Pod Insights The Diary Of A CEO with Steven Bartlett The Anti-Obesity Doctor: If You Don't Exercise, This Is What's Happening To You! Use This Anti-Aging Cure No One Is Talking About! - Gabrielle Lyon About this episode Everyone's heard that obesity is a global crisis, but what if there is a more dangerous hidden trend ravaging health and robbing years of life?
Dr Gabrielle Lyon is the founder of ‘Muscle-Centric Medicine’, an evidence-based method to improve muscle health, and host of ‘The Dr Gabrielle Lyon Show’. She is also the bestselling author of the book, ‘FOREVER STRONG: A New, Science-Based Strategy for Aging Well’.
In this conversation, Dr Gabrielle and Steven discuss topics such as, how weak muscles impact fertility, the truth about cardiovascular training, how Ozempic supports muscle growth, and the relationship between muscle and metabolism.
(00:00) Introduction
(02:39) What Does Gabrielle Do for a Living?
(04:34) Why Do People Seek Gabrielle’s Help?
(05:56) Are Your Solutions Easy to Implement?
(09:39) Why We Hesitate to Act on Advice
(12:25) How to Support Someone Who Feels Down
(15:02) The Importance of This for Your Health
(18:03) Stress, Trauma, and Their Impact on Change
(22:17) How to Heal from Trauma
(25:40) The Best Way to Inspire Change in Others
(28:00) Key Lessons from Studying Thousands of Patients
(28:58) What Drives Your Passion?
(33:41) Common Myths That Hinder Personal Growth
(37:34) Signs You’re Moving in the Right Direction
(41:12) Strength of Body vs. Strength of Mind
(43:53) Ideal Training Based on Age
(47:15) Why Exercise Three Times a Week Matters
(49:14) Will We Become Like Our Parents?
(52:00) Is Muscle More Important than Cardio?
(56:00) Only 6% Meet Physical Activity Guidelines
(58:03) Societies with Longer, Healthier Lives
(59:41) Effective Methods for Losing Belly Fat
(01:02:16) The Truth About Ozempic
(01:03:43) Medications for Muscle Growth
(01:05:03) Does Ozempic Cause Muscle Loss?
(01:06:21) Who Uses Ozempic?
(01:07:40) Costs of Hormone Replacement and Ozempic
(01:09:57) Do Diets Really Work?
(01:12:55) Is Gaining Muscle Difficult?
(01:13:40) Why Some Struggle to Gain Muscle
(01:14:43) Signs of Low Testosterone Levels
(01:15:15) How to Naturally Boost Testosterone
(01:16:59) Gabrielle’s Fitness Routine
(01:21:03) Everyday Tips for Building Muscle
(01:23:13) What Is a Realistic Fitness Goal?
(01:24:40) Gabrielle’s Current Challenges
(01:25:18) Are People Just Making Excuses?
(01:29:38) What Would Life Look Like Following Gabrielle’s Advice?
(01:34:24) The Connection Between Muscle and Fertility
(01:37:04) The Oldest Healthy Person Gabrielle Has Encountered
(01:37:51) What Have We Missed Discussing?
(01:39:29) Key Insights from Gabrielle’s Book
(01:41:59) Surprising Links Between Muscle and Brain Chemistry
(01:46:25) What Will Success Look Like in 30 Years?
(01:47:13) How Relationships Affect Your Health
(01:47:36) Final Question from the Guest
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Transcript 18,373 words · 4 speakers
Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.
0:00 Speaker 00 To this day, everybody focuses on obesity. But obesity is not our problem. If you are in the lower one-third of strength, you have a 50% greater risk of dying from nearly anything. You have to prioritize skeletal muscle. What is that? This is the organ of longevity, the only organ system that you have voluntary control of. And there's only two ways to stimulate skeletal muscle. Number one...
0:19 Speaker 01 Dr. Gabrielle Lyon is a pioneer of muscle science and the board-certified physician for athletes, CEOs, and Navy SEALs.
0:26 Speaker 02 Transforming the way we think about muscle and how it can prevent disease, optimize your body, and completely reshape how we age.
0:32 Speaker 00 When it comes down to your health, it shouldn't be about how you look. It should be about how you perform. And there's no replacement for resistance training and skeletal muscle mass. But only 6% to 8% of people are meeting the resistance training guidelines. The majority of individuals are sedentary.
0:48 Steven Bartlett? Can you describe to me what my life will look like as a 61-year-old if I just sit in this chair and do zero resistance training for the next 30 years?
0:55 Speaker 00 Are you ready? You're 30. So right now, Alzheimer's disease and cardiovascular disease is likely to begin. Throughout your lifespan, your testosterone is probably low and your sperm quality isn't as good as it could have been.
1:05 Steven Bartlett? So there's a link between my fertility for men and women and my muscle mass?
1:08 Speaker 00 Yes. And then you're probably going to be extremely winded walking upstairs, likely have obesity and sleep apnea, which means you're deteriorating your brain and metabolic health. And it's all going to come down to choices. Our present choices will determine our outcomes.
1:22 Steven Bartlett? So run me through your day, because I'm just going to copy whatever you do.
1:24 Speaker 00 Great.
1:25 Steven Bartlett? Okay, so what time do you wake up? What do you eat? How long do you train for? Are you calorie counting at this point? And what time is that last meal typically?
1:32 Speaker 00 Well...
1:34 Steven Bartlett? Question. If you could sit at a table with any four guests from the Diary of a CEO, who would you choose? Here's a challenge for the entire Diary of a CEO community. If we hit 10 million subscribers by the end of 2024, you will get to pick four guests for your dream conversation. And you can make it weird or you can make it wonderful. And here is the best part. 3,000 of you that subscribe will be invited to join this conversation live, in person, and for free. Subscribe now and let's make this happen together.
2:11 Steven Bartlett? Dr Gabrielle Lyon, what is it that you do for people?
2:16 Speaker 00 I believe that I take away any physical restrictions. And I certainly feel privileged to take care of people that change the world.
2:25 Steven Bartlett? And when you say physical restrictions, give me some flavor and color as to what that means.
2:30 Speaker 00 You know, when we think about the way in which humans are, sometimes they have low energy or hormonal problems or gastrointestinal problems, you name it. But those things limit their ability to show up in the world. No matter how high performing or how high achieving, the common denominator is their health. And nobody will ever go higher than their own personal health. It is the great equalizer, that and age.
2:59 Steven Bartlett? And who do you do it for? Give me a flavor of the people you've worked with and the walks of life they come from and what they do.
3:05 Speaker 00 Well, I've been a physician for 20 years and there has been a number of patients and kinds from geriatrics. I did my fellowship in geriatrics and aging. And when I finished that, I started a concierge medical practice. And I take care of, right now, many of the guests who have been on this podcast, like Evy Pompourous and a woman named Danica Patrick. I don't know if you know who that is. She's a race car driver, extraordinary. And many tier one operators, like Navy SEALs and CEOs, individuals that are out there that are mavericks, really trying to change the world. And one of the things that happens is individuals have this capacity to push through
3:51 Speaker 00 any way that they are feeling. But the cost of that is very predictable. And in my clinical practice, and part of what I believe that I was put on this earth to do, is to help people who help change the world.
4:05 Steven Bartlett? So when people come to you and your practice, what is it that they typically say? What is it, the most typical thing that they're searching for? And how do they articulate that?
4:14 Speaker 00 That is a wonderful question. And one of the things that they say is they feel like they know they could feel better, that they could have more energy, better sleep, you name it. That they just have this sense that something is still on the table. And we figure it out. We go through, whether it's environmental testing, again, hormones, blood work. A lot of my patients have been deployed overseas. They come back. They've been to Mayo Clinic and all these other places, but they still don't get better. And I think wellness and health is very holistic in the approach. And I am telling you, once that is taken care of,
4:57 Speaker 00 these people are already making such an impact, but then they can go on because they're not encumbered by inflammation or not feeling well, or let's say their body composition is off. Let's say they are someone who's always been a high achiever and high performer. I don't know. They hit midlife and all of a sudden, things have changed. It's my job to help remove any of those physiological restrictions so that they can do what they do best and not worry about the other things.
5:27 Steven Bartlett? Is it complicated, what you propose? Are your solutions complicated or are they simple?
5:34 Speaker 00 Another great question. It really depends on what it is that we're looking at. The most complicated of all of it is actually not the physical. It is definitely the mental. Because you have to understand that I think a physician needs to be very good at being able to recognize patterns and diagnose patterns of disease. But an effective physician is able to recognize patterns of people. Because people are extraordinarily predictable in their nature. I'm going to give you an example. You're looking at me. There's an eyebrow raised. I had, I'll tell you about one patient in particular. And every year, he put on this massive event.
6:19 Speaker 00 This massive event in Vegas, made millions of dollars, did well. And every year, I would wait for the phone call.
6:29 Speaker 00 I'm feeling depressed. I just did so well. I don't know what's wrong with me. I'm off my diet. I don't work out. I, all the litany of things. And what he failed to recognize was as high as he was going was as low as he was gonna fall. And I see that with all my type A individuals. I wouldn't say that there's a particular demographic of patient, whether they're SEALs or CEOs or moms, but it is definitely a mindset. And the individuals that I see, they want the best out of themselves. And at the other side of that, and I'm sure you know many of these high performers, they drive really hard. But they fail to recognize that as high as they go, after a book launch,
7:14 Speaker 00 and maybe you experienced this with your own book. You worked so hard. You launched this book into the world, or maybe your first massively successful episode, which now may be a little bit less because they're all massively successful. But right after that, there is this dip. And you don't go back to baseline. It's not like any other Tuesday. It's a very big high and a very big low. And one has to recognize that nothing will take someone off any kind of health and wellness journey faster than those lows.
7:47 Steven Bartlett? And is that psychology or is that physiology? I, is that my mind and my thoughts? Or is that my biology and what's going on in my head?
7:54 Speaker 00 My perspective is that it's physiology. There is an internal recognition or interpretation of the stress. But from my perspective, there is a physiological response. And from what I can tell and what I believe and what I've seen is this dopamine drive. It's, and of course, this is a simplistic way of talking about it, but there's this drive. And they are so excited. They're amped up. They've Spent a ton of time in preparation, getting ready to do this thing. And they've deployed so much importance on this one thing that when that thing is over, they're constantly grasping for the next thing.
8:36 Speaker 00 And we all talk about burnout as this thing and burnout happens that way. And it's this drive of more. And once you can recalibrate that drive and understand that you have to have a very neutral mindset going into things, then people are able to mitigate and manage their own physiology.
8:59 Speaker 00 The mindset component is probably the most important because I could give you the perfect plan, but if you are unable to execute that, then it doesn't matter.
9:10 Steven Bartlett? There must be so many millions of people that listen to my podcast that have heard all of this advice in terms of how to better themselves, their cognition, their performance in various aspects, and they still haven't put any of it into motion for whatever reason. And you must experience that too in your practice where someone comes to you, you tell them what to do, but the how part is sort of contingent on them having some kind of motivation or discipline or whatever it is.
9:36 Speaker 00 From my perspective, it's worthiness.
9:38 Steven Bartlett? Interesting.
9:39 Speaker 00 It's when it comes down to the fundamentals, it's does this person feel worthy of having the health and wellness that they, yes, that they desire. And if a person doesn't feel worthy of doing it or worthy of having it, they will sabotage themselves. Once I explained this predictable human nature to this patient of mine, the game plan was he was going to be neutral. He didn't go too high, he didn't go too low. And there's very specific strategies that we can talk about, the way in which one maintains neutrality. But at the end of the day, he felt worthy of feeling really good.
10:17 Speaker 00 We covered intermittent reward. We covered not celebrating every win. Conscious, conscious turning it on and turning it off. Very controlled, dynamic expression of what the goal was. Turning it on, turning it off. Right? I see this. My husband is a former Navy SEAL. I see this in this group of individuals all the time. They're able to have controlled intensity. But the other individuals that never seem to get better. So the individuals listening to this, the one thing that they would have to really settle in on is do they feel worthy? And if someone does not address at the core that they feel worthy of executing the information
10:59 Speaker 00 that you and so many others are providing, they will never make the change. Discipline, motivation. Discipline is easy. It's not difficult. There are constructs in our mind that may tell us it's easier to oversleep or not go to the gym. But at the end of the day, discipline can be practiced. It's not hard. Motivation is another thing. But who waits on motivation to execute? Nobody. I mean, you shouldn't because that is a perishable feeling. But understanding that this worthiness has to be addressed before people are going to make any kind of change becomes critical. And typically, it comes back to what they tell themselves on a daily basis, how they
11:44 Speaker 00 interpret their environment. Maybe they experience everything as stressful and don't feel worthy of taking action to get out of that distraction of stress.
11:57 Steven Bartlett? So if I came to you and I exhibited worthy worthlessness, I didn't think I was worth much in my core, and you could start to pick up on it. Maybe I was, I don't know, I was carrying myself in a certain way, my body language, the way I was talking about myself subtly. I was putting myself down. And maybe, maybe there's other things going on. And you go, you know, this guy doesn't think he's worthy. Where would you start with me?
12:19 Speaker 00 Well, first of all, I would let you come to that conclusion.
12:22 Steven Bartlett? Okay.
12:22 Speaker 00 The first thing that I would do is I would say, Stephen, how are you sleeping? Are you really sleeping well? And I would guess, maybe you're not. Maybe you're staying up late. Your mind is always going. You're really thinking about things. I would ask you how you're sleeping. How are you eating? How is your digestion? What are you being exposed to? And then I would give you a handful of tasks. I would tell you, we've got to get your blood work done. We have to do a sleep study. You know, we have to address what's going on gastrointestinally. Are you reacting to certain foods? And maybe you'll get that done, or maybe you won't. But if you came to me and said, I am not feeling the best version of myself, I would say, are you ready to figure out what this is?
13:05 Steven Bartlett? And then I give you lip service and I say, yes, I am, doctor.
13:08 Speaker 00 Yeah, and then we would have to have a real conversation. Because there's this interesting kind of segue. CEOs, and again, a large portion of my population are CEOs, is they will, the predictable course is they're too busy to get it done. It's not a worthiness aspect, but it is they're too busy. But again, health is the great equalizer. There will come a point that is very predictable, that they will call me. Again, many of your guests have called me saying, hey, gee, I'm not feeling well. My stomach is really bothering me. I feel like it's sour, I'm not sleeping well, you name it. And I go, okay, well, did you knock out these five tests that we had to get done? And they might say, no.
13:53 Speaker 00 Six months, they will come to a point where they will have to get it done. Once they get those testing done, now we start seeing the worthiness aspect. Now we have evidence of what needs to change. And those individuals that execute on those change typically will understand the importance of the long game, right? If you want to be as successful as you can, be a maverick and make a mark and do all of your potential, leave all of your potential on the table. The only way that you are going to be able to do that is to liberate your health. You have to. You cannot push past how you are feeling.
14:34 Steven Bartlett? This worthiness thing is really interesting to me. Because I do, I can relate when I think about certain people in my life that have been unable to make the change, despite having all the resources, the time. But it's hard to know if they have the time, because sometimes people use that as an excuse.
14:50 Speaker 00 Well, also, Stephen, if people don't have time for health and wellness, how are they going to have time for sickness? That's so much more time consuming.
15:04 Steven Bartlett? But they just, people don't assume that they're gonna get sick. Getting sick is a surprise.
15:11 Speaker 00 But is it?
15:12 Steven Bartlett? I mean, it is, it appears to be for most people. They just, we all kind of live in, think about how we live and the decisions we make in the short term. It's evident that we don't believe we're gonna either die or get sick.
15:23 Speaker 00 Which is a huge failure of our culture.
15:27 Speaker 00 You know, when I think about longevity and I think about aging and I think about the individuals that fall and break their hip and end up in a hospital bed because they haven't trained or haven't taken care of this, this body, which we only get one, there is a predictable endpoint. It is happening and we spend all this time trying to increase this concept of anti-aging. We are aging, aging is not a disease. How we do it is largely up to us. And if we can condense this future version of ourselves to now and understand not just
16:07 Speaker 00 the physical attributes, but also the mental attributes that will require us to move forward, then people will begin to take action.
16:21 Steven Bartlett? Can you tell when you meet someone if they're going to make the changes that you describe and that you suggest very quickly?
16:28 Speaker 00 Yes.
16:29 Steven Bartlett? And what are the hallmarks of someone?
16:31 Speaker 00 They're like archetypes.
16:32 Steven Bartlett? Okay.
16:33 Speaker 00 You know, there is the CEO archetype, which I'm telling you, they are gonna put it off for good three to six months and eventually they will get it done. And once they get it done, they will stay on top of it. They will get it done because they recognize that their physicality is the common denominator because they are in it to be the best version of themselves. And then there are other people that have gone to 13 other physicians and have lost hope in the system. And those individuals, or maybe they had a physician that said something to them and it really scarred them. Those individuals will be very resistant to execution, but once you earn their trust, they'll get the job done.
17:17 Speaker 00 And then there are individuals that really struggle with worthiness, that part of them wants to evolve, maybe they had an old trauma, maybe they had a physical trauma or something that really...
17:33 Speaker 00 Really shook them.
17:34 Steven Bartlett? And the trauma can be like a little T-trauma or a big T-trauma.
17:37 Speaker 00 Yeah.
17:38 Steven Bartlett? It could be a small thing, their dad left, they.
17:40 Speaker 00 Yeah.
17:41 Steven Bartlett? You know, or it could be something bigger, more horrific.
17:45 Speaker 00 Absolutely. And one of the things that we see is there is this interpretation of stress. And people think stress is all fight or flight. And we should try to de-stress and take a hot bubble bath. But we actually evolved to manage and mitigate stress as humans. We're much stronger than we recognize. And there are additional stress responses that we don't talk about. And we know from work out of Stanford and other individuals' labs that what you believe about an experience is how your physiology will show up about that experience. So for example, there was a hotel caretaker study. So you could call it a maid's study where they looked at two groups of housekeepers.
18:29 Speaker 00 One group, they said, what you're doing is amazing. You are definitely getting physical activity. Here's all the positives. And the other one, the other group, they just went about their day. And, you know, maybe they were told that they should do physical activity or not. But at the end of the, the housekeeper study, those individuals that were told that what they were doing was in part like physical activity showed and that they didn't need to do anymore, but what they were doing was amazing. Those individuals had lower blood pressure. They had better glucose regulation, better insulin. They had lost a little bit of weight. And it was all their interpretation of the environment they were in. We tell people that the world is so stressful
19:13 Speaker 00 and that everything, your internal response is fight or flight. But we have one word to describe a million different things. And we call that stress. I'll give you an example. A pet dies or you have a white sofa and your kids just spilled coffee all over it. Or you break up with a loved one, or there's a death of a spouse. We have one word and we call that stress. That's it. We have one word to define a million different things. We live in an environment where people talk about, "I'm so stressed," and "this is stressful." But that, we don't have any other word in the English language to globally define something.
19:56 Speaker 00 Maybe that word could be "love," but not really, not in the way that we talk about stress. So people think about stress as fight or flight. That severely limits both their physiology and their capacity. The other two stress responses, which are much more enhancing, is tendinafren, which releases oxytocin, which makes people more capable. It makes them more connected. This is the, they are stressed, yet they go to help other people immediately. That's also a stress response. Or the courage response. The courage response, we see that with a lot of military operators. A moment of stress, they're immediately taking action. I'll give you an example. If both myself and my husband
20:39 Speaker 00 were getting ready to jump out of a plane, I would be terrified, and he would be excited to do it. He would be eliciting courage. We're both in the same experience, but he is having one of courage, and I am having one of fight or flight. When we both jump out of the airplane, who do you think is going to be more capable to get up and do the next thing?
21:03 Steven Bartlett? Your husband.
21:04 Speaker 00 That's right. I would still be in this fear response. Probably take me at least a couple hours to recalibrate, if not a day or a week. Whereas he has a response, which is courageous and can be cultivated. His capacity to then not only experience new things, but continue on, will mitigate much of the physiological damage that would happen from these other fight or flight responses. And what I would say to that is, fear is a normal response. But having courage is a choice.
21:47 Steven Bartlett? You must have, you must have met people in your practice that walk in and they've got some kind of trauma which has led to their state of sort of unworthiness. How does one do anything about that when you can't go back and right the wrongs of their past and, you know, I don't know how much you wanna dig into their psychology and become their therapist to try and unpack some of that stuff, but if these things are so deeply hardwired into them in some way, you know, some early childhood trauma that's stopping them feeling worthy, which is stopping them having quote unquote motivation to change, do you just give up on the person?
22:22 Speaker 00 Never.
22:22 Steven Bartlett? What could you do? And can you give me a specific example when that's happened?
22:26 Speaker 00 Well, the first thing that I would tell you is I would turn to a coach. I have an extraordinary coach and his name is Jim Kachalka. He is, he's worked with myself, helped make that book possible as well as other individuals who you know. And that requires someone who is really willing to go in and dissect that. I have to know where physiology ends and psychology begins. I will also say I trained in psychiatry for two years. And the mind was, of course, the most fascinating part for me at first. That's actually what brought me into my work with the military that I do today.
23:10 Speaker 00 I will tell you that if I were to think of a very particular patient, I will, she had a lot of trouble sleeping. And this woman, we later found out, we did everything. We did a sleep test, didn't have sleep apnea, was extremely unsettled, really had hormonal problems, put her on hormone replacement, still really struggled with sleep.
23:40 Speaker 00 Did all of the things that one would need to do, like a dark room. I know you had Andy Galpin on, he does, talks about sleep and has absolute rest and, you know, we looked at her environment, did everything. At the end of the day, it turns out that the reason she wasn't sleeping is because she had been assaulted and she had forgotten.
24:01 Speaker 00 But every time she would go to bed, her heart rate would spike. And it was something that that wasn't my domain. But I knew that she had to really deconstruct that if she was ever going to move forward. Part of it is figuring out where there are weaknesses and vulnerabilities within a person. Because we think about the way that healthcare is set up, right? Is that it's you see a doctor for 15 minutes. Maybe it's a half an hour intake and then you're on to the next. But a real therapeutic relationship is exactly that. It is a real relationship. It is not transactional. If you are a physician, you know, being a physician, it used to be a very honorable thing.
24:44 Speaker 00 And they were on the council for people. It was, you know, they were your right hand. And we have really changed from that. You know, I'm talking about maybe in the 1800s. It was a very honorable privileged position. And I still believe it is that. And so part of moving people from where they are to a level of wholeness requires being a teammate.
25:11 Steven Bartlett? Do you try and motivate people?
25:13 Speaker 00 All the time.
25:14 Steven Bartlett? Do you think that's part of your remit as a physician to motivate them?
25:18 Speaker 00 Part of my job as a physician is seeing what they are capable of. Is seeing what their true potential is.
25:28 Steven Bartlett? And to push them?
25:29 Speaker 00 Yeah.
25:31 Steven Bartlett? Do sometimes people need a bit more pain before they?
25:34 Speaker 00 Yes.
25:35 Steven Bartlett? And I mean, this speaks to what's going on with like motivation and discipline. Because if you need a little bit more fear and a little bit more pain, then it kind of illuminates what this, what's actually going on with people's motivation. You can almost put it into a formula where like the strength of their why is at one side of that equation. And then there's some other factors in the equation. But it seems to start with the strength of their why and pain, more fear, a bad result seems to amplify their why to the point they go, okay, fuck it, I'm going to do something about this now.
26:05 Speaker 00 Yes. And I think that there is a potential to not wait till that happens because it is very predictable. You know, and if someone is listening to this or thinking about it, you don't need to have to wait to get to that point. Because that point of breakdown is going to come. And you might as well get ahead of it. You can only push so far. Your original question is, do I think that part of my job is to motivate people? Yes. Do I think it is also to see their weaknesses and vulnerabilities? Being a physician and taking care of some of the most extraordinary people in the world, you get to see behind the scenes. And the people that are doing extraordinary things,
26:49 Speaker 00 their characteristics are actually not that different. They are oftentimes extremely motivated by service. They are, it's not a self-service, it's an other service. And when you can tap into, say, hey, listen, in order for you to really be able to expand your reach, grow this legacy, change the world, then we have to fall back on the things that you are completely ignoring. And again, vulnerability is hard for people. But exposing that and letting them come to those conclusions, then you see a full evolution of a person.
27:31 Steven Bartlett? You, I mean, how many patients do you think you've seen over the last?
27:34 Speaker 00 Thousands, thousands.
27:36 Steven Bartlett? Why do you do what you do?
27:38 Speaker 00 I find the greatest joy, aside from my kids and my husband and my family, being able to be of service.
27:47 Steven Bartlett? Why?
27:48 Speaker 00 Well, I would say that I'm always, I've always been wired to be this way. I have always been wired to take care of people. And I would say, right now, when I think about my patients like Danica or some of the other entrepreneurs that you've had on, I believe that no one is going to be able to get the job done better than me and is going to care more. And it feels really good to be able to be there for people.
28:20 Steven Bartlett? Are you a happy person?
28:21 Speaker 00 Yes. For the most part, I would say I have a very positive disposition. I do.
28:27 Steven Bartlett? When are the seasons of unhappiness in your life?
28:30 Speaker 00 I think during training was very hard for me. During my fellowship, I saw a lot of death. And that was really hard.
28:41 Speaker 00 Work a lot of hours, see a lot of death.
28:45 Speaker 00 That was hard.
28:46 Steven Bartlett? You still remember that?
28:47 Speaker 00 Oh, yeah.
28:48 Steven Bartlett? Changed you?
28:49 Speaker 00 Yeah. That's why I got into social media. I had just finished my fellowship,
28:57 Speaker 00 2015, and I hadn't been on social media or anything. And I had just been, you know, you go through and you see patient after patient. And, you know, none of them are getting out of the hospital. They're all gonna die there. Can you imagine? So you're seeing thirty, thirty patients a day. This one is on pain meds. You know this one is gonna die. This one is eighteen and she's gonna die. And she's planning her wedding, but she is.
29:29 Steven Bartlett? She's planning her wedding?
29:29 Speaker 00 She was never gonna be able to. She had cystic fibrosis. There was nothing that they could do for her. And she was never gonna have a chance to get married or do anything.
29:40 Steven Bartlett? And she was planning her wedding?
29:41 Speaker 00 She wanted to pretend like she was gonna be able to get married. Pick her dress, do have an experience she was never gonna have. And, um,
29:54 Speaker 00 you know, during that time,
29:58 Speaker 00 I, you know, as I was coming out of fellowship in 2015, I was seeing all this BS on social media. These people talking about, you know, this cleanse and this fake diet and like all of this stuff. And the information was so bad that
30:18 Speaker 00 I felt responsible. That if I had the privilege to have, you know, had a seventeen-year education and have seen all of this stuff and then to not say anything that I knew was going to make a difference or be impactful for people's health and wellness. The end comes. The decisions you make become critical. But where it really becomes critical is in the beginning, the children, and then at the end. And if you start hearing all of this narrative of how we, you know,
30:54 Speaker 00 should reduce our dietary protein and do all these other things and destroy our skeletal muscle based on this input that we're getting, the information was so wrong that I felt a responsibility to say something. And if I didn't, I would be contributing to the same problem. But it was very hard. It was very hard.
31:17 Steven Bartlett? Does that come at a cost, the caring?
31:20 Speaker 00 Yes, yes, it does. Nobody has ever asked me that. Yes, it does. It, um, and this might not be the best trait, but I am willing to be there at midnight, at one o'clock. If someone needs something, I got it. And yes, does that come at a cost to myself? It does. And my family, it does. I am very careful about protecting the time, but, um,
31:55 Speaker 00 yeah, it's.
31:57 Steven Bartlett? Is there an emotional cost to this as well? Because if I, if I was every day I was waking up and I was being involved with other people's problems in such a way, other people's challenges, their sickness, their illness, their, their death, I, I don't know if I'd need some strategies to, to cope with that, like getting invested in somebody and then seeing a bad outcome. And that sort of feeling of like, what could I have done or, you know?
32:22 Speaker 00 Well, luckily, um, my patients are no longer, knock on wood, life or death. We are dealing with things like, um, hey, you live in a toxic mold environment, or you have Lyme. We can move past this. Or, hey, you have COVID and you're in Washington. Let me get some Paxlovid sent to you. Or, um, maybe this person is going through a bad breakup or their thyroid is off. It's light in that way. I mean, sometimes I have to send people to the hospital, but it's no longer caring for end of life. But now it is positive and it is challenging.
33:07 Speaker 00 But again, I've been a physician for 20 years. You build up capacity.
33:13 Steven Bartlett? I was thinking the other day about some of the like mind, because a good idea that infiltrates your mind can change your life.
33:22 Speaker 00 Yeah.
33:22 Steven Bartlett? Because it's kind of like corrective. It like, it's almost like it goes in there like a vaccine and it attacks a mind virus that you had, something that was holding you back, some kind of limiting belief about the nature of life. In your work, what are those kind of mind viruses, those myths that people carry with them that ultimately inhibit their chance of becoming this optimal performer that you want them to be?
33:45 Speaker 00 There's a handful of things. And also, we have to recognize that we're talking about two things, physiology and psychology. From a physiology, from a physical perspective, there is a, one of the things that is extremely detrimental is this comparison. Individuals that compare themselves physically to other people will stay hooked in. That typically is a comparison of youth. As individuals mature in their late 30s, 40s, I do see that dissipate. But if that doesn't dissipate, they will continue to hone in on this physical readiness, and that allows for certainty. So think about this.
34:29 Speaker 00 We all see amazing athletes or people that are incredible, are incredible shape. And your ultimate question is, what are the things that limit, whether it's a mind virus or something limiting to allow somebody to become the best version of themselves, an uninhibited version of themselves, or unencumbered from a physical standpoint? When an individual is solely focused on the physicality, and that can be from a looks perspective, that can be from, you know, my husband always tells me stories about those guys that go into SEAL training. The first guys to wash out, this is what he tells me, were always the great athletes. Because they had trained physically, they were capable of dealing with certainty.
35:16 Speaker 00 You throw a ball, you know how to do that. They hadn't prepared themselves for mental uncertainty or fortitude. And this circles back to this. So the individuals that are fully focused on this external comparison, it's about looking good, it's about being fit, it's about having more plastic surgery, less wrinkles, whatever it is, those individuals are chasing a game that they will never catch. The perspective is wrong. We all get older. We all will, at some point, not be as physically capable as we are now. You're in your, how old are you?
35:53 Steven Bartlett? Thirty-one.
35:54 Speaker 00 Oof, getting up there. You are thirty-one.
35:57 Steven Bartlett? What do you mean getting up there? You mean I'm getting old?
35:59 Speaker 00 No, I cannot talk. But there is this physical capacity that if you were to just say, Gabrielle, let's just focus on the physical, then we know by the time you are fifty, and listen, fifty's not a great number because I have a ton of amazing fit fifty-year-olds. But when you are eighty, if all you did was look at that physicality, by the time you were more mature, you would become, and I don't want to say more depressed, but this, if your world is purely external, there is an inevitable decline in that. And you know what I'm talking about, right?
36:39 Steven Bartlett? Time is against you.
36:40 Speaker 00 It's gonna happen. You know, your skin is going to sag, whatever it is. Hopefully it doesn't. But those individuals that are fully externally focused, those individuals really struggle with aging. And you will not focus on the things that matter. And that is a virus that will happen. You will always be comparing because it will bleed over to everything. How you manage your psychology will be how you manage your physiology.
37:05 Steven Bartlett? So what should I be aiming at? If I'm not gonna be aiming at the physical attributes and the comparison, what kind of measure should I apply to myself to understand if I'm doing a good job?
37:17 Speaker 00 You should focus on physical readiness, but it shouldn't be about how you look.
37:22 Steven Bartlett? Okay.
37:22 Speaker 00 It should be about how you perform. When you think about gaining physical readiness, it should be about the acquisition of skill, the acquisition of strength. I talk a lot about muscle. I believe skeletal muscle is the organ of longevity. You should be focused on becoming physically strong.
37:43 Speaker 00 But the physical performance outcome, how you look, is not the endpoint. The idea that you are training for life, able to, whether it is to run, or to squat, or to bench press, or to get stronger in a meaningful tactical way, you should continue to move that needle.
38:02 Steven Bartlett? A lot of people, though, they, we were talking before we started recording about how people are driven by like short-term incentives. And it's quite insane for someone to focus on a long-term incentive in the face of like a short-term incentive. So if I, if my short-term incentive is for someone in the office to think I'm hot, or, you know, to find a partner, I'm going to be so focused on getting that blow dry. I'm going to want that like facial. And I'm going to, if I've got, you know, an hour free in a day, I'm going to aim at the facial, the blow dry. How can you convince me that that's a bad idea? Versus aiming it at, I don't know, building muscle or becoming physically strong?
38:39 Speaker 00 Time is finite. And we are given time. How we spend our time will determine our outcomes. It will determine where we're going, how globally strong we become, because strength is clearly not physical. There is a level of global strength, which means becoming masterful at something. For example, you're masterful at business, at interviewing, at learning and thinking about people. If you were distracted, and you could totally choose a life of distraction, you could be distracted by the external shiny objects. Perfectly okay. But that outcome, if that becomes regretful,
39:23 Speaker 00 then that becomes devastating. You know, taking care of people at the end of life, you hear a lot of regrets. And it wasn't that they wished they had had another blow dry. And I know what you're saying is that, how do we think about later life if we can't identify in the short term? Or take, in the short term, what makes us happy? Right? We are thinking about, I want this cake, I want this thing, I want to buy this car. Shout out to my husband. No, we are not getting that defender. But the short term is very limited. And we live in very fast-paced society that will tell us to embrace that and to fight for that thing.
40:09 Speaker 00 But it only takes a moment of spending time with the elderly, or the aging, or people that are wiser than us, to look back and say, these are the moments that you can fully develop yourself. And again, from a physical standpoint, should you focus on physical readiness? Absolutely. You are 31. Do you think it's going to be easier at 41?
40:30 Steven Bartlett? I hope so.
40:32 Speaker 00 We got to get you on a good program. I'll call Lain later. But you have to do these things. And you have to bring back into perspective what is important and what is valuable.
40:43 Steven Bartlett? I'm thinking about a particular friend of mine who I was describing there with the blow dry thing. And the like spray tan and the blow dry. They're, you know, approaching 40. They're looking for a partner. They are spending any free time they have on the, on the spray tan and the blow dry. Listen, I'm not judging.
41:02 Speaker 00 No, but it's you see. And there's many people like that.
41:05 Steven Bartlett? And they're spending zero time on physical strength. Don't go to a gym, don't go near it, don't do any exercise. And I'm just wondering, you know, how you make a case to that individual that actually to achieve the goal that they want to achieve, which might be to find a partner, actually, it's the inverse. It's they should be doubling down on the internal versus the sort of surface.
41:24 Speaker 00 The first thing that this person is obviously driven by the external. And you have to recognize that you cannot have a strong physical body if you are mentally weak. Because you will never feel good about what you are doing. You will be distracted. You will live a life of distraction that will then rob you of your future. And the case I would make to your friend is these immediate distractions. And being a good friend would be telling them this or allowing them to come to that understanding.
41:57 Steven Bartlett? When you say you can't have a strong body unless you have a strong mind, how are you defining? And how do you define a strong body?
42:05 Speaker 00 You should be able to be physically capable in whatever it is that you want. Should you be able to do a pull up? Probably. Should you be able to do at least 10 pushups? Yes. Is that number different for everybody? Yes. If I asked you to please run a mile, could you do it and do it well? I think being and having physical sovereignty and being able to be in control of your body and to be strong and not require someone to help you with things. I mean, granted, you probably couldn't lift a car by yourself or a bed.
42:37 Steven Bartlett? Well, I'm.
42:38 Speaker 00 But this. But this becomes extremely important for our aging population and for where we are now. What do I mean by this? We are becoming increasingly weak as a society. The majority of individuals are moving towards obesity. Children are becoming more and more obese. Are they strong? Are they as strong as they could be from a physical perspective? I would say no. And again, you can choose a marker of goals to hit, which I recommend that everyone does, whether it's squat, deadlift, you name it, run. But you have to be able to have accountability for your physicality.
43:23 Steven Bartlett? If you were going to be giving me goals to hit, right? And I don't necessarily mean like 10 reps, whatever, but just the types of goals that I should be aiming at to have a strong body. What are those types of goals? So you mentioned squatting there. You mentioned, you know, maybe being able to pull myself up, being able to run. Are these the kind of goals that you would give to me? So say a 30, 40 year old, what kind of goals would you be aiming at? And are the goals different if I'm 50 and 60?
43:48 Speaker 00 They are. You should, at a minimum, and I'll give you an example. You should at a minimum be training three days a week with weights, doing resistance training. You've had many. You just had my friend, Mike Isretel. I mean, that guy, he is jacked. He could probably lift you with one hand and me with a pinky and he would be going all over the place. You should be training. Your muscles from a strength and or hypertrophy standpoint, three days a week.
44:20 Steven Bartlett? Okay, so is that everyone?
44:22 Speaker 00 Yes.
44:22 Steven Bartlett? Everyone regardless of age?
44:23 Speaker 00 Yes, yes. That part is regardless of age. Three to, listen, could you get it done in two days a week? Which is the recommendation. The current recommendation for activity is 150 minutes of moderate to vigorous activity and two days a week of resistance training. Is that going to be enough to keep you walking around? Yes. Is that going to be enough to evolve your body to manage and mitigate aging? No, it is not. We have to call ourselves to a higher standard. Three to four days a week.
44:57 Steven Bartlett? Four, you've added a day.
44:58 Speaker 00 Okay, well, I was gonna say three. I was going easy on you.
45:01 Steven Bartlett? Okay, so.
45:01 Speaker 00 Three days a week, you should be doing, and I only train. I do resistance training three days a week. I might throw a fourth day in there.
45:07 Steven Bartlett? For anyone that doesn't know what resistance training is.
45:09 Speaker 00 Moving your body or a load against resistance. So it would be, for example, taking a weight and moving that through space, whether it is a squat or a bench press. These are all resistance training, moving against a resistance of some load. It could be body weight. It could be a band. Three days a week, everybody. I mean, I'm okay with two days a week, but in an ideal world, it should be three days a week. My recommendation is you train for muscle hypertrophy.
45:45 Steven Bartlett? Which is?
45:46 Speaker 00 Muscle growth. 10 to 20 sets per muscle group a week.
45:52 Steven Bartlett? And how many muscle groups?
45:54 Speaker 00 So I would say you could do a upper body, lower body split. You could do.
46:02 Steven Bartlett? What's that?
46:03 Speaker 00 A push pull, like a bench press or a back row. So back and chest. You could do full body training, which was, which I think is the best for people. Compound movements like a squat or a deadlift. This is full body. You should be doing some kind of movement.
46:23 Speaker 00 Steven, if someone said, like my dad, before I came on this podcast, he FaceTimed me, he lives in Ecuador, and he was doing resistance bands with bicep curls. I'm okay with that. If you want to do that, and that's how you're going to do your upper body or your arms, fine. So it could be chest, back, you know, glutes, legs.
46:46 Steven Bartlett? Why should I be doing three days a week? What am I going to get out of that? Make the case to me.
46:51 Speaker 00 Number one, you are never going to regret being stronger. Period, end of story. You need to be physically strong. Skeletal muscle is the organ of longevity. It is not just about looking good in a bathing suit. It helps, it's so great. Your friend who is getting her hair blown out and doing all these other things, put her in some training, and listen, she's probably going to be a killer. Skeletal muscle is your primary site for glucose metabolism. Fatty acid metabolism is your glucose sink. If you decide that you want to eat carbohydrates and you care about metabolic health, you have to have skeletal muscle. You're not convinced yet, are you?
47:33 Steven Bartlett? I'm listening.
47:34 Speaker 00 Okay, well, you're kind of like, maybe convinced that you think skeletal muscle is important. But if I told you that this is your body armor, that if you are in the top one-third of strength compared to if you are in the lower one-third of strength, those that are in the lower one-third for strength have a 50% greater risk of dying from nearly anything. If you are in the lower one-third of strength, you have a roughly 50% chance of dying from all-cause mortality.
48:14 Steven Bartlett? But I'm getting old, Dr. Lyon. I'm 58.
48:17 Speaker 00 Yeah.
48:18 Steven Bartlett? When people get old, they put on weight, they lose muscle, we get weaker, we get frailer. This is what? This is just the nature of life. Don't fight life.
48:27 Speaker 00 The first thing that I would say is congratulations, making it to 58. Well done, sir. And then I would say, that is totally not true. That is not what we see in the literature. Anyone, at any time, can get stronger and put on muscle. Anyone at any time can get stronger and put on muscle.
48:45 Steven Bartlett? Do you know what it is, yeah? Part of the reason why I think people don't believe that is because we look at our parents and our parents looked at our parents and our parents, their parents looked at their parents. And our parents are like a case study of what we, what we should expect. They set the expectation. And when a lot of us look up at our, our parents, we see people that are maybe have had a little bit of weight added. Um, maybe our dads have a bit of a pot belly because of all the beer they've been drinking or whatever.
49:10 Speaker 00 Yeah.
49:11 Steven Bartlett? Maybe they walk a little bit slower, they can't run, they're out of breath. So we kind of just assume that that is normal and that's what we should expect of ourselves. And I think I, I did that. I looked at my dad, who, um, he's on a bit of a health journey at the moment, but before he was on that health journey, I did kind of, I think at some, some point in my mind, I conceded, maybe that's just what like genetics do. They just give you a pot belly, they slow you down, you lose your muscle, you get weak.
49:36 Speaker 00 Yeah. That funny thing about humans is when we hear and see things over and over again, we believe them to be true, whether they are or they're not. Humans are funny creatures in that they experience repetition as truth.
49:52 Steven Bartlett? Mm hmm.
49:52 Speaker 00 What do I mean by that? I say, Stephen, this is stressful, this is stressful. Our fight or flight is the only way. And then you go, you know what, Gabrielle? Fight or flight is the only way. That's all I've ever heard. We see our parents age and we believe that that's just the way that it is. But I can show you many individuals that are aging well and strong. Both of my parents are incredibly fit.
50:20 Speaker 00 Is that genetic? Maybe I picked my parents well. But what I will say is that the traditional framework of aging is in part the way that it is because we have divorced the idea of skeletal muscle from health. The bros got it right. You need to be jacked, you need to be tanned. And if you're not jacked and tanned, or if you are, resistance training is only for.
50:51 Speaker 00 The pros. Nothing could be further from the truth. And because of that thought process, we have divorced skeletal muscle health from overall health and wellness and longevity. If I, as a trained geriatrician, were to say, and by the way, I did seven years of nutritional science training as well. If I were to tell you what is the one most important thing to take you through life, do you know what I would say?
51:20 Steven Bartlett? Probably muscle.
51:21 Speaker 00 That's right.
51:24 Speaker 00 Hands down, across the board, the weaker you are, the less muscle mass you have, the greater chances you will die.
51:31 Steven Bartlett? So in terms of cardio, is, do you think muscle mass is more important than cardiovascular exercise as you age?
51:39 Speaker 00 You're putting me in the hot seat, and I would say both, we know, are important. But, again, both are very important.
51:51 Speaker 00 But there is no replacement for resistance training and muscle mass. There is none. You will not get the same stimulus by doing cardiovascular activity. And, you know, you mentioned your parents or your dad. You see, and we see collectively, our aging population shrink, right? They become thinner and scrawnier and more sarcopenic. We see this happen. There is a transition of fiber types. There's different fiber types, and they transition from type 2 fiber types to type 1.
52:29 Steven Bartlett? What is that?
52:30 Speaker 00 Type 2 are the big bulky fibers that you train for hypertrophy, strength and hypertrophy for. There is a transition that happens if you are not constantly fertilizing these muscles through strength and hypertrophy training, through resistance exercise. If an individual is solely focused on cardiovascular activity, this will not maintain in a meaningful way these type 2 or bigger bulky muscle fibers.
53:00 Speaker 00 When you lose skeletal muscle mass, you also see a change in metabolic health. Muscle is the primary site for glucose disposal. It is primary site for fatty acid oxidation. When you lose skeletal muscle, you see an increase in blood sugar, insulin, type 2 diabetes. Skeletal muscle is what allows us to buffer the foods that we eat.
53:31 Steven Bartlett? So if I'm eating lots of sugar and carbs, for example, and I've got lots of muscle, then the sugar and the carbs are going to be basically stored in my muscle. But if I don't have any muscle, then where is it going to go?
53:43 Speaker 00 Exactly. Liver, fat. You are going to become increasingly unhealthy unless you are training.
53:51 Steven Bartlett? So if I have more muscle, does that mean I can eat more carbs and there'd be less of a consequence?
53:56 Speaker 00 Likely, yes. Especially if you are training and you have healthy skeletal muscle. Skeletal muscle can be marbled. You can get an increase in myostatosis, which is fat infiltration in skeletal muscle. In order for skeletal muscle... There is no such thing as a healthy sedentary person. You will look in the literature and you will see people say, oh, healthy sedentary. There is no such thing as a healthy sedentary person. What do I mean by that? There was some wonderful work out of Yale. They looked at 18-year-old college students that were considered lean and healthy, put them in a timeframe of inactivity,
54:41 Speaker 00 and they became insulin resistant. They had skeletal muscle insulin resistance, even though there were no outward signs of obesity or fat. If you are inactive, you will not be turning over your glycogen stores, which is the stored form of carbohydrates. You will begin to build up byproducts. Your skeletal muscle will be increasingly more unhealthy over time. You cannot get out of doing resistance-type exercises. And to be clear, you do not have to be doing a one rep max. You could simply start by body weight resistance training. It could be yoga, it could be bands.
55:24 Speaker 00 But at some point, you will have to stimulate that tissue in a meaningful way to age well.
55:31 Steven Bartlett? How many people are meeting the activity guidelines at the moment? And how many people aren't?
55:38 Speaker 00 Roughly 6% to 8% are meeting the resistance training guidelines.
55:43 Steven Bartlett? 6% to 8%?
55:44 Speaker 00 Yes, sir. Just if you were to look at resistance training guidelines. Now, 50% of Americans don't even work out. Over 70, roughly 75%, do not meet both recommendations. The majority of individuals are sedentary individuals.
56:06 Steven Bartlett? It's interesting because people will then say, "Well, you know, these stats are all bad, but our life expectancy seems to have gone up, you know, year over year." Well, I mean, I think it's had a little bit of a blip recently because of COVID, but it's typically going up into the right our life expectancy. So we must be doing something, right?
56:23 Speaker 00 Is it about life expectancy or is it about quality? Could we keep someone alive on bedrest? Probably. Would one say that that would be a good quality of life? You cannot have a high-quality life without high-quality muscle. More specifically, people care about autonomy.
56:52 Speaker 00 Can you imagine if you couldn't physically get your groceries?
56:57 Speaker 00 You are young. We are young. We take for granted the physical capacity that one has. That is a gift. It is a skill that must be continuously pushed, or the trajectory of aging is exactly what we see.
57:18 Speaker 00 People get to a point where they can no longer lift their suitcase on an airplane overhead. Do you see that?
57:26 Steven Bartlett? Yeah.
57:26 Speaker 00 People struggle to get their bag on the belt to go through security.
57:31 Steven Bartlett? Is that normal?
57:32 Speaker 00 That is not normal.
57:34 Steven Bartlett? How do we know this? Are there other sort of societies where they just age better than us? And they're, you know, they've got 60 year olds that are being able to lift their bags above their head?
57:43 Speaker 00 I mean, I can tell you from my father's community in Ecuador. My dad is 74.
57:52 Speaker 00 If something is a three hour walk or less, he'll walk it. I definitely don't like to go visit him, as you can imagine. It's a lot of walking. They are extremely physically active. They seem to age well. And I think that you will find pockets of individuals who do things that are very physically active throughout their lifespan, which will allow them to maintain a muscle span, which is the time in which they have quality skeletal muscle. I will also say, we control our environment. Everything can be easy for us if we choose.
58:34 Speaker 00 You can take the escalator, you can take the elevator, you can get in the car, you can do all of these things. Inoculating yourself against muscle aging takes effort, but it has to be done.
58:47 Speaker 00 Each time someone has a choice to either do it physically themselves or to take the easy way, each time an individual continues to take the easy way, the predictable decline will continue. It's like putting another coin in the bank, but maybe that bank is being spent on something worthless. That's exactly what happens.
59:12 Steven Bartlett? What are the misconceptions people have about weight loss? You've touched on it a little bit, but if I've come to you and I say, "Listen, Dr. Lyon, I'm going to be honest with you. I just want to lose some of this belly fat. I just want to be lean and I want to be beautiful. Should I get liposuction? What diet should I go on? What would you say to me?"
59:33 Speaker 00 First thing that we have to figure out is your muscle mass. I mean, this is a little complicated because I would, of course, ask them how we got to where we were.
59:42 Steven Bartlett? Right.
59:42 Speaker 00 How did we get here? Are you emotionally eating? Are you, I don't know, not sleeping? Are you drinking too much? What are you doing? What are we up against? What are the actual tactical behaviors that we are up against? And then I would say, "Let's go. We've got to build some muscle. We have to work on some body recomposition. And really, the two ways that we're going to start are the two basic, and that is diet and exercise."
1:00:14 Steven Bartlett? So no liposuction?
1:00:15 Speaker 00 I mean, Stephen, if you wanted to. I do know a great plastic surgeon. But no, unnecessary. And again, this goes back to this hyper fixation on body fat, when the conversation should not be about obesity drugs or body fat. The conversation needs to swing back to not about making people less obese, but to making them have more healthy skeletal muscle.
1:00:43 Steven Bartlett? What's the link, though? So how is having more skeletal muscle gonna the glucose is going to be stored in it? So that means less glucose is going to be stored in my belly fat. My metabolism is going to be better, you said as well.
1:00:55 Speaker 00 Yeah, your your ability to store glucose
1:00:59 Steven Bartlett? Yeah.
1:01:00 Speaker 00 will be from, you know, obviously stored in your liver, but skeletal muscle is the primary site for glucose disposal.
1:01:06 Steven Bartlett? Am I going to be less hungry?
1:01:08 Speaker 00 Now, that is a great question, and there is observational data. And I say this very hesitantly because it hasn't been published yet. But I believe that we are going to begin to see that skeletal muscle has a role in appetite regulation because of receptors on skeletal muscle.
1:01:29 Speaker 00 You will not find anything out there yet. But I do believe that there is observational data from some of my colleagues that are doing research that we will see that there is some appetite connection with skeletal muscle.
1:01:42 Steven Bartlett? Will I burn more calories when I'm working out if I have more muscles?
1:01:46 Speaker 00 You will.
1:01:47 Steven Bartlett? What about Ozempic? Should I should I consider a little bit of Ozempic on top?
1:01:54 Speaker 00 It depends on how long you've been struggling.
1:01:56 Steven Bartlett? Okay.
1:01:57 Speaker 00 I am.
1:01:59 Speaker 00 I do recognize that these are
1:02:03 Speaker 00 very complex issues, whether it's Ozempic or Monjerno, GLP-1s or GIP. These drugs, these drugs are here to stay. I do think they play a role. I know you had Dr. Tina Moore on. I am fully in alignment with much of what she said. There is an absolute role for this. I will also say that why is it that within that conversation of body composition? Why is it that it is so much more socially acceptable to give someone a medication to decrease obesity?
1:02:46 Speaker 00 Yet the idea of giving someone a medication or an anabolic like testosterone or a testosterone derivative would be shocking to people.
1:03:00 Speaker 00 I can administer a drug to make an individual less obese, but there's an incredible amount of stigma. If I wanted to administer a drug to allow someone to have stronger, bigger muscles.
1:03:13 Steven Bartlett? What kind of drugs would you administer to give them stronger, bigger muscles?
1:03:16 Speaker 00 Testosterone would be my first one.
1:03:18 Steven Bartlett? How much testosterone though?
1:03:19 Speaker 00 Depends.
1:03:20 Steven Bartlett? Michael, he was on the podcast previously, he told me that taking testosterone and steroids made him angry and gave him really vicious thoughts, dark thoughts.
1:03:31 Speaker 00 But Michael is a professional bodybuilder. And we know that there is health and wellness and that those that operate at the pinnacle of their sport, that does not mean that those individuals are training in a healthy amount, right? There is a cost of doing business at the peak of anyone's career in anything. And from a physical standpoint, certainly.
1:03:59 Speaker 00 That utilization would be different than someone coming to say, hey, I need to work on my body composition. The big point here is the dichotomy and conversation between the two, it's fully skewed in the way that it is much more acceptable to give a medication to address obesity and much less acceptable to give a medication to address skeletal muscle mass.
1:04:31 Speaker 00 And I personally believe that that conversation needs to shift.
1:04:35 Steven Bartlett? A lot of people say that Ozempic causes muscle loss as well.
1:04:38 Speaker 00 It doesn't.
1:04:38 Steven Bartlett? Really?
1:04:39 Speaker 00 I have not seen a direct mechanism of action that Ozempic affects skeletal muscle in a negative way. In fact, I have seen the contrary. There is evidence to suggest that Ozempic and individuals like these drugs in this class can actually support skeletal muscle health. The reason individuals are losing muscle mass on these drugs are because they are not training and managing their dietary protein. There's only two ways to stimulate skeletal muscle, and that is through resistance training and dietary protein.
1:05:20 Speaker 00 You cannot out-medicate poor behavior.
1:05:24 Steven Bartlett? Oh, but because they're on an appetite suppressant like Ozempic, that means they're probably just not getting their protein.
1:05:31 Speaker 00 We utilize these drugs in my medical practice all the time. We track body composition all the time. It is routine. We track muscle mass. We do not see a decrease in skeletal muscle mass when individuals are dosing protein appropriately and training.
1:05:53 Steven Bartlett? Does Ozempic and that category of drugs rob people of a certain psychological mindset benefit?
1:06:01 Speaker 00 That's a wonderful question. And here is what I would say as a physician who is in practice. Removing physical obstacles are critical. And individuals can spend time obsessing about their body. Just really it can infiltrate their thoughts. It takes away from their capacity to show up in life, to be present because they're worried about their weight. And can you imagine if someone was struggling with that for a decade or two or three? Now we have a new class of drugs that will take away in part a desire to binge eat
1:06:43 Speaker 00 or take away in part a desire to even potentially drink alcohol? What it allows for is physical freedom. Do I think that that comes with a cost of not doing the hard thing and doing those kinds of behaviors?
1:07:04 Speaker 00 It does. It does make things easier.
1:07:08 Speaker 00 However, there is utility in that.
1:07:12 Steven Bartlett? Yeah, because if someone suggested it to me, I'd say the first thing I'd say is, Dr. Lyon, what's the cost? Because nothing's free in life. So and if I don't know what the cost is, that's even more scary. I'd rather be able to balance the trade off. But not many people are giving me many costs with Ozempic at the moment.
1:07:27 Speaker 00 Well, number one, you don't need it, right? You would not be someone who needs Ozempic or Monjerno or Zepbound. You just wouldn't be someone who needs that. But I do actually believe that this in combination with hormone replacement therapy is going to be the way of the future for longevity.
1:07:47 Steven Bartlett? What's the cost?
1:07:49 Speaker 00 I cannot tell you what the cost is, and here's why. Because people will say it slows down gastric emptying. Yes, that's exactly what it is supposed to do. Will that have a meaningful outcome? Not necessarily. These drugs are not new drugs. This class of drug is not a new drug. It has been around for the last 20 years. I know at least for the last 10.
1:08:15 Steven Bartlett? There must be a cost, though.
1:08:16 Speaker 00 The cost is when you go off of this.
1:08:19 Steven Bartlett? Yeah.
1:08:19 Speaker 00 You likely have, and again, this is just my perspective, is once you titrate off, then normal hunger cues should return. And if you do not have appropriate strategies in place, an individual will then begin to struggle, potentially regain the weight.
1:08:35 Steven Bartlett? Have you seen this?
1:08:36 Speaker 00 I haven't. We take people off these medications all the time.
1:08:42 Steven Bartlett? And they don't rebound?
1:08:44 Speaker 00 They do not rebound. They do not rebound.
1:08:49 Speaker 00 But again, we do very intensive lifestyle interventions. We also figure out why people got into the place or the hole where they are starting. Why? Right? You say there's no free lunch, and maybe the no free lunch is you have to address old trauma. Maybe one will really have to explore the way in which they cope. Right? Cannot cope with emotional eat, like they, you cannot do these things. If you want to maintain your body composition as you age, you have to be accountable for these things.
1:09:28 Steven Bartlett? Do diets work? Do you ever put someone on a diet?
1:09:33 Speaker 00 If they're over consuming calories, yeah.
1:09:35 Steven Bartlett? And what does that look like?
1:09:36 Speaker 00 For us, I mean, we've been doing this for a very long time. We, the first thing that we decide is dietary protein, which is unfortunately seems to be the most controversial macronutrient, which, by the way, you looked at me crazy, and you're absolutely right. Why would any macronutrient be controversial? But dietary protein, again, it wasn't like this until the influx of social media.
1:10:01 Speaker 00 And what do I mean by that? Dietary protein, it just seems as if there's always a reason why people are trying to remove it from the diet, which seems somewhat ridiculous and counterintuitive.
1:10:13 Speaker 00 The first thing that we do is we recognize that dietary protein is what the foundation of any solid nutrition plan should be built on. And that is 0.7 to 1 gram per pound ideal body weight. If you eat high nutrient dense foods like animal products, you could probably go to the lower end at 0.7. If you are someone who does not eat any kind of animal product, you're probably going to be closer to 1 gram per pound ideal body weight of whatever that source of protein is. But protein is what is going to maintain hunger. You know, dietary protein does cause an increase in GLP, GLP-1 in the body. And people will talk about that, although it's only meal to meal,
1:10:57 Speaker 00 which is, so you know, you have these GLP-1 agonists, which improve satiation.
1:11:02 Steven Bartlett? So like a ZMPAC is a GLP-1 agonist, which makes you less hungry?
1:11:05 Speaker 00 Yes, dietary protein in part works on that same kind of mechanism, also releases GLP.
1:11:12 Steven Bartlett? Which makes me less hungry?
1:11:13 Speaker 00 Yes.
1:11:13 Steven Bartlett? Okay.
1:11:13 Speaker 00 Improve your, improve your satiation. Dietary protein, we know, can help regulate hunger, can also maintain blood sugar, right? If you have carbohydrates in check, not a very efficient way, but your body can generate glucose from dietary protein.
1:11:30 Steven Bartlett? A lot of people associate protein with like bodybuilders and stuff like that.
1:11:33 Speaker 00 I know, it's such a mistake. It's a mistake. Because as individuals age, they need double the, the minimum recommendation to prevent a deficiency. The current recommendation is 0.8 grams per kilogram, or 0.37 grams per pound. If someone was 115 pounds, their dietary protein recommendation would be 45 grams. That would be the minimum to prevent a deficiency. As individuals age, they require more dietary protein because skeletal muscle becomes what we call anabolically resistant. It means it becomes less efficient at utilizing dietary protein if you were to eat the way you did maybe in your teens and twenties.
1:12:18 Speaker 00 Body at that time is extremely anabolic.
1:12:21 Steven Bartlett? Does that mean?
1:12:22 Speaker 00 You look like you're pretty fit. Have you always been pretty fit?
1:12:24 Steven Bartlett? No. Pretty fit in terms of what, though? I've not always had as as much muscle mass as I have now, but I've always been fit as in playing sports and stuff my whole life.
1:12:35 Speaker 00 And has it been easy to put on muscle?
1:12:37 Steven Bartlett? Generally, I'd say yes. When I was younger, it felt a bit more difficult, but I just think I had had things wrong. I don't think I was consuming enough calories. But as I've as I got to sort of twenty five, twenty six, twenty seven, it became a little bit more straightforward.
1:12:48 Speaker 00 Which is amazing. Your body is highly anabolic. You are now consuming calories, protein. You're able to put on skeletal muscle. That tissue is very anabolic. It's sensitive to the foods that you're eating, to the stimulus you're providing. As you age, that tissue becomes more resistant.
1:13:07 Steven Bartlett? I've got friends that tell me they can't put on muscle easily.
1:13:10 Speaker 00 How old are they?
1:13:11 Steven Bartlett? One of them's twenty seven and the other one, I think, is about twenty nine.
1:13:15 Speaker 00 Okay.
1:13:15 Steven Bartlett? And they're men. And they've told me that no matter what they do, they just can't put muscle on.
1:13:21 Speaker 00 Well, first things that I would do is ask them what they're doing. Are they consuming enough calories? Do they have enough protein?
1:13:27 Steven Bartlett? What did you think they're going wrong when I said that?
1:13:29 Speaker 00 The first, you want me to be honest? The first thing that I thought was I am seeing a huge increase in low testosterone levels in younger individuals.
1:13:40 Steven Bartlett? Interesting.
1:13:41 Speaker 00 And I know it's just me and you and not the millions of people that watch your show. But the medical answer would be they should look at their diet and training and sleep. But what I am seeing clinically is that young, young men have increasingly low levels of testosterone.
1:14:03 Steven Bartlett? And how does that link to them not being able to put on muscle?
1:14:06 Speaker 00 They are less anabolic than they should be.
1:14:11 Steven Bartlett? What does anabolic mean?
1:14:12 Speaker 00 Building. They are less capable of building.
1:14:14 Steven Bartlett? Okay. If I, this is a problematic question. Is there any way to tell if someone has low testosterone just by kind of looking at them?
1:14:24 Speaker 00 Some of my colleagues might disagree with this. I would say you could potentially guess. But do they have less?
1:14:35 Speaker 00 Hair on their legs, do they have less muscle mass? Do they have what would look like potentially more estrogen in a male? You know, you're putting me on the spot here, right?
1:14:46 Steven Bartlett? Yeah, but all those things, I was thinking of my one particular person. I think all those things are true. So maybe it is low testosterone. So my next question becomes, is there a way that they can stimulate their testosterone without having needles stuck into them?
1:14:58 Speaker 00 Absolutely. I mean, the first thing is you have to look at lifestyle. What is their diet? You do need nutrients. If they are not sleeping and they're taking potentially recreational drugs, this can all affect testosterone. It could be, it can affect sleep. It can affect a number of things. The first thing that I would do is, are these guys sleeping? Are they eating well?
1:15:24 Steven Bartlett? Eating well being the protein we talked about?
1:15:26 Speaker 00 Yeah. Are they eating a diet that is fully processed? Are they training? Training in and of itself isn't going to generate testosterone per se, but it would increase the receptors, increase the skeletal muscle receptors, increase those androgen receptors. The other thing that I would say, and this may be a little bit outside the box, but what are they being exposed to? We do a lot of heavy metal testing. We see, we do see a lot of exposures. Those things can affect fertility, whether it's lead or mercury, those kind of things. Absolutely.
1:15:59 Steven Bartlett? And where do these things come from, these heavy metals?
1:16:03 Steven Bartlett? I mean, we're drinking out of a metal cup.
1:16:04 Speaker 00 I know, I know. This is stainless steel. I don't think that this gets into the water. They could certainly get it from aluminum cans. They could get it from eating a lot of seafood. They could have exposures.
1:16:18 Speaker 00 Maybe they're training on weapons, maybe not. Could be getting lead.
1:16:23 Steven Bartlett? You're in great shape.
1:16:24 Speaker 00 Thank you.
1:16:25 Steven Bartlett? What do you eat?
1:16:26 Speaker 00 Diet high in protein and I eat a lot of carbs. I train a lot.
1:16:30 Steven Bartlett? So run me through your day. What time do you wake up?
1:16:34 Speaker 00 Between 5:30 and 6:00. My husband wakes up at 4:00. So.
1:16:40 Steven Bartlett? And then?
1:16:40 Speaker 00 That's a problem.
1:16:41 Steven Bartlett? And then what do you do?
1:16:42 Speaker 00 I get up, see if the kids are asleep or awake. Usually one is in the bed, two is in bed. And then I get ready to go train. Get up, three days a week. I head over to meet my coach. Shout out to Carlos Manna. He's the man. And we hit it hard. And I'm usually five minutes late every single time. Because in the morning, one or both children will decide if they are going to come with me or not. I include my kids in my training.
1:17:12 Steven Bartlett? How old are they?
1:17:13 Speaker 00 Three and five.
1:17:15 Steven Bartlett? Oh, damn. You're getting them training at three and five?
1:17:17 Speaker 00 I am.
1:17:19 Speaker 00 My five-year-old is in jujitsu. They have their own kettlebell sets. Because people and children, they don't care what you say. They care what you do.
1:17:33 Speaker 00 So sometimes they decide to come with me. Sometimes they don't. And I train fasted. Wait, I didn't tell you I caffeinate a lot. A lot. I am drinking coffee now. I may be someone who is tired, drinking water or coffee.
1:17:49 Steven Bartlett? How long do you train for?
1:17:50 Speaker 00 An hour.
1:17:51 Steven Bartlett? And you only do three times a week?
1:17:53 Speaker 00 I do three times a week of lifting.
1:17:56 Steven Bartlett? Okay.
1:17:57 Speaker 00 I try to train as hard as I possibly can. By that second day, I'm tired. It would take a lot for me to do some kind of major lifting. I'm in the middle of rehab the next day. So I'll train Mondays, Wednesdays and Fridays. Tuesdays, Thursdays will be some kind of light cardio. Maybe I'll do 20 minutes. Maybe it'll be intense. Whatever I'm feeling. I'm very active during the day. Sometimes I wear a weighted vest. I take calls walking. I move a lot. My friends joke that I am someone who never sits still. Period. End of story. You can see me now. I'm moving all over the place. I have high energy expenditure. My first meal of the day will either be a shake.
1:18:40 Speaker 00 It might be 30 to 50 grams of a whey protein shake. Typically, I might even have collagen in my coffee. Collagen in coffee doesn't necessarily stimulate muscle, but I use it for hair, skin and nails. It's an incline protein. It has a protein score of zero. I just wanted to clarify. So am I training fasted? Yes, mostly fasted. Might be shot of collagen. 30 to 50 grams at that first meal. I might have some kind of carbohydrate, but usually. I'm running around, gotta get the kids to school or whatever it is. My, my next meal might be some lean beef. I'll definitely have carbs. I'll have either rice or potato and some kind of greens.
1:19:23 Speaker 00 And that will be another, you know, if I were to think about how much protein, I'm a tiny person. I'm maybe a hundred and 10 pounds. I might have a hundred and 20 grams of protein a day.
1:19:34 Speaker 00 And then the last meal is also between 30 and 50 grams of protein and probably close to 50 grams of carbs.
1:19:42 Steven Bartlett? And what, what time is that last meal typically? If you can help it.
1:19:46 Speaker 00 Around seven o'clock. I eat it with the family. Nothing crazy. I'm very consistent.
1:19:53 Speaker 00 I think it's important that one meal or one workout doesn't take you off track.
1:19:58 Speaker 00 I don't really think twice about it. I know what I have to eat. Food is not complicated. It's effective.
1:20:07 Speaker 00 I don't drink alcohol. I don't like the way it tastes. I don't really have a sweet tooth.
1:20:11 Steven Bartlett? Is that the only reason you don't drink alcohol? Because of the taste? Did you, did you drink alcohol before?
1:20:15 Speaker 00 No.
1:20:16 Steven Bartlett? You've never drank alcohol?
1:20:17 Speaker 00 No. Tastes terrible. I'm sure you've had it. It tastes like rubbing, I mean, tastes terrible. Maybe I'm lucky. But also think that, you know, can be toxic for the brain, but I choose not to have it because I do think it tastes terrible.
1:20:33 Steven Bartlett? Every single time you eat, you have an opportunity to improve your health. And that's why I love Zoe, because Zoe helps me to make the smartest food choices for me and my body. And as you guys will know by now, Zoe is a sponsor of this podcast and I'm an investor in the company. And if you haven't tried Zoe, I highly recommend you do because Zoe combines my health data with Zoe's world-class science. And using those two things, Zoe guides me to better health every single time I make a food choice and eat, which means that I have more energy, better sleep, better mood, and I'm less hungry. And the most important thing is Zoe actually works. It's backed by their recent clinical trial, something called the method study, which is the gold standard of scientific research.
1:21:15 Steven Bartlett? I started Zoe just over a year ago now, and I've been able to track my progress week after week. So I can learn how to be even smarter the following week. And if you haven't joined Zoe yet, I'm giving you 10% off when you join Zoe now. Just use the code C E O 10 at checkout. Are there small parts of your protocol that people can implement? You talked there about not sitting. You know, you said weighted vest.
1:21:38 Speaker 00 Yeah.
1:21:39 Steven Bartlett? Are there anything else that we can do that might help us build muscle mass without having to go to the gym?
1:21:44 Speaker 00 Yes.
1:21:45 Steven Bartlett? What are the key things you think about that?
1:21:47 Speaker 00 If you can take a call, walking or rucking, you can load up weight. It is extremely easy to do and you can do it slowly. Whether you start with, you could start with seven pounds. I have a five pound weight vest. I have a seven pound weight vest, 20, and then from there you can load up weight. So you can build up over time. People should be doing that. It is effective and easy. Everyone can do that. People are taking calls. You don't have to do a Zoom call. Why not? Get on the phone, get moving.
1:22:24 Speaker 00 Human body will like to sit, right? As opposed to be forced to move. But you become,
1:22:32 Speaker 00 it's almost like a rote activity. If you are someone who is sedentary, it becomes easier to become sedentary and stay sedentary. It requires friction to change. You can mitigate some of that friction by incorporating movement into your life. For example, walking with a weighted vest, easy. Training with your kids. People will say, I don't have time. I'm so busy. Pick up your kids after school. We, instead of go and play video games, we do a push up challenge or a dance party in our, have you ever heard of Texas Hold'em?
1:23:09 Steven Bartlett? The poker game?
1:23:10 Speaker 00 No, the dance. Have you ever seen this Beyonce made an amazing song called Texas Hold'em?
1:23:16 Steven Bartlett? Yeah, I thought she was talking about poker.
1:23:18 Speaker 00 She might be, but there is a line dance associated with that. There are a million fun ways to do something. We just have become accustomed to doing less. And we'll dance, we'll do whatever, push ups, physical challenges, playing outside, get the Nerf guns, whatever it is. Easy.
1:23:38 Speaker 00 I mean, it couldn't get easier than that.
1:23:40 Steven Bartlett? What do you think a good goal is to have? What kind of goal? Because I was, I'd said this before, but there's a time in my life when my goals were very superficial. And they were anchored to a date. What are the best kind of goals that we should set ourselves as it relates to our health?
1:23:57 Speaker 00 I don't think we should set goals.
1:23:58 Steven Bartlett? No goals?
1:23:58 Speaker 00 I think we should set standards.
1:24:00 Steven Bartlett? OK.
1:24:02 Speaker 00 When you set a goal, you can either reach that goal or not. But if you set a standard, then you will always keep your standard. And that standard will allow you to reach a goal. But the standard won't change. For example, the standard is, you wake up and you set whatever that is. You train every day. For me, I train three days a week, depending on how intense that training was. On Saturday, I might do a fourth day of training. And on Sunday, I forgot to tell you this, we do a group workout. My standard is physical activity has defined moments. And that is my standard, even if I'm traveling. I know exactly what that's going to be before I get to the hotel. That is the standard of physical activity. I don't have to think about a goal.
1:24:47 Speaker 00 I don't have to have a goal of, am I going to hit that or not? Because I know that those are things that I won't fall short of. My standard is my nutrition plan. I have between 110 to 120 grams of protein. I have between 110 to 120 grams of carbs. I know what that looks like. That is my standard. I don't deviate from that.
1:25:08 Steven Bartlett? And what are you struggling with as it relates to your own advice?
1:25:12 Speaker 00 Sleep.
1:25:13 Steven Bartlett? You're struggling with sleep?
1:25:14 Speaker 00 Yeah.
1:25:15 Steven Bartlett? Is that because of the two little kids?
1:25:17 Speaker 00 It is, because I have to make a choice. Am I going to spend time uninterrupted and undivided with them? Or am I going to do work?
1:25:28 Speaker 00 And my choice is I spend time with them. And then when they go to sleep, I work another two to three hours.
1:25:37 Speaker 00 And I should probably do a better job and know that eventually everything is going to get done. But I set standards.
1:25:47 Steven Bartlett? Do you find it difficult? You know, because people always talk about not being able to have everything at once. This is what a lot of women have said to me. They said there was a time where we were sold this dream that you could have everything.
1:25:57 Speaker 00 You can.
1:25:58 Steven Bartlett? You can.
1:25:59 Speaker 00 I think so.
1:26:00 Steven Bartlett? You must see a lot of excuses in people.
1:26:02 Speaker 00 I do, I do. Because it's hard to face the truth.
1:26:07 Steven Bartlett? And what's the truth?
1:26:08 Speaker 00 What is the truth? The truth is, are you doing this? Or are you not doing this? Because of some kind of internal choice. There has to be some truth telling. And sometimes that truth is uncomfortable. You can get the job done. There might be things that you have to sacrifice.
1:26:33 Speaker 00 But the job, the thing that you want, the outcome that you want, the standard that you set, it can be done.
1:26:41 Speaker 00 It can be done. It's, you tell yourself, you can't do it. I mean, I have a three and a five year old. Do you know what kind of chaos ensues at my house?
1:26:53 Speaker 00 You should come over and I guarantee you, you will hold off having any kind of children for at least five years. But, nothing is perfect. It can't ever, everything cannot be curated. Do I still get my training in? Do I still get my nutrition in? Am I anything special? I am not. But my discipline is. I am very disciplined.
1:27:12 Steven Bartlett? Have you always been?
1:27:13 Speaker 00 Yes.
1:27:14 Steven Bartlett? A lot of people aren't, and they haven't ever been.
1:27:17 Speaker 00 It's much more difficult to not be disciplined. The reason I am disciplined is to be able to manage my life.
1:27:25 Steven Bartlett? How do I get your discipline?
1:27:26 Speaker 00 You execute. You don't overthink it. There's nothing to think about. What do you want?
1:27:31 Steven Bartlett? I want to be like you.
1:27:32 Speaker 00 No, what do you want? Where are you falling short?
1:27:35 Steven Bartlett? I want to be like you.
1:27:38 Speaker 00 You would not be nearly as successful if you were undisciplined. You have to be disciplined.
1:27:43 Steven Bartlett? I'm just trying to embody the audience. I'm just trying to, I'm trying to think through all the bullshit that people tell themselves. And we all tell ourselves bullshit in various aspects of our life. If we're not telling ourselves bullshit as it relates to like exercise, it's something else. It's our relationships, it's playing. And we will, and so many people struggle with personal responsibility. Cause if I was to post, if you were to post, or I was to post anything on my story that you just said in the last sort of five minutes.
1:28:05 Speaker 00 They would be very offended.
1:28:06 Steven Bartlett? Yeah, and there'd be, well, not everybody, there's a small group of like.
1:28:09 Speaker 00 So are they gonna edit this out?
1:28:10 Steven Bartlett? No, no, no.
1:28:10 Speaker 00 Oh, no, don't, listen, don't send crazy people after me.
1:28:13 Steven Bartlett? No, we will, but um, it's like the what aboutery gang. And the what aboutery gang, you could say anything and they'll say, yeah, but what about?
1:28:19 Speaker 00 Totally.
1:28:19 Steven Bartlett? Yeah, but what about? And I understand some people have, they have legitimate exceptions to rules.
1:28:24 Speaker 00 The truth is, it is very difficult to do what I do. I run three different businesses. I take care of some of the most incredible humans on the planet.
1:28:35 Speaker 00 I have my own podcast. I'm writing two more books and I don't have full time help. I'm a mom.
1:28:43 Speaker 00 The one thing I don't find is I don't find excuses. I figure out ways to get it done because if it matters, you find ways to get it done. You know, if I were to say, and this is an extreme example, but let's say I said to someone who, I'll just make this up, loved cupcakes. I said, if you eat another cupcake, then something catastrophic is going to happen to your dog. Do you think that they would ever touch another cupcake?
1:29:18 Steven Bartlett? No.
1:29:18 Speaker 00 Not in a second, just like that. So the consequence is just not meaningful enough. When you find a meaningful consequence and you understand the consequence of your actions in that moment, it becomes easy.
1:29:32 Steven Bartlett? And this goes to what we were saying about the discipline and the why part of that equation. You, you referred to it as consequence. Like why does this matter to you is the central part of the equation. And deep in your head somewhere, there's, you're so clear on why this matters.
1:29:45 Speaker 00 Yeah.
1:29:45 Steven Bartlett? Because you've, you've seen the research, you've studied it, you've seen the consequence of.
1:29:49 Speaker 00 I've seen the end result.
1:29:50 Steven Bartlett? Yeah.
1:29:51 Speaker 00 I've seen the end result. At the end of the day, we are all, health and age and death, these things, nobody's getting out of them. Like nobody.
1:30:04 Steven Bartlett? So if I follow your protocols for the next thirty years,
1:30:10 Steven Bartlett? yeah, then I'd be sixty years old, I'd be sixty one years old. Can you describe to me what you think my life will look like as a sixty one year old?
1:30:18 Speaker 00 I can.
1:30:18 Steven Bartlett? Versus if I just sit in this chair and eat processed foods and do zero resistance training for the next thirty years. Can you describe the two different Stevens? We'll call it, we'll call one sedentary Steve and we'll call one Dr. Lion Steve.
1:30:33 Speaker 00 Okay. Let's start with sedentary Steve.
1:30:41 Speaker 00 I will say you're thirty, so right now you're sedentary. Alzheimer's disease is likely beginning. Cardiovascular disease is likely beginning.
1:30:52 Steven Bartlett? Right now at thirty?
1:30:52 Speaker 00 That's right. Remember, these diseases that we believe are diseases of aging are at their core and at their root in part due to the health of skeletal muscle. The only organ system that you have direct voluntary control over. That's it. I cannot say, Stephen, I want your heart to beat at forty five beats per minute. Go.
1:31:23 Speaker 00 I cannot control. You might be able to control your respiration, but you can't physically contract your diaphragm. Go ahead, contract.
1:31:33 Speaker 00 Okay. Maybe. It's a muscle. Skeletal muscle is the only organ system that you have voluntary control over. That's it. Now, if you decide to not hear what I am saying, then if you are someone who has a genetic propensity, maybe you have, I don't know, when you overeat, you get high triglycerides or you choose not to exercise. We will start to deteriorate your brain because contracting skeletal muscle is an endocrine organ. Not only does exercise increase blood flow to your brain.
1:32:17 Speaker 00 I just wrote a narrative review with a colleague of mine, Luisa Nicola, amazing.
1:32:24 Speaker 00 We looked at the influence of resistance training and brain function. I cannot restore your brain, but I'd love to be able to prevent from the connections
1:32:37 Speaker 00 to become weaker and weaker and weaker. So you decide not to exercise. I can do nothing for your brain.
1:32:45 Speaker 00 Eventually, you might forget, I don't know, your neighbor's name, your kid's name, your, um, anything, what you did, any meaningful memory. If we don't address your brain now, then the potential outcome is clear, right? Two thirds of Alzheimer's, the majority of dementia is Alzheimer's dementia, which plays a role in metabolic regulation. Type 3 diabetes is the brain. If your skeletal muscle is unhealthy, you are likely having not only skeletal muscle insulin resistance, but brain insulin resistance. No such thing.
1:33:28 Speaker 00 You cannot be sedentary and be healthy. So that will begin now. The other thing is your cardiovascular activity can't help, can't help you there. Not getting increase in blood flow, you're not moving your cardiovascular health the way that it should, your lung capacity, your cardiovascular capacity. You're probably going to be extremely winded walking upstairs. It might take so much effort for you to get up, you might not even be able to fully stand up and sit down from your chair multiple times. You might struggle with that.
1:34:07 Speaker 00 If I said, Stephen, I need you to go to grab something out of the car for me, you would probably say, oh, man, hey, doc, that's going to take a lot of effort. I, I, I'm not sure, I'm not sure I could even grab that, I don't know, 15 pound grocery bag.
1:34:23 Speaker 00 You likely have central obesity, probably have sleep apnea, which means you're further deteriorating both your brain and your metabolic health. I would just throw in there, you haven't trained your entire life, your testosterone is probably low. And maybe throughout your lifespan, who knows? Maybe you have challenges with fertility because your sperm quality isn't as good as it could have been if you were training and eating well. Are you convinced yet?
1:34:52 Steven Bartlett? So there's a link between my fertility for men and women and my muscle mass?
1:34:56 Speaker 00 There is a link between exercise, training, metabolic health, and definitely fertility. I think we are going to see more and more literature come out on this, muscle mass and fertility. By the time you're 60, you'll definitely have more.
1:35:19 Steven Bartlett? Is there a link between polycystic ovary syndrome and muscle mass? You talk about that, I think, in chapter two of the book.
1:35:24 Speaker 00 I do. There is insulin resistance. When you think about skeletal muscle and insulin resistance, skeletal muscle makes up 40% of your body weight or so, depending. For me, it might be less. For you, it might be more. When skeletal muscle becomes insulin resistant, again, which means insulin is a peptide hormone that is released from the pancreas, you require insulin to move glucose out of the bloodstream into cells. When you exercise, you do not require insulin to move blood glucose out of the bloodstream into skeletal muscle tissue. It can be insulin independent.
1:36:06 Speaker 00 Polycystic ovarian syndrome is multifactorial. There is a component of polycystic ovarian syndrome that is related to skeletal muscle insulin resistance. Once an individual manages their skeletal muscle mass, again, there's a various number of reasons as to why someone would have it. But in part, addressing skeletal muscle mass and skeletal muscle insulin resistance can help resolve polycystic ovarian syndrome in certain cases.
1:36:35 Steven Bartlett? I was reading on the subject of PCOS and fertility. I was reading a study by Earth, which was done at Harvard, that found that men who reported to frequently lift heavy weights and objects at work had a 46% higher sperm concentration and a 44% higher total sperm count compared to those with less physical jobs. So you're telling me if I want to up my sperm count and have a baby?
1:37:00 Speaker 00 And health.
1:37:01 Steven Bartlett? I should start lifting some weights?
1:37:03 Speaker 00 Yes.
1:37:05 Steven Bartlett? I was thinking about the 61 year old guy that listens to Dr. Lyon's Protocols.
1:37:09 Speaker 00 But also, let's say we didn't talk about what would happen if you listened.
1:37:14 Steven Bartlett? Yeah, which is what I'm saying. So the guy that listened, so the 61 year old Steve Bartlett that listens to your protocols.
1:37:19 Speaker 00 Holy cow, the guy's a beast. He's now taken over the world because.
1:37:24 Steven Bartlett? Does he have a six pack?
1:37:26 Speaker 00 Of course he does.
1:37:27 Steven Bartlett? Really, at 61?
1:37:28 Speaker 00 Yes.
1:37:28 Steven Bartlett? Is it possible?
1:37:29 Speaker 00 Yes.
1:37:32 Steven Bartlett? What's the healthiest, oldest person you've ever seen?
1:37:35 Speaker 00 My dad.
1:37:36 Steven Bartlett? Really?
1:37:36 Speaker 00 Oh, my gosh. He's 74. He could put on a little more muscle.
1:37:40 Steven Bartlett? Okay.
1:37:41 Speaker 00 His testosterone is like 800. He's not any hormone replacement.
1:37:46 Speaker 00 He has been following what I've been telling him. Unfortunately for him, because I'm his daughter. He's been listening to this message. I'm just sitting here with you, but we are talking about over 10 years of talking about this, of seeing this with patients and people.
1:38:04 Speaker 00 He has amazing hemoglobin A1C, fasting blood sugar. Cholesterol is in check. I mean, he is strong. He is capable.
1:38:16 Speaker 00 He's 74.
1:38:19 Steven Bartlett? What is the most important thing that we haven't talked about, Dr. Lyon?
1:38:24 Speaker 00 I would say that nobody is getting out of this alive. And it's all going to come down to choices. Choices for how we execute. Our present choices will determine our outcomes. And it is not difficult. It's not complex. You have to prioritize skeletal muscle. This is the organ of longevity. With this physical framework comes mental strength.
1:38:55 Speaker 00 And what's most important about this isn't for us now. Like, this is great, you can do it. But it provides hope and an example for our children. That, them, those people, the little ones, that is who I am truly worried about. Because we have normalized supersizing everything, including ourselves.
1:39:20 Speaker 00 We have more electronics than ever before. We are more disconnected from people. People will say the internet has done a great job at connecting. Face-to-face conversations, connection is huge.
1:39:34 Speaker 00 The most important is our youth and how we raise them and the messages that we give them. Because they are our responsibility. And if we cannot advocate for our own health, whatever those limitations are, whether it's personal or worthy, it is our responsibility to do a much better job so that we not tell them, but we show them the way forward.
1:39:57 Steven Bartlett? And what's the most important subject in your book that we haven't covered? Forever Strong: A New Science-Based Strategy for Aging Well. How to Reboot Your Body to Burn Fat, Fight Heart Disease, Reverse Diabetes, Stay Sharp, Build Muscle, and Boost Energy.
1:40:12 Speaker 00 I mean, we talked about dietary protein. We talked about how that potentially can be controversial for some people.
1:40:22 Speaker 00 We discussed carbohydrates. Carbohydrates are earned through activity. If someone is metabolically unhealthy, they have to understand that potentially starting with 100 grams and titrating up or down depending on their activity level is important.
1:40:36 Steven Bartlett? How quickly do I lose muscle?
1:40:39 Speaker 00 If you were in the ICU, you could lose 2% of your muscle mass in a day.
1:40:44 Steven Bartlett? Ugh, God, what?
1:40:45 Speaker 00 If you are in a highly catabolic state, on bedrest, you will lose muscle rapidly. Depending on your age, within seven days, you could lose, if you're young and healthy, two pounds of skeletal muscle mass.
1:41:03 Steven Bartlett? Because I'm thinking, if I go to the gym today and I did my biceps and I really smashed it, how long before those gains were lost?
1:41:12 Speaker 00 I would give you, you'll lose strength and then mass.
1:41:16 Speaker 00 You will lose it rapidly. Seven days of bedrest, you will lose it.
1:41:22 Speaker 00 But it will return if you've been well-trained.
1:41:26 Steven Bartlett? And it will return faster the second time than it did the first time, right? People talk about muscle memory a lot.
1:41:31 Speaker 00 That is a interesting perspective. Yes, if you are well-trained, will it return? Yes. It also depends on how long you have been untrained for. It also will depend on how highly catabolic you are. For example, if someone had cancer, they're in a highly catabolic state, their body is breaking down. Skeletal muscle mass will improve their survivability. If someone goes on bedrest, you will lose muscle mass and strength extremely rapidly. Now, will you able to re-return insulin sensitivity? Yes. If you decided to just begin basic activities of living and not exercising, you will not
1:42:16 Speaker 00 be able to recover that muscle. Getting out of the hospital, just doing basic things, will not be enough. And now, as you can imagine, that happens to people.
1:42:27 Steven Bartlett? I can imagine, yeah. And I go through periods in my life where, for whatever reason, I have to be a bit more sedentary.
1:42:36 Steven Bartlett? Things like filming TV shows. I film the show called Dragon's Den, where we basically sit in a room for 10 hours a day. It's like Shark Tank here. And whenever I go through that season of life, it's very difficult. I always see this correlation between how much activity I've been doing and how much motivation I have. So if I've been sat down and not been exercising for a while, I find it harder to find the motivation to go again, and it's this kind of vicious downward spiral.
1:42:59 Speaker 00 Yeah, one thing that we didn't talk about is how skeletal muscle mass functions as an endocrine organ.
1:43:04 Steven Bartlett? What's an endocrine organ?
1:43:05 Speaker 00 An endocrine organ is something that produces hormones that act systemically, locally, and there's an inter-organ connection. When you exercise based on intensity and duration, you release myokines. Myokines like interleukin-6 or interleukin-15. These are what people typically think is cytokines that are released from inflammatory cells or macrophages. But when you contract skeletal muscle in a meaningful way, based on the intensity and duration, you release myokines from skeletal muscle that interface with your brain. They affect mood, they affect neurogenesis. It also affects your liver and your kidney. There's this interorgan crosstalk. You know, we talked about skeletal muscle,
1:43:49 Speaker 00 about how important it is from a metabolic perspective, as a body armor perspective, but also as this endocrine organ that can affect a mood because of the components that it's releasing. And that is fascinating. It can counterbalance inflammation based on the activity, duration, and intensity.
1:44:11 Steven Bartlett? So that explains why if I've not been moving, I don't feel as good in terms of motivation. And I feel more fatigued when I've done less exercise over a long period of time.
1:44:20 Speaker 00 I mean, yes. And it doesn't take much to maintain what you have. For example, if you could during those days, do you have to be, so you're shooting for 10 hours? You don't have breaks?
1:44:30 Steven Bartlett? We have lunch break.
1:44:32 Speaker 00 You should be training on that lunch break. I don't care how tired you are.
1:44:35 Steven Bartlett? I'm hungry.
1:44:36 Speaker 00 Then you should eat in 10 minutes and get to training.
1:44:41 Steven Bartlett? It's a good point, and you're totally right.
1:44:42 Speaker 00 Pushups, have a weighted vest, do whatever you have to. You will feel exponentially better. And also, this is predictable. So here is an example. You know it's coming, right? You know that you'll be filming this for 10 hours a day.
1:44:57 Steven Bartlett? Yeah.
1:44:57 Speaker 00 What is your strategy to execute in a way that is effective and meaningful?
1:45:02 Steven Bartlett? And that's really it, isn't it? It's about forward planning.
1:45:04 Speaker 00 Yeah. You know it's coming. It's predictable. It's also predictable how you're going to feel afterwards. And then you are going to have to account for how you feel. And then you are going to have to deal with the repercussions of now not being motivated, now having to address your diet, and now probably feeling a little bit more down than you would have. We totally know it's coming.
1:45:23 Steven Bartlett? It's one of the big things I've just realized as you're talking is I don't schedule my workouts. So my workouts are kind of this residual beneficiary, i.e. they get whatever time's left over in the day, which might mean last night it was super late. It was almost at midnight. And then today, I've got a flight after this. So it's a 10-hour flight. So it's like. But I could quite easily, I have the fortune and privilege of being able to ask my assistant to change something. So I can say, while you schedule everything else, also schedule an hour for me to train. But I think everyone could probably do that. I would, I wonder how many people schedule their workouts?
1:45:58 Speaker 00 Everybody who is, you show me your habits and I will tell you how successful you will be able to continue to be in the long run.
1:46:06 Steven Bartlett? You can probably look at someone's calendar and figure out what they're gonna look like in 10 years' time.
1:46:10 Speaker 00 I definitely can. But I will say that there's this privilege of youth and then there becomes a tipping point. Yes, you should be scheduling those things. You can add, let's say you say to me, Gabrielle, I don't have time to do it. You are not, you could schedule three days a week. You know that we're filming all day. You know that you're doing these things. That is a non-negotiable because you're setting a standard. You set a standard for everything in here and everything else you do. Nothing is going to be more critical for your impact than being able to manage your health. Because again, there comes a point in time where it's a very predictable turning point, inflection point.
1:46:53 Steven Bartlett? If we get together again, and I don't know, say it was 30 years from now, and I say to you, how, and you've been successful over the next 30 years, however you define that, what happened?
1:47:05 Speaker 00 We've completely changed the conversation. We are no longer at nauseam talking about obesity. That is a side component. We are focused on physical and mental strength. We are focused on understanding that it is a muscle problem and a problem and a solution that we can do something about. Obesity is an afterthought.
1:47:27 Steven Bartlett? And personally?
1:47:29 Speaker 00 My kids have done amazing and they're happy and adjusted and can withstand whatever, whatever comes their way. And my husband will be picking up his socks.
1:47:40 Steven Bartlett? If he stopped taking care of himself.
1:47:42 Speaker 00 He would never. He's a Navy SEAL. He would never.
1:47:44 Steven Bartlett? No, but just say, play out the scenario.
1:47:45 Speaker 00 Yeah.
1:47:46 Steven Bartlett? Would you say something to him?
1:47:47 Speaker 00 Uh, yes.
1:47:48 Steven Bartlett? What would you say?
1:47:50 Speaker 00 Probably don't want to put it on camera, but it would be something totally inappropriate and somewhat aggressive, but yes, I would say something to him. But ultimately, he has to be an example for our kids. It is his responsibility. It's not about him.
1:48:04 Steven Bartlett? We have a closing tradition on this podcast where the last guest leaves a question for the next, not knowing who they're going to be leaving it for. And the question that's been left for you is, regret can occur due to action taken or action not taken. In light of that, what is your biggest meaningful regret and why?
1:48:28 Speaker 00 My biggest meaningful regret and why?
1:48:33 Speaker 00 I don't know if I have a regret.
1:48:38 Speaker 00 I don't know if I have a regret that I can think of because I think that we are responsible for our choices.
1:48:46 Steven Bartlett? What if I put the word mistake in there?
1:48:50 Speaker 00 I mean, the only thing that I could think of is,
1:48:54 Speaker 00 I, again, this isn't a mistake or I don't even know if I consider this meaningful, is that
1:49:03 Speaker 00 outcomes unfold. And instead of, you know, I was so driven and have been so driven by doing good, you know, thinking like, I have to contribute. I have a responsibility to contribute to the world. I could have put a lot less pressure on myself, but is that, is that meaningful? Is that a meaningful regret or a mistake? I can't say that that's true. Would the outcome have been any different? Would I have worked any less more diligently? I don't know.
1:49:34 Steven Bartlett? Well, it's a good thing you have because you've really led the charge as it relates to muscle and the conversation around muscle and these subjects more broadly. But when I think of someone that is at the very forefront of educating the world on muscle and its importance, and especially as we age, that we can be forever strong, at least strong while we're still alive, then that person is you. And I can't imagine how many millions of people are better for that. I can't imagine. It'd be crazy if you could put them all in like a stadium or something and get to meet them all. That have just had their lives just subtly altered, even if it's just, you know, one decision to go for a walk or to do a little bit more resistance training once a week, that matters, right?
1:50:16 Speaker 00 It does.
1:50:17 Steven Bartlett? And that's a really wonderful thing. And that's, I kind of guess what your, all of your work is really aiming at is to find, understand someone, but then give them the missing piece of information or inspiration so that they can pursue their very best self. And I thank you for doing the work that you do because I'm sure those millions of people can't thank you themselves, but it's, it's really altering not just their lives, but also, as you say, the generations that are set to come after them and their children and so on. And that's one of the things I'm actually thinking much more about having spoken to you is the, I've never thought, because I don't have kids yet, about the role model that I, that I am or aren't to those kids that are watching me. And as you said, I had this little flashback of my mum outside my house when I was like a four or five year old and just watching her run up and down the street over and over again in this tiny little sort of circle that she used to do
1:51:02 Steven Bartlett? and how that stayed with me for forever, that she cared about that. And that, what that meant for us is her children. And it's a really powerful thing. It's a really wonderful thing because, you know, this isn't really about muscle. At the end of the day, this is about much more than muscle.
1:51:17 Speaker 00 It's not, and medicine is the gateway to really be able to provide freedom for people. That's what I want. Muscle is the way in, medicine is the way in. But what I really want for people is I want them to have freedom.
1:51:32 Steven Bartlett? And that freedom is happiness.
1:51:33 Speaker 00 It is, yeah, or whatever it is that they want to do.
1:51:37 Steven Bartlett? Thank you so much. It's such an honour to meet you.
1:51:39 Speaker 00 Thank you for having me.
1:51:48 Steven Bartlett? Isn't this cool? Every single conversation I have here on the Diary of a CEO, at the very end of it, you'll know, I ask the guest to leave a question in the Diary of a CEO. And what we've done is we've turned every single question written in the Diary of a CEO into these Conversation Cards that you can play at home. So you've got every guest we've ever had, their question, and on the back of it, if you scan that QR code, you get to watch the person who answered that question. We're finally revealing all of the questions and the people that answered the question. The brand new version two updated Conversation Cards are out right now at theconversationcards.com.
1:52:33 Steven Bartlett? They sold out twice instantaneously, so if you are interested in getting hold of some limited edition Conversation Cards, I really, really recommend acting quickly.
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