him but he's very into
connecting and
talking about stuff and
that kind of a thing
I'm kind of curious
because he you said he was a Navy SEAL
for 10 years he seems also very
emotionally intelligent
he is shocking but you know when someone thinks of a Navy SEAL for 10 years? He seems also very emotionally intelligent. He is.
Shocking.
But when someone thinks of a Navy SEAL, they don't think of somebody who would have that type of awareness.
So was it the way he was raised?
Was it just did he read books?
I actually think it's really interesting.
Again, I have the great fortune to care for a lot of the military operators.
And they're a breed of their own and not i mean all of everyone is different and it's hard to generalize i can only share my experience with with about my husband i mean you know a lot of
the patients are similar but certainly with the connection with my husband is um he is really
interesting because he has no narrative have you
ever been around someone that doesn't actually have a narrative have you meaning like doesn't
he doesn't have like an agenda it doesn't or there's no stories from like the past or no
have you ever been around somebody like that i'm really trying to think i mean i used to be that
like i just like oh monday through friday go go to work, come home, and that's my life.
That's it.
And there's just kind of wasn't really doing, like, no goals, no, nothing was set, and I was just boring.
No, I'm really thinking.
Because I actually had never met or never experienced it at this level.
So a narrative would be, oh, like, I'm not good enough, or, oh, my God, I'm so tired.
Oh, does Mark like me?
You know, am I being annoying or whatever
it is okay so there's like
narrative so my husband
doesn't have a narrative
and it's so bizarre
to see and I
think that it was trained out of him and Buds you know
Buds was you know everyone's like oh
Buds I guess it's gotten a lot of heat
these days
but I mean you're trained to go to war.
We're not trained to do underwater scrapbooking.
So Shane doesn't have a narrative.
And you're being around someone that doesn't tell a story.
I mean, so I don't – if I were to piss him off, it wouldn't be some – I just have – it's like crickets.
So he just executes. executes um in multiple domains
you know he's in uh just applying so he was a medic in the seal teams and i was telling mark
this time he taught himself calculus and physics while he was deployed in afghanistan you know
between operations at night and um you know he then went to uh you know his last appointment was teaching trauma to other
navy seals like if someone is on the battlefield and gets their legs blown off what you do when
you send the guy in how do you sew them up how do you do all this stuff so he was teaching um you
know naval special warfare trauma to these guys.
And while going to night school.
So he would work from,
you know, leave at 5 a.m.
Work from six to five or six.
Then go to night school and go to night school and then study when night
school is over 10 to 1 a.m.
And then do it again.
Wow.
Right.
Yeah. And me, I'd be bitching the whole time. Like, I can't believe I have to do this.m. and then do it again. Wow. Right? Yeah.
And me, I'd be bitching the whole time.
Like, I can't believe I have to do this.
Like, this sucks.
My life's miserable.
It sucks.
No narrative about it.
Like, nothing.
Like, hey, honey, doesn't this suck?
No, no, I'm just like knocking this out.
Right?
Just what you do.
Like, you're weird.
Yeah.
You should at least bitch about it.
Are you like eating Cheetos too?
Nothing.
Like, nothing. Yeah. Then he goes to medical school. By the way, he's actually top of his class. you should at least bitch about it are you like eating cheetos too nothing like nothing yeah then
he goes to medical school by the way he's actually top of his class and this guy you would think he's
a total raw knuck dude right like beard top of his class top of top of the country multiple
publications interviews at harvard yale hopkins mayo, all these places. And I watched him do this. And,
you know, he'd be embarrassed if he listens to this. But by the way, he loves Mark,
so he's gonna be totally embarrassed. He, you know, during that whole time,
there was no narrative about how hard it was. And what he would say to me is, you know,
he's gonna be really embarrassed
I'm like the strongest applicant
I'm the best applicant
that they are seeing this from
I'm the best applicant
I'm like how can you say that
he goes because I acknowledge that there is competition
but I have put in more work
and I have the capacity to work harder
than anybody
and I am the capacity to work harder than anybody. And I am the best applicant.
Not in a hubris way, just very humble.
It's factual.
Right?
Yeah.
He said, I've been a Navy SEAL for 10 years.
I've been to war.
I have, you know, like 16 publications.
I'm a medical student, right?
16 publications.
I'm top of the country.
Like, I can be a a teammate i'm the best applicant
so and you asked me that okay like so you're the whole point that we went on this like whole rabbit
hole yeah and i'm sorry about that was um narrative and i've never seen someone not i mean
so i guess that was a positive narrative but i've never actually been around somebody for so many
years that doesn't have a negative narrative. It's just all about the execution and being the best
and also understanding that failure is a natural component to execution and that you can have your
15 minutes where you bitch about it, but then you move on and what are the steps that you need to
take to execute?
And it's really interesting.
I think that we could probably
all learn something.
And he'll also tell you,
I'm nothing special.
He'll say, I'm nothing special
and I just have habits.
How did you?
This is our show.
That's all, man.
How did you lure this guy in?
I actually told, you want to know how i did it
i said i am never going to go out on a date with you you need to stop calling me i have no interest
in dating you i was coming out of a relationship at the time um i was really not interested in
dating i we i met uh shane through mark divine do you know former Commander Mark Devine? Amazing human.
Don't know him personally, but yeah. Incredible.
He is wise and very sage-like.
He's like, hey, this guy,
he was trying to get into medical school
and I had already been taking care of seals.
I was like, you know, they come into my office
and they're like, what do you think about this chick?
She's in Texas.
What about her?
She's in Oklahoma.
What about her?
She's in California.
She's hot, huh, doc?
I'm just like, oh my God, who dates these guys? They say they're Navy SEAL and like the pants drop. So, you
know, I'm like cured from this. So I talked to him. I really liked him as a human. He's
very funny, dry sense of humor. And I helped him kind of navigate in terms of medical school, you know, the kind of studying that needs to go, what are the steps you have to take.
And then he found out that my ex and I had broken up and he was just like, oh, by the way, I like you.
A hundred percent.
No chance.
Don't call me again.
Meanwhile, I had really liked him as a person.
It was a hard no.
And he said to me, so you're saying there's a chance and i said no and so i didn't answer his phone call for three
months wow so i guess so ladies if you are trying to catch you a frog man the way to do it is to
just say no you want a root and tune frog man there's how do you do it is to just say no. You want a root and tootin' frog, man?
There's how you do it.
Damn, he really bob and weave that shit.
He's like, so there's a chance.
A hundred percent.
A hundred percent.
That was it.
Yeah.
I can't believe he married a NARP.
I know.
Is that what it is?
NARP?
Yeah, yeah.
Totally.
Wait, what's a NARP?
That's what your friend called you, right?
Yeah, yeah, yeah.
Kara.
Kara Lazowskis, who I think you know. We've had her on the podcast, yeah. Totally. Wait, what's a NARP? That's what your friend called you, right? Yeah, yeah, yeah. Kara. Kara Lazowskis, who I think you know.
We've had her on the podcast, yeah.
A NARP is a normal athletic real person.
That's what they call me.
Normal NARP.
NARPy.
Normal athletic real person.
You know, when I first met my husband, you know, I like doing pull-ups.
I think they're fun.
It's great.
You know, who doesn't so i'm like
i got this i'm gonna show you i've been doing training 100 pull-ups a day
10 sets of 10 though so it's like not consistent um right so of course i ripped my shoulder doing
that i didn't recommend it um so we go to the gym and i'm doing my 10 pull-ups and he's like
good job babe and i'm thinking yeah right i got this and he's like
okay do it again and so i did another 10 he's like okay it's my turn and he totally you know
i'm thinking okay he's gonna do you know straps on i don't know if it's like 80 pounds the guy
straps on you know it's probably at least 50 pounds he's just repping him out so long story
short just don't i mean talk about buzzkill wow just was not
you know like you know i say you can't be good at everything oh god so anyway that was the last
time i worked out with my husband i don't really like to lose it just really makes you it's just
like not fun yeah that and doing cryotherapy with a seal it's just like those two things don't do it all right just totally real before we leave this topic
a few weeks ago we talked about a news a new segment we saw where they were talking about uh
how some train uh seals were training in buzz or something and some guy died and they were blaming
on they're blaming on anabolics right so we were having this conversation because we were thinking like if there's anyone who might need some anabolics it might be the
people who are defending the country if it can be done in a safe way and you work with a lot of
people in military so just what are your thoughts on that topic um number one i would say the guys
going and i i mean i can only speak from when my husband
went through buds, anabolics were not a thing. They were not a thing. How long ago was that,
by the way? He went through 10. Oh, so he retired four years ago. Okay. So 14 years ago. So after
9-11 is when he went into the SEAL teams. He felt very responsible, wanted to do something for the
country. And, you know, for him, it wasn't even,
I mean, I'm sure maybe guys were doing it, but it wasn't even a thought. At least, again, this is
what I'm hearing from his perspective. Anabolics weren't a big thing. And I would say, yeah, I
don't, you know, that was a very, you know, I have a lot of thoughts on this. Are they trying to make
our warfighters softer?
Are they going to now audit?
Again, you're not training for scrapbooking.
You are training for war.
And Shane will tell you, you want the toughest guys there because they depend on each other.
It's a brotherhood. You don't want to find out what happens when someone's cold and hot and cold and hot over and over again. It is a selection process where only the best and the strongest and the toughest,
I say strongest, mentally strong.
And it's supposedly they'll say it's like the little stuff that gets you like,
you know, that you're not going to get sleep.
You know that they're going to get you cold.
You know that they're going to make you hot.
You know that you're going to like do a lot of PT.
But it's like little stuff that you weren't thinking about about like how chafed your legs get because of sand and like you just
you don't have opportunity like chain it's like tough shit like you don't get an opportunity to
like take care of yourself for a moment and so these wounds like if you have anything happen to
you that's just going to get worse and worse and worse and so it takes a ton of mental toughness
to overcome.
It's not just the big things. It's like these little things.
I mean, you know how bad that is.
Like when something like you are,
your toe nail got like bent the other way or something, right?
That shit kills.
Yeah.
And then like for whatever reason,
now when I'm walking around the house,
fucking everything attacks that foot now.
Like literally like my,
my dog was outside probably stomping a hole in his own,
you know dog
shit and he walks in with the big old toenail or his big you know paw nail and it clips my toe and
it opens everything up and there's blood everywhere like fuck like come on dog but like if that wasn't
there like it would have been no big deal and i wouldn't be acknowledged not in a million years
would i be cut out to do any of that stuff your husband and by the way that guy died of pulmonary edema yeah so it wasn't necessarily anabolics he was
then taking cialis or something else i mean the guy should have been he should have gone to
medical probably been rolled right uh so you know the fact that he was willing to do whatever it
takes uh you know i mean he shouldn't have died.
That's terrible.
He doesn't deserve that or whatever.
But could he have gone to medical and not necessarily done that?
Does that mean that we should reevaluate the training and lower standards?
I think that that depends on what you want for this country.
Are you pretty excited about where you're at in your life right now? Like you just started this
podcast, you have a book, it's not going to be a while, but pretty excited about like a future
of things to come and maybe moving out of maybe seeing so many people in person and doing what
you were doing previously? Am I excited about it? I always, you know, I have this thing.
And so I don't necessarily sit to think.
There's twofold, two parts to this answer.
Number one, I believe that we are all put on earth to do something.
And I believe I am put on earth to change the perspective of obesity and muscle.
And I believe that I can do that.
the perspective of obesity and muscle. And I believe that I can do that. The other part is,
do I ever feel like I am further or far enough along? And I would say no, which is probably a negative. I will say, oh, more people should know about this. How come this message is still under the radar?
Or how can I do better?
How can I do more?
It doesn't mean that that's real, right?
Again, I have two children.
I run a concierge medical practice.
I just finished a book.
I have a podcast.
A lot of responsibilities.
I do a lot of different things.
There's always a drive to do more,
contribute more, and be more. And perhaps that will be a lifelong uphill experience.
So you asked me, am I happy where I'm at? I am grateful. And I know that there's a lot more work
to be done. But that being said, you also
mentioned, will I step away from seeing patients? I will never step away from seeing patients.
It keeps me grounded. It keeps me connected. It allows me to do good work for people.
And if you have the privilege to serve other people, you have a responsibility to do that.
So I will never step away from practice.
That being said, I actually have a team, which I didn't last time I was here.
Can I tell you about my team?
They're actually all military.
Well, the providers are all military based.
So I have Brian Stepanenko, and he is very big into the special operations world.
He's an amazing physician, very military-esque, very operational, stoic.
He's from the Army.
I won't hold it against him.
He's amazing.
And then I have Colleen Johnson, just beautiful PA.
Also, she actually comes from an Air Force family.
Amazing.
She's really big on female hormones.
He's very
big in optimization and kind of that integrative approach. And then I have Peter Roth, who is a
health coach and also runs the operations. So I have a lot of support. I have Alexia Belrose,
who's a health coach. I have Kylie Fagnano, who is a registered dietitian. And then what makes
our practice also really unique is I have a PhD input.
So we have Dr. Donald Lehman and Dr. Alexis Cowan, other individuals that also collaborate to create ideas and forward thinking and new protocols.
How does someone gain access to this team?
You have to apply, actually.
Okay.
Just go through your website or something like that?
Yep, yep.
You actually do that, or unless you know somebody.
So if there's any friends of Mark that want to be a –
you can't come into the practice.
Hard no.
Yeah, so it's either a personal referral from somebody else
or they can apply to be a patient on the website.
And also if they are special operations. either a personal referral from somebody else or they can apply to be a patient on the website.
And also if they are special operations. If you are special operations, we will take care of you.
Whether you can afford it or not, we will try to get you funding, but we will take care of you.
If you have served our country in the role of a special operator, we will take care of you. And of course there's, you know, Seal Future Foundation and Task Force Dagger.
What else is there?
You and your husband do charitable stuff for the military.
All the time.
Right?
All the time.
And your husband is going to run the New York Marathon, right?
Yeah.
And there's also a 777 expedition.
Have you heard about that?
It was just on Joe Rogan's.
It was Andy Stomp and Mike Sorelli. And it's a
triple seven expedition. It's for Folds of Honor, where they are jumping out of a skydiving,
seven continents in seven days. So seven jumps, seven continents in seven days.
I am on the medical team. It's myself, Andrew Huberman, Kirk Parsley, and another one, Kristen Holmes, I think her name is.
I'm not 100% sure on that.
So that's another way we're giving back.
My boy Smokey, he went skydiving recently.
Oh, he did?
Yeah.
I think that's a – I mean, that would terrify me.
He said it was horrible.
I bet.
He's like, no, like it wasn't.
I hope they didn't go to the spot here in Sac.
It has like one of the worst, I think has like, there's a spot here that has the most deaths in the United States.
Wow.
Well, that's terrible.
Yeah.
Maybe didn't go that way.
So unless you are trying to raise money or raise awareness for special operations, you should not be jumping out.
Yeah.
I mean.
It's kind of funny because Smokey is a,
he's a very careful person
in general.
Yeah.
Like he's a very calculated.
He's a wary wart.
Yeah.
And,
but he's like riding his motorcycle.
He's,
I don't know if you guys
ever seen any video
of him skiing.
Like he goes like
60 something miles an hour
down the slope.
Snowboards.
Yeah.
Yeah.
Snowboarding.
There you go.
So is he a careful person?
Very much so.
Yeah.
No,
you cannot be. Right? What are you talking a careful person very much so no he cannot be
what are you talking about
but very much so
like in his like
day to day
but when it comes to that shit
he loves that stuff
and I'm like
damn that's crazy
he's shown me video
of him snowboarding
before I'm like
that is like
it's like a helmet cam
it probably wasn't him
like doing tricks and shit
it probably wasn't him
that's probably true
that is true
I didn't really get
verification
get it together guys nah Smokey wouldn't try is true. I didn't really get verification. He's lying about all of it. Get it together, guys.
Smokey wouldn't try to lie, right?
I don't.
Right?
He's a good guy, right?
No?
Huh?
What?
Hello?
Anybody?
He's the best.
He's the best.
Yeah.
So military effort.
So that's how people say, go to my website, sign up.
We have a great newsletter, which I curate.
So some of the studies that I'm talking about, very interested in putting it out there, making it accessible to people.
And then, of course, my podcast, which is fun, which I'm hoping both of you will be on, all three of you, actually.
That podcast is amazing, by the way.
It's a lot of good info.
It's important to me to do that.
And then my book that comes out, goes on presale February 2023, and it doesn't come out until September.
But a lot of blood, sweat, and tears, mostly tears, went in and I'm like, oh my God, I'm so tired.
You know what my husband would say to me?
I would wake up at 5 because I take care of the two kids in the morning.
We do all the thing.
And I would wake up at five
and he said and i'm like i don't know how i'm gonna meet this book deadline it's a lot of it's
a lot of information and he said well you know what truth is you don't care if you really care
you would get up earlier and you would get up with me at four if you really cared about what
you were doing god damn i'm like uh i'm gonna punch you in the about what you were doing. Goddamn. I'm like, I'm going to punch you in the throat.
What are you talking about?
Do you just avoid him a lot?
Totally.
That's what I'm thinking.
I think I would just try to avoid him.
How was your day?
It was good.
This is that open communication shit
we were talking about on the last podcast though.
You're probably brutally honest with him though too, aren't you?
100%.
Yeah, that's a good thing.
100%. Yeah. And you know what he tells me?
Honey, can you tone down the bitch about
10%? Oh shit. He's like,
tone down the bitch 10%, like the whole
bitch tone 10%. Just a little less.
Just 10% down. Just dial it down.
He doesn't even tell nothing. A percentage.
But you need to fill that
gap in because he doesn't do any bitching.
No, he doesn't. You gotta get a certain amount of it, right?
Yeah.
God damn.
By the way, he can't find his socks.
You can navigate lead nav in Afghanistan, but you can't find your socks or put away the dishes?
You ain't got to be kidding me.
He can't find his socks either.
What is with the socks?
I'm going to Bluetooth the socks.
That'd be great.
You have microchip or something. Yeah.
So ridiculous.
Oh, God.
You mentioned hormones, but we
never mentioned anything about supplements.
Are there any particular supplements that you like?
Yeah. I don't know that you particularly like
that you use for yourself? I'm really into this
urolithin A. I think it's
very interesting. This is a
pomegranate prebiotic kind of gut thing
creatine can't go wrong with creatine for me personally you know i'm saying oh you know
i'm not taking creatine so that you know there's that i always take a fish oil i i you know i work
with first form they're amazing i use first forms fish oil. I take a vitamin D.
What else do I take?
Some protein powder here and there, stuff like that.
Typically not.
Not right now.
Typically just eat.
What else?
Fish oil, vitamin D.
That's it.
Urolithin A.
I'm sure I'll cycle through.
Sometimes I'll have glutathione.
Sometimes I'll do a prebiotic fiber. Have you found those IVs to be worthy? I used to do them all the time.
Worth anything? I don't do them anymore. I used to do them all the time. In fact,
when I had a practice on Fifth Avenue in New York City, we used to have an IV lounge.
And could they be of benefit? Totally. The vitamin C, I found them to be very valuable.
I have a Parkinson's patient where this was unbelievable.
I had a Parkinson's patient that we would put on IV glutathione.
And in Parkinson's, they have a gate that is – it's not just ataxic, but there's
a somewhat of a shuffling gate depending on what, you know, where they are in their disease progression.
We literally give her upwards of, you know, five grams of glutathione and she was able
to walk.
I mean, it was tremendous.
And, you know, we titrated her up.
We titrated her up to see the dose.
It was incredible.
And now she does it regularly and it really helps her dyskinesia,
really helps her capacity. So there are some major benefits. And the other thing is, I will say,
one of the things I'm seeing more of, we talked about autoimmunity, is autoimmune gastritis and
pernicious anemia. Pernicious anemia can be masked by men on testosterone. So if guys are all of a sudden
getting a ton of anxiety, and I saw this in one of my seals, he was getting a ton of anxiety.
And we thought it was in his hemoglobin and hematocrit were elevated because he was on
testosterone. He also had sleep apnea, but the sleep apnea and the testosterone made it look
like he had plenty of iron. So pernicious anemia affects his B12
and ultimately affects your ability to utilize iron.
And so, you know, you have pernicious anemia, you die from it.
And then subsequently B12 shots work and fix it.
Wow.
So there's that.
Cool question about the urolithin A.
I'll definitely check out examine.com.
But is that something you take every single day and is there a certain –
I just started.
You just started.
I just started taking it.
I'm just very interested in the research.
I like it when there's some evidence behind it and I understand the story and the professionals that created it and were doing the studies.
Yeah.
Mark and I were talking about this.
It's really interesting.
People discount studies when they're, quote, industry funded.
You shouldn't.
I completely disagree with that.
As someone who did research, and obviously I'm not a career researcher, you know, marginal
at best.
However, when you do a fellowship, especially when you do a research fellowship, you do
learn, you know, what is it like to get funding?
What are, you know, what are the implications and who are kind of doing the studies?
And for example, beef, there's something called a beef checkoff where they have certain amount of millions of dollars that they can provide to scientists to actually study the effects.
It doesn't mean that scientists are bought.
It doesn't mean that scientists are bought.
They are getting funding from multiple sources to be able to do research on something that the population is consuming.
They're not going to change the results.
And in fact, industry funding – so if something goes through the beef checkoff, it is highly scrutinized for exactly the reasons that we're all talking about. And this is an important statement is that just because something gets industry funding
doesn't question the credibility necessarily of the researcher.
You have to look at what is the researcher's intellectual integrity, who is a researcher.
It can't be just this blanket statement.
And listen, there are some researchers that do get funding and there are researchers that
suck and are getting money from Kellogg and getting money from PETA.
I don't know.
And then perhaps they have an agenda, but it doesn't always mean that you should discount
all that research.
Anyway, but you're asking about urolithin A. I think that it affects, I think there's some evidence to suggest that it really helps endurance and mitochondria function
somewhat like endurance exercise. And I think that that can be very valuable,
especially for example, if you are someone who is not doing quite a bit of endurance activity
and you are simply doing strength and or hypertrophy training, you know,
and maybe not doing as much HIIT or SIT, you know,
high-intensity interval training or sprint interval training.
Is there any potential dosage guidelines?
What I'm seeing here on Amazon is like a consistent 250 milligrams or 500.
Like what do you suggest?
Well, I am going to begin experimenting with double that.
So 500 milligrams twice a day.
Yeah, I'm going to begin experimenting with that. Cool. Cold plunge? I don't do it. It's probably great. So there is
some great evidence for that. And what about a sauna? Great. Yeah. Also love it. I do have a
sauna. I think the saunas are great. But again, it's interesting in my life, I'm pretty busy.
I have two very little children. I prioritize the things that I think are going to be of most benefit, which is nutrition and training.
I do red light.
I love a red light because it's easy.
Yeah.
And my kids can do it with me.
Sauna.
I do have a sauna.
I love a sauna.
Cold plunge would be great.
I don't have a cold plunge.
Oh, we'll fix that. You guys sent me a cold plunge. I love. I don't have a cold plunge. Oh, we'll fix that.
You guys sent me a cold plunge.
I love that.
I saw Mark's cold plunge.
You know, it's really interesting.
Like it looks all beautiful.
The room's all beautiful.
Yeah.
And like you hear the water.
It sounds like it would be relaxing.
And then you stick your finger and you're like, did I just pee myself?
That is so cold.
Yeah, yeah, yeah.
Nothing about that feels good.
Yeah.
The cold plunge from this company, Pl Plunge it's great because it's pretty big
but it takes up minimal space wherever you are
and you probably don't have a problem with space but
it looks nice so
I could put it on my porch
take us on out of here Andrew
make sure you guys stick around for Smelly's tip
once we get through all this stuff here but thank you
everybody for checking out today's episode please drop us some
comments down below let the conversation
keep going go ahead and drop some questions i want to hear what you
guys have to say uh make sure you guys hit that like button on the way out and subscribe if you
guys are not subscribed already uh please follow the podcast at mb power project on instagram
tiktok and twitter my instagram tiktok and twitter is at i am andrew z and sema where you at go hit
up the discord links in the description people are popping over there and see my ending on
instagram youtube and see my union on tiktok and twitter dr lion where can people find you yeah uh i am not on tiktok
very regularly but after hearing all that i think i should be i do have a tiktok account it's probably
dr gabrielle lion very active on instagram at dr gabrielle lion.com uh twitter same name my website
dr gabrielle lion and of course the epic dr. Gabrielle Lyon show and on YouTube which is a Dr. Gabrielle
Lyon channel awesome thanks for coming out here yeah appreciate it thank you so much for having
me I really appreciate it awesome so the tip for today I was uh in there doing some lifting lifting
some weights and it occurred to me that I haven't really talked about this
much, but in your pursuit to lift heavy ass weight, when you're warming up, try to use really,
really low repetitions. So something I used to do is I used to just do singles all the way up
in my warmup. It is important to actually make sure that your body temperature is up. So make
sure I ran previously. So I came in and just started hitting the singles.
My body was already warm.
But your muscles don't need to really be warm
the way that a lot of people think.
It's been super effective for me over the years
to really conserve that energy for the top sets.
And I was able to do,
I did 405 today for two reps.
And I'm going to be pursuing
and working my way back up over 500 in a slingshot, and then we'll kind of see what I'll be able to do after that.
But it felt good, you know, and to be at a lighter body weight kind of sucks because, like, my arms are kind of shaky because I feel a little feeble at the moment.
But over the next couple of weeks, hopefully that will get better. Strength is
never weakness. Weakness is never strength. Catch you guys
later. Bye.
That was good.
What that end up being?