#147 Muscle as the Cornerstone of Longevity | Optimizing Strength for Disease Prevention with Dr. Gabrielle Lyon

Aug 15, 2022 | MOVEMENT, The Gabby Reece Show

Dr. Gabrielle Lyon Landscape

My guest today is the creator of Muscle Centric Medicine, Dr. Gabrielle Lyon. Board certified in family medicine, Dr. Lyon completed a research/clinical fellowship in Nutritional Science and Geriatrics. Dr. Lyon is a woman on a mission, and she wants us to build and keep our skeletal muscle system and make sure to consume enough protein. Gabrielle’s message is clear and direct. As we age, we need to dose our protein to ensure the intake of vital amino acids. She is not asking you to become a bodybuilder and eat hunted meat all day long, but she is asking us to re-think how we are approaching some of our health habits. If you are interested in managing weight, living vitally, and avoiding chronic disease, then Dr. Lyon believes she has some of the answers. Has anyone ever said to you we should treat the Skeletal Muscle system like another important organ? Enjoy

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Muscle as the Cornerstone of Longevity | Optimizing Strength for Disease Prevention with Dr. Gabrielle Lyon

“If we care about heart disease, Alzheimer’s, or insulin resistance, there are multiple facets to it. From my perspective, the target organ is skeletal muscle. You can’t go exercise your liver last time I checked. Gabby, you might be able to exercise your liver but the rest of us normal people can’t go out and exercise our liver.”

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“Muscle is the organ of longevity and understanding that muscle and training skeletal muscle and inputting hard physical activity is a cornerstone for health and wellness. We’ve all heard that but I’m not talking about it as it relates to losing weight. All of these things are critical. The real magic of muscle is understanding that it is the focal point and it is now optional whether we use it or not.”

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“Knowledge or if you have information, then you have a responsibility to share it. I feel passionate about this because I’m seeing what’s happening. I’m seeing that people are trying to do the right thing. We have industry, bias, and narrative, which are pulling people off the path. The reality is if you have ever spent time in a nursing home or you have seen people break a hip and not walk or if you’ve seen people waste away, you have a responsibility to fight for the people in the middle. It’s not going to get easier. If we continue to push this confusion and these narratives, that window of youth closes and there are going to be a lot of regrets that happen. We’re not going to be able to fix that.”

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Welcome to the show. My guest is Dr. Gabrielle Lyon. Dr. Lyon created the Muscle Centric Medicine idea. She’s saying, “We should be treating the skeletal muscle system like another important organ.” She’s able to break down information about the importance of certain amino acids in our diet. A lot of times, when we get into the discussion of vegetarian, vegan, and people eating high quality protein, it’s about what’s in the protein that we need. I’m all for everybody doing it the way that is best for them and supporting them wherever you’re at, whether it’s a belief or a combination of, “I feel better this way.”

Dr. Lyon is clear about us dosing our protein in the healthiest ways to do that. It’s confusing. You’ll hear one thing over here and another thing there. For me, it’s about talking with people that spend a lot of time in these spaces and have opinions that if they ring true or you want to experiment, the hope is that it can support your health. She’s certified in family medicine. She completed her Research Clinical Fellowship in nutrition science and geriatrics. This is a smart, powerhouse woman. I hope you enjoy the conversation.

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Gabrielle Lyon, here we go. It’s a perfect last name. Let’s dive right into Muscle Centric Medicine. I’ll set the table and then I want to get in. You’re the most fun type of person to talk to because there’s so much to learn. Also, I have to try to reel it in because there’s so much that we could talk about. I want to go there. I’ll let you dive into where you had your epiphany.

You have an osteopathic background and you did a lot of geriatric care. You’re coming from a lot of different backgrounds. You were studying a mother of three and it dawned on you about the connection of even muscle amount, health, and weight, and the brain and such. Maybe we can start there and dive deep into the importance of skeletal muscle.

I would love to. I have to say that, in life, we are prepped for certain things depending on our level of training and depending on the influences that we’ve had in our life. I came about medicine reluctantly. I had originally thought I was going to go into nutritional sciences first and foremost as I lay out the story. I then realized that I wanted to be able to do something and have a real impact, not that nutrition alone isn’t but to be able to treat patients.

I was fortunate enough to do my undergraduate in the University of Illinois in Champaign Urbana. I don’t recommend it. No offense to anyone who lives there but the winters are cold and there’s not much to do. I fell under the mentorship of someone named Dr. Donald Layman. To this day, he is one of the world’s leading protein experts. He was doing some of the early studies that are very much in line with what I talked about. He has mentored me and continues to mentor me for over twenty years, which is a long time.

I went into medicine with a foundation of thinking about nutritional scientists and muscle first. What happens along the way is we lose our primary training. In a way, it goes to the wayside, that becomes our foundation, and then we venture into the mundane of learning medicine and doing all those things. I went through medical school. I did traditional medical school. DO and MD, it’s the same. I did two years of psychiatry training, believe it or not, at the University of Louisville. I did three years of family medicine.

I went back and did a postdoc in nutritional sciences, obesity medicine, and geriatrics. This is where everything came together for me and for your readers. I had seen five years of a broken system and that was through residency and training. It’s very high volume. You see a broken system. You then move into an academic fellowship, which is what I did. What that means is we’re looking for answers. We’re thinking about questions, executing on questions, and trying to solve problems that then create protocols for other individuals.

I remember imaging this woman’s brain. It had been an early morning and it was a late evening. We did some fMRI studies of her brain. Her brain looked like an Alzheimer’s brain. It was at that moment that I felt personally responsible. I felt that the medical system had failed her. I felt that I had done nothing to contribute to a way in which this could have been prevented. I realized after getting to know her, speaking to her, seeing her, and doing biopsies on her that she had done the best she could.

[bctt tweet=”What I do believe is that we can make good decisions based on a good, scientific foundation.”]

It wasn’t that she had a lack of effort. There was a lack of knowledge and we had been focusing on the wrong tissue. To this day, all we do is talk about adipose tissue. In reality, she didn’t have an adipose problem. She had a muscle problem. Had we solved that, she probably wouldn’t be in this predicament that, within the next 10 or 15 years, she probably was going to start to have memory issues. Of course, being trained geriatricians, we know what that looks like. We’ve all had older parents. We’ve all known someone. That changed it for me.

I feel like Alzheimer’s or dementia besides cancer is everyone’s greatest fear.

I would agree with you.

This is what I hear a lot and I know you hear this more than I do. It’s hard and confusing out there. From my point of view, I’m like, “All the information is out there, everybody.” We all know what it is over and over. I would like to start at that point. First of all, I’m going to establish this because you’re going to say it again. You’re saying, “We need to treat skeletal muscle like an organ. We ignore it.” You say, “If you’re interested in Alzheimer’s, diabetes, or all these things, we need to be interested in muscle.”

It is critical. It is the pinnacle. It is not the periphery. You’re right, if we care about heart disease, Alzheimer’s, or insulin resistance, there are multiple facets to it. From my perspective, the target organ is skeletal muscle. You can’t go exercise your liver last time I checked. Gabby, you might be able to exercise your liver but the rest of us normal people can’t go out and exercise our liver.

When you say this, I can hear somebody going, “They’re telling me to watch sugar or they’re telling me to try to exercise. They’re telling me to get to bed early. Now, this.” When I hear this, I get excited because I’m like, “This is another way to simplify and get another tool.” Let’s talk about what it means to pay attention to muscle.

For example, you have patients that come to you. I see you and I can tell you have a physical practice. Your husband is a Navy SEAL. There’s a physical language. When people hear the word muscle, they think, “Bang iron.” Maybe we can start there when you talk about muscle and how we serve that organ in the way that you mean.

You bring up a good point. I want to put this on the table that physical activity now is optional. It never used to be optional.

People think of muscle and they immediately get gym rats. You’re saying that we used to have a life or that was built in.

The biggest failure in the medical system is that we have this dichotomy between physicality and fitness. We think about fitness as looking good in a bikini or going for a run and being strong. We have the medical side. True movement is going to come in if we interface the two. Muscle is the organ of longevity. Understanding that muscle and training skeletal muscle and inputting hard physical activity is a cornerstone for health and wellness. We’ve all heard that.

I’m not talking about it as it relates to losing weight. All of these things are critical. Where the real magic of muscle is understanding that it is the focal point and it is now optional whether we use it or not. It’s interesting because we have this concept that people can be healthy and sedentary, “I’m not overweight.” You’re healthy but you’re sedentary. I would say that’s not the case.

The reality is skeletal muscle is an endocrine organ. That means when you contract it, it does a number of things. It interfaces with the immune system, which we all care about. If you have low levels of inflammation, skeletal muscle interfaces, and help regulate your immune system. In essence, skeletal muscle is an immune regulatory organ, number one, which is so cool.

We never hear this.

You’re right. This is the problem. What you hear is to train for athletic performance, train because you want to get better at the row, the jump, or whatever, and then there’s the medical side. The medical side is limited to eating right and exercising. What I’m saying is eat right and exercise, what does that mean? Also, we have to leverage skeletal muscle as the endocrine organ that it is, as the immune interface that it is, and as the metabolic sync, which is pretty common knowledge.

As it relates to metabolic sync, we have to think about the diseases like Alzheimer’s, obesity, and cardiovascular disease. These are diseases in which skeletal muscle plays a central role and yet it’s never tackled first, it’s always after. Obesity is, in my opinion, symptomology of impaired muscle. Insulin resistance is symptomology of impaired muscle. These things are not black and white. There’s a multitude of factors. From my perspective, this is completely missed. I’m sure the readers would agree.

You can get away with some weird stuff when you’re young because of your hormones and some other stuff. Let’s say you’ve got someone in their 20s. Is it making sure you’re getting enough good diet and enough protein? I want to break that down a little bit more and what that means because it means something very different to you than what a lot of people hear and exercise.

In a perfect world, if you had a patient in front of you between their 20s and 30s, you’d say, “What type of training is going to serve you?” Let’s keep it generic. If they’re an athlete, maybe they’ll be a little more of this or that. You’re an athlete. Because you’re a doctor, you have a physical practice, you probably have things that you enjoy doing more than others. When I say athlete, I don’t mean somebody who puts on a jersey and gets paid for it.

I’m also married to a Navy SEAL who’s doing a bazillion push-ups and pull-ups I have to keep up with.

A pull-up is so hard. On the movement side, we’ll get into the protein because that needs some real attention, what’s your loose umbrella?

The first thing is you are in a prime muscle-building time. We can all agree that muscle takes time to mature. An 18-year-old isn’t going to be as well developed as they are after they’ve spent a decade training.

They’ll tell you, “It’s all muscle.”

Dr. Gabrielle Lyon caption 1

Dr. Gabrielle Lyon – I feel motivated to contribute to the world. I have never been good at downtime. As a heart-driven person, that’s my comfort zone.

The reality is those fit and jacked 45-year-old men didn’t start at 40. They started in their 20s and 30s training and building. When individuals are younger, satellite cells and muscle tissue is malleable. It makes sense that the more well-trained you are from a younger age, the better your trajectory of aging. Also, you prime your body from youth to be able to execute to have healthy skeletal muscle. What I say is that training early on is critical. I’ve always trained. Training early on sets the foundation. It’s not just for a year, it’s not just in your 20s, but as we move to the 20s and 30s, these decades of training are what makes the magic.

When we talk about the 20s, 30s, and beyond, forever, training, and training muscle, there are different kinds of muscle. For a lot of people, it’s one way. They say, “I grew up. I always lifted.” It’s a natural language that you speak. A lot of people don’t even know where to start. What does that mean? Do I go in and lift heavy? “I do biceps. I do squats.” How do we direct somebody, like, “This is what it means to build muscle. These are the different muscle.”

Number one, working with a fitness professional, individuals should absolutely invest in that. I will also say that when you’re young, there are a few things to think about. Number one, everything is much more forgiving. You’re much less likely to get injured. Your joints, your hormones, everything is more optimized when you’re young.

I hesitate to say systems but hypertrophy training is not difficult and beneficial for everybody. Hypertrophy training is exactly what it sounds like, putting on more muscle mass. As it relates to mitochondria training or cardiorespiratory training, there’s always a place for that. It’s interesting because right now, it’s almost as if we’re seeing a shift opposite where people are saying, “I don’t do cardio, just training.” That’s probably also not a great idea.

Everybody has a certain aptitude. They like and are good at different things. Whether it’s functional movement or for you, you’re probably very explosive, optimizing for those things and doing what you’re good at is also very valuable. From my perspective, it’s hypertrophy training because it is easy and individuals can do it.

I care about not just muscle mass for muscle mass’ sake but I care about it from the perspective of disease prevention. That’s where I would leave that. Of course, cardiovascular training, yes. The reality is you can pretty much always do cardiovascular training. Does the capacity diminish over time? Yeah. The reality is it’s much more difficult to put on muscle later on in life.

To that point, someone might be reading and going, “In my 20s and 30s, I was on the hedonic treadmill working my ass off trying to get it going and do my career. I either didn’t pick up the baton or I dropped it for a long time.” Once we reinforce some of the nutritional aspects of this in this conversation, there’s still always an opportunity for people. There are many women that were never encouraged to be physical, to sweat. They say things like, “I don’t want to be too big,” all this stuff. They still can get on it.

There is always room for improvement. You pointed out that I have a practice where I see patients. I have a concierge in medical practice. The one thing that all those patients have in common, every single one of them, is they all know where their weaknesses lie. That is different for different people. An example of weakness would be, they’re detrained. My patient population isn’t detrained. For example, if that was their experience, they would leverage that. They would understand that can be changed and they can move forward in a positive manner. You can always get stronger.

It does feel uphill to people but we always try to say, “There’s only one first day.” Those people, more than even some of the sharp-end-of-the-stick people that you work with because you do work in performance with military and Navy SEALs, would benefit by getting a guide. Get a trainer, even if it’s for a month. Learn some of the basics and then go from there. When you are dealing with a high-performance person, and these people are already very physical, in what ways are you tweaking and helping them through this same concept?

One of the things is it depends on the individual. Individuals are very predictable. What makes a good physician is not just the diagnosis of illness but it’s the ability to understand the archetype of the individual. Over a period of years, you begin to see not just a pattern of disease but the pattern of the individual sitting in front of you.

High-performance individuals are also driven in the way that they are disconnected from overstimulation, pushing themselves beyond any kind of feasible limit. Ultimately, protecting them from themselves is important. Protecting them from themselves also augmenting any kinds of issues that maybe if there was head trauma and hormones are now low, there are all kinds of things that you want to balance. Ultimately, it’s being able to protect people from themselves and see a trajectory of where someone is going and put a positive influence on that to prevent the wheels from falling off.

They’re going to keep training at that level. Let’s say you have somebody with some kind of concussion or head trauma, what protocol is part of them protecting themselves? That is more common than we realize. It takes somebody having a mountain biking accident and it’s like, “For this period of time, you need to be doing this.” What sort of things do you do?

Early intervention as soon as possible. There’s hyperbaric oxygen therapy, which is helpful and available. Also, one of the things that people don’t realize is the importance of sleep. While they may realize the importance of sleep, they don’t realize that oftentimes with head trauma, people develop sleep apnea. Being tested at home for sleep apnea is super simple whether it’s a mouthguard to reposition.

A lot of the guys are like, “I’m not wearing this CPAP machine.” If they need it, the time in which the brain cleans itself, the glial cells, and can get rid of waste is when we sleep. We know that individuals who don’t sleep are at increased risk for Alzheimer’s. Another protocol is fish oil, it’s very important. Because of head trauma, if they have hormonal imbalances, that’s important to treat. Those things are important to treat.

Can people have hormonal imbalances from head trauma because then the system goes awry?

Absolutely. Hypothalamus. In fact, they can and do oftentimes. It’s important for people to realize that no matter what your belief system is, there’s no shame in treating something that is not optimized or that an individual needs. A lot of people feel as if they’re going to muscle through it. Perhaps their testosterone has tanked out or a woman’s progesterone or estrogen is totally low or their testosterone. When we are in the space of taking care of people and individuals are in the space of taking care of themselves, there’s nothing wrong with addressing those things.

I get guilty of this. Hopefully, you’re smarter than me on this. I’m happy to encourage everybody else to go get their bloodwork done, take a test, or get their MRI. I will drag my feet and I’ve got stuff to do. Also, secretly between us, I don’t want to know.

That’s when you partner up with a physician who knows exactly that you’re going to do that and then they send someone to your house.

My husband is on me. I want to talk about quickly on this part. I don’t want to say an underserved group but a group that gets their ass kicked in this area is women moving into pre-menopause, menopause, and perimenopause. They think that their sentence is to put that weight on around their belly and that’s the way it is.

[bctt tweet=”The goal is to understand that high quality protein is part of a healthy diet and to continue to reduce it is a big mistake.”]

Many people crash down on them like a wave. Let’s get your blood work done. Let’s check your levels and some of that baseline stuff. What are the things that maybe you’re sharing with them that they’re not hearing from some of their doctors? If you want to use this to slide into, like, “You need to eat more protein.”

There are a few things that happen around perimenopause and menopause. Number one, people stop moving as much. It’s a decrease in spontaneous activity when estrogen decreases. If you see me, I’m like this all the time. Their spontaneous activity decreases. Perhaps they’re more sedentary than they would be. The other thing that happens is individuals, they’re more sedentary, they’re consuming the same amount of calories or even more for whatever reason. Anecdotally, there’s an increase in alcohol consumption oftentimes whether it’s wine.

I started thinking, I’m like, “Either the kids are teenagers, they’ve been in a very long relationship, or the kids are finally out of the house. They’re bored.” Sometimes you get to that place in your life and you’re like, “Was this it? Is this what we did?” I don’t drink alcohol but all those things came to my mind, of course.

Oftentimes, women or men, tend to do that. What’s also important is as hormones decline during this time so does skeletal muscle mass. Skeletal muscle as the metabolic sink, as our metabolic regulator, we see an increase in insulin resistance and elevated levels of glucose. There are all kinds of metabolic issues that can happen as skeletal muscle decreases. It’s at this time that I recommend high-intensity interval training. That intense stimulus is more potent than anything.

People always ask me, “What’s more important? Diet or exercise?” The reality is both are important. Physical training is what moves that metabolic needle for people. They got to train. Also, carbohydrate reduction. It’s about calories. Managing carbohydrates and understanding that carbohydrates are important in a meal threshold amount means that it’s not just a 24-hour carbohydrate intake that’s important. From my perspective, it’s a meal threshold. How many carbohydrates are you having at one meal? You do want to mitigate insulin response. Of course, dietary protein.

I was happy I was getting to visit with you. Kerri Walsh introduced us. I’m like, “Why has protein consumption become a thing? It’s controversial.” Maybe we need a little bit of punk rock, beautiful woman to say, “We need to not be afraid to eat protein.” This is important. It’s packaged and trended. There are always stories about these things. It’s like, “Fat is bad. Protein is bad.”

When I was younger, believe me, we carbo loaded before. Give me a bagel and a bowl of pasta because you have to carbo-load. I’ve heard it all. You talked about a study by Stuart Phillips about the function of protein in the kidney. Let’s talk about your belief about how much protein we need to eat, probably a lot more protein than we are eating. As we get older, we need to increase that.

We’ve argued about carbohydrates, which we’ve gotten wrong. We tried the Food Guide Pyramid and that was a complete disaster. You saw it. They recommended, “Let’s go more grain-based.” From my perspective, that’s a plant-based message and that’s exactly what we did. Everybody became overweight. We’ve had a whole slew of problems since that time.

Saturated fat and cholesterol, we’ve pretty much argued about that since before the ‘70s. The dietary guidelines finally came out in the ‘80s. What’s interesting is from the ‘80s to 2010, nobody even addressed protein, protein wasn’t the primary. Within that 30 years, you mean to tell me that there was no scientific advancement in dietary protein?

I say this because I want to point out that protein has been largely ignored when it comes to changing the recommendations. It’s still 0.8 grams per kilogram, which is the recommended dietary allowance. It’s the minimum to prevent deficiencies based on something called a nitrogen balance study. Last time I checked, we’ve never used nitrogen balance as a health endpoint in the clinic ever. Nobody has, ever.

It sounds important though.

Is it absolute insanity that we haven’t changed these recommendations? I’m writing a book and I was going back through the history of where the divide happened. If we don’t understand the history, we’re going to repeat it. If we don’t understand the history, we’re going to be naive to the cyclical nature of messaging, which is fascinating in nutrition. It’s never just about nutrition. It’s never just about the science. Nutrition is emotional. Nutrition is cultural. It has all these other aspects to it other than just the biology of what we’re dealing with.

Back to the dietary protein part. These guidelines came out in the ‘80s. No one changed or so much addressed protein because everyone’s focused on saturated fat and carbohydrates. In 2010, maybe they’re going to start to address it. The reality is the recommendations that we have are the minimum amount to prevent deficiencies. I want to point something else out. When you’re sick, do you hesitate to take more vitamin C?

Never.

You don’t? The RDA for vitamin C is 60 milligrams. If you were sick, you wouldn’t think, “I’m going to need more protein. My muscles need it. I’m highly catabolic. I have to regenerate my gut lining.” There are all these other stressors that are important. Nobody would look at the RDA for vitamin C and say that’s the maximum. Yet, society looks at protein recommendations at 0.8 grams per kilogram as the maximum. We missed the mark.

If someone’s reading and they want to recalibrate based on body weight from what we’ve been seeing, what would you recommend?

Understanding your 24-hour protein need as this idea of a protein hierarchy is valuable. When I think about protein on the higher end, I think about one gram per pound ideal body weight. I’m 110 pounds. I eat 110 grams of protein, maybe 120 grams of protein.

You’re 110 pounds?

I’m 5’1”. I’m tiny.

You’re compact. We call that compact. When you work with men and if they are more compact, you say that they’re compact. You don’t say that they’re short, by the way.

No wonder why I’ve offended everybody. Now I know. Thank you.

You have to say you’re compact. I’m 6’3”. I weigh 180 pounds. I’m not going around like, “You’re short.” Guys are like, “Thanks a lot.” You got to say you’re compact. It sounds good.

It’s like, “Get it together. It’s okay.”

You say, “You’re organized.” Let’s say I was 200 pounds and my ideal weight is probably less than 180. It’s probably 175 let’s say. You’d say, “Back it down to 175.”

Dr. Gabrielle Lyon caption 2

Dr. Gabrielle Lyon – Muscle is the organ of longevity and understanding that muscle and training skeletal muscle and inputting hard physical activity is a cornerstone for health and wellness.

Yeah. I would also say, “Yes, that would work.” I would have no problems with that. That is on the high end. The reason it is on the high end is, number one, we have to understand that when we eat those essential amino acids, when we hit the need for muscle, everything else falls into place.

Let’s talk about that. If you dig down about the meat, it’s about the amino acids for you.

I would have been done talking about protein if I could but I cannot because I feel that if you have the knowledge or if you have information, then you have a responsibility to share it. I feel passionate about this because I’m seeing what’s happening. I’m seeing that people are trying to do the right thing. We have industry, bias, and narrative, which are pulling people off the path.

The reality is if you have ever spent time in a nursing home or you have seen people break a hip and not walk or if you’ve seen people waste away, you have a responsibility to fight for the people in the middle. It’s not going to get easier. If we continue to push this confusion and these narratives, that window of youth closes and there are going to be a lot of regrets that happen. We’re not going to be able to fix that.

One thing I always wanted to talk about for this show is I don’t think good health, feeling good, or vitality should be an exclusive proposition. It should be, how do we disseminate this in a way that people can go, “I know how to add this into my everyday life.” You talk about increasing your protein intake. Maybe you can explain how some of the sensors in your body can the ability to sense things. Leucine diminish.

You are well prepared for this interview.

If I have time with someone like you, I want to maximize it. Also, I want to understand it for myself. When people understand the why behind things, it’s so much easier to stay consistent with it instead of, “She said I should have more protein.” Yes, because it’s the amino and you should have more as you get older because certain things are not doing their job as easily.

That is an elegant way of explaining something that is called anabolic resistance. This is the efficiency of skeletal muscle as it relates to protein sensing and utilization. I don’t want to throw anybody off but when an individual is well trained like yourself and continues to be well trained, there’s probably a lot more flexibility in that. For the normal human being that is not a professional athlete, which is everybody else, the muscle tissue changes, unfortunately. As all things change like skin changes, nearly everything changes.

Tell me about it.

You look great for 29. When it relates to skeletal muscle, if you eat the way that you did when you were in your 20s, you are not going to optimize that tissue. The reason is that when you’re younger, you can get away with ten grams of protein. You’re highly anabolic, your muscle is stimulated and there’s no issue. As we age, that efficiency goes down. If you are perimenopause or if any of your readers are obese or have any kind of chronic health condition or don’t have the body composition that they would like, collectively, I mean everyone has something that they can improve upon, you have to eat for optimizing muscle.

From my perspective, that first meal and that last meal are the most important. This is the most important thing that I’m going to say other than how cute my kids are throughout this whole interview. When you eat between 30 and 55 grams of dietary protein at one sitting, your body can overcome that anabolic resistance and your tissue acts like a youthful tissue.

For a picture, a chicken breast fillet has how many grams?

For one ounce of a steak, there are 7 grams of protein. If you have a five-ounce filet, that’s 35 grams of protein. That’s not very big. You can have a whey protein shake. If you are plant-based, I only add that in. I don’t necessarily think that that’s maybe optimal from a caloric or carbohydrate load. If they use a rice pea blend, that’s an option. You have to make sure that the leucine content is adequate. We’re looking for 2.5 grams of leucine. 2.5 of leucine in a high-quality protein will be in 30 grams of a high-quality protein like your five ounces of fillet or five ounces of chicken breast.

I’m glad you brought this up. Whey is bioavailable. If you can find a good source, you’ll love that. The tricky part with some of maybe the pea proteins and the soy is hormonal. Also, the incomplete amino profile. We have a food company. I eat high-quality animal protein but those products happened to be vegan. We have protein. Trying to find something with an omega-pure amino acid profile has been interesting. It is possible. Sanchi Ichi, we like it very much. It’s reminding people that these things might be good but there are these little consequences if they’re incomplete or what have you.

That’s why we eat dietary protein. We eat for these essential amino acids. There are nine essential amino acids. By the way, not all nine are equally essential, meaning we don’t need them in equal amounts, which is important. As we age, the essential amino acid leucine, which is in high-quality animal-based proteins, is what differentiates muscle health. From my perspective and my mentor’s perspective, this is key.

Can you do this on a more plant-based diet? You can. I am not in favor of omitting whole food groups. I don’t think that is healthy. I don’t think that’s how we were designed to eat. I have no issue if someone wants to do that. My professional perspective is we have to think of things in their entirety. If it exists in nature and it’s non-processed foods, there’s a lot of value to that.

Food is a matrix. We’re not eating saturated fat by itself. I don’t know about you but I do not have a scoop of saturated fat for breakfast. We don’t eat these things in isolation. We eat them as whole foods and there’s a whole foods matrix. You mentioned whey protein, which has all the essential amino acids and in robust amounts, specifically leucine, one of the branched-chain amino acids, which is what we need.

Do you think it’s impactful to supplement with high-quality amino acids? I know it’s different. There are people who are like, “I can’t get it in,” or they are choosing to eat vegetarian or vegan.

Also, there are a couple of ways. Number one, calories matter. There are a couple of take-home strategies that people can utilize. If you are on a lower-calorie diet, one of the ways in which the guidelines got it wrong is there’s an acceptable macronutrient range. They’ll say protein can be anywhere from 10% to 35% of calories. That’s not very helpful.

If you’re on a 1,400-calorie diet and you want 15% of your calories to come from protein, you’re going to get 52 grams of protein. That’s not enough. From my perspective, one gram per pound ideal body weight is important as it relates to muscle health. It’s not just muscle health but when you reach that threshold of muscle health, protein turnover in the body, and liver turnover, all the other essential amino acids fall into line.

When we think about how we create a nutrition plan that is viable, we have to think about that food matrix and that is about optimizing for dietary protein and reducing calories if someone wanted to reduce calories. Branched-chain amino acids. For example, if someone is like, “I’m going to be on a 1,400-calorie diet,” first of all, they have to prioritize protein first. They should reduce calories from fat and carbohydrates.

[bctt tweet=”The more emotional response you get from someone, the less in control they are.”]

However, if they are eating even a lower calorie diet, having fifteen grams of protein plus a scoop of branched-chain amino acids will then bring up that amino acid threshold up. That is valuable. That is one way in which people can use branched-chain amino acids or if they’re eating more of a plant-based diet, adding in an essential amino acid mix or a branched-chain. It’s not just about the overall protein intake. We have to think about everybody, especially in an aging population. You have to hit that threshold is my personal opinion.

You’re a big proponent of phytonutrients. You’re not going, “Protein is the first best meal of the day.” you emphasize first and last. This is an interesting place for me because a lot of times I will have coffee with fat and then train. Personally, I don’t love to eat a lot of food. When I listen to you, you like to train maybe fasted and then your first best meal is bison.

I might not eat right after I train. I might not eat until 2 or 3 hours. I did a CrossFit workout. I was not hungry. I was like, “I’m good.” I am not interested in eating anything for three hours after I train and that’s fine.

You have your nutrition dialed in a different way. I’m sure you know Dr. Stacy Sims. They talk about high-performance women. Especially as you get older, maybe fasting can be a little bit of a dance where they’re not getting that recovery. I’m saying this in a nuanced way. We’ve gone off the rails a little bit. I’m maybe being selfish here. It’s also like getting in touch with yourself. My stomach is small so there’ll be times after I train when my stomach suggests, “How do you keep that recovery window open a little longer by maybe having a small something?”

The question with the recovery window is probably always there. The next question would be, what are you training for? If you’re someone like me, I’m not training for performance. I want to be lean. I want to be ripped. I want to be fit.

That’s why I want to bring this up. She was talking specifically about high-performance female athletes and how fasting can not maybe serve them well. I appreciate that subtle difference where it’s like, “If you’re doing it right, you’re going to be okay, especially if you’re not training for a marathon or you’re in the WNBA.”

It then becomes, what is your goal? Could it be beneficial to have a meal post-training when blood flow is optimized to skeletal muscle? If you’re older and postmenopausal, yes. There are nuances. Do you have trained muscles? Are you super fit? Do you feel like you’re recovering well? I wouldn’t be stressed out about getting that immediate meal in.

When I think about macronutrients, I think about protein for muscle health and then I think about carbohydrates for glycogen repletion. What is the end goal? If the end goal is performance, do you want to eat post-training? For sure. Those things matter. I can see where Sims would say, as it relates to maybe stress hormones in the body, maybe fasting is not ideal. I can totally agree. There are many reasons why individuals shouldn’t fast. Can it be a stress response if you cannot manage your blood sugar? Yeah. There are counterregulatory hormones that happen. What is the goal for the individual?

I appreciate that. Sometimes people hear something and all of a sudden I’m like, “Why don’t you try to also experiment?” I experiment with things for myself all the time. By the way, at certain times of the month, I feel differently than at other times. It’s also connected to your hormones and how old you are. Is this an athlete who’s competing? Is this a person who’s trying to have vitality and manage their weight? It’s completely different. Can we educate the audience or remind them if they already know about mTOR and how to stimulate cell growth? It feels foundational to all of what you’re talking about.

mTOR, which is mechanistic target of rapamycin, comes under fire for whatever reason. My mentor, one of his big contributions to science is that leucine in a meal threshold stimulates mTOR. That was one of his contributions, which is pretty incredible. mTOR is mechanistic target of rapamycin and it’s in every cell in the body. I’ll lay this out there because I believe that the population can make good scientific decisions. I believe in the people. When we hear about protein and cancer, people are talking about mTOR. I want to put that out there.

It doesn’t mean that that’s real. mTOR, mechanistic target of rapamycin, is a protein kinase and it’s in every cell. There are numerous ways to stimulate it. In skeletal muscle, it is stimulated by exercise, stretching, resistance training, and dietary protein and leucine. It can be stimulated by insulin and carbohydrates but that’s a good thing.

mTOR is necessary for muscle protein synthesis. Its sensitivity is different in different tissues. It’s different in the liver and the pancreas. It’s different in different tissues. mTOR is essential. When I talk about eating for that leucine threshold, I’m talking about eating enough high-quality protein to stimulate mTOR and that’s important. That is the reason why.

We always have to ask ourselves, what is the mechanism of action? If I understand the why, I can make an educated decision. This isn’t what you’re getting at but this is what your readers are going to interface with. They are going to say, “Reduce your dietary protein because it’s not good for you.” I’m going to argue and say, “What mechanism of action?” Leucine stimulates mTOR, specifically in skeletal muscle, which is a good thing.

When we think about cancer, first of all, cancer is a disease of the genome. There are so many different kinds. What are we even talking about? We have to question, what is it that is being said and why is it being said? If we care about mTOR, then we have to care about excess calories, insulin, and obesity. That’s what we have to care about. mTOR stimulates the pancreas and liver by insulin and by excess energy.

mTOR has gotten a bad rep. It’s tempting for us as a society to try to pin one thing as the issue to everything. The way I see it when we talk about mTOR and protein is it’s almost as if we’re pinning it against high-quality animal products because that’s where they tie mTOR and animal-based proteins. That’s a mistake.

Protein is red meat and protein is not responsible for everything that goes wrong in the world or everything that goes wrong with our health. That’s the argument. There’s a guy named David Klurfeld and he has sat on the boards of the IARC committee, which are these cancer committees. He’s talked about how the way in which they’ve pulled the science is extremely biased. That’s worth reading.

I share that I do eat high-quality animal protein. I’m curious about a couple of things. A lot of times, because of the way we do get meat now, they’ve done a doozy. I’ve heard you say bison a lot. I feel like they can mess with that the least or one of the meats that they mess with the lease. What’s cool is that we can also order meat, which is incredible. If you’re in your regular grocery store, would we say that bison could almost be some of the safest as far as how it’s treated, raised, and what have you that’s available?

Dr. Gabrielle Lyon caption 3

Dr. Gabrielle Lyon – People always ask me, which is more important, diet or exercise? In reality, both are important but physical training is what really moves that metabolic needle for people.

What you’re getting at is the practices around conventional-based meats. Number one, there are issues in all industries, no matter what, especially with the food industry. I would rather eat conventionally raised beef than I would eat a bunch of carbs. I would have no issue if I couldn’t get organic. There are issues with everything and we have to risk stratify.

First of all, the majority of even conventionally raised cattle are grass-fed, raised on pasture, and then grain finished. There are issues with all kinds of practices. Personally, if someone is going into the grocery store, I would rather have them choose a nutrient-dense food matrix like red meat then a processed form of protein, hands down.

How do you feel about eggs?

Great. Eggs are incredibly nutrient-dense with high amounts of choline. They’re phenomenal. It’s a great source of protein.

There are a lot of people that gravitate toward fish. Depending on the fish, you hear people getting themselves into a mercury issue or what have you. Overall, does it have a role in this quest?

Absolutely. The goal is to understand that high-quality protein is part of a healthy diet. The message is to continue to reduce it. That is a big mistake. Whether it’s fish, chicken, eggs, whey protein, or dairy, these are all high-quality proteins and they all have a unique place in our diet. I believe that. Fish is great.

Fish has its place.

I personally don’t like fish because I don’t.

I am not a person that needs to get people onto my side about anything. Whatever you want to do, I’m good with it. For organizational sake, if somebody’s like, “I have a belief system. I feel better. I want to be a vegetarian. I want to be a vegan.” What are the things that we want to encourage them to add into their buckets in a clear way so that they can continue to thrive?

Number one is picking higher-quality sources of protein. If they are going to be on a vegan diet, understand that protein is the most important macronutrient. A vegan type diet is typically much higher in carbohydrates and that can have metabolic consequences. Understanding whether they are using soy or supplementing with a shake like a rice-pea blend is all important. We have to get these amino acids. If an individual wanted to use essential amino acids, this would be a good place to use them or branched-chain amino acids.

My vegan patients are very deficient in iron and B vitamins. Getting enough calcium can be an issue. It’s not that you can’t get these vitamins and minerals from plants but can you get them in the same bioavailable amount? You cannot. Also, creatine, which is important for brain health, doesn’t exist in plants. It’s understanding creatine, choline, taurine, and some of these components within a food matrix. Making sure that they’re supplementing well is important.

I like that. I visited with Simon Hill and he’s the most reasonable person. He chooses a practical way. He did say that especially if you have a teenager, you have to be on it while they’re developing so they don’t have these deficiencies. It’s not about the good or bad. This is the information. How do we get ourselves equipped so we can be as healthy as possible?

Simon is reasonable. He does a good job at promoting a plant-based diet that is high in protein. He’s typically who I refer individuals who are plant-based to go listen to. It’s not about division. It is about if people have these beliefs, how do we meet the needs that are ultimately going to move the individual? That’s what’s most valuable.

Most of us, if we’re feeling pretty good, all live closer together. How to navigate our differences, how to even agree to disagree, and how to move through the world, all that becomes easier. I want everyone to be healthier because it makes it easier to be here.

We all have different seasons. Is there room for a period where an individual would go on protein restriction for one week every three months? Yeah. I don’t believe that we have all the answers. What I do believe is that we can make good decisions based on a good scientific foundation that we know. We understand the mechanism. We’ve seen a body of literature that would support certain behaviors over a period of time. People can experiment and decide if they’re going to do a self amino acid restriction or a meat-based diet for a period of time. There are seasons to everything.

That’s reasonable. Let’s talk about you for a second. Is there food that you don’t eat, ever?

There is. I do not eat sushi. I do not eat raw fish. I don’t eat anything raw. With the patient population that I deal with and the frequent amount of travel, I have seen so many and so much weird stuff that I can only be isolated from sushi. I would never eat sushi.

Does Shane eat sushi?

No.

Does he listen to you? Sometimes we always joke in our house, somebody who lives a mile away. Are you always like, “Bla, bla, bla.” He’s like, “What do you know? I’m doing this.”

It’s funny. Shane is a medical student. He was a medic in the SEAL teams. Can you imagine living with a medical student? Does he listen to me? No. He wants to see the evidence. He’ll listen to me after I’ve delivered him 3 or 4 papers.

That’s the foreplay talk, “Show me. I will.” You have two children, a daughter, and a baby son. You’re driven. You’re organized. You’re goal-oriented. You’re getting it done. Not besides the obvious things but what in part of your daily practice has changed in that, “I can’t control this element of my life.” What in you has changed and also maybe surprised you?

I’m extremely driven. I feel very motivated to contribute to the world. I have never been good at downtime. I am very much a heart-driven person. That’s my comfort zone. If you didn’t give me something to do, I would have anxiety. I don’t know what I’m going to do with myself. The thing that surprised me is when I’m with my children, I’m very much with my children.

Do I love changing the diapers when they’re both screaming? No. The interface of teaching and growing a human and being able to see how they can contribute to making the world a better place is amazing. The other thing is I care less about external influences. I have a finite amount of energy. I focus on my work. I have things I want to contribute. I focus on my children and then I focus on the people that are important to me. All the peripheral stuff doesn’t matter. I don’t spend much time thinking about that.

[bctt tweet=”Managing and understanding carbohydrates are important in a meal threshold amount.”]

Once a woman’s had a kid, she becomes different about time. How do you find that real estate to take care of yourself? It won’t be as long. That was the one way I was ruthless, even if it was 15 or 20 minutes. Have you found a way to protect that a little bit?

Yeah. I always train. I don’t do the warm hot bubble baths. It’s not in my scope of experience. I get up and I train. It doesn’t really matter. I get it done. In terms of other things, I would forego a massage to do something with my kids. It’s understanding what fulfills an individual. Movement, for me, is big. I’m not a very sedentary person.

You’re more compact. Were the pregnancies easy?

It was horrible. I had hyperemesis gravidarum for the first one, which means I threw up for ten months straight probably 5 or 6 times a day. I trained throughout all pregnancies and worked. I did kettlebells throughout my whole training. I was into that. I would do a set and I’d throw up. I was very sick. It was not an easy pregnancy, that first one. The second one was a little bit better but I was pretty sick the whole time but not hyperemesis gravidarum. I didn’t throw up.

That’s genetics. It’s a luck of the draw a little bit.

It was terrible. I did have two natural births. I was induced but I still did two natural births. That was intense and awesome.

You forgot long enough to then go and have a second.

I don’t know why people say they forget how bad it hurt. I did not forget. That hurts bad. The whole time, I’m thinking, “I got to do this again.” It’s true, it hurts. That’s okay.

I heard you talk about it and I thought that this was a beautiful point that I wanted to drop into the conversation. When you use carbs more as the medicine part of your nutritional life, I thought that was interesting. You talk a lot about cilantro. Maybe you could also share what chlorogenic acid is.

Chlorogenic acid is something in green tea and green coffee. I use this product called Sunup Green Coffee. I have no financial connection with them. I just love them. It’s an amazing product. There is some literature to suggest that it does help with fat oxidation and it also has a lot of antioxidant capacity. The magic of food is that there are these medicinal components however you want to define medicinal. There are these substances in foods that I don’t even believe we have a whole grasp on understanding like cilantro, herbs, and chlorogenic acid. I drink Sun up in the morning. It’s one of my drinks. They rotate depending on how much caffeine I need.

Gabrielle, when someone looks and listens to someone like you, people think, “It’s easy for her. She’s smart. She started early.” All these things. Is it a constant tweak to calibrate the relationship with yourself, with your partner, with your kids, and with your work? Maybe you could share that. Sometimes people don’t realize that it’s a practice, it’s constantly surveying, like, “How’s everything going?”

It’s not easy for anybody. What differentiates the people that make it look easy from people that are always struggling, and I say this gently, is discipline. It is disciplining your mind, your actions, and your execution. My husband was a Navy SEAL for a decade. He went to war. He taught himself physics and calculus in Afghanistan in between ops. I talked to him and some of the other team guys. They are the 1%. I’ll say, “Is there anything special about you?” They will all say no. He will say it is about the habits that make them what they are. I’m nowhere near that. I’m not a SEAL. I do believe that to be true. It is all about personal discipline.

You see patients. They don’t have this type of discipline. Sometimes people have other types of discipline and not this. They can work themselves to the bone. They can care for their family and put everybody first. They make homemade thank you cards. They can do it. Yeah. How do you encourage them? What’s the invitation to say, “Let’s start to develop this.” What are the steps?

I don’t think that steps are slow. When you identify the attribute of someone having external discipline versus internal discipline, the slower the process of understanding and implementing internal discipline takes away from what needs to happen. At the end of the day, everybody has it within them. Understanding an individual’s weakness and probably asking the hard question, for example, do you feel worthy of having what it is that I am laying in front of you? Do you feel worthy? Oftentimes, it’s a worthiness issue.

Somewhere along the line, almost somebody said to them, “You’re built like that. You’re good at this but you’re not good at that.” It’s an interesting thing how something lands on us and then we accept that and don’t know how to get out of that definition. I have that in my own things. Even within my own physical practice, it’s like, “I’m not flexible.”

Everybody has four different narratives and it could be, “I’m not flexible.” People have narratives.

I’m trying to get rid of old ones and at least keep the new ones in check. When your kids get bigger and you have grown-ups that are younger than some of your kids, you’re like, “Whoa.” With aging, I get asked all the time and it’s not that I don’t think about it, it is what it is. I can’t control that. I’m going to do the best that I can. Even in your own programs, there are ways through living like this where you can at least slow down or even reverse the elements of aging. For you, as a human woman, do you have any secrets about your relationship with time and how you’re moving through it?

This is going to sound a bit morbid but I have seen a lot more death than I’d like to remember. Time is always something on my mind. The time that we have here is finite. It‘s such a bummer. That joke, nobody gets out alive, is true. I think about it a lot. I think about what is this year and how it goes. The only thing that I can lean back on is being grateful for the moments. I know that probably wasn’t what you were asking.

If you worked in geriatrics, is there a part of you inside? I do this, I’ll be honest. I see certain people that are a little bit older than me biologically and I’m like, “I’ll do it this way.” I see other people and I’m like, “I’m not doing it that way.” Fine lines, the skin, it’s going to do what it’s going to do. There’s a part of me wondering based on your experience, especially having seen it, if you are bucking it like, “I’m also going to try my best to construct it and define it for myself a certain way.”

Dr. Gabrielle Lyon caption 4

Dr. Gabrielle Lyon – When we think about how we create a nutrition plan that is viable, we have to think about the food matrix that is about optimizing for dietary protein, and reducing calories.

This goes back to what you said about narratives. We have a lot of self-imposed aging. We don’t even know what it would look like to age in an optimal warrior-esque way, which is valuable and can completely be done. We don’t even know what that is. You’re doing it. I’m doing it. I am oftentimes very inspired by people. Maybe they’re not people in the social media world but you see them out here. I’m in Southern California. We got some savages.

I want to end on that. If you’re younger, in your 20s, 30s, or 40s, if you haven’t done it, get that foundation going. It’s that reminder to don’t bite the hook that they’re selling you like you can or can’t do something because you’re a certain age but you got to do the work. You have to be accountable. Dr. Gabrielle Lyon, please direct everybody. You’re doing a book on top of it all. Do you know when that’s coming out?

That manuscript is due October 1st, 2022.

I want to talk to you in October 2022. Are you allowed to tell us the title?

We are going back and forth on the title. The concept is muscle-centric medicine and changing the way longevity is. It’s different than the current longevity discussions.

One final question because it just came to me. When people buck you or criticize what you’re saying because it’s a very emotional thing, where do you go within yourself to manage that and to be willing to stick to your message? It’s harder and harder for people to be like, “I’m sharing what I’m seeing, feeling, or experiencing.” How do you do that?

The more emotional response you get from someone, the less in control they are. I do have a bit of compassion for that. I’m not going to change everybody’s mind and I don’t need to. What I do have a responsibility to do is share what I know. I am extremely fortunate to have been mentored by some very incredible individuals. Whether people agree with that or disagree with it, okay.

Where do I go? I don’t take it personally. Would they ever say that to my face? Maybe or maybe not. It’s not personal. When I was in training, I didn’t dare to be disrespectful to people. There are other ways to communicate. The ways in which we’re seeing now show the character of people and that character is sad. There are ways to interface with people.

Also, we’re not connecting as much. We’ve got this other world. Remind people of all the places they can find you.

I have a new podcast called very uniquely The Dr. Gabrielle Lyon Show. It’s all about transparent conversations. It’s for the listener to be able to learn and ask questions. It is a labor of love and it’s important work. It’s what I love to do. I am on Instagram, @DrGabrielleLyon. I am taking patient applications. They’ll apply on my website. I have YouTube, Dr. Gabrielle Lyon. I have a great newsletter and a free downloadable protocol.

I appreciate your time. I’m going to put a couple of things in play myself and experiment. Thank you so much.

Thank you for having me.

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Thank you so much for reading this episode.

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About Dr. Gabrielle Lyon

Dr. Gabrielle Lyon headshot

Dr. Lyon received her doctorate in osteopathic medicine from the Arizona College of Osteopathic Medicine and is board-certified in family medicine.
She earned her undergraduate degree in Human Nutrition from the University of Illinois Urbana-Champaign where she studied vitamin and mineral metabolism, chronic disease prevention and management and the physiological effects of diet composition. She also completed a research/clinical fellowship in Nutritional Science and Geriatrics at Washington University in St. Louis.