# Muscle - The secret endocrine Organ to keep you healthy - A conversation with Dr. Gabrielle Lyon

## Метаданные

- **Канал:** Dr. Jason Fung
- **YouTube:** https://www.youtube.com/watch?v=wnWFOPwPcoQ
- **Просмотры:** 21,652

## Описание

Why does muscle matter so much—not just for strength, but for fat loss,
insulin sensitivity, metabolism, and long-term health?

In this in-depth conversation, Dr. Jason Fung sits down with Dr. Gabrielle Lyon
to explore why muscle is one of the most misunderstood—and most
important—organs in the human body. This discussion challenges the traditional
calorie-focused model of weight loss and reframes health through a muscle-
centric, hormone-driven lens.
Throughout this 58-minute discussion, you’ll gain clarity on:
● Why muscle plays a critical role in metabolic health and fat loss
● How low muscle mass contributes to insulin resistance and weight gain
● Why focusing only on calories often leads to failure
● The connection between muscle, fasting, and metabolic flexibility
● How muscle loss accelerates aging and chronic disease risk
● Practical ways to preserve and build muscle without extreme dieting
● Why hormones—not willpower—drive long-term weight regulation
Dr. Gabrielle Lyon explains how muscle functions as a metabolic organ,
influencing blood sugar control, energy production, and longevity. Dr. Jason Fung
adds crucial insight into how insulin, fasting, and metabolic health intersect with
muscle preservation—especially for people struggling with stubborn weight gain.
This video is especially valuable if you:

● Are losing weight but still feel metabolically unhealthy
● Struggle with insulin resistance or slow metabolism
● Want sustainable fat loss without damaging muscle
● Care about longevity, strength, and aging well

�� Recommended Resource
To dive deeper into muscle-centric health, explore Dr. Gabrielle Lyon’s
Playbook:
�� https://drgabriellelyon.com/playbook/
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⏱️ Chapters / Timestamps
00:00 – Why Muscle Matters So Much (Intro & Core Idea)
02:15 – Dr. Gabrielle Lyon: Muscle Is More Than Strength
05:10 – Muscle as a Metabolic Organ Explained
08:00 – How Low Muscle Mass Affects Fat Gain
10:45 – Insulin Resistance, Muscle & Weight Loss
13:30 – Hormones vs Calories: A Broken Model
16:40 – Why Traditional Dieting Fails Long-Term

19:30 – Muscle, Metabolism & Energy Production
22:15 – Aging, Muscle Loss & Chronic Disease Risk
25:10 – Intermittent Fasting and Muscle Preservation
28:20 – Can You Lose Fat Without Losing Muscle?
31:15 – Protein Intake, Muscle & Metabolic Health
34:00 – Muscle-Centric Health vs Weight-Centric Health
37:10 – Exercise, Resistance Training & Longevity
40:00 – Common Myths About Muscle and Fat Loss
43:15 – What Most People Get Wrong About Metabolism
46:20 – Practical Steps to Build & Protect Muscle
49:30 – Sustainable Fat Loss Without Starvation
52:10 – Long-Term Health, Longevity & Muscle Mass
55:00 – Final Thoughts: Rethinking Muscle & Health
57:10 – Closing Message & Key Takeaways
=============================
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�� The Diabetes Code - Reviewing how type 2 diabetes is a reversibl
disease and dietary strategies. https://www.amazon.com/dp/B0795BLS8D?...
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https://www.amazon.com/dp/0062894005?...
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�� YouTube Medical Lectures (for specialist physicians)
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## Содержание

### [0:00](https://www.youtube.com/watch?v=wnWFOPwPcoQ) Why Muscle Matters So Much (Intro & Core Idea)

I'm really privileged to be speaking with Dr. Gabrielle Lion and uh she's you know really come out of um nowhere to be this really important uh person spreading this really important message on sort of the importance of muscle building for longevity for health. I mean, I think it's I think the message has always been there, but you know, the more people we have like really expert medical opinions, the better. Um, and you know, I'm really happy to uh be here, Gabrielle. I'm I'm glad to uh be talking to you. — I'm interested also just to uh go over how you got into this uh sort of space because, you know, it's not the typical sort of career path of somebody with your training. So maybe you can take us uh you know from the beginning you know how you h you know your training how you got interested and how you got to where you are right now. — I'd be thrilled to. Uh first of all it's really nice to be able to meet you even though it's virtual. It's been really a long time coming. I've been watching you for quite some time now. I did and by the way you recently did a video on the dietary guidelines. So I want to frame this up with the nutrition aspect how it's becoming into the forefront. I did my undergraduate in human nutrition vitamin mineral met metabolism and I trained with one of the worldleading experts in protein metabolism. 25 years later he's mentored me throughout both medical school residency and fellowship. And when we think about the kind of where medicine is going and also just my practice of muscle centric medicine, it's been decades in the making. Um, nutritional sciences, protein metabolism, then I went to medical school, did two years of psychiatry, three years of family medicine, and then went and did a fellowship in nutritional sciences and geriatrics. uh and that was at WashU and it was a combined uh clinical practice fellowship with nutritional science research and quite frankly I didn't want to do geriatrics when we think about geriatrics it was the opposite of where my mind was I was very interested

### [2:15](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=135s) Dr. Gabrielle Lyon: Muscle Is More Than Strength

in muscle physical health and nutrition because throughout from beginning in uh my undergraduate I continued on the path to nutrition so the deal was in order for me to do a fellowship ship in nutritional sciences, a real clinical fellowship or a real research fellowship. I had to pick a medical specialty. Um, well, let me rephrase that. I had to be get funding from a medical specialty. And at WashU in St. Louis, which is a extraordinary institution, nutritional sciences and geriatrics, those two were connected. For two years, I did geriatrics while doing research in nutritional sciences. And when we think about muscle centric medicine, muscle is this organ of longevity. And I'm sure Jason that you've had these moments of insight, you know, with the obesity code, there's probably a moment of insight. And I was looking at body composition, brain function. I was in I was we were looking at this study of individuals with uh BMI over 30, uh body fat percentage, and brain function. And I imaged this woman's brain and she was in her mid50s and her brain looked like the beginning of an Alzheimer's brain. And she was doing everything right, doing what all the quote medical experts had told her, eat less, move more. And she had cycled through bouts of weight loss for the last 20 years. She lost the same 20 to 30 pounds. And I just had this moment where she was just representative of so many of our patients. And I vowed that was never going to happen again. If I had something to do with it, there had to be a solution. something better that we were telling people. And this is where muscle centric medicine was born. I realized, you know, just thinking about it and also I was just so deeply affected that this was not an obesity problem that this was a problem of muscle first and that's essentially where muscle medicine was born. — Wow. that um that's amazing. I mean I think it's you know like you sometimes you have these moments where it's like you're doing medicine, you're doing medicine and then you think oh my god we're doing it all wrong. It's like and it's a strange feeling because it's like how can you know what you've been doing all along been so wrong? And I think you know like you I completely agree that sometimes medicine as a practice sort of gets a little lost because you get focused down on one pathway. um as this is the way to health and stuff. And unfortunately in medicine, I think it ran through drugs and take more drugs, right? Oh

### [5:10](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=310s) Muscle as a Metabolic Organ Explained

here's newer drugs, right, that are better. It's like I'm not sure that was the actual problem. um you know and and that's where I think it's great to have voices uh like yours that are like um really talking about sort of how to be healthy. So how did you go from there to your uh bestselling book uh Forever Strong? — Yeah. Well, again, this was in the making for a long time. And I think that that's where you and I are very similar. I've been I mean I graduated med school in 2006 been in clinical practice and I'm still doing research in publishing not just in um for the lay public for public consumption but also in peer-review journals and your question so forever strong the first book was a New York Times bestseller and it really positioned muscle skeletal muscle as this organ of longevity and um on in my roots of nutritional sciences again having just done a fellowship well I finished my fellowship 5 um really focusing on the nutritional aspect of muscle health. Really part of the problem the way that I see it is that we are eating in a way and living in a way that is mismatched for muscle health. Uh and I'll take this a step further because you asked this where did this book come from. Forever Strong is was kind of a manifesto of how we need to understand dietary protein, build um a nutrition plan, some of the science of nutrition because my mentor Dr. Donald Layman was around when Anel Keys was giving lectures and again these are the you're standing we stand on the shoulders of giants but he was um at the precipice of this lowfat saturated fat is the cause of heart disease and um I realized that the gap was we needed a book that focused not about muscle from an aesthetic standpoint but muscle as the focal point for disease. Uh I'll give you an example. Obesity, heart disease, Alzheimer's, which is type three diabetes of the B of the brain. These are all diseases that have their roots in metabolism as you talk about all the time. And I would argue that the root cause medicine where this originates is in skeletal muscle first. Here is why. Skeletal muscle is your primary site for glucose disposal. At rest, healthy muscle burns primarily fatty acids. It is your amino acid reservoir. It is, you know, it functions as an endocrine organ. And skeletal muscle as the focal point that makes up 40% of one's body, this is this becomes deranged first. So when we think about

### [8:00](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=480s) How Low Muscle Mass Affects Fat Gain

how we diagnose as physicians metabolic syndrome, we think about that as an obesity problem. It's not elevated triglycerides, elevated glucose, elevated insulin, uh elevated blood pressure, a wider waistline. These are diseases of skeletal muscle. That makes a lot of sense actually. And um I love the way that you frame it as an organ because really it that's really all it is, right? You have to think of it just the same as your liver or your kidney or your brain, you know, your heart. I mean there are certain things that affect it and are good to do and this is where the new book comes in right it's the uh so maybe you can talk about your new book coming out which is very exciting — very exciting um the new book is called the forever strong playbook it's behind me here and it's the book that I originally wanted to write it is a tactical field manual for what you need to do how you need to train think it really is this manual for living a stronger, more resilient life. And it covers the new dietary guidelines because my mentor wrote the protein section of the dietary guidelines and he also co-authored the nutrition aspect of this book. And it's not the um physiology behind it, but it's the action. How do you implement this into real life? There are training protocols in there. There are recovery protocols. It's a book that is very visual and distilled down, easy to understand whether someone is a beginner, intermediate or advanced. It really covers the whole spectrum and it's evidence-based and this is again it's a tactical field manual. The first chapter is actually how to think. Most people are interested but there is a divide between being interested and being able to take action. And until you can identify that mental piece too and close that gap becomes very difficult to facilitate change and of course there are tons of recipes and just it's I'm proud of this book and as an author it's hard to say that you're quote proud of something I know because you've uh published quite a bit but this one I feel really proud of. — Yeah. I mean it's like your children. You're not supposed to have favorites, but you do. — So far, this is it. — Yeah. I mean, you love them in different ways, right? And I think that's what this is, right? It's a different um it's a different take on it, right? You go from sort of a lot more of the science-based um you know, why muscle matters and so on to the practical

### [10:45](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=645s) Insulin Resistance, Muscle & Weight Loss

right? Because they're not always it's not the same thing, right? Some there are some people who love to dive deep into the real sort of heart of the matter and there are some people that are like just tell me what to do right it's like I want to do this and eat this and do this and tell me what to do and I think both are fine right because honestly as much as I love to dive deep into certain aspects of metabolism stuff there are other parts of you know my life where I'm like just tell me what to do like you know it's like when I'm you when I'm doing like videos or something, just tell me what to do, right? Like you don't need to tell me why I need to do this. Just tell me. So, I think that certainly there is that uh there is that um sort of need for this book. So, yeah, congratulations. I mean, I think that's fantastic. Um maybe you can tell us a little bit more about um some of the science then like just going back into the uh science of the muscle and why it matters like what is it about the muscle and you you've introduced this concept of so muscle span maybe you can talk a little bit about that and uh sort of explain why you know this is such an important sort of underappreciated aspect — you know I was I I've been thinking a lot about this as how did we miss this you know Because when we think about say the obesity epidemic that started the late 70s early 80s, the focal point was food and it was this idea that we were outpacing our um we were just cons over consuming too much highly processed highly palatable foods. You know at the time exercise was not even discussed muscle as part of the equation. And the reason that I think history is so important is because if we don't recognize history, then we're going to be bound to repeat it. And when I went back and I'm like, how do we even get ourselves in this kind of situation? I realized that as humans, and you alluded to this earlier, as humans, as providers, we become very good at hearing a question, answering it in our way, and then being taught that this is the way. this is the way that we treat obesity and quote obesity is the problem. What ended up happening is because we became so hyperfocused on obesity, we ignored the fact that muscle is an endocrine organ. When you contract skeletal muscle, it releases mioines. And myioines are peptide hormones that travel throughout the body, both act locally, systemically, act on the brain, does various of has various effects on the brain and the body.

### [13:30](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=810s) Hormones vs Calories: A Broken Model

Skeletal muscle as an endocrine organ releases these myioines based on duration and intensity of training. What becomes so fascinating about this is say your listener or viewer they're like well why do I care about muscle as an endocrine organ number one because it's under voluntary control you are a nephrologist you are a kidney doctor you cannot tell your kidneys to secrete ariththropoetin as much as you want to talk to them but you can say I want to do a squat I want to contract my bicep and because this system is the only system under voluntary control it means that it's a choice And once we reorient ourselves to the importance of muscle, which has always been about aesthetics, frankly, I mean, it's been about sport performance. It's about aesthetics. It wasn't even considered to be an organ system. We didn't even discover that until the 2000s. And not only that, fast forward to how we classify diseases as physicians, the ICD10 codes, sarcopenia didn't even get one until 2016. The idea that muscle could be diseased or dysfunctional from say a decreased muscle mass and strength and function wasn't even recognized as a disease. It wasn't given this international classification of disease till 2016. Why do I say all this? Because as humans, if we don't challenge conventional ways of thinking about things, we are very good at executing on the algorithms that we know. And once we recognize that skeletal muscle A is a voluntary choice and B requires very certain inputs to care for it, just like the kidney requires fluids and certain inputs, then as a choice, as this idea of muscle span, the length of time you live with healthy muscle changes the trajectory in which we age because it makes up 40% of our body and muscle There's three main influences as we think about it. So, obviously, when you're young, you know, we are up against a ton of myths. We're behind on our muscle science. There's been this myth, you know, I have two little kids. There's this myth that kids shouldn't lift weights. Kids shouldn't exercise. But that's not supported by the data. And when you are young, your muscle is primed. We all have various types of muscle fibers, say, that we're born with, but are largely informed by our activity. And fibers. And I'm I I'm saying this simply. There's a bit of nuance because of course there's hybrid fibers. But when you do resistance training, you build those bigger bulkier fibers. When you do more endurance type cardiovascular training, you maintain those type one fibers. And if we think about our parents, we think about this aging trajectory. we see them maybe they were bigger and more robust in their youth throughout life and then say 65 all of a sudden we see this kind of shrinking this sarcopenic effect um and that doesn't have to happen but there is

### [16:40](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=1000s) Why Traditional Dieting Fails Long-Term

this natural progression with aging and muscle span is the length of time you live with healthy strong muscle youth you have to pay attention to it midlife you build and maintain as much as you can 18 to 35. 35 and up, there is this transition of muscle becomes more anabolically resistant. — Yeah. And I love the way that you frame it because the, you know, when I think about how I used to think about muscle, too. It's it was always sort of this, oh, well, it's great for sports, right? And it's like when you're young, you want to look good. But not a lot of people thought about it in terms of longevity, in terms of staying healthy, but it actually plays such a key role because you see how it it impacts you in the long term. And I think that's where perhaps maybe your training as a geriatrician really uh helped, you know, make clear those important um aspects for older people, right? And that's something that was certainly not ever emphasized when I was training. I mean, I actually thought about doing geriatrics too, but then eventually chose nefrology, but it was not one of the things that anybody ever talked about in terms of staying healthy, right? You talked about all the hypertension, cholesterol, you know, all that sort of stuff, but not muscle. But then you go into the hospital and you see what are people coming in with? Well, they tripped and they fell and they broke a hip and all this sort of stuff that it's like well you know if you had like healthy muscle that would be preventable. So what are the most important say the the most top three most important things for keeping that muscle span that muscle uh longevity — resistance training it is the most important. People will say well you know what about diet what all these other things resistance training the input because this is an adaptive it's an adaptive plastic muscle input is the most important thing and there's various ways to have input into skeletal muscle. So skeletal muscle really it has this main sensor in it and its main sensor is called mTor and it's a protein kynise and it has various inputs. Um, diet is one input. Leucine, one of the amino acids, triggers this system. Growth hormones, insulin also trigger this system. Resistance training is another way to trigger this system. And the balance between these inputs change as we age. Resistance training, hands down, is the most impactful way to

### [19:30](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=1170s) Muscle, Metabolism & Energy Production

a maintain and build healthy skeletal muscle. Now I say healthy skeletal muscle because again in our way of thinking people will say well if you struggle with obesity you have a lot of muscle because you're um carrying more weight and the reality is we don't test the quality of muscle and probably the most detrimental fact that I believe a biioarker that we're going to see emerge in the next five years is something called intramuscular atapost tissue. It's IMAP. It's fat within the tissue. It's your muscle looking like a wagoo steak versus a fillet. And this happens when someone is sedentary. Now, when you and I go into the literature or your listeners or viewers go into the literature, they might Google and PubMed and it might say something like a healthy sedentary cohort. There is no such thing as a healthy sedentary individual. When you are sedentary, the health of that muscle decreases. there's byproducts that build up, there's muscle glycogen that it's almost like a stagnant pond that this creates low levels of inflammation. This can decrease the strength, the quality of the tissue. So, resistance training is the way around that. Regardless if body composition changes or not, regardless if your body fat percentage changes, regardless if you put on skeletal muscle, the simple act of doing resistance training three days a week with meaningful effort is a way of becoming healthier. And I think that it's very liberating because it's not just about my body fat percentage is 35, I want it to be 25, or I want to put on two pounds of muscles. Again, these are external drivers that we ultimately have no control over. We don't have exact control, but we do have voluntary control over the amount of effort that we put in. And simply putting in that effort changes the health and quality of that muscle tissue. You know, do you remember when we were um give doing orders, doing admissions into the hospital, and you probably still do this. Remember there was a a check mark for bed rest? — Yeah. That was like the worst idea. — Yeah, no kidding. Eh, — no one ever does. I mean, think about that. Why was bed rest so detrimental, which we don't recommend bed rest. We want people moving. Is that think about uh glucose control? If 40% of your body is skeletal muscle, you're putting people on bed rest. You're immobilizing them. You're increasing insulin resistance in skeletal muscle. You're decreasing any kind of fuel utilization. I mean again at rest

### [22:15](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=1335s) Aging, Muscle Loss & Chronic Disease Risk

skeletal muscle is not very metabolically active. You're beginning to derange metabolism. What do you end up seeing? Well, with decrease in muscle mass, you see again increased levels of blood glucose, triglycerides, insulin. This is the recipe for metabolic disaster and ultimately frailty later on. So again, what you can do about it, resistance train, three days a week. If someone is listening to this and they are uncomfortable with training or they say they don't want to go to the gym, there's a million different ways to do it right. It could be bands. It could be body weights. It could be going to the gym with machines. It could be one single kettle bell, which you know I used through my second my first pregnancy. All I had was one kettle bell. That's all I did. One kettle bell. Or maybe it was the second pregnancy second pregnancy. Um, and there's a million different ways to get it done, but it is critical and it needs to be a non-negotiable. People get mad at me when I say this, but we don't wake up and go, "Should I brush my teeth this morning? " I mean, you don't. — This is that important. And it's the one thing, again, as a trained geriatrician, this is the one thing that is most important. And then the second second — before you get on to that, let me just uh interject if I can. I think just before I lose this thread about bed rest because it's actually really important because you know I admit people all the time and it's incredible how fast the muscle deteriorates on bed rest and and I because I'm still admitting a lot of inatients and stuff and I have a lot of dialysis patients who are quite sick. Uh sometimes they'll come in with pneumonia or something extrinsic, right? and they'll be on bed rest and within like three days like they can't even move get back out because their reserve was low and the rate of deterioration of muscle on bed rest when it's completely immobilized like that is fast. So if they were just above the threshold where they were getting up, they're getting around going to the washroom, all that stuff in three days, five days, I'd be like, "Whoa, what happened to this fellow or this lady? " It's like she can't even get up anymore, right? And it was only a few days, but it's it really speaks to the importance of that. And of course when that happens, the number of complications just skyrockets like it's crazy like the bed sores and then you get the um you know, it really is. And then of course you don't have the strength. So then you might trip on stuff or because you're shuffling your feet, right? So it's not just the one thing, right? And this is why it's important you say it's just strength. No, it's not

### [25:10](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=1510s) Intermittent Fasting and Muscle Preservation

just strength, right? It's everything because everything you do is based around movement and so on, right? And then it impacts your metabolism and so on. So and then, you know, I love the point about it's not, you know, a bunch of free weights in your basement. It can be anything. So, the classics, you know, push-ups and sit-ups and pull-ups, all these body weight exercises, you know, calisthenics, — right? — They're exact. Like, you don't need all this equipment. It can be jumping. It can be, you know, push-ups. I mean, that's been ingrained into, you know, us since grade school, right? Sit-ups and push-ups, right? Was the classic, right? And I think we have to get back to that idea that hey, it's resistance. It's but you don't necessarily have to buy an expensive Smith machine or some, you know, you don't need that. You can just do it like there are ways around it. So, a great uh great point on that. Sorry. — Sorry. Go ahead. I really like that you pointed out again because you're a practicing physician and so am I and there's a we there's a million different ways to make these quote recommendations and this is what I see out there is that people will make recommendations but that is different when you are in the real world seeing patients and you know that the average carbohydrate intake for um for people is 300 grams of carbohydrates a day. That's three glucose tolerance tests a day. This is the average. The average individual isn't moving. The average individual is sedentary. And so when we really think about there's all this idea of um you know there's the athletic space and that's great and that's in a perfect world, but that's that is not what we are up against if we want to build a stronger more resilient future and just more resilient humans. And I love what you are pointing out, what you see in patients, the acceleration of weight loss, of muscle loss in one week of bed rest. They could easily lose five pounds of muscle in one week of bed rest versus when you're younger, you know, might take 30 days, right? You are much more resilient and your baseline is much higher. And what you're pointing out is a critical component to aging and that is a catabolic crisis model that there are moments of discrete loss of muscle and mobility that happen on the hospital admission. All of a sudden it's seven days later they've lost 5 pounds of muscle. They've lost strength. And now someone who is already compromised will never go back up to baseline. And we hope that never happens. There are ways to avoid it. And that is I think the work that while both while you and I are doing it from different angles, that's really the work that we're doing. It doesn't have to be complicated, multiple barriers to entry. It just has

### [28:20](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=1700s) Can You Lose Fat Without Losing Muscle?

to get done. And that's and the playbook highlights if you're going to do something with body weight, uh dumbbells, you know, I did dumbbells. to buy dumbbells on Amazon and also highintensity interval training. One of the things that I hear is that people don't have time to do this. And the reality is if you don't have time for this, how are you going to have time for sickness? diialysis? How are you going to have time to all the other complications that come from not being well? Um, and it just it if we can rethink the way that we prioritize muscle, can you imagine if someone went to the hospital and they lost that percentage of kidney? — Yeah. It'd be a it'd be like, wow, that's problem, right? Yeah. — Organ system. — The thing with muscle is that the changes of muscle are subtle over time. — Sarcopenia, when we think about the definition of sarcopenia, it's really roughly a 4% loss per decade. Maybe it's a little bit more, but that's 10 years. It's not that much. And I think that number is very misleading. I in fact I think it's wrong. And part of the reason I think it's wrong is because we haven't been measuring muscle directly. We extrapolate muscle numbers from, you know, at population levels from a DEXA. A DEXA doesn't look at muscle directly. It extrapolates lean tissue. It looks at bone and fat. — Yeah. Um and we've just uh we haven't been able to highlight the importance of it but now we can we are going to get more I you know there's more advancements coming whether it's MRI and ultrasound and looking at muscle quality the advancements are coming but in the interim knowing that we must prioritize resistance rate you must um and then you have to mirror that with the most essential macronutrient as we age it which is protein and especially for older individuals dietary protein is the most essential macronutrient and um finally it is reflected in the dietary guidelines and also the playbook covers that. — Yeah. So let's get into that what that would be your number two uh important recommendation and maybe just take us through because there has been a big change actually in the recommended daily allowance. So maybe you could just speak to what the recommended daily allowance was, what it is now, and why you think protein is really such a critical uh sort of macronutrient. — Yeah, the new guidelines, I couldn't be more ecstatic about them. It was very emotional. I was there uh and it was a very emotional moment. Like I said, my mentor wrote the protein component of the dietary guidelines and the old guidelines really highlighted grains. And this these new guidelines flipped the pyramid upside

### [31:15](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=1875s) Protein Intake, Muscle & Metabolic Health

down. Now, there's a few important aspects to understand. Number one, dietary guidelines are designed to help inform choices. They are not it's not a hard fast number that it's saying you must have this. It typically is a range there. The dietary guidelines for Americans does it it's really two things. Number one, it informs a range which we're going to talk about. Number two, it impacts those that receive federal funding like nursing homes, schools, military, some sometimes hospitals and and prisons. Why this is becoming why it's so important is that up until this point, protein has never been prioritized. The current RDA which is the recommended dietary allowance is set at8 grams per kg. Now this is important. Those minimum recommendations which is the minimum to prevent deficiencies did not change. The RDA still exists at8 gram per kg. What changed was the recommendation. Now what is being recommended is 1. 2 to 1. 6 g per kg. Another important point is the studies that were used. They didn't use any epidemiology for these guidelines. Randomized control trials was the data that was used and it is all available for people. It's a very transparent and based on evidence. I can't say that with the other guidelines because we don't necessarily know the question that they were trying to answer, nor do we know the data. Um, and I think that is important for the physicians listening to you and the people that are really interested in the literature. You can read where these guidelines come from and scientific rigor is important and we're finally beginning to see it especially in the protein forward-f facing presentation. Why? Yeah, go ahead. — Yeah, it's just to echo the old pyramid which I always thought was insane, right? And it's like God first of all like so the old pyramid had on the bottom you know breads it was breads cereal rice pasta right that's the main thing so really no protein whatsoever right even in the second tier it was vegetables and fruits right again no protein right — and then and there's four levels of this right and each getting smaller by the third level now you've got protein but it's actually split in half. There's a half is milk, yogurt, and cheese group and then the other side. So, you're only talking about only at the third out of fourth

### [34:00](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=2040s) Muscle-Centric Health vs Weight-Centric Health

right? It's so deemphasized in that guideline in that sort of pyramid. You and even though you're at the third out of fourth, it's only half of that level of pyramid. So, really no protein um at all in that old guideline, right? So that's just that's just really like talk about deemphasize. It's really almost actively discouraged. And I think probably, you know, because proteins often come with fat. Like if you eat meat, you're going to have some protein, but then fat, which was the big bugaboo of the last pyramid, right? That was the big demon, you know, lowfat. I mean, you know, if you ever like there was this lowfat era in the 80s and 90s. — The food did some of the food did taste good, though. I have to You know exactly what I'm talking about. Those fat-free cookies, all that stuff. I mean, — I'm not gonna say that it didn't taste good, but it really diluted the nutrient density of the diet — and was in part responsible for the obesity epidemic. — Yeah. They were recommending 12 gra 12 servings of grains. Now it's down to two. Two and three. — Crazy, isn't it? It's like and I think this is super — I think the science was long like it was there for 20 years before this new guidelines and nobody bothered to change it because I think this is only my guess — because you'd have to admit that the previous pyramid was so bad, right? And I think that's where this new one, this sort of fresh start where they're saying this is the most substantial change we've ever seen. It's like good because it's actually reflects the la like 20 years of science and admitted that hey, it was actually not very good. But nobody would ever nobody ever wanted to. Everybody wanted to save face. Oh, it was good. We're just going to tweak the edges. No, no, no, no. Like you've got protein down to like a bare minimum. You've got fats on, you know, using on a monthly basis, right? And it's like, okay, but the data on fats has been, you know, with saturated fats that go along with the protein, with, you know, with the um Mediterranean diet, the olive oil, all of that. It's just crazy. So, — yeah, that's exciting news from that standpoint. — It's a really good point. you bring up another very valuable point is that the saturated fat um we don't have a great number for it. Previously saturated fat in the diet was 15%. Now it's 11% in totality. The recommendation is quote 10. I don't think that anyone understands exactly where that number came from. We don't have good scientific evidence for that number. And I'll highlight something else. Again, the recommendation is now to get your fats from whole food sources, animal fats, as opposed to say

### [37:10](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=2230s) Exercise, Resistance Training & Longevity

this hydrogenated crappy fat. And we don't really have a number for what saturated fat should be. If someone is eating a 4,000 calorie diet and 10% saturated fat is their recommendation or less, then that person could have a quote healthy diet at 44% saturated fat. But if someone like me who's a very just small person, if my diet is 1,500 calories and my saturated fat is 16 grams, then my diet would be considered unhealthy. If saturated fat was so unhealthy, we would have a number. — We would know what that number is. And it really highlights um that we do need more data. And you know, arguably that number was just kind of picked arbitrarily. And um I think that it wasn't changed. People were saying, "Well, it should have been changed. It should they should throw it out. " I think the reality is again, you and I work with real people. And it would have been really disruptive to take out also saturated fat and then not have a number. And this I believe that much of the resources now are going to go to studying saturated fat, understanding what could potentially that number. And I think precision nutrition is really where we're at. For some people, saturated fat might be a problem. For other people, carbohydrates might be a problem there. There really is genetic variabilities. And then, of course, muscle health. The more you train, the more carbohydrates you use, the healthier your muscle is, the better it is at burning fat. — Yeah, there's a certain link for sure. Because when you're talking I mean metabolically you talk about sinks right and that's for you know um for listeners a sink is sort of where you dispose of stuff right so a glucose sink is where your body if you're putting in a lot of glucose where does it go out right just like your sink how does it go out and of course muscle is actually one of your biggest glucose sinks um that you have so therefore that's why it's such an important aspect of it uh because you know It's just like if you're looking at your tub or whatever. It's what goes in, but what goes out and that's where the sink is really important because that's what's going to drain the system, right? But yeah, I think the whole saturated fat thing is always interesting to me too because it's like, okay, we're demonizing saturated fat and um you know, we you've been doing this for 50 years, so where's that data that says a diet high in saturated fat is really unhealthy, right? We have all this data on dairy fats, for example, palmitic acid and all this stuff. It's actually quite healthy

### [40:00](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=2400s) Common Myths About Muscle and Fat Loss

when you look at a lot of these the data on uh the saturated fats you find in butter and other dairy products, right? And whole milk, of course, you know, that's why the whole milk is sort of back on that and the red meats again, show me the data that the the eating the beef is really uh that detrimental because you've had 50 years to produce this data, right? You've had the NIH, you've had everybody, like literally millions and millions of research dollars at your disposal to prove your hypothesis because it's never been proved that eating this saturated fat and to some extent I sort of hate the term because remember all fats are different, right? They're different chemical structures. So choose one, right? Butter fat or animal fat or the beef and show me where's that data? Well, it's not there, right? And it's like, okay, if it's not there, you can't make any conclusions, but it does say something that this is not easy. Like, it's not a slam dunk that, hey, you know, eating all this stuff is really bad for you. So, yeah. And I think that protein is is of course uh you know, getting recognized. I mean, I see it in the um you see it in you know, everywhere you look now. It's like protein. there's a real protein forward and I think that's that's you know progress right definitely progress — it definitely it is absolutely progress and when we think about um well I just want to say one thing on saturated fat because you have done a really great job at talking about how we eat whole foods and we eat within a food matrix I've heard you say we don't eat quote saturated fat we don't eat protein we eat whole foods and that is absolutely right the, you know, almost 40 maybe 47% of the fat in beef is olive oil. It's monounsaturated — and that I mean this is again just items that are not discussed and we eat whole foods and that becomes really valuable and the whole protein discussion is you know it's interesting because as a nephrologist you've heard about protein forever. This is all that we hear is that protein is bad for our kidneys. And the reality is why do we need protein? Well, protein turnover, the rebuild and repair uh becomes less efficient as we age. If our body is rebuilding and repairing four times a year, it's the enzymes, it's the structures. We become less efficient at doing that. And we have an essential need. We cannot make these essential amino acids. That's why they're called essential. We must get them from the diet. and the efficiency of utilization decreases. So we actually need more protein as we age, not less. And that is a really important consideration as we think how do we build healthy aging? So long we've been oriented to the minimum number when it's 1. 2 to 1. 6 for more optimal aging. And you know as a nephrologist diabetes is dev again because as geriatricians so

### [43:15](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=2595s) What Most People Get Wrong About Metabolism

for those of you guys don't know nephrologists and geriatricians we work hand inand uh oftentimes because we are usually seeing the same patients and diabetes type two diabetes dev I mean metabolically devastates people and you don't hear carbohydrates are bad for your kidneys but you hear protein and it's very confusing for I think the public and even the medical providers need to be taught that you know dietary protein helps maintain lean muscle when carbohydrates are controlled. It helps uh maintain triglycerides level triglyceride levels. It can you know reduce cholesterol. It can improve fasting insulin, improve fasting blood sugar. all of these positives that relate to healthy muscle. — Just an aside on the protein aspect as a nefologist, it's actually a really interesting why people say this because honestly it's been like nefologists don't say it anymore. We haven't said it for like 15 years. That's really way in the past, right? So it was something that we used to say to people, eat less protein as your kidneys decline. And that was based on so the where it comes from is actually strange. So the kidneys they basically clean the blood. So the way you measure it is you have you measure creatine and you measure ura nitrogen. Okay? So that's the bun and the creatin in your blood. And the reason you use those markers is because remember the kidneys are passing out. They're getting rid of the ura nitrogen and creatinin. So if their levels of creatinin go up in the blood, one possible explanation is that you are uh excreting less of the creatinin and the ura nitrogen. Okay, so that's why rising levels of that can signal kidney disease and that's usually what's used for. The other thing that can cause it to go up and it's just like a sink, right? It's either if the level of water in your sink is going up, it's either because you're putting in more or you're draining out less, right? So the kidneys is the drain, right? So it's draining out the creatinin. But the other way that goes up is ura nitrogen, which is linked to protein intake. And the other creatinin is a reflection. It's a breakdown product of muscle. So if you have lower muscle, you also have lower creatin, which looks like better kidney function, but isn't. Okay. And same with ura nitrogen. That's from protein intake. So if you're eating less protein, your ura nitrogen is going to be less. But it doesn't mean that your kidneys are working better. It only looks like it, right? So that's where this whole thing came from. this whole hypothesis that eating more protein puts strain so-called strain on your kidneys which it actually doesn't because it's

### [46:20](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=2780s) Practical Steps to Build & Protect Muscle

just the levels in the blood. It's just makes it look like but isn't actually. So about 15 or 20 years ago there was a study looking at low very low protein diets and of course it didn't really show any benefit of low protein diets to kidney function. So, it hasn't been in the nefrology space for ages, but that hasn't made it out to the sort of popular literature, which is that protein is hard on your kidneys. No, we tell our dialysis patients, right, the ones with almost no kidney uh function at all to eat more protein, right? That's what the renal dietitians are telling people. You need to eat more protein because you need to maintain your muscle. That's what's important. Not this sort of artificial changing of your blood level bu and creatinin so that it looks like you have better kidney function. Right? If you had zero muscle mass like you see in the ICU sometimes it looks like your kidney function is good but it's not. It's just as bad as it was. It's just that the markers you use. So that whole scare which is still there. I see it all the time now. It's like no no like just talk to any nefologist. We haven't talked about protein restriction. Like if you go to any of the nefrology meetings — like that this is gatherings and these are like gatherings of like 20,000 nefologists across the world sort of thing, right? Nobody talks about protein restriction. Nobody talks about this. It's it has we haven't talked about it I don't know since the 2000s maybe. It's a long time, right? So, every time I hear it, I'm like, "Yeah, no, it's it's not a thing. " I get why you're confused at why it's a thing. It's not a thing. — You must hear it every day. Tell me, do for the new patients, I mean, I'm sure they have read your books, but you must hear it all the time. — Yeah. It's a crazy why people still think it, but it's really based on a sort of flawed a flawed understanding that was sort of debunked at the specialist level many many years ago. So it's like you know for pro people who are worried about taking too much protein it's like yeah that's not one of my worries generally there are other things to worry about that are much more than you know kidney function right so — do you hear I have a question for you do you hear you know as I just think about this as you're talking it makes me think of these cognitive biases you know it's this idea that for example women shouldn't lift heavy because they might somehow get bulky again I don't think I've ever seen a woman lifting heavy get bulky or lifting it all get bulky. It's just again this narrative of hearing it once and then anchoring and anchoring to it. Have you ever heard someone ask about carbohydrates in the kidneys? Do people say, "Hey, are these carbohydrates bad for my kidneys? " — Yeah, nobody ever does. And the truth is that it's so obvious, too, right? The link is so obvious, right? If you eat a bunch of refined carbohydrates, which have a very high glycemic index will

### [49:30](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=2970s) Sustainable Fat Loss Without Starvation

spike your glucose, which is obviously going to be detrimental for type two diabetes, which is by far and away the most important cause of kidney failure um that we deal with, right? So, it's like, oh, okay, there's a huge link there, but nobody talks about it. Instead, it's protein, right? It's like, should I eat less protein? I'm like, absolutely not. like you should try to eat less of the carbohydrates like and and exactly it's just this old thinking. It's it gets out there. It gets repeated and then by the time it gets repeated sort of like this let's eat all the time sort of thing and you know like what science was that really based on like oh fasting is bad for everybody all the time. It's like okay what science was that based on? Sort of like the saturated fat right? It's like it gets in there and it's like, "Okay, well, show me the data because I'd like to see it because I've never seen it, right? I've never seen the data that definitively says, hey, you eat more saturated fat, you get more heart disease, right? Show me that data because if you have it, then I'd love to see it. " But there is no data, right? And that's the big problem with a lot of these things. So, it's great that we're finally putting, you know, with these new dietary guidelines sort of putting these things forward, right? like proteins are not harmful to you that can be beneficial and then the whole fat milks and all these natural foods. One of the real focuses of course is on natural real foods, right? And that's really uh terrific. And why don't we finish up on your third what would you say is the third most important thing to say maintain muscle health and muscle longevity? — First is resistance training. The second is dietary protein. And then the third and I would say I this is probably a tossup but you do have to recover. There is a level of recovery and um caring for the tissue. Meaning I I say sleep but uh you know sleep is very important. I'm not great at it. So I just want to go on record of saying that. uh being able to recover well, the input, the stimulus is very important. And then understanding that the recovery aspect is also important. As you get older, your muscle health and muscle strength will outpace your tendons. And it's critical to have a well-designed program so you do not get injured. And movement is not just in that 45 minutes to an hour. It's really an all day thing. and figuring out how to add movement and also how to add premovements to exercise and recover

### [52:10](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=3130s) Long-Term Health, Longevity & Muscle Mass

well. That is the third bucket that I would say you've got to be able to recover well. I think that's very important and really unappreciated because you know you you read hundreds of books on how to exercise what exercise but it's like how many people actually talk about the recovery process because that's where actually the sort of magic happens right you don't get stronger during your exercise it's actually during your recovery phase that your muscle rebuilds repairs and becomes stronger to take the stress of the body. That's sort of how the body works, right? It's a stress on the system because everybody stress is a you know, it's like a bad word, but it's like that's how you live, right? You can only live by stressing the body, right? Otherwise, you don't grow. And that's the same whether it's muscle or uh anything else, right? It's it's true for you know your mind too. If you never stress it, you never expand your sort of through your comfort zones and stuff. If you just keep thinking that saying the same thing, thinking the same thing, well, you'll never grow as a intellectually. Same thing for your muscles, right? You have to stress yourself and get yourself into that situation. So, I think the recovery is actually super uh important. And um you know the I think all three of those are actually uh fantastic things to focus on uh for longevity and really a bit of a neglected uh sort of organ. I mean people have always talked about exercise but really in sort of nebulous sort of ways. I remember we used to talk about it in grade school and stuff you get taught and it's like it was just this sort of nebulous thing that you should do but it was always framed as a kids thing, right? It's like you should be active as a kid. Well, kids are active anyway. You can't stop them from being active. Um, but you know, I see it changing now and you see a lot more people sort of taking that advice to heart uh and and staying. I think a lot of these messages have, you know, have their time has come and I thank you for uh, you know, being a strong part of that. um sort of advocacy because I think it's probably long overdue. Um just as we finish up here, any uh parting thoughts, parting advice? I think you've given us some really valuable advice here already, but uh anything else you would add? — I love that you said uh that we that stress is not bad and I actually cover that in the first chapter of the book, how to think and adding purposeful friction. — Right. Life is we've only been taught

### [55:00](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=3300s) Final Thoughts: Rethinking Muscle & Health

about one stress response which is fight or flight. But there are other stress responses, tendon befriend and the courage response. Both can be cultivated but are never discussed. And friction and challenge, all of these things, they're good. And this is quite frankly how people thrive. It's how we were designed. The other stuff is a narrative. You don't need a hot bubble bath. You need discipline. You don't need another foot rub. you need to put in structures and boundaries for execution for the things that become very meaningful for you. Um and that really closes the gap. — Yeah, I love that phrase purposeful friction because it's like we all know that it is something that needs to be done. It's not necessarily what you want. You want the bubble bath and the foot rub. Um — only in the beginning. — Yeah. — Thank you. until you step into the harder things and then you recognize that meaningful that a meaningful life it's it really is built on the on the challenge and the overcoming and the capacity that you build. — That's so true and it's really the uh that meaningfulness is what a lot of people sort of lack. I mean a lot of these um studies of happiness and stuff it's clear that the meaningfulness of what you're doing is important like you see all these sort of sometimes you see these billionaires who are just depressed and it's everything — all the time — you have no purpose purpose in life everything is you have already — so it's like yeah what do I do now it's it really is a void. I mean, um it's such an important aspect. And what would you say is your uh meaningful purpose that you see right now? — I mean, for me personally, it's that's easy. It's two things. Obviously, my family, my friends, my community, but I believe that we can build stronger, more resilient humans. I truly believe

### [57:10](https://www.youtube.com/watch?v=wnWFOPwPcoQ&t=3430s) Closing Message & Key Takeaways

that — and I have spent decades — putting I mean it's not and you can vouch for this. It's not easy doing what we're doing. It's you know the first one through the gate that one gets bloody and it's difficult. It's not easy. But I believe that if you have the ability and you have the knowledge to help the world or help people then you have a responsibility to do that. And it is very easy for me to say that my purpose is to help build stronger, more resilient humans. And I know that it can be done. — Well, thank you so much, Gabrielle. This is great uh conversation. I really enjoyed it. It's uh you know, fantastic. Thank you so much. — Thank you. — All right, I think we're good here. I don't know if Karen's still on. — I was actually laughing um because of the friction thing. I was just reminded of something that

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