The Peter Attia Drive - #205 - Energy balance, nutrition, & building muscle

00:00:00.000 Hey, everyone. Welcome to the drive podcast. I'm your host, Peter Atiyah. This podcast,

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00:00:41.720 head over to peteratiyahmd.com forward slash subscribe. Now, without further delay, here's

00:00:48.080 today's episode. I guess this week is Lane Norton. Lane was a previous guest on episode 163 back in

00:00:55.600 May of 2021. In that discussion, we only got through about half of what I wanted to. So it

00:01:00.580 was pretty clear that Lane was going to come back for round two. In this episode, we really dive into

00:01:05.180 two major topics. The first thing that we get into is energy balance and what role macronutrients and

00:01:10.980 calories play in weight loss. This really gets into the energy balance equation and what it means,

00:01:17.220 what it doesn't mean is a calorie, a calorie, and what this means in various contexts around different

00:01:22.160 diets. We also speak about the struggle people have with tracking food and calories on their own

00:01:27.420 across a variety of diets and how all of this can impact someone's nutritional habits and behaviors.

00:01:32.640 The second half of our conversation really looks at the importance of protein and weightlifting

00:01:35.800 through two different case studies. So the first is how Lane would work with a roughly 50-year-old

00:01:41.080 female who wants to improve her health through nutrition and exercise, but was more interested in

00:01:46.080 cardio than lifting weights. The second is a case study looking at a 40 to 50-year-old male who wanted to

00:01:51.880 begin to focus on maximizing muscle mass. Now again, these are both hypotheticals, but I kind of chose

00:01:56.960 them because I think they can be quite illustrative of what many people are going through. We end this

00:02:02.180 conversation by looking at a number of supplements, including whey protein, branch chain amino acids,

00:02:08.440 leucine specifically as one of the branch chain amino acids, creatine, and nitric oxide boosters. Now by

00:02:14.160 way of background, Lane is a bodybuilding figure and physique coach, a natural pro bodybuilder, and a

00:02:19.160 professional power lifter. He received his undergraduate degree in biochemistry and a PhD

00:02:24.320 in nutritional sciences from the University of Illinois. So without further delay, please enjoy

00:02:29.040 my second round conversation with Lane Norton. Hey Lane, good to see you again, man.

00:02:38.940 Yeah, I'm happy to be back. I'm stoked for this. We had the marathon session the first time and I think

00:02:42.860 we got through like a third of the topics that you were interested in. So we'll see how we do this time.

00:02:46.960 Yeah, yeah. Well, and of course, a lot of people had a bunch of follow-up questions. So it's some

00:02:50.600 combination of all the things we didn't get to talk about the first time, plus some new things

00:02:54.500 I thought about. And you and I have had a bunch of emails exchanged over the last few months,

00:02:58.520 coupled with some of that residual stuff. But one of the topics that people really want to hear you

00:03:03.820 and I talk about, because I think there's this belief that we are going to be so orthogonal in our

00:03:09.160 views and we will have not a single thing in common, although I'm pretty sure this isn't going to be the

00:03:13.620 case, is on energy balance and the role of calories in weight gain. So why don't we just

00:03:21.140 lead with the fireworks that everyone is hoping for? So talk to me about energy balance, calories,

00:03:31.500 and weight gain.

00:03:33.480 So I think one of the big misunderstandings is people don't really understand what energy balance

00:03:37.900 truly is. If we look at what most people think it is, is, well, I track my calories in, I track my

00:03:44.340 calories out. Therefore, if I am burning 2,500 calories a day and I'm tracking 2,000 calories a

00:03:51.180 day, I should lose one pound of body weight per week linearly. And that's just how it should go.

00:03:57.120 Perfect math. And when that doesn't happen, they go, well, see, this doesn't work. And there's a lot of

00:04:01.800 different reasons for that. But before we get into that, let's talk about what energy balance actually

00:04:06.560 is. So it is calories in versus calories out or the energy you consume versus the energy you expend.

00:04:12.600 And it's worth talking about real quick before we get into that. What do we mean by energy? A lot of

00:04:18.080 people say, well, it's calories that don't even exist. You can't look at them under a microscope.

00:04:22.820 No, you can't look at them under a microscope. What we're talking about is the energy stored in the

00:04:28.440 chemical bonds of food. And when you break that food down, when those molecules go through metabolism

00:04:34.600 and they go through glycolysis, the Krebs cycle, that energy is liberated, but captured ultimately

00:04:42.060 as mostly ATP, which is our high energy phosphate. But you can't just store a bunch of ATP. It's not

00:04:49.620 practical for the body. And ATP is very unstable molecule. So we evolved to have fat stores or

00:04:57.060 adipose tissue, basically to store excess energy. Now you can store some in glycogen.

00:05:00.680 And I would argue that you really can't store some as protein. Some people will say, well,

00:05:05.140 you can break down lean tissue. To me, that's kind of like saying, let's build a house. So it's a

00:05:11.140 reservoir for wood. I don't really think that that's a...

00:05:13.900 That's a great analogy. I built this amazing teak table such that if I need firewood, I've got it

00:05:21.060 right there.

00:05:21.880 Right. In practicality, are you right? Sure. Yeah, you could, but that's not why you built the table.

00:05:26.760 Yeah, that's the nuclear option. Yeah.

00:05:28.680 Right. For sure. And if you look at the contribution of glycogen to your relative

00:05:33.980 energy stores, it's actually really small. I mean, you're talking about 1,500 to 2,000

00:05:38.720 calories of energy. So your adipose is by far the biggest store. And you store it that way because

00:05:43.640 one, it's economical for space because you can fit a large amount of lipid in a small area.

00:05:48.900 And it's energy dense. And it's relatively easy to convert to ATP.

00:05:52.640 And it's anhydrous. So therefore, it's incredibly well-packed, as you said.

00:05:57.620 Glycogen has to track with all that water. It's not a very efficient way to store energy.

00:06:01.760 Correct. You would be 800 pounds if you were trying to store the same amount of energy as glycogen.

00:06:06.360 There's a lot of really practical reasons why the body evolved that way.

00:06:10.180 Now, when we say calories, calories are literally a measurement of energy. And so this is really

00:06:16.520 important to understand. When people say, well, are all calories created equal? That's like saying

00:06:21.400 are different notches on your speedometer different? No. This is just a unit of measurement.

00:06:27.140 Literally all that is. And you truly have to think of it as energy. So if we think of it as the energy

00:06:34.120 stored in the chemical bonds that can be transferred throughout these various metabolic processes,

00:06:39.040 and that's what metabolism really is, is trying to capture that energy. When we look at what the

00:06:44.520 energy inside of things is, that is essentially the metabolizable energy in food. There's a couple

00:06:51.880 important caveats to that. Notice I said metabolizable energy, because not everything in

00:06:57.600 food is metabolizable, especially with regards to fiber, and specifically insoluble fiber.

00:07:02.900 It used to be thought that insoluble fibers can't digest it at all. It's absolutely zero calories. And

00:07:08.740 I wouldn't say that there's good evidence, but there's starting to be some evidence that suggests

00:07:14.340 that our gut microbiome can actually extract some calories from the insoluble fiber you eat.

00:07:20.420 That's coming from a friend of mine, Suzanne Devkoda, who's one of the premier gut microbiome

00:07:25.980 experts in the world. She actually did her master's at the same lab I was doing my PhD in. Very smart

00:07:31.040 person, has been to like the Nobel ceremony, incredibly well-respected scientist. So there is some

00:07:37.640 evidence of that. And then when you come to soluble fiber, it's pretty variable. It's like anywhere from

00:07:42.760 one to four calories per gram. So anywhere from a normal carbohydrate amount to one calorie. And it

00:07:49.560 also probably depends on your individual gut microbiome. Even before we get to the calories

00:07:54.240 outside of things, we see that there is some variability and probably some individual variability

00:08:00.120 in how many calories one person can consume and then actually have available as energy.

00:08:08.160 Lane, I like that you started with this. I'm just going to add a couple of points so that we can

00:08:11.920 build off this together. So let's even give people the definition of a calorie. And I think we should

00:08:18.100 remind people that when you and I and most people are talking about calories, we're really talking about

00:08:23.260 kilocalories. And some people will get those confused. So big C calorie is equal to a thousand

00:08:30.120 little c calories or a K calorie. But regardless of that nomenclature, I think most people,

00:08:36.240 when they're saying I eat 2000 calories are, of course, referring to kilocalories.

00:08:40.420 One of those, if I'm not mistaken, and you're going to be probably remembering this better than

00:08:45.040 me, Lane, one calorie, I believe, is the energy required to heat one gram of water from 14.5 to 15.5

00:08:55.760 degrees Celsius at one atmosphere. Correct?

00:08:58.700 Bingo. About right. I actually have specifically forgotten the exact definition, but it's basically the

00:09:03.760 Matt to increase the degree of water by one degree Celsius. So again, to your point, it's simply a

00:09:09.060 unit of energy, just as we would think of a joule as a unit of energy. I also want to highlight

00:09:13.640 something you said, which I think is a very important thing for people to understand, which is

00:09:18.100 when we talk about the conservation of energy, that also implies when you change forms of energy.

00:09:25.440 So when you eat food, the energy, as you said, is stored within the bonds. It is chemical energy.

00:09:33.540 We turn that into electrical energy via the electron transport chain, and then we turn it right back

00:09:39.300 into chemical energy, both in the immediate sense of ATP, where you, again, now create the energy and

00:09:45.580 the phosphate bond. But more importantly, as you said, when you're storing it, you're putting it right

00:09:50.340 back into a hydrocarbon. And it's those carbon-carbon-carbon hydrogen bonds that, if my memory serves me

00:09:56.140 correctly, are the most energy-dense bonds within our body, much more than, say, a carbon-oxygen bond would

00:10:01.320 be. And that's why we see fatty acids have much more calories or much more energy per gram compared

00:10:08.800 to carbohydrate, because carbohydrate has more oxygens, whereas fats, through beta-oxidation, where you're

00:10:14.620 having, lopping off two carbons with hydrogens, you can pretty much, I mean, it's not direct, but you can

00:10:19.160 pretty much create acetyl-CoA right from that, which then goes directly into the Krebs cycle,

00:10:23.700 whereas glucose, there's a lot more involved in generating ATP from that. Now, glucose does have

00:10:29.040 benefits in terms of amount of oxygen required to generate the same ATP. It just depends on the

00:10:33.880 metric you're looking at. The final point you make there, Lane, I think is worth restating because

00:10:38.360 it is so important, which is, and this will come up later, I think, when we talk about genetic

00:10:42.660 differences in tolerance to amounts of macronutrients and things like that, but you can really liberate

00:10:47.560 different amounts of energy from the same foods, depending on many things, but presumably based

00:10:54.540 on your gut microbiome. That's probably one of the things that's going to create a pretty sizable

00:11:00.220 delta when it comes to how much food you're capturing. In other words, how much of that chemical energy

00:11:05.600 you're able to recoup and repurpose into electrical energy. There is evidence, for example, that obesity

00:11:11.480 prone people, they have a gut microflora that is better able to extract energy from the foods

00:11:18.140 they eat. Now, that could be reverse causation as well. It could be that obese people eat a diet that

00:11:22.820 causes this kind of gut microflora to bloom, so on and so forth. So we got to be careful about

00:11:27.440 establishing correlation versus causation. And I will say that, because they can actually assess how

00:11:32.820 much energy is lost in fecal matter. It's usually around five to 10%, depending on people,

00:11:38.560 and most of your 95% of your Gaussian distribution falls in there. It is a significant difference,

00:11:44.940 but what I would tell people is be cautious about saying, well, this is why we see huge differences

00:11:49.800 between individuals, maybe for certain individuals, but I think for the vast majority of people,

00:11:55.320 unless you're literally an outlier, probably going to be somewhere relatively close. So I think

00:12:01.380 establishing that, we understand that there is some variability in how much energy you can extract from

00:12:08.220 the food you eat. And I'm going to come back to that as well, because there's another aspect,

00:12:12.500 the tracking portion that we need to talk about as well, that confuses people. Now let's talk about

00:12:17.560 the energy outside of things, because this is way more complicated. So different ways people have

00:12:23.620 broken it down, but essentially you have your BMR, which is your basal metabolic rate. And that's usually

00:12:29.760 about 50 to 70% of the energy people expend per day. The way I tell it is, it's basically the cost of

00:12:35.860 keeping the lights on. And we would determine that if you were putting somebody in a metabolic

00:12:40.140 chamber, I believe that we don't require them to be sleeping, but it's laying there, but being awake,

00:12:46.920 correct? And that's slightly different from your energy expenditure while sleeping.

00:12:50.540 Yep. You have RMR and you have BMR, and there are some subtle differences between the two,

00:12:54.560 but I mean, essentially it's very similar. I've had my RMR assessed, which is basically you go into a lab,

00:13:00.200 you lay down, they make sure you're stable for 20 minutes. You don't talk,

00:13:03.540 you don't listen to music, you don't do anything. You lay there and breathe.

00:13:07.760 RMR and BMR are going to be very similar. I'm going to simplify it for our audience just because

00:13:11.500 it's an already complicated subject. The other way to think about it is if you were in like a coma,

00:13:15.920 per se, where you're awake, having some brain activity, that sort of thing, you're not moving,

00:13:21.320 you're not physically moving. That's still about 50 to 70% of people's total daily energy expenditure.

00:13:27.380 And that's what we've referred to as metabolic rate.

00:13:30.220 And when you had yours measured, Lane, did you have it done using indirect calorimetry?

00:13:34.860 Yes. When I had it done, I'm anywhere between 1900 and 1950 calories per day, pretty consistently.

00:13:40.900 Tell folks how that works. Because I think when most people say, I just had my BMR measured,

00:13:47.020 it's usually not the rigorous way that we're talking about using indirect calorimetry. It's

00:13:51.500 usually relying on heart rate and respiratory rate, which can probably give some approximation,

00:13:55.860 but it's probably important for people to understand that there's an enormous error that's

00:13:59.740 introduced when you make that approximation. So what's the rigorous way to determine energy

00:14:03.680 expenditure?

00:14:04.800 So direct calorimetry is the most rigorous way. And that is literally kind of a bomb calorimeter.

00:14:10.880 Right. You're in a metabolic chamber and they are looking at how much heat you're generating,

00:14:17.820 essentially. And from that heat that you generate, they're able to determine

00:14:21.600 your total daily energy expenditure, and then using an equation based on your oxygen consumption

00:14:26.740 versus your CO2 production, they can determine what from that is your BMR, which is actually

00:14:31.160 the same way they do it for indirect calorimetry. You're inside this like hood, you're breathing

00:14:36.060 into a tube, essentially. Basically, your metabolic rate is very closely associated with how much

00:14:42.440 oxygen you consume. How much oxygen you consume versus how much CO2 you expire will, one, give you a

00:14:49.640 really good idea of your metabolic rate, because the end products of metabolism are CO2 and water.

00:14:56.020 So when everything goes through this process of breaking down carbohydrates and fats,

00:14:59.780 if you talk about like what happens to body fat, it ends up as CO2 and water. So if they know that,

00:15:06.080 and you can use a constant for water, if they know that, it's also why they can use doubly labeled water

00:15:10.840 to estimate energy expenditure. We'll get to that later. But if you know that, and you know these

00:15:15.300 constants, and you make several assumptions, I mean, again, this isn't direct. You're making

00:15:18.660 assumptions, you're making assumptions about how much is being generated, you can come up with a

00:15:23.280 relatively accurate estimation of your metabolic rate. And for reasons that I can't explain, this is

00:15:30.200 something I can never forget, which is the coefficients for that equation. The Weir coefficients,

00:15:36.040 right? So energy expenditure is 3.94 times VO2 plus 1.11 times VCO2. So as you said, it's heavily

00:15:45.040 weighted to oxygen consumption. It's nearly four times the consumption of oxygen plus about one times

00:15:51.540 the production of carbon dioxide. And that gives you that. And for anybody listening to this, who's

00:15:55.880 ever had a VO2 max test, I would encourage you to ask the lab that does it for you to give you the raw

00:16:02.600 data, because what they'll spit out for you usually in 15 second intervals is VO2 VCO2. And while the

00:16:11.080 purpose of that test might be to determine your maximal VO2, you can also plug in these two variables

00:16:17.880 to the Weir equation and get how many calories per minute you're consuming or requiring to maintain

00:16:24.820 that energy output all the way to your max. It's actually quite remarkable when you consider that a

00:16:30.020 highly trained individual will easily get to 20 calories per minute of energy demand.

00:16:37.540 If you think about when we say lean mass is by far the biggest correlate total daily energy

00:16:43.420 expenditure and resting metabolic rate, lean mass requires quite a bit of oxygen compared to like

00:16:48.840 adipose tissue, which is relatively non-vascular. It makes a lot of sense that you would see that.

00:16:55.400 And then if you think about activity, obviously, if you start doing activity, it requires a lot of

00:16:58.720 oxygen. So we have our BMR, which is about in terms of the energy outside of things. And I guess I

00:17:04.960 should define that. Energy out is your total daily energy expenditure. So all the energy you expend

00:17:10.580 in a day, that's your TDEE, we call it. And the biggest portion of that is your BMR for most people.

00:17:17.440 Now, if you're an elite athlete who trains like six, eight hours a day, you can get to the point

00:17:21.260 where your physical activity is actually greater than your BMR. Those listening, don't be dogmatic

00:17:25.040 about these numbers. But for most people, 50 to 70% is a relatively accurate representation.

00:17:29.800 For me, it's probably about 55 to 60% of my total daily energy expenditure because I do train

00:17:34.580 like two and a half hours a day. So that is a significant contributor.

00:17:38.480 So we have that. Then we have what's called TEF, which is the thermic effect of food or diet

00:17:44.580 induced thermogenesis. And this is anywhere from five to 10% of your total daily energy expenditure

00:17:51.100 for most people. Very, very hard to measure. Usually it's expressed in terms of calories per minute

00:17:57.780 because they're only looking at it in the short term. And when we do studies of total daily energy

00:18:03.080 expenditure, I mean, usually what they're doing is using a constant for TEF. They're making an

00:18:08.600 assumption because it's just so hard to measure unless you're just measuring that over like the

00:18:13.620 course of a couple of hours or maybe a day at most. But we feel relatively confident based on the

00:18:20.220 studies out there that it's about five to 10% of your total daily energy expenditure. So not a big

00:18:24.520 contributor, but still. But it also seems to be macronutrient dependent, correct?

00:18:29.940 It is. It is.

00:18:31.140 We'll come back to that when we get to, yeah.

00:18:32.480 Yeah, yeah. And then if we look at the last component, we have our physical activity and

00:18:37.800 this encompasses all physical activity. So people hear this and they think exercise,

00:18:41.320 but actually for a lot of people, their biggest component of physical activity is actually what's

00:18:48.340 called NEAT, which is non-exercise activity thermogenesis. That is something that's actually

00:18:53.740 extremely modifiable. We see it in terms of one, people who are obese resistant,

00:18:59.860 what we term obese resistant, they tend to fidget a lot. They tend to move a lot. I was like this as

00:19:05.240 a kid. I still am. Whereas people who are obese prone tend to have very low NEAT. In fact, there was

00:19:12.680 a study done by Liebel in 1995 where they overfed people by, I want to say, a thousand calories per day.

00:19:19.220 They looked at their total daily energy expenditure in a metabolic ward, so very accurate.

00:19:22.240 And then they took that number and added a thousand calories on top of it. And they looked at how much

00:19:28.460 weight people gained. Some people gained more than they expected. One person did not even have

00:19:33.600 significant weight gain. And what they found was this individual's NEAT, their spontaneous physical

00:19:38.760 activity went up so much, it just compensated for that extra calories. So I think this is what people

00:19:46.200 really don't understand as well. I want to be very purposeful about how we define NEAT. Because

00:19:51.560 when it comes to NEAT versus exercise, exercise is purposeful. So something I'll hear a lot is,

00:19:59.520 well, I'm going to go do a walk and get my NEAT up. No, you're doing exercise. Maybe I'm being a

00:20:04.240 little bit pedantic, but it's important. Because NEAT is what I'm talking about. I'm waving my hands

00:20:09.540 around. I'm moving from one foot to the next. I've seen, Peter, that like you kind of move your

00:20:14.480 fingers and you'll twitch your neck. All that stuff, even though it seems like nothing, thousands

00:20:19.600 of those movements over the course of a day actually add up. So then I have people say, well, I'm just

00:20:24.080 going to tap my foot to get NEAT up or fidget. Well, guess what's going to happen? Whenever you try

00:20:29.300 to do something that also requires your brain, you're going to stop doing that because you actually

00:20:33.540 can't really do two things at once in terms of thinking about it. So this truly is spontaneous

00:20:39.560 energy expenditure and appears to be modifiable by about five to 600 calories per day. And we do

00:20:46.520 see this with overfeeding and underfeeding. And we'll get into talking about metabolic adaptation

00:20:50.460 and how this affects things. But people who lose like 10% of their body weight, they've seen up to

00:20:55.620 a 500 calorie reduction in NEAT. So that's a big portion of it. And then obviously you have your

00:21:01.120 purposeful exercise. If we look at energy in, metabolizable energy, energy out, BMR, TEF,

00:21:08.160 NEAT, and exercise. I'm simplifying this equation a little bit, but that's essentially it.

00:21:13.920 If people want to invalidate energy balance, what I always say is, listen, you ate those carbons.

00:21:19.000 Something must happen to them. They don't flutter off into oblivion and you don't create them out of

00:21:24.320 nothing. Something has to happen to them. And we have a lot of metabolic tracer studies to pretty

00:21:29.240 much know what happens to them. I think the confusion becomes, well, I tracked my calories. I ate in a 500

00:21:36.900 calorie deficit and I didn't lose weight. First off, if we look at where these mistakes come in,

00:21:44.220 people weigh themselves sporadically. If you only weighed yourself once a week, I would say it's

00:21:49.620 virtually meaningless. When we are trying to get data on people, we're very regimented with how

00:21:54.760 we do it. So it's you weigh in first thing in the morning after avoiding your bladder and bowel,

00:21:59.160 if possible, fasted. First thing you do, as soon as your feet hit the floor, after you've gone to the

00:22:03.720 bathroom, you weigh in. And then we take that weight every single day. And then we look at the average

00:22:07.780 and then we compare week to week averages. Because anybody who's ever tracked their weight, I'm sure

00:22:13.160 you've had this experience, Peter. You're eating very consistently. You're tracking your weight. It'll

00:22:18.240 easily fluctuate by one to 2% per day. So if you're 200 pounds, you could be 204, you could be 196. And I

00:22:25.460 always tell people, it's like the stock market. Sometimes there's a good explanation for why it goes up

00:22:30.960 and down like that. But other times there's no good explanation whatsoever. You don't just want

00:22:35.220 to take like one isolated data point. And this is also with people who get DEXs done and they freak

00:22:39.460 out because I've lost a pound of lean body mass. No, you went and had it done at a different time

00:22:43.500 where you were less hydrated. Or on a different machine, different software. Yeah. I don't want

00:22:48.060 to tell them not to get DEXs done, but unless you're going to do it, same tech, same machine,

00:22:52.380 same conditions. I'm like, cool. Doesn't really mean anything, but you have it. So when you look at that,

00:22:58.480 so you can have somebody, I've shown this example with clients where I've said, your average weight

00:23:03.940 is down by a pound. But if I had weighed you on this day last week and this day, this week,

00:23:10.140 you would think you were up by two and a half pounds. So people will start doing a calorie

00:23:14.600 deficit diet and they'll say, well, I see, I gained weight. So this doesn't work. No,

00:23:19.660 that was a fluid shift. Day-to-day changes in weight are much more dictated by fluid shifts than

00:23:24.540 they are adipose tissue levels. But your weekly and monthly changes in weight are much more dictated

00:23:31.280 by your actual body mass. So that's one thing that confuses people. The other thing I think that

00:23:36.700 really confuses people is their idea that they can actually track their energy expenditure correctly

00:23:41.980 using one of these. The wrist-worn devices, there was actually a study that was published in 2018,

00:23:47.960 where they looked at about 20 different devices and found that they overestimate exercise energy

00:23:53.620 expenditure anywhere from 28 to 93%. So you're doing this exercise that tells you you burned

00:24:01.060 500 calories, when in reality, you probably burned something more like 260 to 400 calories.

00:24:06.600 So again, people say, I burned a thousand calories on the treadmill today. And I always tell people,

00:24:11.160 what do you think is more likely that you have found a way to violate the laws of thermodynamics or

00:24:15.420 that this watch might not be accurate? Because I'm going to go with the latter. It's very funny how

00:24:20.520 people are very distrustful of certain things. And other things are just like, oh yeah, I totally

00:24:25.240 trust this thing. So there's that. And then there's also the fact that we can't completely

00:24:31.540 accurately track calories in either. Because there is up to a 20% error label that's allowed in foods.

00:24:38.940 I think that's where some of the confusion comes in. The other thing I will say that's worth saying

00:24:44.020 that will really upset some people is people are horrible estimators of their energy intake.

00:24:52.340 There was a study done, I think it was back in the nineties, where they took people who were

00:24:56.320 self-reportedly resistant to weight loss. These were people who said, I eat 1200 calories a day,

00:25:01.520 I can't lose weight. They put them in a metabolic ward and they also had them do doubly labeled water,

00:25:07.840 which is basically a free living way of determining energy expenditure. Plus they had the direct

00:25:11.780 calamity. And they said to them, we want you to track your food and report it to us,

00:25:16.900 but we will know if you're incorrect. We will know. So the average under reporting was by 50%.

00:25:25.760 So they were under reporting their energy intake by 50% on average. And that's right in line with a lot

00:25:32.000 of the other studies. If we look at people who are overweight and obese, most of them under report

00:25:36.680 by 30 to 70%. The demographic of obese women tend to be at the higher end of that.

00:25:41.780 Obese men tend to be at the lower end of that. Even lean people.

00:25:46.340 Yeah. I was about to say for lean people, would the same bias, I mean, bias might be the wrong word,

00:25:50.920 but would the same error in reporting still exist?

00:25:54.200 There is an error. It's less. I think it's around 18%, but even dietitians under report by about 10%.

00:26:00.900 That's kind of amazing that they could be within 10%.

00:26:04.060 Yeah. Some of the subjects actually argued with the researchers about it, which is funny,

00:26:08.840 but people don't like that self accountability sort of thing. Now, the message people will hear

00:26:15.640 when they hear that is you're saying I'm a liar. And I don't think that people were necessarily

00:26:19.840 lying. I think people are horrible estimators of their food intake. Because if I put a salad in

00:26:25.120 front of you and I dump 50 grams of oil on it versus 20 grams of oil, you will have absolutely no idea

00:26:33.120 of the difference. You might be able to taste like a little bit of difference in mouth feel,

00:26:36.940 but most people go, ah, that's a salad. It's got some dressing on it, probably 200, 300 calories.

00:26:43.620 Meanwhile, it's got nuts. It's got bacon, eggs, it's got oil, all that kind of stuff. And I'm not

00:26:50.340 saying any of those things are inherently bad. I'm just saying it's all energy. I think that's

00:26:54.260 another big component is people are just horrible estimators of their food intake. And what I'll tell

00:26:57.960 people is if you really believe that you are not able to eat in a calorie deficit, lose weight,

00:27:03.980 I want you to just for one week, track every single piece of food you put in your mouth.

00:27:08.480 No licks, no bites, no snacks, not an account of, I'm not saying you got to do this for the rest of

00:27:12.620 your life, but just do this for one week. And usually I'll come back with people who are mind blown.

00:27:17.660 They'll say, well, I thought I was eating 600 calories. I was eating 2,700 because they didn't

00:27:21.800 realize that like they grabbed that handful of nuts or they grab a handful of potato chips or whatever it

00:27:26.320 is. When they take a bite of a candy bar. Yeah. In isolation, none of that stuff is a big deal,

00:27:30.860 but when you accumulate it throughout the course of a day, it can be a big deal.

00:27:34.960 Eight years ago, when I was really, really interested in this topic, I had the luxury of

00:27:40.300 being able to spend probably about a total of six days in total inside a metabolic chamber in two day

00:27:46.580 blocks. So three, two day blocks or four, two day blocks inside. It probably wasn't actually very

00:27:51.640 much fun at the time, but. Actually it was the most fun thing ever lane because it was everything I

00:27:57.480 love. First of all, I got to be in a room. Nobody could bug me and we had arranged it so that I could

00:28:03.360 do all my exercising. So I had my bike on a fluid trainer. I had tons of weights in their plyometric

00:28:10.200 box, a bed. It was literally a vacation. And I had this amazing food being prepared by a metabolic

00:28:17.860 kitchen. Like you've got this staff that is making to the gram, everything that we had agreed at the

00:28:24.060 outset, we were going to be testing. And then after the fact, I went and did the 10 day doubly

00:28:29.140 labeled water experience, which I guess we could explain for people what that is, right? So water,

00:28:32.920 everybody knows is H2O, hydrogen two, oxygen one, but it turns out there's a heavy form of hydrogen

00:28:38.760 called deuterium. And there's another form of oxygen that doesn't have 16, I'm so bad in my

00:28:45.680 chemistry now. Is it 16 protons or is it? The neutrons. Neutrons, 16 neutrons. So instead they have

00:28:50.100 one with 18 neutrons. And so you drink a D2 regular O and then an H2 heavy O. When you drink

00:28:59.100 this, you basically get to exploit a trick, which is by collecting your urine, you're measuring the

00:29:05.860 hydrogen that's coming out without measuring the carbon that's coming out. So you can impute

00:29:11.460 what your VCO2 is effectively and you collect urine serially. And over the course of 10 or 12 days,

00:29:18.660 you get an estimate. And so the only instruction to me when doing this was try to be weight stable

00:29:24.080 for that period of time, which I was able to do. And it was interesting. That was a time in my life

00:29:28.920 when I was really tracking ins and outs pretty well, mostly just out of curiosity, not because I was

00:29:34.520 trying to lose weight or gain weight. I wasn't. And by my calculations, I was about 4,400 calories in,

00:29:42.480 which would imply about 4,400 calories of energy expenditure. The DLW ended up being 4,200.

00:29:49.600 So I was surprised it was pretty close because I agree. I expected it to be way far off,

00:29:54.620 but it was such an amazing experience. And it's like, I almost wish stuff like that could be done

00:29:59.620 commercially. Because of course I had to do this with an awesome guy named Eric Ravison at the

00:30:04.100 Pennington Biomedical Research Institute. And Eric's staff had done this for me. So I was able to do

00:30:08.900 this in a research lab. This would be an amazing thing that I wish you could order a home kit,

00:30:14.080 drink this stuff down, run it out for 10 days, and truly get a sense of your energy expenditure.

00:30:19.400 What I would say is, since you're supposed to be weight stable, most people could actually do it

00:30:23.520 just by default. Because at the end of the day, if you're weight stable within reasonable amount,

00:30:28.860 then whatever you're eating is actually, for all intents and purposes, your total daily energy.

00:30:32.760 I'm just saying it's so hard for people, to your point, that is a hard thing for someone to do

00:30:36.580 unless they're going to have a food scale with them everywhere. And then the other thing is,

00:30:40.700 it becomes a little bit of an artificial exercise. Because even if somebody says,

00:30:43.300 I'm willing to, for 10 days, measure everything, then you get this sort of Hawthorne effect of,

00:30:49.440 they won't take that extra bite of the candy bar. Because A, they don't want to measure it,

00:30:53.800 and they won't grab the handful of nuts, and they won't do this, that, and the other thing.

00:30:56.960 Whereas if you say, look, I'm just going to eat the way I normally eat for a week and not measure

00:31:00.460 anything, all I have to do is maintain my weight and do what you're saying. Every morning you get on

00:31:05.120 that scale, and you kind of tweak it up and down, then you can say, okay, in a truly free-living

00:31:10.760 environment without the Hawthorne effect, this is my energy intake.

00:31:14.880 So funny you say that. In science, we know that right down to individual particles,

00:31:20.500 when you observe it, it changes its behavior. And that's true for just on the atomic level,

00:31:26.760 and it's true for people. We have a coaching team called Team Biolane, where we do one-on-one

00:31:31.100 coaching. We have a team of seven coaches. And one of the big things that we train our coaches

00:31:36.520 on is like, hey, if somebody's like really resistant to something, just see if they'll

00:31:40.160 just track what they're already doing to enlighten them. We'll tell them like, listen, we want the

00:31:45.000 raw data. We don't, don't change anything. And almost every time, just by them doing that for a

00:31:53.340 week, wow, you know, I lost half a kilo or a kilo this week. And it's like, yeah, like you said,

00:31:59.280 you didn't take that extra bite of snacks. We have that problem actually in our practice

00:32:03.660 with our patients, because for at least half the patients, once we do our intake, we realize

00:32:08.620 nutrition is going to be an important thing to modify. And a lot of times we want to see what

00:32:13.460 the baseline is. We go one step further, which is we do exactly that, which is we don't want to see

00:32:18.740 you do anything different, but we really go out of our way to say, please do not change anything.

00:32:24.260 In other words, eat that candy bar and grab that handful of nuts,

00:32:27.620 pour that glass of wine a little taller than you think it should be like, do everything

00:32:32.360 naturally. And even still to your point, it's almost impossible to get a true baseline once

00:32:38.600 you apply those constraints. That just shows you how inaccurate 24 hour food recalls can be

00:32:43.700 and all that kind of stuff. So, yeah. And so I think those are some of the biggest

00:32:47.640 misunderstandings. Now I do want to address the whole, is a calorie a calorie thing? Yes.

00:32:53.720 All calories are equal because again, calories are just a unit of measurement. All sources of

00:32:59.640 calories are not equal in terms of their effects on energy expenditure and metabolizable energy.

00:33:05.300 We already talked about soluble fiber and insoluble fiber. And then if we look at the TEF of various

00:33:10.380 foods, let's start with fat. Fat has the lowest TEF. So if we talk about TEF, it's basically the amount

00:33:17.600 of energy the system has to put in to extract the chemical energy out of food. So you can't just

00:33:23.680 put it in and then boom, you have the energy. Your body has to do work to get it. Now it's always a

00:33:29.080 higher net, even on stuff like people said, well, celery is a negative calorie food because your

00:33:33.740 body has to put more. No, no, no, no. Unless we're talking about tree bark, there is no energy negative

00:33:37.960 food. Even celery has like 50 calories. I think it's, or it might be five calories per hundred grams. So

00:33:43.340 very, very low, but still not negative. We would not have lived long as a species if we had energy

00:33:48.680 negative foods. If we think about how much energy has to go in to get energy out, we have how many

00:33:54.600 calories you consume and present as metabolizable energy. And then how many calories we net out of

00:34:00.660 that after the energy expenditure required to get the chemical energy out is done. So if we look at

00:34:06.220 fats, fats are the lowest and they're about zero to three calories. Meaning if you eat a hundred calories

00:34:09.840 from fat, you net about 97 to a hundred calories. And then we have carbohydrates. Carbohydrates are

00:34:15.580 about five to 10%. So if you eat a hundred calories of carbohydrate, you net about 90 to 95 calories.

00:34:22.300 Protein is around 20 to 30%. So if you eat a hundred calories from protein, you net about 70 to 80

00:34:29.580 calories. People will hear that and they make a much bigger deal of it than it actually is. Because

00:34:34.560 when you consider how much of a proportion of your overall energy expenditure it is. And I do this

00:34:40.540 example where I'm like, let's double your protein and see how much more TEF you get. It ends up being

00:34:44.960 like 150 calories if you double your protein. And we're talking about people already eating like

00:34:49.060 standard amount of protein to a really high amount of protein. So yeah, it helps, but it's probably not

00:34:54.400 the cure for the obesity crisis. To push back on that for a second, one of the challenges when thinking

00:34:59.220 about weight loss, sustainable weight loss over a long enough period of time is how much is enough

00:35:06.320 on a daily basis before an adaptation would take place that would correct it. So for example,

00:35:12.240 if we were talking- You're asking the right questions.

00:35:14.900 You're asking the right questions. Yeah, yeah, yeah. So if we were talking about,

00:35:18.760 let's just say one of your dieticians came to you and said, Lane, I've got this idea. I've got this

00:35:21.860 patient who is truly by every metric, 50 pounds overweight. We could do it on lean body mass,

00:35:26.640 body fat, whatever. If this guy's 50 pounds lighter in a year, everything about his life

00:35:31.420 has gotten better from a health perspective. And this person said, look, I'm going to double

00:35:34.960 their protein intake and let's not make it the extreme example of where you're getting an extra

00:35:39.340 150. Let's just say it's a hundred calories or 75 calories. If you could create an energy deficit,

00:35:45.540 and this again assumes that you can change nothing else and there's so many silly assumptions,

00:35:51.160 but think of this almost more as a thought experiment. If you could create an energy debt of 75

00:35:55.800 calories per day by a macronutrient shift to more protein over a long enough period of time,

00:36:02.220 could it be relevant? It could. However, what we're neglecting to talk about is something I

00:36:08.420 briefly mentioned, which is metabolic adaptation. I think this is the other big thing that confuses

00:36:13.400 people. They think energy in, energy out. These are static things that do not affect each other.

00:36:19.500 And the reality is they are intrinsically tied to each other. Anybody who's ever tried to lose

00:36:25.920 weight, if you went on a, let's say a 500 calorie deficit per day, which is a pretty significant

00:36:30.140 deficit. Do you just lose linearly one pound per week until you no longer exist and you die because

00:36:36.260 there's no more body weight? No, we all know that eventually like that plateaus. Now, part of that is

00:36:41.280 just because you have less body mass. So your body has to expend less energy in order to just maintain

00:36:47.860 upright posture and those sorts of things. But then there's also the neat component.

00:36:52.280 As you lose weight, you become spontaneously less active. We see this in animals all the way up to

00:36:57.060 humans. Then not just that, voluntary exercise tends to go down past a certain point. Like if you're

00:37:03.200 very obese and you start to lose weight, it's not really going to affect this that much because you

00:37:06.780 have such an energy surplus. But especially people who are going average to lean, your will to exercise

00:37:12.700 will go down. I've definitely experienced that during contest preps, getting very lean,

00:37:16.300 just having to like will myself to get up off the couch. And then if you look at their BMR,

00:37:23.940 you actually get a reduction in BMR above what you would expect based on the loss of lean tissue and

00:37:32.580 fat tissue, because fat tissue is somewhat metabolically active. There's actually up to like

00:37:37.720 on average, a 15% reduction in BMR. Almost at every level of energy expenditure,

00:37:43.620 your body is kind of fighting you to get back to homeostasis, to reestablish homeostasis.

00:37:49.760 We see this in people who lose weight. So if we take people with the same lean body mass and fat

00:37:56.000 mass, people who have never been obese, people who have been obese and weight reduced, the weight

00:38:01.540 reduced people will have a lower BMR than the people that have never had to lose fat. John Speakman

00:38:07.400 had a really good paper on this. This is kind of getting into set point theory, that we have this

00:38:12.040 kind of native set point that the body likes to be at. And the idea is kind of, okay, what's regulating

00:38:18.000 the ends of that set point? So we understand that if we get too lean and lose too much fat mass,

00:38:23.740 we die. That's a really negative outcome for evolution. Can't pass on your DNA if you're dead.

00:38:29.480 At the higher ends, there are things that work against obesity. Like we already talked about that

00:38:35.020 NEAT goes up if you overfeed. Your BMR also goes up if you overfeed. But obviously based on what's

00:38:41.020 happening in society with this shift towards adiposity, the regulations going up are not as

00:38:48.080 strong as going down. If you think about it from an evolutionary perspective, the risk of getting too

00:38:54.220 overweight in the short term, because obesity is not going to kill you when you're 40. It's going to be

00:38:59.320 the difference between you dying at 80 versus 70. That's what the research tends to suggest.

00:39:03.660 The risk in the short term is predation or fighting or that some sort of physical altercation

00:39:09.740 where you can't defend yourself very well or you can't run away. The risk of predation after man

00:39:16.040 learned how to use tools pretty much went to zero. Yes, you have shark attacks and you have these

00:39:22.240 things. But I mean, they're essentially lightning strikes when humans get killed by animals or even

00:39:27.020 other people. I mean, it's very, very rare. But then we look at the risk of starvation.

00:39:32.100 It's very real even now in some parts of the world and was very real in this country until

00:39:38.480 the 1900s. I mean, even into probably the early 1900s. And so it makes sense that the regulatory

00:39:47.500 mechanisms were more powerful on that bottom end to prevent people from becoming too lean

00:39:53.660 than they are on the top end. And so bringing this back to energy balance,

00:39:57.740 you have to think of energy balance like a car that changes its gas efficiency based on

00:40:04.420 how full the tank is. So think about if you had a car that when you have the gas tank filled all

00:40:10.820 the way up, it gets horrible gas mileage. But as that gas tank starts to go down and think about

00:40:17.360 your gas tank as your body's out of post stores, your energy stores. As that gas tank starts to go

00:40:22.400 down, you become more and more and more efficient to buy the time there's very little gas left.

00:40:27.420 It's just sipping gas. It really is kind of a dramatic comparison. It is an apt comparison.

00:40:33.380 And I think the biggest thing to take away is we cannot know. We can know at a snapshot in time

00:40:39.120 what your energy expenditure probably is, but it's likely to change. And it's a sliding scale.

00:40:45.520 And it depends on a lot of variables. That's also led people to say, well, see, we can't accurately

00:40:51.220 track calories in. We can't accurately track calories out. There's no point in tracking calories.

00:40:57.020 And what I would say is that you're kind of throwing the baby out with the bathwater. I'm not

00:41:00.480 saying you have to track calories to lose weight because obviously you don't, because there's all

00:41:03.840 kinds of methodology that people use to lose weight that doesn't involve tracking calories.

00:41:08.060 But it would be like saying, well, keeping a budget is worthless because I have multiple

00:41:14.720 streams of revenue and I have investments. And so I can't know exactly how much income I'm getting.

00:41:19.400 And also things pop up, like your car breaks down, you have repairs to your house. So you can't exactly

00:41:24.460 know what your expenses are going to be. So therefore keeping a budget is worthless.

00:41:28.520 So the comparison I make is you don't have to keep a budget to save money, but it's a useful tool.

00:41:33.840 It gets you in the ballpark and it gets you a baseline. And I would say the same thing about

00:41:38.800 tracking calories. The act of keeping a budget alone is what enables you to think twice before

00:41:46.420 a frivolous purchase as one example, right? And we know this too. What's so funny is the

00:41:51.900 parallels here. So did you know that the average person, I'm kind of a finance nerd, the average

00:41:56.920 person under reports their debt by about 155%. And again, it may not even be a lying thing. It might just

00:42:02.860 be, they have really horrible ideas about how much debt they actually have. And so same thing,

00:42:08.280 when you have people track their budget, well, now all of a sudden they're on their best behavior

00:42:11.960 because not only do they don't want to admit to anybody else, they don't want to admit to

00:42:15.620 themselves where they're actually spending their money. I use that comparison a lot when it comes

00:42:20.800 to tracking calories and we use it a lot with our clients. Hey, look at this thing like a budget.

00:42:25.100 So Peter, you made the example that you were maintaining your body weight on 4,400 calories a day.

00:42:29.440 By the way, for the listener wondering, I was training a heck of a lot more than I train now.

00:42:34.840 That's when I was truthfully probably exercising three hours a day.

00:42:40.140 You had a very large budget. If you have a large budget, if I'm talking monetary,

00:42:45.740 is a sports car a good purchase? I mean, if it brings you happiness and joy, sure,

00:42:50.720 but not if you can't afford it. If you have a large enough budget that you can pay your mortgage and

00:42:54.660 you can pay your utilities and you can do all the responsibilities that you need to and you still

00:43:00.100 have some left over to buy that sports car and it brings you happiness, I would say go for it.

00:43:04.500 By the same token, if you make $50,000 a year and you're going to buy a $70,000 or $100,000 sports car,

00:43:10.160 I would say that's probably a really bad idea unless you've got a ton of money socked away in

00:43:14.120 the bank. By the same token, when people see what I really tend to utilize, flexible dieting for myself

00:43:20.900 a lot of our clients, people say, well, they're just eating junk food all the time. No, no. What

00:43:25.080 you're seeing is people are posting this because they're so shocked that they can eat some junk food

00:43:29.540 and lose weight that they tend to post that stuff. And people will say, well, you know, that can't be

00:43:33.880 good for them. And my response is everything is on a continuum here. There's a big difference between

00:43:39.420 somebody having like a small bowl of ice cream that they fit into their budget for the day that allows

00:43:45.480 them to feel less restricted and feel like they're not missing out. That prevents them from having a

00:43:51.520 huge binge session, you know, down the road when their willpower eventually breaks. It doesn't work

00:43:56.800 for everybody, but it works for some people. If they can have that bowl of ice cream, but they're

00:44:00.260 still getting enough dietary fiber, they're still hitting their protein, they're not going over

00:44:03.820 calories, they're getting micronutrients in. I would say, what's the problem with that?

00:44:08.200 This is probably the question I actually get asked the most, Lane, from patients, and I'm guessing you do a

00:44:12.800 lot, which is, Peter, do you think it is better to be completely restrictive or to have frequent

00:44:23.500 cheat meals, like one meal a week or one day a week where you go completely off the rails,

00:44:29.280 or just to have a little bit of stuff that is an indulgence every single day? And actually,

00:44:35.860 I don't have a great answer for them other than there is no right answer here. Even for an individual,

00:44:40.600 that might change. And I'll use always my example, which was for three years, I was on a ketogenic

00:44:46.340 diet with the exception of one day. Whatever, 365 times three is, for that many days, I never deviated

00:44:54.160 from a ketogenic diet except for one meal when I had about seven pieces of cake at my wife's birthday.

00:45:00.500 And I said, that was really interesting. Like, I'm amazed I was able to do it. I look back at that

00:45:05.340 period, which was 2011 to 2014. And I think, I don't know how you did it. I could never do it

00:45:11.460 again. It'd be very hard for me to go on a ketogenic diet for more than two weeks now. Someone put a gun

00:45:16.620 to my head and said, I really want you to do this for a year. The reality of it is like, that would

00:45:20.220 be a very difficult thing to do. So for me, I can definitely get away with a daily indulgence

00:45:27.680 or a weekly indulgence. And it's very easy for me to get right back on program because I basically

00:45:33.580 follow a very simple rule, which is never do two bad things back to back. If you ever miss a workout,

00:45:39.200 which sometimes is going to happen, the single most important thing is making sure the next day you

00:45:43.300 work out. And if you ever have a complete blowout meal, the single most important meal is the next

00:45:48.780 one. So that works for me. But I also realize in working with so many people, there are some people

00:45:54.820 who do very well in a highly, highly restricted environment. And when they deviate from that

00:46:00.060 restricted environment, it sets them off on a path that doesn't make sense. So do you have any

00:46:04.720 insights for helping someone predict where they're going to be? Or do you just say, no, you know what,

00:46:09.200 just try them all out. Try all of these approaches and let's revisit it in a month.

00:46:13.220 Part of it depends on the person's personality and their individual psychology. What we know is that

00:46:18.080 if you want to lose weight specifically, you are going to have to use some form of restriction,

00:46:22.820 whether it's calorie counting points, carb restriction, fat restriction, unprocessed

00:46:29.080 food, whatever. You're going to have to use fasting. You're going to have to use some form

00:46:33.120 of restriction. Either some form of dietary restriction, calorie restriction, or time

00:46:37.700 restriction. You have to do something there. When we say calorie restriction, we talk about

00:46:41.860 counting calories and actively, but all of these things work because they restrict calories.

00:46:45.980 That's also important to note. I want to come back to that, by the way, because this is to me,

00:46:49.940 the crux of where I think people will assume you and I don't agree, but I'm pretty sure we do agree.

00:46:55.200 But let's go with that thread. And then I'm going to come back to the jugular question around that.

00:46:59.440 Very simple. You have to have some form of restriction, but you should pick the form of

00:47:03.700 restriction that feels least restrictive to you as an individual. And this is where people get

00:47:09.360 really crossed up. And I'll give you an example. People will find that form of restriction that felt

00:47:14.780 really unrestrictive to them. And you hear it all the time. I tried intermittent fasting.

00:47:18.160 It felt like I wasn't even dieting. I lost 50 pounds and it wasn't even hard. Then they will

00:47:22.900 assume that one, this is the right approach for everyone because it was the right approach for

00:47:28.440 them. And we tend to retroactively then try to justify why physiologically that also is the best

00:47:35.720 approach. And this is why you hear people make crazy claims about whether it's low carb or

00:47:40.860 intermittent fasting or any one of these diets, which are all excellent tools. People think that I

00:47:46.980 don't like ketogenic diets or that I don't like intermittent fasting or anything like that. And

00:47:50.880 that's not true. I just am not a fan of insane claims about those particular diets. I think part

00:47:56.960 of the problem is people will say, I tried restricting calories. That didn't work. I went on a

00:48:00.720 ketogenic diet and I was eating more and lost weight. You probably felt like you were eating more,

00:48:06.140 but unless you were weighing out again, you were weighing out. And the other thing that we should

00:48:11.020 talk about is when you go to a ketogenic diet where you have really limited food choices,

00:48:15.660 there's not a whole lot of options for snacking. You're mostly eating defined meal food. Intermittent

00:48:21.140 fasting, you're not really snacking. You're having defined meals. By the way, that is a very,

00:48:26.640 very, very vigorously present characteristic of people who lose weight and keep it off is they don't

00:48:35.060 really snack. They have defined meals. I realize I'm going on a tangent here, but there is something

00:48:39.800 to be said for snacks do not appear to be as satiating, not just because of the food,

00:48:45.120 but because of the mindset. Because when you snack, you tend to do it, not being mindful about it.

00:48:50.160 And it doesn't have the same satiety effect. So one of the things we tell our clients is, hey,

00:48:54.820 stop snacking. Again, if you like snacks and they work for you and you can fit them in your calories,

00:49:00.000 it's fine. But if you're having trouble, try to stop snacking. And they say, oh my gosh,

00:49:04.780 I didn't even really feel like I was that less hungry. And all of a sudden I'm losing weight again,

00:49:08.280 cut three, 400 calories out. I'll add one point to that lane, which is I agree just empirically

00:49:13.360 that if you can absolutely eliminate what you eat between defined meals, and that could be two or

00:49:19.720 three meals per day, most people will have not just an improvement of body weight and body composition,

00:49:26.260 but biomarkers get better. I mean, you tend to not be snacking on the best things to begin with.

00:49:31.420 Actually, this is where one of the things where I have found fasting to be a valuable tool,

00:49:35.680 because if you put somebody through a three, five, or even longer day fast, I'm talking a water only

00:49:42.000 fast, even once in their life, they learn a very important lesson, which is I'm not going to die if

00:49:48.640 I'm hungry, acutely. If I made you fast for 40 days, you might die. But I pretty much don't think

00:49:55.560 there's a human being on this planet outside of the most sick individual who couldn't go five days

00:50:02.300 without food, subsiding only on water and minerals. And something about doing that, even if you do it

00:50:08.720 once, for no other reason, it teaches you a couple of things. One, you can do it. That's a big aha moment.

00:50:15.900 Two, hunger comes in waves. So that five-day period of eating nothing, you will have periods of time when

00:50:23.800 you literally want to eat your arm, and you will have periods during that five days when you have

00:50:30.780 forgotten that you're fasting. And so when you take that mindset into, okay, Lane, I just put you

00:50:36.580 through this five days of very difficult fasting. Now we're going to go to a regimen where I just don't

00:50:42.120 want you to eat any snacks. And that means from noon till six, I don't want you eating anything.

00:50:48.600 And now all of a sudden you're like, three o'clock, I'm really hungry. But you now anchor that to

00:50:53.880 something that was so much more severe, which is, wait a minute, I'm really hungry because I haven't

00:50:58.360 eaten in three hours. I'm going to eat in three hours. I think I can make it. At least for me and

00:51:02.740 for a number of patients that I've used this sort of method with, it's a very powerful tool. And you

00:51:08.100 don't need to become a fasting guru to do this, right? You don't have to do a quarterly fast to

00:51:13.440 experience this. I think just one fast will teach a person this lesson. I certainly remember the first

00:51:19.140 time I really had that aha moment when I did my first really long fast and realized everything that

00:51:25.600 I knew intellectually, but all of a sudden it emotionally made sense as well.

00:51:29.540 Well, people confuse hunger and appetite a lot. Here's the other big thing is people say, well,

00:51:34.020 you don't get as hungry on the ketogenic diet or you don't get as hungry on a plant-based diet. You

00:51:38.280 don't get as hungry on X, Y, Z. I say that's true, but there's a lot more reasons people eat other than

00:51:44.620 hunger. In fact, I would argue that some of the major reasons people eat has nothing to do with

00:51:49.420 physical hunger and that it's actually societal cues, stress, and various other things. One of

00:51:56.140 the things we'll tell our clients... Boredom is a big one for me.

00:51:59.200 Absolutely. One of the reasons exercise works so well is one, it sensitizes you to satiety signals.

00:52:04.040 That's actually the most powerful effect it has on weight loss. You actually become more sensitive to

00:52:08.680 your satiety hormones. But two, you're spending an hour doing something physical. You're not bored

00:52:14.860 and eating. It makes a difference. But one of the things we tell our clients is like, listen,

00:52:19.500 if you want to lose weight, you're going to be hungry at some point. Physically hungry, you will

00:52:23.660 be. This is coming from somebody who has been stage lean as a bodybuilder with absolutely minimal

00:52:30.060 amounts of body fat. When I talk about the level of discomfort, it is an all-consuming. You cannot

00:52:36.340 think about anything else other than when you're going to eat next. When you finish your meal,

00:52:40.620 you're hungry five minutes later and already thinking about your next meal. And the level

00:52:45.680 of fatigue is so high that the best way I can describe standing up off a chair is a monumental

00:52:51.140 effort. There's no other way to describe it. And we talked about this in the first podcast,

00:52:55.940 but just because I find it so amazing. Can we relive a few minutes of that, Lane? So going into a show,

00:53:01.800 we're obviously referring to your bodybuilding stuff, not your powerlifting stuff. You'll be what,

00:53:05.980 4% roughly on stage? I've calipered at 2%. Dexa is the gold standard. But again, I tell people,

00:53:13.320 unless you're a cadaver and they're excising your adipose tissue, you'll never know exactly what your

00:53:17.540 adipose tissue is because all of these measurements make assumptions. On Dexa, I was probably 5% or 6%.

00:53:22.500 That's where a lot of stage lean bodybuilders end up being. So how many days leading to that moment on

00:53:29.500 stage are you really in the throes of this type of discomfort that you're describing? I will tell you

00:53:34.400 that on calipers, I can get to about 7%, come down from like 14 or 15. If I'm up to like 230 pounds,

00:53:42.180 I'll be 14 or 15, probably more like 15 on calipers. Get to seven, no problem. Doesn't even

00:53:48.900 hardly faze me. I've done it so many times. From seven to two or 3% is exponentially more difficult.

00:53:57.080 That'll take you how many weeks?

00:53:58.180 Probably 12 to 16 to go for those from seven to two. Because again, it's not just losing the

00:54:05.220 weight. It's also-

00:54:05.960 Sort of maintain the lean mass too.

00:54:07.940 Maintaining the lean mass as a drug-free athlete is extremely difficult. Those conversations I have

00:54:13.480 with our team bioling clients all the time, and if we want to do a show is 12 weeks is not going to do

00:54:17.620 it if you're drug-free, unless you're already extremely lean. The best natural bodybuilder I ever

00:54:22.480 coached, his name was Brian Whitaker, and he won the WNBF lightweight world title six times and is the only

00:54:27.300 man to win the WNBF overall world title and the IFPA overall world title, which were the two

00:54:32.780 biggest federations, the only man to ever unify them. And this guy at 12 weeks out, you would say

00:54:37.680 he's ready. And then he would lose 10 more pounds from that.

00:54:41.200 Of those 10 pounds, how many would be fat?

00:54:43.380 Probably six or seven. This is the problem is the loss of body fat and lean mass. What we see in,

00:54:50.720 I realize we're going off on the tangent, but this is really interesting,

00:54:52.600 is when you're looking at people who are like overweight and obese, they can lose almost 100%

00:54:59.420 fat tissue. Now, what people don't realize is adipose is actually about 13% lean tissue.

00:55:05.240 So it is very normal to see about a 13 to 20% loss of lean tissue when dieting, because even if you lost

00:55:13.040 just adipose tissue, you would lose some lean mass.

00:55:16.620 You mean lean mass in terms of some of the water loss?

00:55:18.900 Water and adipose also has protein in it as well. And part of that is lost during the remodeling of

00:55:24.360 the tissue. You have that, but then as a drug-free bodybuilder, again, it's important to make that

00:55:31.160 distinction because if you're on steroids, that obviously changes the physiology and tilts things

00:55:35.740 much more towards retention of lean mass, if not building some. As you get leaner and leaner,

00:55:41.280 you are going to have a progressive shift of more and more lean body mass loss for a few reasons.

00:55:48.600 One, because your adipose stores are lower. Your body is sending out hormones to try and conserve

00:55:54.160 fat tissue. Think about it from this perspective. If you are 200 pounds and 190 of that is lean body

00:56:02.840 mass.

00:56:03.620 You're 5% body fat. Yeah.

00:56:05.180 That last little bit of body fat. Now guess where the biggest reservoir of energy is? It's the wood

00:56:12.420 table. So now we're in emergency mode and okay, well now we can start to tear the house down

00:56:17.240 because it's more important to keep this fat tissue than it is to keep this massive amount of lean

00:56:25.100 tissue. So it really is interesting. So for him, people might look at that and say, well, he lost

00:56:30.100 10 pounds and almost half of it was lean mass. Yes. But fundamental things that people do not

00:56:35.280 understand is the best way to look as muscular as possible is to be as lean as humanly possible.

00:56:42.740 And I would encourage your listeners to go look up a guy named Brian Whitaker. He's actually a

00:56:47.040 professor of economics at Oklahoma state, one of the greatest natural bodybuilders of all time,

00:56:50.620 and also very smart guy. Lovely person too. His gluteus muscles, he's so lean that he has veins

00:56:58.420 in his glutes and striations that look like fingers. It's really incredible.

00:57:04.680 I remember the first bodybuilder I ever saw that in, which is not to say it was the first

00:57:07.800 bodybuilder it appeared in, but I remember as a kid seeing that in Samir Banu, who was the 1983

00:57:12.780 Mr. Olympia. And I was like, I remember as a kid, like, you know, I'm maybe 13 years old,

00:57:18.920 seeing him looking at the striations in his lower back and in his glutes. And it was exactly that

00:57:24.380 look that you described. To think that one could achieve that without steroids and diuretics is

00:57:29.760 pretty amazing. Brian was about 160 to 165 pounds on stage and he's five foot nine. If you saw him

00:57:35.720 in his shirt, you would go, oh, he's nothing. He looks athletic. If you see him with his clothes

00:57:41.360 off, he would say, oh, he's 200 pounds at least. And sorry, you said he's five nine and was 165?

00:57:47.740 Yep. You can't hardly see it. But the photo right there, we did a three times bodyweight

00:57:54.160 deadlift challenge at Oklahoma State years ago, because Brian's also very strong. That's him

00:57:59.580 there. And he would walk around at what? In his off season, 185, 180. Still looked very lean. So

00:58:08.140 again, when you're talking about bodybuilding, and I realize we probably lost about 90% of the audience

00:58:12.680 talking about this. We'll bring it back to the other stuff in a second. But I think bodybuilders can

00:58:16.240 really teach important lessons about physiology in terms of energy metabolism.

00:58:21.260 I think it is such an underappreciated discipline because it's very easy to dismiss bodybuilders as

00:58:29.780 drug using whatever. And everything you're saying applies to the steroid using and the natural.

00:58:37.020 It's just that in the natural, it's a bigger lever, but it's still a huge lever if you're a drug

00:58:42.600 competing bodybuilder. Whenever I interact with these guys, I am blown away at how dialed in they

00:58:48.300 are on their nutrition. Insane.

00:58:50.940 And so one of the things we tell our clients, and one of the things I've heard so many times

00:58:55.280 from different competitors is, you have to learn to sit with your discomfort.

00:59:00.620 That can apply to many things. I mean, even in business, I'm sitting with my discomfort right now

00:59:06.100 because we've expanded our businesses and our expenses are way higher. Now we're making good

00:59:10.320 revenue, but the 20-year-old lane in me goes, it would just take one bad month and these expenses

00:59:17.980 will crush us. That voice is in there. So it's talking yourself through and sitting with that

00:59:22.940 discomfort. When it comes to food, it's really asking yourself, okay, am I actually hungry or am I

00:59:29.880 just queued up to eat right now? And then if the answer is yes, if it truly is physical hunger,

00:59:37.520 it's really talking yourself through this and saying, okay, what are my goals? What's important

00:59:43.660 to me? Could I eat? Sure. Is it going to make it more difficult later? Like for example, if you're

00:59:48.280 hungry at 11am, okay, well, if I eat a big meal now, I'll feel better now, but then what's it going

00:59:53.340 to be like later? All these things weigh in. And again, there's no right or wrong answer to this,

00:59:57.540 but what I would say is most people can handle a lot more discomfort than they think they can.

01:00:01.880 Just because you're uncomfortable doesn't mean you have to do anything about it. You can sit with

01:00:07.560 that. I think a lot of people really haven't done that. And even that like internal conversation,

01:00:14.100 again, this is why obesity is so difficult when we talk about people because people want to make it

01:00:20.760 about the X's and O's. It's not about the X's and O's. It's not about eat this protein, carbs, fats.

01:00:25.600 It's not about any of that. I remember when I first got into coaching people, you know, 15 years ago,

01:00:30.220 I was like, well, if I just tell them to eat this, they're going to lose weight. And then you realize

01:00:34.660 that stress and trauma and hardwired habits and behaviors are so difficult to change. And it really

01:00:45.720 is. If you look at the research data, it really is more about changing people's habits and behaviors

01:00:52.540 than it is about the X's and O's. And I mean, even right down to like sports, I'll use this comparison.

01:01:00.400 X's and O's matter. But you know what really matters for a head coach? Leadership. That's what really matters.

01:01:08.800 Communicate and get everybody on the same page. They call it changing the culture. This person came in and they

01:01:14.320 changed the culture of this team. That's not X's and O's. That's habits and behaviors.

01:01:19.240 There was a really great systematic review by a gal named Marie Shbreckley. She's doing her PhD over in

01:01:26.160 England. Humble brag. She actually messaged me and said that reading my book is what inspired her to

01:01:33.080 go do her PhD. And now she's done this great systematic review. So that's always like the most

01:01:36.880 cool thing when I hear that. She did a systematic review and looked at people specifically who lost

01:01:43.840 weight and kept it off. What did they have in common? What were the things that identified as

01:01:49.760 being really difficult? And what were the things that they identified as being really motivating?

01:01:54.620 The things that came up weren't dietary really. It was their environment. It was their habits,

01:02:01.860 their behaviors. One of the big things that came up was support, either good or bad. That support made a

01:02:07.760 big difference. And specifically support in terms of, I believe in you. I know you can do this. How can

01:02:14.460 I help you? Those sorts of things versus the criticism micromanaging type of support. And then also

01:02:22.480 stress was a big one. Trauma was a big one. Binge eating was a big one. That's a really underappreciated

01:02:29.920 part of this is the binge eating component. I think a lot more people struggle with that than would like

01:02:34.580 to admit. Because if you look at people, I would say Monday through Friday, a lot of people do great.

01:02:40.560 And they get to the weekend and they get the pancakes in the morning. They're drinking throughout

01:02:44.700 the day. By the way, everyone, alcohol has calories and it's really calorie dense. It also causes you to

01:02:50.560 make not so great food choices. And so a lot of people eat 1500 calories a week and then they'll easily

01:02:56.060 go 4000 calories on the weekends. A lot of this is just reprogramming habits and behaviors. And that's

01:03:01.680 what really came up in that systematic review was it was not, hey, this diet came out as this was what

01:03:07.660 these people were using. No, there was no one diet that came up as being superior to the others.

01:03:14.180 What came up repeatedly was these series of habits and behaviors that people had that helped them do

01:03:21.220 this. Yeah. And I think bringing it back now to the energy balance question, I think today we know a

01:03:29.680 lot more than we did 10 years ago. I think 10 years ago, at least for me personally, there was still an

01:03:36.100 open question about the impact of different macronutrients on energy expenditure, both deliberate

01:03:44.560 and non-deliberate. But I think when you look at the body of literature, so I used to be part of an

01:03:51.140 organization that actually funded two of the really big studies in this space, one out of Boston Children's

01:03:58.100 Hospital by David Ludwig. And then one was a consortium of people that included Rudy Libel,

01:04:02.180 who you mentioned a moment ago. Kevin Hall was the PI, Eric Ravison, Steve Smith, et cetera.

01:04:06.700 That's like the heavy hitters name of metabolism right there.

01:04:11.160 The six PIs on this study were six of the biggest names in all of this space. And this was a very

01:04:15.740 rigorously done study. Look, was it a perfect study? No, it was a pilot study. It was really designed to be

01:04:21.720 the study to work out the kinks to do the enormous study that actually never got funded.

01:04:25.520 But it was still a very good study and it still answered an important question, which was at

01:04:32.360 least comparing a relatively clean standard American diet to a ketogenic diet. It'd be hard to make the

01:04:39.580 case that there was more than 50 to 150 calorie difference in energy expenditure at an isocaloric

01:04:48.280 swap. There's different ways to interpret that. Some would say that's huge. If you have a 50K,

01:04:54.260 which is what the difference was in the chamber versus 150 or 160, which is what the doubly labeled

01:04:59.440 water showed, that could still be very significant over a long enough period of time. There has been

01:05:04.180 a significant debate about the validity of doubly labeled water in a ketogenic diet. You mentioned

01:05:08.900 John Speakman. He and Kevin Hall wrote a review about this suggesting that doubly labeled water really

01:05:13.880 doesn't apply. There's an artifact in a ketogenic diet. So if you just look at the chamber data and say,

01:05:19.560 well, 50 K cal per day, does that really matter? Not sure. But regardless, it wasn't 250 or 500 K cal

01:05:27.840 per day. And to me, that was a very important insight because prior to that point, I didn't

01:05:32.840 really know. Because if you look back at the Vermont study from the 1960s, if you look back at

01:05:38.600 Ancel Keys stuff where they didn't have metabolic chambers, they're on wards, but it wasn't quite the

01:05:43.680 same. It was really unclear to me. I would say today, the evidence has to be overwhelming that

01:05:50.620 if, for example, a ketogenic diet produces remarkable weight loss, it has to be doing it

01:05:57.800 through intake reduction, not through an increase in energy expenditure.

01:06:02.960 I think that you're 100% right. And I'm going to take that kind of piecemeal. So the first thing I

01:06:08.140 will say is let's throw out the energy expenditure stuff for now. And I know we just spent a lot of

01:06:13.680 time talking about energy balance. It's important, but we're assuming that these measures are accurate.

01:06:19.740 There's even error in direct calimetry because you can only measure as accurately as your equipment

01:06:25.920 that you have to measure it. Those numbers I just touted, you could argue that they were at the

01:06:32.020 limit of detection, at least for the indirect calorimeter. The 57 K cal per day was probably right at the

01:06:37.560 detection. So it could have been zero, it could have been 100. We're really on a razor's edge of

01:06:42.600 detection. The point you made was that the carbohydrate insulin model of obesity would

01:06:46.860 predict a much bigger change in energy expenditure. So therefore, at least that version of it, it has to

01:06:52.720 be falsified based on that. And even with the 150 calories, that would not explain the difference.

01:06:58.080 And again, if we look at studies that assess loss of body fat under controlled environments,

01:07:08.100 we just don't see differences between low carb and low fat when calories and protein are controlled.

01:07:13.020 We don't see it. In fact, there's actually very small favoritism towards low fat. But again,

01:07:17.920 I think that that's probably a data artifact and not actually a real difference.

01:07:21.760 Um, there was, you mentioned David Ludwig, there was a recent or more recent, um, meta analysis he did

01:07:29.980 that got a lot of buzz because basically his assertion was that, well, if you look at the

01:07:36.880 short term data, yes, there doesn't appear to be much difference. But if you look at after 17 days,

01:07:43.960 there appears to be a large difference in the energy expenditure, anywhere from like 150 to 300

01:07:50.860 calories per day, favoring low carb. Was that with doubly labeled water again?

01:07:55.240 That's it. So the issue was, and I went through this with a fine tooth comb. And again,

01:07:59.540 the meta analysis itself was very well done. The statistics were very good.

01:08:03.120 But when there was metabolic chamber data available or doubly labeled water, they use doubly labeled water.

01:08:10.460 What I would tell you is that's like saying I've got caliper data available and DEXA data available,

01:08:15.860 but I'm going to use the caliper data. Well, that's fine. But keep in mind that

01:08:19.980 DEXA is what calipers are validated against. So you're talking about a primary measure versus

01:08:25.200 a secondary measure. By the way, I've already forgotten Kevin Hall and John Speakman's

01:08:29.980 primary criticism of DLW in a KD. Do you remember the gist of the thesis where the artifact comes from?

01:08:36.420 So basically there's more CO2 produced than is accounted for in the constant of the equation.

01:08:45.340 The 1.11 is probably too low a number.

01:08:49.300 Yeah. So you overproduce CO2 compared to what the prediction would be based on that equation.

01:08:54.820 Basically what that means is that in a low carb setting, you're probably getting an artificial

01:09:01.260 increase in energy expenditure.

01:09:04.060 Oh, so the 1.11 would actually be too big. It's probably too big a coefficient.

01:09:07.820 What I went back to is I said, okay, you know what? Let's say that this isn't an artifact,

01:09:12.060 an effect of the differences in measures. And again, direct calimetry. If you're on a standard

01:09:17.720 diet, the association with AA level water is an R of 0.8, which is pretty good for like free living

01:09:22.460 stuff. It ain't 0.99 either. Right.

01:09:25.100 0.8 is good, but not exceptional. And then a low carb is 0.5, which is a pretty big difference

01:09:30.340 from a 0.8. It basically just means it's not as tightly correlated. But let's throw all that out.

01:09:36.040 I went through every single one of those studies that Ludwig looked at and then looked at,

01:09:40.980 did they measure body composition? And what did the body composition stuff say? Because

01:09:44.720 what do we really care about? Do we care about what energy expenditure says on a readout

01:09:48.880 or do we care about losing body fat? I think most people would say we care about losing body fat.

01:09:53.340 Not one study saw a difference between the low carb conditions or the low fat or balanced diet when

01:09:59.740 calories and protein were equated. So to me, that's truly the metric and that's what we care about.

01:10:05.180 So to me, that's actually great news because what it says is, hey, do whatever diet you prefer.

01:10:11.720 If you like low carb, heck yeah, it's certainly not any worse than doing a low fat diet.

01:10:17.260 If you don't like low carb, there's other options. By the way, you can just do a balanced diet too.

01:10:22.280 There's nothing wrong with that. I think balanced diets sometimes can be a little bit harder for

01:10:26.160 people to moderate unless you're doing some kind of portion control. But yeah, it says that pretty much

01:10:32.080 you can do what you want and still lose body fat. So I'm not trying to throw shade at David Ludwig,

01:10:37.440 even though I have on Twitter before. It just goes to show you that if you change the inputs for a

01:10:42.980 study, and this is one of the really fundamental problems I think is out there, some doctors and

01:10:49.120 scientists just aren't equipped to understand studies, to interpret studies correctly. And people

01:10:54.520 have asked me like, how can I get better at reading this stuff? And I hate to be somebody who sits in an

01:10:59.460 ivory tower, but I'll tell them, if you really feel so passionately, go to grad school, because I can

01:11:04.800 tell you sitting down with my PI, Don Lehman, who I'm sure you're very familiar with, and just talking

01:11:10.160 about studies and having him literally, not in a nasty way, but just crush me so many times based on my

01:11:20.380 hypotheses and everything and say, what have you considered this? That was so enlightening for me. I mean,

01:11:25.520 the best part of grad school was just sitting around a table with graduate students and Don, and just

01:11:31.260 wrapping back and forth and doing these studies. And you just really get a good idea for how to look

01:11:37.520 critically at this stuff. And now I'm to the point where I tell people, I'm like, I don't get excited

01:11:42.180 about one study. Wake me up when there's 10. You know what I mean? Wake me up when there's 10. And even then, I'm

01:11:47.720 going to look at how it was done and make sure. And I tell people, I hear this a lot. I don't trust science

01:11:53.180 because this study says this thing and this study says that thing. I said, if you truly understand

01:11:58.140 what you're looking at, you understand statistics, you understand research design. When you go into

01:12:02.840 the methods and you look at the results, don't read the conclusions of the authors. Look at the actual

01:12:09.180 results, look at the methods, and you can usually understand why they seemingly found different

01:12:15.660 results. Yeah. I'll put in one shameless plug for something we did. We have a series on the blog

01:12:21.140 called studying studies where we go through all of this methodology, but I agree with you. It's not

01:12:27.540 a substitute for getting reps on the field. In other words, that's sort of like reading everything

01:12:33.380 about playing a sport, but you actually have to play. And one of the things we've done internally,

01:12:38.460 and we've toyed with the idea of if we should just put them out there is journal club. What you

01:12:43.820 describe is basically journal club. That's really how you learn how to read studies. You sit around with

01:12:47.180 a bunch of people and it's formal. We had it every Monday morning, I think, or maybe Thursday

01:12:51.860 afternoon. I can't remember, but twice a year, depending on the size of the lab or four times a

01:12:56.560 year, you present a paper for an hour and everybody else's job is to see how you've maybe missed

01:13:03.280 something or misunderstood something and really poke and pry. And so every single week you're getting

01:13:07.580 those reps on the field and you get pretty darn good at reading the fine print. We do this once a

01:13:13.740 month internally with our team in part because it's just such a fun experience. And two, it gives

01:13:20.320 us a chance to pick a paper a month and really dissect it. So maybe at some point we'll put

01:13:24.980 those out there just so people can at least watch. It's one step closer, I guess, to doing the reps,

01:13:29.320 but yeah, you kind of have to do it. Yeah, it's tough. There's no substitute for that experience.

01:13:34.240 Now, that being said, understanding this, I started thinking about how can I help people with this?

01:13:39.280 And so we're actually going to have a periodical research review coming out monthly through our

01:13:45.220 website that's going to be subscription-based that we're going to take. There are other research

01:13:50.080 reviews out there, but we're really going to try and make this for the layman, for somebody who has

01:13:54.480 no... We're going to say, here's what they looked at. Here's what they found. Here's what we think

01:14:00.600 they found if we disagreed. Because I've read studies where I'm like, I read the author's conclusion.

01:14:05.800 I'm like, well, that's not what you found. You actually found this. We're going to say, here's

01:14:09.380 what it means for you practically. So that's funny that we've both seen that need. And again, a lot

01:14:14.800 of this is also media-driven because it's about what's the most punchy headline we can get out

01:14:19.800 there. I remember a great example was this happens so much of mechanistic stuff. It's like there was

01:14:25.340 an article and it was something to the effect of smelling your partner's farts might help prevent

01:14:30.760 cancer. What the research study actually showed was that one of the volatile fatty acids that's

01:14:39.840 produced by the gut microbiome in response to fiber may have a protective effect on breast cancer when

01:14:46.180 they gave it to animals in a high dose. And it's like, that's a long way from you taking a sniff of

01:14:52.540 your partner's fart and preventing cancer. But that's what confuses people.

01:14:57.940 All right. Let's pivot to another application of this. Everything we've talked about so far has

01:15:04.120 really set the stage for understanding the role that macronutrients, but more specifically calories

01:15:11.240 and energy intake and expenditure play in weight loss. Let's now talk about a very specific macronutrient,

01:15:17.360 which is protein and its importance in muscle acquisition. So I have a saying that I'm sure

01:15:24.980 many others have said, and I'm sure I'm paraphrasing it from somebody, but never in the history of

01:15:29.700 civilization, I will assert has a 90 year old person said, I wish I had less muscle that can't be

01:15:38.120 uttered. If you want to be metabolically healthy, the best thing you can do is have lots of lean body

01:15:44.940 mass. It is a metabolic sink is the best way to describe it. If you look at people who are even

01:15:53.480 like obese, who are power lifters, they might have some elevations in blood lipids and whatnot,

01:16:00.900 but usually their insulin sensitivity and blood glucose is still okay. If you look at people who

01:16:06.340 train really hard, even with excess adiposity, they see this with people who are obese, who they start

01:16:13.120 than just exercising. Exercise is one of the only things that we know of that without even weight

01:16:17.560 loss improves metabolic health substantially, really substantially. I was actually on the Rogan

01:16:23.640 podcast. And one of the points I made a few years ago was I said, this was the one with Dom.

01:16:28.280 Yes. So I said, you know, a lot of people get real caught up in carbs and fats and all this,

01:16:32.660 and they're not even exercising. You are stepping over dollars to pick up fractions of pennies right now.

01:16:40.400 Now, if you just got active and it's not even a high dose that's required, it's not, I mean,

01:16:45.680 a high dose is great, but just going and being sedentary and walking, you will see improvements

01:16:51.380 in health markers for a hundred minutes a week. That's it. And then obviously there can be a linear

01:16:56.660 effect. People will look at me and I remember I had my blood work done a while back. Now I do have

01:17:01.240 familial hypocholesterolemia. So my LDL tends to run a little bit high, but people were speculating that I

01:17:07.160 would have like really high inflammation because I talk about, I still will eat probably around 70

01:17:11.220 to 80 grams of sugar a day, but I'm also getting 60, 70 grams of fiber along with that. It was,

01:17:16.040 oh, your CRP is going to be able to, my CRP wasn't hardly detectable. It was on the low ends of

01:17:21.740 detection. Again, that just speaks to the fact that there is a big difference between somebody who

01:17:27.160 is a athlete training hard, who has a lot of muscle mass versus somebody who's sedentary

01:17:33.800 with excess adiposity. It's just not even comparable when you talk about food choices

01:17:38.880 and whatnot. You have a lot more you can get away with, with a lot of muscle mass.

01:17:42.640 Your point that being older and frail, people don't think about this. The funniest thing I get,

01:17:49.720 Peter, is people say, oh, you do all that heavy lifting. You're going to be in pain when you're

01:17:52.560 older. You're going to be in pain when you're older, regardless. You might as well be in pain and

01:17:57.840 strong versus in pain and weak. I have members of my family who I love dearly, who have

01:18:03.740 been sedentary for a long time, who have all kinds of sciatica and back issues. I mean,

01:18:08.920 I have had back issues from heavy lifting, but they come and they go and I'm still here. I'm

01:18:14.900 still able to lift. And honestly, I find most people who have experienced activity and inactivity

01:18:20.180 will almost always tell you if they're being deliberate in how they recall it. You're generally

01:18:26.280 in more discomfort when you're inactive. I don't remember where these zingers came from,

01:18:31.100 but none of them are mine. But this is one of my favorites. Sitting is to lower back pain what

01:18:36.620 bourbon is to alcoholism. Hell yeah. The worst thing you can do is be immobile.

01:18:42.320 I say as I'm sitting here, right? I notice you're standing, but yeah.

01:18:45.980 Yeah. Part of Journal Club in grad school, we had seminars every week where people would either

01:18:51.820 present their exit seminars for their PhD or we'd have outside speakers come in. And one of them,

01:18:56.440 interestingly, was a lower back pain specialist. And this would have been circle like 2007,

01:19:00.340 2008. And one of the interesting things he said was, which is now common knowledge. If we MRI

01:19:06.500 an elite athlete, a lot of times I'll look at their MRI and go, Oh my God, you must be in horrible

01:19:13.980 discomfort. And they go, really? No, I feel fine. And they've got all these disc bulges and herniations

01:19:19.600 and whatnot. And they're completely asymptomatic. He said, we'll have sedentary people come in and

01:19:24.520 there'll be an excruciating pain and I'll pull up their MRI and they've just got a little tiny disc

01:19:27.820 bulge. There is probably no more diagnostic test that is uncorrelated from clinical outcome

01:19:33.840 than an MRI of the lumbar spine. Not a specialist. You know, I've spoken with lumbar specialists like

01:19:39.480 Stu McGill. It's data. It's kind of like a DEXA, but it shouldn't really dictate treatment. Treatment

01:19:45.880 should be based on pain and what triggers your pain. And that's a whole nother rabbit hole. The pain

01:19:51.860 world is a whole nother rabbit hole. People think the human body is like a bag of meat that's just

01:19:56.420 connected to your brain. And now we know that pain is more like an emotion than anything. I digress.

01:20:01.300 So let's talk about it now through this lens. I want to talk about it, whether we're dealing with

01:20:07.800 a 50 year old woman who comes to you, who's never lifted a weight in her life. Okay. So she's the mom

01:20:16.060 of three has never touched a weight. She's going through menopause. So now she's actually starting

01:20:21.440 to put on a little bit of weight, maybe for the first time in her life. So she's actually starting

01:20:25.600 to get a little chubby and she's not overweight. Her clothes are getting a little bit snug and her

01:20:31.080 assumption is I need to do more cardio. I need to be more active and it probably needs to be

01:20:36.760 disproportionately cardio. You look at her and you make the diagnosis, ma'am, we can do some cardio.

01:20:43.840 We got to put some muscle on you. So you do a DEXA on her and she comes back 30% body fat,

01:20:50.340 but it's kind of skinny fat. Her ALMI is six, puts her at the 10th percentile of muscle mass.

01:20:59.240 What are you going to do with her and what are you going to make her eat?

01:21:02.640 Yeah. So I think the first thing to say is that muscle is a lot like bone in that you want to lay

01:21:09.200 down as much as possible because eventually it's going to start receding, but it is still possible

01:21:13.640 to add muscle and people will hear that and go, well, I'm 50. I might as well not even.

01:21:17.200 Yeah, exactly.

01:21:18.220 No. In fact, right across the street from my lab at the University of Illinois, sorry, not my lab,

01:21:23.240 the lab I was in, right across the street at the exercise physiology building, they did a study

01:21:28.520 an 80-year-old frail elderly. Well, they basically had them start where they would squat to a high

01:21:35.100 chair and come up. Gradually, they put the chair down. This was like a 16-week study and I don't have

01:21:40.720 the citation, but I just remember talking to the other grad student about it. So please forgive

01:21:44.920 me, everyone out there. But they said they were amazed because by the end of it, one, these people

01:21:49.980 as a percentage of their body weight increased their lean body mass pretty much the same amount

01:21:54.560 that a 20-year-old does. The relative increase was similar. Now, they had less overall mass they put

01:22:00.640 on because their weight was lower to start. And they said by the end, some of them were actually able

01:22:04.720 to add weight. Squat with weight, yeah. And squat all the way down to a parallel chair.

01:22:10.420 The people in the study were completely mind-blown that this was possible for them.

01:22:14.300 And it's 16 weeks. It's not even a long time. And we're talking about people who probably think that

01:22:19.560 they're heading for a wheelchair. It is never too late to get active.

01:22:23.700 And let's bring it back to your finance example. It's never too late to start saving. It's true

01:22:29.040 if you can be one of the fortunate people who write out of college or who doesn't even go to

01:22:33.480 college and go straight to work out of high school or whatever, and you can start saving right away.

01:22:37.280 Well, that's fantastic. But just because you've made it to 40 and you've been scrapping by and

01:22:42.540 you haven't been able to save, but now you come into a little bit of disposable income and you

01:22:46.360 can start saving, there is zero downside to that. Better late than never. Absolutely.

01:22:52.720 That's a great comparison. I actually never thought about that before. So I'm going to steal that for

01:22:55.680 later. So I'll give correct attribution. And then as far as diet-wise...

01:23:01.960 When I see that woman in my practice, which I see all the time, I'll tell you what she looks like.

01:23:06.020 And I want you to compare it to your version of that. But when I see that woman, she looks exactly

01:23:09.960 as I've said, right? So she's 50. She's going through menopause. She still looks normal, but

01:23:15.400 the composition of her body is really changing. You do that DEXA. She's 30, 35% body fat,

01:23:20.940 very little muscle mass. You take a close scrutiny of what she's eating. She's getting 50 to 60 grams of

01:23:28.240 protein a day on a good day. And when you do a strength metric assessment on her, she is incredibly

01:23:36.200 weak. Even if you were to compare her to another female at an appropriate age adjustment. I have a

01:23:43.620 very stark conversation with her when I pull up something called the death bars. So the death bars

01:23:49.660 are this analysis that Bob Kaplan did for me, God, probably about six months ago, a year ago,

01:23:56.820 which is basically just causes of death by decade. I double click on accidental deaths.

01:24:03.760 This death bars is so cool because you can double click on it all over the place. And

01:24:06.820 once you call out accidental deaths, you realize something really interesting.

01:24:11.160 Unlike cardiovascular disease, cancer, Alzheimer's disease, which are very age dependent,

01:24:17.040 meaning the older you get, the more the incidence goes up. Generally with cancer,

01:24:20.540 it actually comes down a little bit in the last decade. Accidental deaths are basically the same

01:24:25.760 forever. So from 10 year olds to 20 year olds and 80 year olds to 90 year olds, they all have the

01:24:32.340 same number of accidental deaths per year, more or less. What differs dramatically is the type of

01:24:39.380 accident. So in young people, it is disproportionately, sadly overdoses that are the lion's share followed by

01:24:47.860 automotive accidents. In the oldest subset of the population, it becomes almost entirely accidental

01:24:55.240 falls. And when you show somebody this graph, cause it's so pronounced, I've never seen a person who

01:25:01.140 doesn't just stop in their tracks because they cannot believe how much morbidity and mortality results

01:25:08.100 from falling and frailty. Once you reach about the age of 70, 75. I mean, the data is there to back it up.

01:25:14.420 I may butcher this citation, but I believe there was a study by Bob Wolf, kind of a review that showed

01:25:21.600 essentially after age 65, you could tie the majority of deaths to some kind of lack of muscular strength

01:25:30.120 or lack of muscle. And if you look at, they've done these meta-analyses of mortality showing that

01:25:37.140 your lean body mass is inversely proportional to your risk of mortality after age like 50.

01:25:44.700 And by the way, strength is even slightly higher.

01:25:47.900 Yep.

01:25:48.240 So the hazard ratio for being strong to not strong is about 3.2 for all cause mortality.

01:25:53.720 Think about that.

01:25:54.280 Which is a big hazard ratio.

01:25:55.380 Freaking staggering hazard ratio.

01:25:57.220 You're talking about on the level of smoking right there.

01:26:00.040 No, it's higher than smoking actually.

01:26:01.560 Yeah.

01:26:01.680 Smoking is about two. So to put that in perspective, end-stage renal disease is about three.

01:26:09.220 And the only thing that's higher, and I talked about this on another podcast, is elite, meaning

01:26:14.380 top 2.5 percentile of VO2 max compared to bottom 25th percentile of VO2 max. That has a delta of 5.

01:26:22.360 5.1 is the hazard ratio. And of course, these are not mutually exclusive. So why not have

01:26:27.620 remarkable cardio-respiratory fitness, muscle mass, and strength?

01:26:31.980 So I think one of the big barriers, especially with the type of client you're talking about,

01:26:36.480 is, well, I don't want to get too bulky or too muscular.

01:26:40.440 Can you dispel the myth of accidental muscle, please?

01:26:44.240 Yeah. So as someone who's spent their entire adult life trying to get too muscular and basically

01:26:51.560 just looks really fit in a t-shirt, don't worry about that. You're going to be okay.

01:26:56.400 And if you do start to get too muscular, you can always just back off. Pretty easy. That's like

01:27:02.220 saying, I mean, literally, let's use a financial comparison.

01:27:04.560 I'm worried about getting too rich.

01:27:06.100 I might get too rich. And if you're worried about that-

01:27:09.540 We've got some great philanthropies that we can introduce you to.

01:27:11.700 Yes, exactly. So it's like getting in a car and worried about becoming a NASCAR driver

01:27:17.240 spontaneously. Just the amount of benefit you will get from three times a week, 30 to 40 minutes

01:27:27.420 of resistance training, not even crazy intense resistance training, just an amount that forces

01:27:35.280 your body to adapt will be unbelievable in terms of your level of fitness and your ability to live

01:27:45.980 a long, healthy life.

01:27:47.660 So tell me what you would do. So let's use this again, this generic, but rather very specific

01:27:53.500 example of this 50 year old woman who is not completely unfit. So let's even give it to her

01:27:59.980 that she still does yoga, walks, does some stuff, but she's never lifted weights before. Tell me

01:28:05.660 what her first four month program looks like from you. First off, what's reasonable for her

01:28:11.600 lifestyle? Like what can she actually do? So let's say she says, Lane, I'm willing to commit to 45

01:28:17.500 minutes three times a week in the weight room. I think that probably lower body strength is a little

01:28:24.380 bit more important than upper body strength in terms of preventing falls. I mean, we always think

01:28:28.600 about falls from a bone density perspective. We don't want people to fall and break their hip

01:28:32.460 because that specific fall is pretty much a death sentence. If you're over the age of 65,

01:28:37.980 people worry about the bone density. Well, if they didn't fall in the first place,

01:28:41.680 if they had the muscle mass to catch themselves, you wouldn't have to worry about that. And also,

01:28:47.060 by the way, bone density is increased by lifting weights much more than anything you'd ever get

01:28:51.720 through your diet. So I would say, let's just see what you can do. And then I would probably do two

01:28:57.940 lower body days, one upper body day, could even flip-flop it on alternating weeks if you wanted

01:29:03.240 to even it out. And it would mostly be, honestly, just some machine stuff that's very easy for her

01:29:08.560 to do to get in there. Because honestly, she's never trained before. Everything's going to cause

01:29:13.120 an adaptation. And that's what we're looking to get. And I'm not going to have her come in and try

01:29:17.860 and free squat or deadlift or anything like that. That's a really horrible idea. It's just going to

01:29:23.500 frustrate her and not actually apply the load where we want it because she's not going to be

01:29:27.520 able to balance it very well. So when you say machines, would you be thinking like, look,

01:29:32.300 you'd be happy with her doing a leg extension, a leg curl, a leg press? Yeah. Would you have her do

01:29:36.760 anything that's a little more compounded and complicated? For example, holding dumbbells and

01:29:41.560 stepping up onto a bench where now she has to manage grip strength with a bit of balance and also

01:29:47.780 getting the leg load? Or is that not first cycle? I probably wouldn't do that in the initial

01:29:52.560 weeks just because the soreness is going to be so high. It's going to impede a lot of that movement

01:29:57.200 well. And people tend to think about soreness in the wrong way. It's correlated with muscle growth

01:30:03.760 and strength, but it is not causative. And so what I'll tell people is if you're sore all the time,

01:30:09.560 you're probably training incorrectly. If you're never sore, you're also probably training incorrectly.

01:30:14.560 So it's something that if you're doing an appropriate amount of volume and intensity,

01:30:18.260 there probably should be some soreness from time to time. But if you're getting sore all

01:30:22.880 the time, then your programming is pretty bad. What I'm trying to do in the initial stages

01:30:27.420 is just actually get enough to adapt and not cause enormous amounts of soreness.

01:30:33.900 Can discourage her as well.

01:30:35.660 It can be discouraging. That's it. I mean, if you can't go about, like everybody's known that

01:30:39.740 feeling after their first like hard squat day, good luck doing anything. And so that's going to be a

01:30:45.220 discouraging thing, especially if somebody has got life. Not all of us are meatheads who love

01:30:49.020 that feeling. Also, it's going to impede her subsequent sessions, especially if you're talking

01:30:53.560 about something like a step up that requires more coordination. If you're overly sore, that's going

01:30:56.860 to be really, really difficult. So I'm probably going to try and get her through like four to six

01:31:01.060 weeks, which if we look at the data on muscle protein turnover, I think we talked about this last

01:31:06.260 time a little bit. You don't really see increases in hypertrophy during the six weeks, the first six weeks

01:31:11.020 of resistance training. What you're getting is actually a remodeling of the tissue

01:31:14.020 to be stronger, more resilient, and it starts protecting itself against damage.

01:31:19.060 That seems to be where muscle protein synthesis goes up, but muscle protein degradation also goes

01:31:23.820 up. So basically you're kind of in this futile cycle where it's just turning over the tissue.

01:31:27.860 After about six weeks, muscle protein degradation tends to go down. Muscle protein synthesis stays

01:31:32.460 up and that's where you start seeing those increases in hypertrophy and lean mass.

01:31:36.200 Does a trained athlete also go through that or have you long since passed through that? And are you

01:31:41.520 now generally at the point where degradation is not having this disproportionate rise relative to

01:31:47.820 synthesis? I thought you might ask this. So I actually have a paper from Damas et al pulled up,

01:31:52.420 which is really interesting. So if you look at myofibrillar protein synthesis in response to

01:31:56.580 resistance exercise, we see what tends to happen is the amplitude of muscle protein synthesis in trained

01:32:07.680 people is a little bit lower than untrained. So you don't have quite the same response.

01:32:15.000 It depends on when you measure. If you measure it 16 hours post, they're about the same. They're about

01:32:19.760 a 40% increase. If you measure it four hours post, trained is still about 40%. Untrained is about 70%.

01:32:26.260 So you've got a little bit of difference in amplitude, but what really is the difference is the

01:32:30.800 duration. In trained people, it's back down to baseline about 10 to 20 hours after the initial

01:32:38.780 resistance training bout. Whereas the untrained people still have elevated rates of protein synthesis

01:32:45.500 even like two, three days later. And sorry, Lane, this is just synthesis or this is net accumulation?

01:32:51.700 This is just synthesis. Got it. So it could be offset by degradation.

01:32:55.800 It could be. And degradation is much more difficult to measure, unfortunately. If we get into the

01:33:01.540 techniques that are used to measure this, what you find is you really can't measure all three things

01:33:05.620 at one time, unfortunately. So you can measure kind of the net balance. We do that with what's called

01:33:09.640 an AV balance. You take a labeled amino acid, you're infusing it, you're sampling in the arterial

01:33:15.740 of a muscle bed and then the veneus of the muscle bed. And so basically, depending on how much of that

01:33:21.780 label shows up in the vein versus the artery, we know how much is being retained in muscle so that

01:33:27.520 we know what the net is. You can infuse a second label to presumably get synthesis as well. And then

01:33:34.020 you can figure out the difference of degradation. But the problem with this is it requires a steady

01:33:38.260 state. You can't do it when you've trained or had a meal or anything like that. It's pretty much

01:33:42.340 exclusively fasted because there's too many assumptions you have to make about the rate of

01:33:46.900 appearance versus rate of disappearance and those sorts of things. You can measure synthesis very

01:33:51.740 easily. Well, I wouldn't say very easily, but much easier than degradation. And you can measure

01:33:56.220 degradation. But the problem with degradation is how you're measuring it. We know that, for example,

01:34:01.940 out of every amino acid that's used for protein synthesis, seven out of eight of them are actually

01:34:09.100 from degradation. So it's amino acids being recycled. Of all the things we talked about in our first

01:34:14.700 episode, Lane, this was the most novel to me. And it's the one thing that I literally find myself

01:34:21.240 thinking about every day when I finish a workout and go and get a protein shake is I wonder how many

01:34:28.020 of these amino acids in said shake versus these amino acids that I've just eviscerated from deadlifting

01:34:35.280 are actually going to be the ones that form through the summation of new myofibril synthesis.

01:34:42.120 What I would say is don't think about it that way. What I would say is if you want to maximize muscle

01:34:48.280 mass, you want to maximize protein synthesis, obviously, and maximize deposition. The theory at

01:34:54.520 first was, all right, if it's only one out of every eight, and you can only really deposit about five

01:34:59.280 to 10 grams per day net in muscle overall of amino acids, I mean, that's kind of the max.

01:35:05.580 Wow. Say that again.

01:35:07.100 So about five to 10 grams a day. If you do that over the course of a year, every single day,

01:35:12.800 I've done this calculation before, so I don't remember it exactly. So I'm going to estimate.

01:35:17.780 Look, if you do the math on 10 grams a day, that's eight and a half pounds.

01:35:22.660 But what do we know about muscle tissue? It's about 70% water. We're just talking about the

01:35:28.220 actual protein content. So if you take that eight pounds and we divide it by...

01:35:33.540 0.3. Yeah, 0.3.

01:35:35.540 Yeah, it's about 26 pounds.

01:35:37.220 About 26. That's a lot of lean body mass. I would say that's a lot of lean body mass,

01:35:41.800 even for a novice trainer. So we know the max is probably about five to 10 grams per day in terms

01:35:47.580 of drug free. Do you know how much that can go up to with anabolic steroids?

01:35:52.840 I'm not sure, quite honestly. There's just a dearth of information about that just because

01:35:57.740 it's hard to get IRB approval for doing research on steroids.

01:36:01.580 Yeah, I mean, it would simply be basically the anecdotal evidence of looking at a professional

01:36:06.300 bodybuilder and asking...

01:36:07.580 Correct. I think the magazines exaggerate a lot of stuff. And I would even say 30 pounds of

01:36:12.580 actual skeletal muscle wet tissue would still be a ton for someone on drugs. I mean, that's a lot of

01:36:19.660 skeletal muscle tissue. Go to the store and look at 30 pounds of beef.

01:36:22.940 We just had a female patient in our practice who went from being not very active to getting very

01:36:29.660 active. And she had a DEXA scan separated by five months, which I generally don't like doing DEXAs

01:36:37.240 that close together. But the cardinal sin was just through circumstances were done at different

01:36:42.160 facilities. The DEXA suggested she gained six pounds of lean tissue. One of these DEXAs was wrong.

01:36:50.160 Six pounds of lean tissue in five months? I mean, is that possible? Am I...

01:36:55.060 She probably did gain some.

01:36:56.520 Would that be expected to... I mean, we'll know, I guess, when we repeat it at the one-year mark from

01:37:00.560 the beginning, because maybe it'll plateau. And this would be this remarkable adaptation out of

01:37:05.220 the gate. But it struck me as a lot of lean tissue.

01:37:07.900 But I mean, if you want to gain eight pounds of lean tissue on a DEXA...

01:37:11.900 It could be a lot of water, yeah.

01:37:13.180 Take a DEXA, jump off, drink a gallon of water, and jump back on, and you'll have gained eight pounds of

01:37:16.940 lean tissue, so...

01:37:17.720 That's my point. There's the hydration artifact and all these other things that could be doing it,

01:37:20.740 yeah.

01:37:21.160 She probably did gain some. Most people's lifestyles aren't that volatile that you see that difference.

01:37:25.740 So she probably did gain some. But in terms of muscle protein synthesis and how much you deposit

01:37:30.460 muscle, people say, well, if you only need 50 grams to meet your requirement in terms of being a

01:37:38.640 positive nitrogen balance, because that's how that's determined, is nitrogen balance.

01:37:42.180 Can we dismantle the RDA in a minute?

01:37:43.960 It'll kind of get to that. People say, well, just throw 10 grams of amino acids on top of that.

01:37:48.620 10 grams protein on top of that. I mean, you're there. That's not how it works. You're assuming

01:37:52.700 that every single amino acid after that just goes straight to lean tissue.

01:37:58.560 You've already mentioned the thermogenic effect. How much of that is actually coming from the protein

01:38:04.100 itself being inefficiently metabolized versus a stored energy source? Do we know that?

01:38:09.220 I would say it's more about the oxidation of the protein and where it's going, but I'll get to that

01:38:15.920 in a moment. The thing to keep in mind is that in order to maximize your deposition, to get that 5

01:38:21.200 to 10 grams, you need to maximize protein synthesis. But to maximize protein synthesis requires a

01:38:26.120 disproportionate amount of total protein. So in order for you to maximize protein synthesis,

01:38:32.000 we think it's around 1.6 to 2.4 grams per kilogram of body weight.

01:38:37.540 Sorry, say that again. 1.6 to...

01:38:39.900 2.4 grams per kilogram.

01:38:41.960 Of lean body weight or total body weight?

01:38:44.000 The meta-analysis on this was total body weight. But if you want to say lean body mass,

01:38:48.340 then you could pump it up to like 2 to 2.8 grams per kilogram of lean body mass. And you're pretty

01:38:53.140 much at the same number, unless you're like obese or super lean. And people will like quibble about

01:38:57.680 that. And I'm like, listen, just get in the ballpark.

01:38:59.380 Yeah, exactly.

01:39:00.480 Which kind of winds up with that old 1 gram per pound of body weight number.

01:39:04.060 You need a disproportionate amount of protein to maximize the deposition. It's just kind of an

01:39:10.660 interesting fact. And the other thing people will say is one of the ways that protein is assessed

01:39:14.960 or needs are assessed is what's called the indicator amino acid method, or they also look at direct

01:39:20.200 amino acid oxidation. But usually the indicator is kind of the one that's the gold standard.

01:39:24.540 But if you look at direct amino acid oxidation, I did this. I pulled up a bar of direct amino acid

01:39:29.300 oxidation, which basically is like, if you feed a certain amount of protein, or if you're feeding

01:39:33.620 increasing levels of protein, and you look at the oxidation levels of a specific amino acid,

01:39:38.220 it'll be kind of flat. And then you'll hit an inflection point and go up linearly. And they've

01:39:43.360 said, okay, that inflection point right there, where you start increasing amino acid oxidation,

01:39:47.640 that's obviously wasteful. That's extra protein. You don't need any more than where that inflection

01:39:52.360 point is. And then if you look at what actually increases muscle protein synthesis,

01:39:55.980 it's right at where amino acids start getting oxidized.

01:40:00.580 And do you think that that's just an association?

01:40:03.100 I think it's an association.

01:40:04.760 You don't think that that's causative?

01:40:06.260 No, I don't think it's causative. I think it's more, if you think about it from a teleological

01:40:09.700 perspective of evolution, to me, and this is one thing Don Lehman was great about, he would always

01:40:15.880 ask me, why do you think this is happening from an evolutionary perspective? It would make sense

01:40:21.120 that at the same amount of protein that you can start using it for energy, that you could also

01:40:26.460 start building extra tissue. To me, that actually kind of makes sense. You've got such a surplus

01:40:31.920 that now you can begin to build more lean tissue.

01:40:35.460 And did you say that on average, that was going to occur at roughly two grams per kilo?

01:40:41.720 That's going to be the higher end of that linear bar.

01:40:44.700 So maybe even two and a half.

01:40:45.980 You're probably going to see amino acid oxidation. I don't know the exact number. I could find it if

01:40:51.260 I dug through enough stuff, but probably around one gram per kilogram of body weight protein intake,

01:40:56.580 something around there.

01:40:57.760 Oh, I see. So you even start to see that at such a low level.

01:41:01.620 Oh yeah.

01:41:02.080 Once you pass the RDA, you'll probably just start to oxidize amino acids.

01:41:06.520 So you really got to think about protein as you've got to throw in a lot more to get out what you

01:41:12.080 want.

01:41:12.500 So it's just a very inefficient system.

01:41:14.460 Correct. Which works to your advantage because again,

01:41:17.720 that wasteful futile cycle is wasting energy. You're expending more energy.

01:41:22.060 And is that all through gluconeogenesis lane? All of that oxidation, is it going to the liver

01:41:26.300 to make glucose?

01:41:27.580 It's been a while, so forgive me. I could be wrong. There is, I believe, some direct amino acid

01:41:33.540 oxidation in terms of you have to deaminate it first. But after that, there's some pretty quick

01:41:39.960 ways to oxidize some of those intermediates. And some of them can enter the Krebs cycle directly.

01:41:47.000 That's right. Yes, yes, yes. We do see some paths for amino acids to enter.

01:41:51.840 Think about ketoglutarate.

01:41:52.900 Alpha ketoglutarate. Yep, exactly.

01:41:54.320 So that's a direct, I believe, from glutamate. There are these places. I think it's like 60%

01:42:00.640 of protein is gluconeogenic. That's right. Not all of it is, yeah.

01:42:04.240 There is some specific ketogenic amino acids. If I was still in grad school, I would know this.

01:42:09.580 This is a Dom D'Agostino question. He would know this, right?

01:42:12.160 Yeah, yeah, yeah. I think one of the branch chains is actually ketogenic.

01:42:15.380 There are pathways to both, but that's the beautiful thing about metabolism. It's like nothing is actually

01:42:20.220 wasted. If it's given off as heat or something like that, it's because there was a reason for it.

01:42:25.060 If it's metabolized in the glucose, it's because there was a reason for it. It's one of the beautiful

01:42:28.740 things. In fact, one of the pieces of artwork I want to get in my office is the chart of metabolism.

01:42:33.700 It's just such a cool thing to look at. And almost as a scientist, I can look at that and go,

01:42:38.880 I could believe there's a God. Just from how beautiful that is. You know what I mean?

01:42:44.800 This is actually great background. So let's go back to our woman. You got her in the gym. She's

01:42:49.080 there three days a week, 45 minutes at a time. We're doing two days, lower body, one day upper

01:42:53.660 body to start. For the first six weeks, the goal is don't get hurt. Don't get too sore. Build up the

01:42:59.380 habit of doing this thing. Find some enjoyment, get the tissue resilience. You're probably overly

01:43:05.300 degrading muscle and not so much synthesizing. So don't expect to actually add lean mass.

01:43:09.840 When you do your intake assessment on her, you find out she, let's say she weighs 135 pounds.

01:43:16.000 So that's what, 60-ish kilos. And you find out she's eating 50 grams of protein a day.

01:43:24.180 You can probably think better through how many calories she's probably getting on average. But

01:43:27.920 let's say she's getting 2,300 calories per day of which only 200 is coming from her protein.

01:43:35.000 How do you change her macros with obviously the most important being the protein?

01:43:39.180 I think one of the biggest things that I really work on people, especially with like our

01:43:44.400 app, Carbon Diet Coach. Tell me what the app is again. I've seen it on Instagram.

01:43:48.680 Yeah, it's called Carbon Diet Coach. So basically it's, if people feel like they have a little bit

01:43:53.360 more independence or they can't afford a one-on-one coach. So basically the app is a nutrition coaching

01:43:58.780 app. If you put in your metrics, it will give you macros to follow, has a food tracker. And then

01:44:04.280 every week you check in with the coach, which is an algorithm, and it will adjust your macros

01:44:09.320 based on your progress. We've had thousands of awesome testimonials. So it's pretty cool to see.

01:44:15.660 But one of the big things we'll get, especially from like Gen Pop, is how do I hit these protein

01:44:20.000 recommendations? And when I go in, most of their protein sources are really fatty cuts of meat.

01:44:24.480 That's one thing. And so I'll say, okay, one, pump up your portion size, but let's select leaner cuts

01:44:30.780 of meat.

01:44:31.280 Because you're not necessarily trying to increase their calories. You're trying to basically keep

01:44:36.260 them almost isocaloric, but shift more to protein.

01:44:40.120 Absolutely. And sometimes even like in her case, I wouldn't necessarily recommend it because she's

01:44:45.180 already kind of small. But if people do have a little bit of excess body fat, especially if

01:44:49.860 they're new to training, they can recomp. Absolutely can recomp, lose fat and gain muscle at the same

01:44:54.200 time. And in that case, that might be a place where I would do it just because it sounds like she

01:44:58.460 has a little bit more body fat than she probably should for her body weight.

01:45:01.940 Let's assume her height is such that by BMI, she's totally fine. She's at

01:45:06.080 BMI at 25. But we would love to see her be at 22% body fat in two years instead of 35% body fat

01:45:14.360 in two years. I'd like to see her have 10 more pounds of muscle.

01:45:18.700 And that's pretty reasonable goals. And so one of the things I would say is, okay,

01:45:23.120 let's look at the portions of if you are eating meat, let's look at the portions of meat you are

01:45:27.360 eating.

01:45:28.120 What's your protein target for her?

01:45:29.920 A lot of it's going to be one, what can I get her to eat?

01:45:32.480 Starting from theoretically exceptional.

01:45:34.540 Yeah, I would probably say if we could get you at like 120 grams.

01:45:39.040 About a gram per pound, almost.

01:45:40.900 Yeah. It probably could be a little bit less, 110. Doesn't have a lot of lean body mass. So

01:45:46.180 probably 100, 110 is going to be just fine. Anywhere in that range is going to be just fine.

01:45:50.080 And then your strategy is what? How much in shake? How much in, yeah.

01:45:54.660 First thing is breakfast. So breakfast is where most Americans are very low in protein because most

01:46:00.720 breakfast foods either don't eat breakfast or it's a banana or it's cereal or it's oatmeal or

01:46:05.460 whatever.

01:46:06.480 Oh, and sorry, I'm going to just keep making shit up to be funny. She says, but Lane, the thing that

01:46:11.520 has been so helpful for me is I do time restricted eating. I do just two meals a day, lunch and dinner.

01:46:18.260 So first thing I would say is, okay, why are you doing time restricted eating?

01:46:23.600 And she'll say, because it really helps me maintain my weight.

01:46:26.600 Thing I would say is, okay, you can probably still get the vast majority of the benefits of

01:46:31.880 time restricted eating, just throwing down a lean protein source or a shake in the morning.

01:46:36.240 You're getting in, boom, another 25 or 30 grams of protein. You're stimulating protein synthesis

01:46:40.440 and protein itself. High protein diets actually mimic some of the things that go up during fasting.

01:46:47.700 I would say that protein acts a little bit differently. And one of the things I said to

01:46:51.280 people, if they are trying to increase or maximize lean body mass, but they want to do

01:46:56.320 time restricted eating for the benefits of satiety and lifestyle, cool, do that, but throw in a protein

01:47:03.620 shake in the morning just because it's not going to mess up any of those things. And it's going to

01:47:08.100 help with lean body mass. If she said, I mean, maybe I'm saying this now, but just what about

01:47:12.480 mTOR? mTOR is responsive to amino acids. And of course, I'm going to argue you're not getting much

01:47:18.060 mTOR suppression with an overnight fast and skipping breakfast. But what about low IGF and all of these

01:47:23.660 other things? Aren't these the important pillars of longevity? Isn't all this extra protein you're

01:47:28.240 making me eat at odds with that? Let me answer that question after I get to how I'd add more protein.

01:47:33.180 I was talking about somebody about this the other day and so many people mess it up.

01:47:36.620 The next thing I would do is, okay, let's look at lunch. Where can we get more protein?

01:47:40.920 If it's not a shake or anything like that, let's pump up some lean protein in the sandwich or let's

01:47:46.040 add it to your salad or whatever it is. I don't want to fundamentally change how she's eating if

01:47:52.160 the calorie amount is okay. I want to make small changes that aren't going to feel disruptive to

01:47:56.880 her current lifestyle, the minimal disruption of the current lifestyle. In fact, the research shows

01:48:01.040 that in terms of dietary adherence, the less you can change, the better they will do because it's

01:48:06.460 already close to their current lifestyle. Then if we get to dinner, which is where most people get

01:48:10.280 about 65% of their protein, again, assuming we've got 20, 30 grams of breakfast, 20, 30 grams at

01:48:16.560 lunch. Again, people say, well, how many shakes can I have? Hey, if you like having shakes, there's

01:48:22.240 nothing wrong with shakes. Absolutely nothing wrong. Go ham. There's nothing wrong with it.

01:48:27.520 Then at dinner, obviously, okay, if they've been having fattier cuts of meat, which a lot of people,

01:48:31.580 they have a ribeye. Again, I'm not saying you can't have those things, but again, if calories are a

01:48:35.820 consideration, ribeye, T-bone, those sorts of things, okay, well, let's move to like a sirloin or a filet

01:48:41.020 or a chicken breast. You can get pork chops that are really lean too, that are very tasty. Venison,

01:48:47.540 I was at a place called Steelbox here in Tampa, and they had a venison ribeye or something like that.

01:48:53.920 I think it was a venison ribeye. Amazing. It was like four grams of fat per serving. Amazing. By simply

01:49:00.640 changing the cuts of meat, you can pump up the protein, reduce the fat, your calories kind of stay

01:49:05.600 about the same. I like to use shakes wherever somebody just says, hey, I just don't have,

01:49:09.900 especially as people get older, they tend to consume less protein and have less of an appetite

01:49:14.660 for protein, especially like the mastication. As people get older, they just don't like having

01:49:19.320 to chew as much. And so shakes can be a really, really useful tool. And even if somebody's having

01:49:24.500 a carb heavy breakfast, typically like a cereal or something like that, there's such good ready to

01:49:29.660 drink shakes out there right now. Instead of milk on your cereal, just put a protein shake,

01:49:34.980 a vanilla protein shake, and boom, you've got 30 grams of protein instead of eight.

01:49:39.700 Now, I mean, Peter, I'm sure you can speak to this. Compared to when I started, like in the late

01:49:44.240 90s, early 2000s, I mean, literally, I got a can of unflavored protein from GNC one time.

01:49:50.620 I was like, oh, I can do this because it was cheap and I was a college student. And I could not do it.

01:49:55.160 It was like chalk. It was literally like chalk.

01:49:58.120 When I was in high school, there was this brand called Sheckley, I think.

01:50:01.280 Yep.

01:50:02.040 Yeah. It was, it was pretty bad, but boy.

01:50:04.740 And the protein bars, again, not the best tool, but again, what are we replacing it with?

01:50:10.060 So if you're having a protein bar instead of like a really burger or something like that,

01:50:14.060 great alternate substitute. And there's some great tasting ones out there now.

01:50:19.160 Now, your question about mTOR and IGF-1.

01:50:22.240 Before we wrap up her, the biggest change you've made is you've doubled her protein intake,

01:50:26.700 which in reality is almost an isocaloric switch. It's a rounding error in terms of how many

01:50:32.260 additional calories you've had. Are you paying attention to what percentage carb versus fat in

01:50:37.920 this woman, given that our primary goal is going to be hypertrophy over the next couple of years?

01:50:43.300 So the research on hypertrophy leads me to think as far as carbs and fats go,

01:50:48.400 it mostly doesn't matter as long as you're not at the extreme of either. If you are very,

01:50:53.360 very low fat, it can impair testosterone levels. Now they've not really shown like an impairment of

01:50:59.680 lean mass accrual, but they haven't really measured it either. And I would say that if

01:51:02.920 it impairs testosterone enough, you may get an impairment of lean body mass.

01:51:06.620 As far as how much fat that is, it's very difficult question because they've done it as a percentage of

01:51:10.300 calories, which to me is almost useless because obviously if 10% of calories, if you're eating 5,000

01:51:16.860 calories is still probably enough fat. And as you have more calories, you can also create fat or spare

01:51:22.640 fat from oxidation by using more carbohydrates. So first off, it's a calorie amount issue as well.

01:51:28.820 But I would say if you're getting at least 20% of your calories from fat, you're probably safe.

01:51:33.240 And as an absolute floor, 40 grams of fat. Again, I'm guessing. So please don't be dogmatic about

01:51:39.260 these numbers to those who are listening. But then also like a ketogenic diet does appear to impair

01:51:44.660 lean body mass accrual, probably through a few different mechanisms. Even though carbohydrates

01:51:48.920 aren't stimulatory for muscle protein synthesis, they do inhibit muscle protein degradation and fat

01:51:55.280 doesn't appear to have the same effect. It's probably an insulin effect. Insulin doesn't

01:51:59.100 inhibit muscle protein degradation. It's almost impossible to be on a ketogenic diet if you're

01:52:04.360 actually generating sufficient ketones. And that's your metric for saying you're ketogenic

01:52:08.760 with the amount of protein that we were talking about anyway, because for someone your size,

01:52:14.000 it would be very difficult for you to get high levels of beta hydroxybutyrate with the amount of

01:52:18.340 protein that you would need to be in that positive nitrogen balance anyway.

01:52:21.940 Correct. The other way that it probably impairs lean body mass accrual is through just effect on

01:52:29.040 training because resistance training is anaerobic for the most part.

01:52:33.920 So her glycolytic capacity goes down.

01:52:35.740 Yeah. The research shows that if we're talking about ultra endurance or even endurance in terms of

01:52:40.820 under 65, 70% of a VO2 max, ketogenic compares to be just fine. But once you start getting over that

01:52:48.340 65% VO2 max, there does seem to be a significant impairment in performance. So there was a

01:52:53.940 couple of 12-week studies looking at lean body mass accrual and showing an impairment with the

01:52:58.000 ketogenic diet. My guess is it's one, through not inhibiting muscle protein degradation as much,

01:53:02.640 and two, just through not performing as well. And they did show lower strength accrual as well

01:53:07.300 in the ketogenic diet group.

01:53:09.160 So your fat to carb ratio in her, given that we're not going to go to any extreme,

01:53:12.980 I notice in your programming, some of the stuff that you've written about, you talk about, look,

01:53:18.560 here is where you customize it based on how you respond to carbs. So some people,

01:53:24.220 carbs really increase their appetite. They create brain fog, all sorts of things. If you're in that

01:53:28.640 camp, you're going to push to a lower carb variant here. If you're someone who tolerates carbohydrates

01:53:32.980 very well, you could easily be on a higher version there. That becomes the secondary fill

01:53:38.360 after the primary bucket of protein is established.

01:53:41.940 Absolutely. Protein and calories, most important two things. How you distribute your carbohydrates

01:53:46.560 and fats should be based on what you can adhere to and what you enjoy. I could argue brain fog or

01:53:51.500 appetite that it depends on the type of carbohydrate. A lot of it might be possibly placebo as well,

01:53:56.780 just based on things that have been said in the media. Regardless, if you know that you just prefer

01:54:01.720 a lower carb diet, then there's absolutely nothing wrong with doing it as long as you're not getting

01:54:05.940 to the extreme end of a low carb diet. And even then it's a balancing act. It's okay. You know

01:54:10.340 what? I really, really enjoy the ketogenic diet. My goal isn't to be the biggest, most muscular

01:54:15.020 person I possibly can be. Well, you can still gain lean body mass on the ketogenic diet.

01:54:20.460 This is where nutrition communication really requires nuance because what somebody might hear,

01:54:25.560 what I just said is Lane saying you can't gain muscle on the ketogenic diet. I'm just saying you

01:54:29.660 can't gain as much, but you can absolutely gain muscle. Same thing with intermittent fasting.

01:54:34.300 You can absolutely gain muscle on intermittent fasting. Are you going to build as much?

01:54:38.680 Probably not quite, but again, it depends on what your goal is. If your goal is my primary focus is

01:54:44.240 muscle mass, then I would say, okay, protein, calories, and making sure you have enough

01:54:48.900 carbohydrate as well. But if your primary goal is maintaining body composition, if you put on a

01:54:53.640 little bit less muscle mass, but you like being low carb, then do it. So it's really going to boil down

01:54:58.340 to for this individual lady, what do you like best? And then even for some people when, you know,

01:55:03.820 if they get overwhelmed by like protein, carbs, and fats, I'll say, hey, hey, just track your

01:55:08.140 calories and track your protein. That's it. Those are the big buckets. And then if you want to get

01:55:12.120 more granular, you can. Like I get granular because I want to make sure I'm kind of getting

01:55:15.900 a consistent amount of carbohydrates and fats because I don't want my performance to fluctuate

01:55:19.680 very much. I also don't want my body weight to fluctuate a ton because I use that to track various

01:55:23.440 metrics in our app. For most people, calories and protein, two huge buckets, and you're getting 99% of the

01:55:29.840 benefits. Now I want to come back to your, what this person might say about mTOR and IGF-1. I've

01:55:34.560 heard these things are bad. I know David Sinclair has brought a lot of stuff and saying, you know,

01:55:38.900 I really try to limit mTOR and IGF-1 and it will never cease to amaze me how many scientists do not

01:55:46.920 understand the difference between a short-term truncated acute response to a stressor versus

01:55:54.420 dysregulated signaling that persists indefinitely. And what I mean is when you look at mTOR elevations

01:56:03.260 that lead to cancer and whatnot, those originate at what I would say mostly insulin resistance.

01:56:09.500 So you're having elevations in insulin, you're having elevations in insulin signaling through AKT,

01:56:15.360 which can then transmit to mTOR. It's like this chronic low level pushing that button.

01:56:22.040 As opposed to a pulsatile. That is a big difference between a dose of protein that causes mTOR to rise,

01:56:30.460 go back down in a natural rhythm. Also tissue specific. We're talking about in skeletal muscle,

01:56:36.900 not liver, not brain necessarily, those sorts of things. IGF-1, same deal. And what I will say is,

01:56:43.880 where are all the resistance trained people that are getting cancer by the droves? Because if you want

01:56:50.440 to talk about amplitude of response from mTOR, resistance training dwarfs what protein does.

01:56:57.660 If we look at the meta-analyses on cancer incidents amongst resistance trainers, and there's getting

01:57:02.020 to be some now, we see lower levels of cancer in people who resistance train. So what that tells me

01:57:08.380 is there's a difference between these two signals. And I want to point out something there because I

01:57:12.960 think it would be very quick to say, but Lane, there's a healthy user bias there, blah, blah, blah,

01:57:17.400 blah, blah. I don't think what you're saying is that that proves that lifting makes you live longer.

01:57:23.020 I think what you're actually saying is, no, it's the contrapositive. It demonstrates that lifting

01:57:27.520 doesn't increase mTOR to the point of it being detrimental to your health. That can be asserted,

01:57:34.420 I think, from that observation. Or that it's also tissue specific. That's part of it.

01:57:39.300 But let's use a different example. So let's look at exercise in general. Peter,

01:57:44.920 if you got educated in medical school, but knew nothing about exercise.

01:57:48.460 This is one of my favorite discussions.

01:57:50.400 You know where I'm going with this. And I told you, I'm going to do something that's going to

01:57:54.200 make you elevate your heart rate, elevate your inflammatory markers,

01:57:58.260 elevate your reactive oxygen species, raise your blood pressure.

01:58:01.500 Increase hepatic glucose output.

01:58:03.440 What would you say to me about that?

01:58:04.860 Yeah, of course I'd say, yeah, this can't be good for you.

01:58:06.880 Don't do that. And what is exercise? It does all those things.

01:58:10.400 Why is exercise good for us? Because that is a short-term stressor. I mean,

01:58:15.540 we use the term hormesis if you want. The body responds to, and it actually acts kind of like

01:58:21.920 a vaccine. I realize that's like a really triggering term for a lot of people right now,

01:58:25.840 but it's like, it's like a vaccine, right? It's a controlled dose of a stressor that your body can

01:58:29.500 handle. And I kind of look at protein. I wouldn't say protein is a stressor necessarily,

01:58:35.120 but again, it's this acute response versus a chronic hum. Your inflammatory markers,

01:58:41.960 people who deal with elevated inflammation, it's not actually super high elevations,

01:58:47.900 but it's just all the time. That chronic pulse on that, that is the problem. That is the issue.

01:58:56.500 Again, they might say, well, there's healthy user bias there. And I would say, well, so what?

01:59:00.240 Okay. So you're saying that people who have high rates of IGF-1 and mTOR who are healthy,

01:59:08.800 okay, well show me them getting higher incidence of cancer. You can't. You can't because all these

01:59:14.140 things are tied together because people who have high levels of mTOR activation and IGF-1

01:59:18.760 typically have insulin resistance. They have poor dietary habits and poor lifestyle habits.

01:59:24.520 So I would say, okay, that's a fair point. There's confounding variables, but all these

01:59:29.520 things are tied up together. You can't really separate them. Am I saying that mTOR plays absolutely

01:59:33.460 no role? No. But again, it can be cart before the horse sort of thing. People say, well, rapamycin

01:59:39.860 is an mTOR inhibitor and that's a cancer treatment drug. And I would say, yes, but do you think it's a

01:59:46.720 good idea to do chemotherapy to prevent cancer? It's not even really true because rapamycin is not

01:59:52.520 really, I mean, it's never really been a particularly successful cancer therapeutic

01:59:57.620 used constitutively, which is how it would be used. I think rapamycin does have significant

02:00:03.400 longevity benefits in basically all models that aren't humans. So the extrapolation would be

02:00:09.160 pulsatile rapamycin is probably beneficial, but in that application, it's not really being taken.

02:00:16.620 Again, to constantly suppress mTOR because remember, if you took it all the time, you're suppressing

02:00:21.380 mTOR complex two and mTOR complex one. So I agree with that point actually completely, which is that

02:00:27.280 tissue specificity and time course are very difficult things to infer from the outside, which is sort of

02:00:37.460 the meta view of all things equal, you know, IGF levels have a J curve with mortality and therefore

02:00:44.380 very, very high levels of IGF must be problematic and high protein increases IGF and therefore

02:00:49.880 must be bad.

02:00:51.140 And I think it's important to also understand the following. And that is, I think I might have

02:00:55.780 missed this on the last show, but I think we have this idea that like there's this perfect diet out

02:00:59.140 there. It's going to be the one diet that's going to reduce cancer and cardiovascular disease

02:01:04.020 and mortality and all. And the fact is that there's probably trade-offs for everything.

02:01:09.520 I know there's people out there that will say that protein increases cancer. Well, there's a ton

02:01:14.200 of confounders to that. Like somebody saying, well, there's healthy user bias. Sure. But there's a ton

02:01:18.000 of confounders to people who eat high protein. Most protein in these meta-analyses looking at cancer,

02:01:23.780 I mean, you're talking about high protein is above 70 grams of protein per day or 1.2 grams per

02:01:29.440 kilogram of body weight. Okay. Well, where do most people, most Americans eat high protein by

02:01:35.060 definition of the RDA, but where's it from? It's from burgers and hot dogs and like a bunch of

02:01:41.360 processed meat. What does the cancer incident say about people who have high protein, but an overall

02:01:46.600 healthy diet? And there was a really interesting cohort study out of Alberto and a hundred thousand

02:01:51.960 people where they said, okay, we're going to look at meat intake. And I think even red meat intake

02:01:57.980 specifically, we're going to look at low medium and high levels of red meat intake, but also with

02:02:04.240 low medium and high levels of fruit and vegetable intake. And because here's the big thing is most

02:02:10.180 people who eat high levels of meat and protein eat low levels of fruits and vegetables. What they

02:02:14.980 found was that at the highest levels of meat intake, but also with the highest levels of fruit

02:02:20.420 and vegetable intake, there was no difference in cancer incidents between the lowest level of meat

02:02:25.940 intake. And even with the highest level of fruit and vegetable intake, it's not an issue.

02:02:31.580 In other words, it's a marker for overall diet quality.

02:02:35.460 Bingo. I don't want to extrapolate too much out of one study, even though it was a large study.

02:02:40.200 But what that would seem to suggest is that overall diet quality is the big rock that we're looking at

02:02:47.340 here. And you can achieve good diet quality on a whole host of different diets. I mean, you can have a

02:02:53.060 ketogenic diet that's very poor quality diet. You can have a ketogenic diet that's very high quality

02:02:57.060 diet. You can have a plant-based diet that's very low quality. And you can have a plant-based that's

02:03:01.940 very high quality. You can have intermittent fasting that's low quality and so on and so forth.

02:03:06.400 A lot of it boils down to like, what are the food choices you're making on balance? Are you getting

02:03:12.620 enough fruits and vegetables and minerals and micronutrients? And even then, it's so interesting.

02:03:18.240 Every time we try to say, okay, well, fruits and vegetables have these benefits on health that we

02:03:24.180 see pretty consistently. So let's try and take out these isolated micronutrients and give them in a

02:03:28.960 supplement. We're always disappointed with the results. And it just seems to be a little bit of

02:03:34.540 mother nature's kitchen. Kind of have to eat the whole food to really get those benefits. Again, if the

02:03:41.940 entor story were true in terms of dietary protein, we would have expected in that study to see a linear

02:03:50.160 increase in cancer, especially at each level of fruit and vegetable intake. But we didn't. What

02:03:56.400 we saw was more of a linear inverse association with fruit and vegetable intake is what we saw.

02:04:01.800 So let's now talk about a different example of a person who comes to you. So now let's just

02:04:08.360 use a male instead of a female last one. And let's talk about a 40, 50 year old male. So they have a

02:04:14.640 training background, but they are also realizing what you said earlier, which is, hey, I'm going to

02:04:20.860 start losing muscle mass at a pretty good clip once I'm in my fifties. And certainly by the time I'm 65,

02:04:27.200 it really starts to nosedive. So the aha moment is I need to build up as much of a reservoir as possible.

02:04:34.000 So there's a person who says, look, I've always been an athlete. I've always done X, Y, and Z,

02:04:37.640 but I've never really thought about muscle mass. I want to start thinking about it now.

02:04:41.360 Maybe I've got a decade to pack as much on as possible before I'll go into that,

02:04:46.240 just maintain it as long as I can mode. Okay. So this is a person who they're lifting weights

02:04:51.220 three days a week, an hour at a time. They squat, they deadlift. Let's say they do a whole body split

02:04:57.500 every day for those three days. And let's say their DEXA scan is 20% fat. So they're probably

02:05:04.460 25th percentile actually for a 50 year old. And now they come to you and they say, Lane,

02:05:08.780 okay, I want to go all in. I want to know, can I be 10% body fat? So they're not trying to be a

02:05:14.160 bodybuilder. They want to be 10% body fat in two years. And let's just assume that their BMI is

02:05:22.700 25 as well. No, let's say it's not. Let's actually say their BMI is 27. So they're technically a little

02:05:28.800 bit overweight and they've got a little extra body fat. How are you going to change their training?

02:05:33.120 How are you going to prescribe nutrition? Yeah. So let me ask a question back. Have they been

02:05:40.140 training consistently up to this point? Yeah, they've been training relatively consistently,

02:05:44.920 but when you look at it, you realize they're not really in a progressive overload mindset.

02:05:51.700 They've become a little comfortable in their training. If you dig under, you'll notice that

02:05:57.040 they haven't really increased the weight in anything they're doing in five years.

02:06:01.320 The first thing is looking at the resistance training is okay. Just what you said. All right,

02:06:06.220 you're doing three sets of 10 on everything and you slap a plate on and you slap two plates on and

02:06:11.080 you do the same thing you've been doing. Adaptation is never comfortable. So what you're trying to do

02:06:16.020 to grow muscle, you're trying to induce adaptation. Muscular hypertrophy is an adaptation to a stressor

02:06:21.840 placed on the body. In this case, the stressor is volume and mechanical load. So either you need to

02:06:29.380 increase the weight, the repetitions or the number of sets and doing so is going to be uncomfortable.

02:06:37.980 Your body is going to tell you it's uncomfortable. Even my own coach is coaching me for nationals this

02:06:43.880 year for powerlifting. It's so funny. I was starting to kind of have this linear effect coming back from

02:06:49.080 these injuries I've had. Then one week had a dip in performance. I also was feeling really beat up and

02:06:54.840 he just responded one line and said, adaptation is never comfortable. It's so true. It really is.

02:07:00.060 And we talked about this sort of thing. So just mentally gearing this person up for the idea that,

02:07:05.360 Hey, you've been comfortable. We're going to go start doing some things that are uncomfortable.

02:07:09.820 And whether it's those particular exercises he's been doing, and it sounds like he's been doing big

02:07:14.160 compound movements. So probably going to keep him on that. I would like to get video feedback to see

02:07:19.260 what his form is like, especially with injury considerations as we age and pain. So getting

02:07:25.120 some feedback on those, making sure that he is getting the requisite amount of load, progressive

02:07:31.440 overload, and also at this age and with trying to push now, it's also about knowing when do we build

02:07:39.080 in some tapers so that he can actualize those gains and recover as well. Because here's the thing

02:07:44.820 about adaptation at a certain point. If you've been training for long enough and you're old enough,

02:07:52.020 the amount that you need to cause adaptation versus what is going to cause you to overreach is going

02:07:57.060 to become closer and closer and closer. When you first get into training, you need almost nothing to

02:08:02.980 adapt. You come in and do one set of leg extensions. You will get an adaptation from that if you do it

02:08:08.600 consistently for several weeks. Been training five years, one set of leg extensions is going to do

02:08:13.200 absolutely nothing. It might maintain what you have. That's it. And so if you want to push adaptation,

02:08:20.000 you have to push harder, which is going to create more of a recovery deficit. Recovery capacity is

02:08:26.800 going to increase as you get older and have a greater training experience. It's not going to increase as

02:08:31.360 much as the amount of stress that you're going to have to apply to adapt. So again, I think having

02:08:36.100 built-in tapers is really important. And whether you do them responsively in terms of, okay, this

02:08:42.860 person has been getting week to week. We've seen he's adding five pounds. Oh, this week we had a dip

02:08:48.620 in performance. Now maybe we reactively do a taper. That's possible. Or whether you build them in

02:08:54.480 systematically to try and get ahead of that curve, either way can work.

02:08:58.840 In the latter lane, what is the typical duration of a build cycle, taper cycle?

02:09:05.720 It's probably going to get progressively closer together the more advanced you get.

02:09:09.320 My situation is kind of unique. So I get my kids week on, week off. And we have noticed that the

02:09:15.260 weeks I get my kids, I get less sleep. I have a little more stress. My performance goes down a

02:09:19.360 little bit. I track bar velocity as well. How do you do that? What equipment do you use for that?

02:09:23.860 I use a device called Rep1, which is a accelerometer. It's available for purchase by

02:09:30.080 private individuals. It's about $400. So it's nerd stuff. If you're really dialed in,

02:09:34.720 if I don't push the weight, I can try and look at the speed and see comparatively. Okay. Compared

02:09:41.860 to last time, did I move the same weight faster or slower? When we look at my performance in terms of

02:09:46.940 strength, RPE, speed, all those measures consistently show that typically on weeks that the

02:09:53.800 kids are with me, I'm just not quite as good. I'm about 90 to 95% as good. So we've actually built

02:10:00.220 in micro cycles of tapering. Sort of a push week, a slightly back off week at one week at a time.

02:10:07.520 Yeah. Yeah. Overall, through these micro cycles, we're trying to walk up the volume and the progressive

02:10:12.660 overload. And then after probably four to eight weeks, we'll do a much bigger taper where we pull

02:10:19.060 back on everything, but we do micro tapers in between. So for this guy. For this guy, probably

02:10:25.780 four to eight weeks. Okay. So you'd say, look, I'm going to guesstimate that, split the difference.

02:10:30.640 For six weeks, I'm going to push you. And then you're going to back off how much and for how long?

02:10:36.640 So I like to back off the volume and also the intensity a little bit. So whereas maybe we're up to

02:10:44.180 a seven, eight, nine RPE on most sets. And when I say RPE, we're talking about rate of perceived

02:10:50.520 exertion. And an easy way to think about it is if it's a seven RPE on a set, then that person could

02:10:57.060 have done three more reps before they hit absolute failure. So most RPEs to me for advanced people

02:11:04.260 should be close to seven or eight with a few sets pushing into a nine and very rarely should you push

02:11:10.160 to attend. There's quite a bit of literature out there to show that you get basically the same

02:11:15.260 hypertrophy training close to failure that you do going to absolute failure. It's not necessarily

02:11:21.340 that failure is bad. It's just the amount of recovery deficit it creates, the amount of taxation

02:11:30.420 it creates is disproportionate to the stimulus. So what we really want to do is maximize hypertrophy

02:11:38.400 and stimulus while minimizing fatigue. Yes, sure. You can get a similar stimulus by going to failure

02:11:45.020 and maybe even just a little bit more. But if it then causes you to have performance decrements the

02:11:51.260 following week or not be able to push as hard overall, we have to think about this as an overall

02:11:57.860 training program and not just isolated workouts. I'm very purposeful when I tell people I go into

02:12:04.220 train. I don't go into workout. Working out is just an isolated workout. And I've had so many people

02:12:10.500 with big egos who say, well, I couldn't possibly not train to failure. First of all, I've watched them.

02:12:17.400 They're not actually training to failure. I know what actual muscular failure feels like on a squat.

02:12:23.780 For example, a free bar squat. I've seen this on Dr. Mike Israel's Instagram too, because he talks about

02:12:29.220 training shy of failure a lot as well. And people will say something like, oh, you trained like a

02:12:33.220 wuss. This isn't that hard. What I want to say to them is I have done probably one of my most

02:12:38.560 impressive squat sets is I did 480 pounds for 14 reps. And I've done 405 pounds for 21 reps before.

02:12:46.560 I couldn't move afterwards. First off, it probably took me five minutes just to get my breath back,

02:12:53.240 just to breathe enough to like be a functional human after that. Then as far as like going to do

02:12:59.940 another set, first off, when I hit that 480 and I grinded out that last rep, that 14th rep,

02:13:06.520 I was so fatigued. I couldn't rack the right side of the barbell because for whatever reason,

02:13:13.520 I'm a little bit lopsided and it sits just a hair lower there. I could not fully lock out

02:13:18.080 my glutes and lower back and I couldn't rack it. And there was actually somebody had to run over

02:13:22.960 from across the gym to help me rack it, even though normally it's no problem. And then I laid

02:13:28.220 down for five minutes, just trying to get my breath back. And then when I got up, if you told me I had

02:13:34.300 to go squat 480 again, I'm telling you, I couldn't have gotten a single rep, even after resting 10,

02:13:39.620 15 minutes, there's not a chance in hell. So you're telling me if I stopped two reps shy of that,

02:13:44.800 that that would have felt easy. You're insane. Or that it would have failed to produce

02:13:49.460 bingo benefit. Yeah. And actually with compound movements specifically,

02:13:53.540 you don't have to get as close to failure to get the benefits with compound movements.

02:13:58.540 By the way, I feel so much better hearing this. Today was a deadlift day and this cycle I'm doing

02:14:03.860 trap bar, which I actually don't like very much, but I did sort of my trap bars. And then I was

02:14:07.640 supposed to go to hip thrusters after, and I was not feeling great. It just didn't feel like it was

02:14:12.280 going on. So I was like, you know what? I really missed doing sumo deadlifts. So I went and did

02:14:15.260 sumo deadlifts and they felt great. But on the very last set, I added a bunch more weight on.

02:14:20.260 And at the sixth rep or eighth rep, I was like, I feel really good, but something tells me if I try

02:14:26.580 to get to 10 today, I'm going to push just a little too much. So I sort of bagged it at eight.

02:14:31.480 And afterwards I was like, I'm really proud of myself. I didn't do something stupid because today's

02:14:36.080 one of those days. Cause you know, to deadlift two different deadlifts on one day,

02:14:39.540 and it's at the end of the workout. Those are the moments when you make mistakes.

02:14:43.900 And that was probably truthfully, I think I probably had four reps in me left. So that might

02:14:48.500 have only been a six or a seven RPE, but you still get benefit. Absolutely. And the research shows that

02:14:54.580 what was popular a few years ago was kind of the effective reps hypothesis. I don't know if you've

02:14:58.800 heard of this. No, what's that? Basically the idea is that the majority of the stimulus that you get

02:15:05.020 for muscle growth is in the last five reps before failure. So whether you're doing 20 reps means you

02:15:11.380 need to get to at least 15 reps to really get a similar stimulus. And in terms of volume and

02:15:15.760 progressive overload, you really need to think about volume in terms of just number of hard sets

02:15:19.360 within a five RPE. But the research shows that that's much more accurate for isolation stuff than

02:15:25.440 it is for compound. So compound lifts are kind of their own beast. You can train at a sub five RPE

02:15:31.860 and still get maximal EMG recruitment and quite a bit of hypertrophy. Whereas with isolation,

02:15:39.420 you pretty much have to take it close to failure. And then the other thing I would say is that

02:15:43.420 exercises are not equivalent. That's a big thing. It's like, all right, let's do a five RPE on a squat

02:15:49.660 and then a nine RPE on a leg extension. I'll tell you the nine RPE on leg extension. I can do that all day.

02:15:55.500 I was just about to say that is infinitely less painful. Exactly. Versus a big compound movement

02:16:03.140 that requires core and stabilization and breathing and creating intra-abdominal pressure. All that kind

02:16:10.020 of stuff factors into fatigue. So for this individual. Yeah. So tell me about sets and reps

02:16:16.980 here. So let's assume he's much more interested in hypertrophy than strength. He's not going to power

02:16:22.940 lift. What's the rep range you're going to keep him in for compound movements and for isolated

02:16:27.900 movements? Variety is the spice of life. The research shows that from one rep to 30 reps,

02:16:35.720 you can build very similar amounts of muscle. So this is amazing, right? Because the conventional

02:16:41.100 wisdom says, oh my God, if you're doing fewer than, I don't know what the number is that they would

02:16:45.700 say. If you're doing fewer than six reps, there's no hypertrophy. It's all strength. That's what

02:16:48.940 conventional thinking would say. There are benefits to being in that hypertrophy rep range of six to 15

02:16:55.400 reps. That's kind of like traditional. Here's the benefits and downsides. One of the nice things about

02:17:01.440 the six to 15 reps is you can accumulate quite a bit of metabolic fatigue. You can use relatively heavy

02:17:09.400 loads. You can get quite a bit of volume in that rep range. If you're doing really heavy weights for low

02:17:17.720 reps, say under five reps, you are going to induce more. You functionally would have to double your

02:17:22.700 number of sets just to get the volume, right? Probably not because it's more about the number

02:17:26.580 of hard sets. But doing a hard set of five is not the same thing as doing a hard set of 10.

02:17:32.320 You have fewer of them in you, presumably, right? Probably. There's probably a greater fatigue effect.

02:17:38.240 But some people, again, like me, if you told me I couldn't train under five reps, I'd be like,

02:17:43.120 I'm just going to be bored. I don't like doing high reps. I get bored. For me, and the same thing

02:17:49.500 with clients, again, adherence is number one. So if he says, oh, I'm not worried about creating

02:17:53.820 strength, but I really like lifting heavy weights. Okay, we're going to find a way to incorporate

02:17:58.820 that. But it might be where, hey, we're touching one set that's under five reps and the rest are

02:18:03.420 going to be six to 10 on these compound exercises. And then on the isolation exercises, you know, we'll go

02:18:08.180 15, 20, just for some variety and whatnot. But really, the research, at least in the short term,

02:18:15.000 and when I say short term, I mean like 12 weeks, we don't see differences in hypertrophy between

02:18:21.380 anywhere from low reps up to 30 reps, as long as the number of hard sets are equated. So really,

02:18:27.420 it says do what you like, do what you enjoy. What is that sweet spot for hard sets if we just pick 10

02:18:34.060 reps? So then we can do the math and go up or down. So the sweet spot is what maximizes per body

02:18:41.800 part is probably about six to 10 sets in a session. They don't really see improvements above 10 sets.

02:18:50.320 Now, this gets a little bit complicated because if you rest longer, each set actually becomes more

02:18:56.660 effective as a stimulus for hypertrophy, presumably because you perform better and you can use more weight

02:19:01.700 and do more reps on that individual set. So the number based on the meta regressions out there, and I think

02:19:08.120 James Krieger did a really good one. The number seems to be like if you're resting more than three minutes

02:19:14.560 between sets, six sets. If you're resting like one to two minutes, it might be more like 10 sets. But again,

02:19:22.480 the other thing to keep in mind is you don't have to just jump to 10 sets immediately per body part.

02:19:27.340 But that's a lot of sets. You should probably use what is ever allowing you to adapt at the time.

02:19:33.100 If you're somebody who is relatively new to training, you start doing 10 sets per body part.

02:19:38.680 One, what's going to happen once you plateau? That's a lot more sets you're going to have to add on top

02:19:42.280 of that. And two, you're probably going to outpace your recovery capabilities. When people tell me

02:19:47.740 they're going to do, I know you talked about covering squatting and deadlifting every day.

02:19:52.040 What I would say is you better be in very good physical condition to do that. And even then,

02:20:01.360 there is an expiry date on that. And I've talked to people who have done this. To be clear,

02:20:06.680 I've never done this. I look at the people who have tried it in awe. I'm not willing to give up so

02:20:11.440 many other things I do exercise-wise to just make sure I squat and deadlift every single day.

02:20:15.620 But what I noticed that they're doing is they're being very clever. Every day is not a crushing

02:20:21.540 set of that, right? I mean, some of those days, it's a very, very low volume, low intensity that

02:20:29.360 functions effectively as a recovery day where they're basically working on the muscle memory

02:20:33.880 and the form. So for example, in the case of this guy, if he says, Lane, I'm willing to train as much

02:20:39.320 as you need to tell me to. So even though currently I'm doing three 60 minute workouts a week,

02:20:43.600 if you tell me I need to be in there five days a week with two rest days, and that should be two

02:20:48.580 hours a day, I'm willing to do it. Where would you say, again, let's assume that his form is

02:20:54.100 decent. You're not concerned about overuse. Where would you want to put him? If he's not looking to

02:20:59.040 power lift, if he says, I don't really care about exercise selection, just pick whatever,

02:21:04.840 probably not going to be doing a lot of free squatting and deadlifting, even though that's my

02:21:09.380 personal love. Because those do create a very high recovery debt. And not just that, it's very

02:21:14.900 mentally taxing. When my wife Holly moved over, and she's a phenomenal athlete, went to the junior

02:21:21.340 world games as a track athlete, won the natural Olympia two years after she started lifting weights.

02:21:27.000 I mean, just incredibly genetically gifted and hardworking person. But she would look at me doing

02:21:32.400 like triples on squats and then resting 10 minutes between sets and say, why are you resting so long?

02:21:37.880 That can't possibly be that difficult. Meanwhile, she's over there doing sets of 10. She's slapping

02:21:42.620 a plate on each side doing sets of 10 and resting a couple minutes. And I said, well, you'd have to

02:21:47.640 really do a powerlifting meet to understand. And then she did one. And then she was like, yeah,

02:21:53.960 the amount of intense mental focus it requires when you have that much weight on your back and you

02:22:00.760 know, this could literally kill you. Now, obviously you have safeties and spotters and whatnot,

02:22:05.620 but just strapping 600 pounds across your back. I mean, there's a reason your adrenaline spikes.

02:22:12.360 So after that, she understood, but that's a lot of recovery debt to create for something that you

02:22:20.300 could get a similar stimulus by doing a hack squat or a leg press or that sort of thing. As long as

02:22:24.680 you're working through a full range of motion. And that's the other thing, very important to work

02:22:29.560 a muscle at a long muscle length. In fact, there was actually a recent meta-analysis that came out

02:22:36.900 looking at partial range of motion, but partial range of motion at different muscle lengths

02:22:42.180 and found that while partial range of motion at shortened muscle lengths does not produce the

02:22:48.520 same hypertrophy as full range of motion, partial range of motion at lengthened muscle lengths

02:22:54.180 produce similar hypertrophy as full range of motion. So let me make sure I understand that lane. So

02:23:00.180 let's just use a bicep because it's easy. At the lengthened part of the bicep, when you are

02:23:05.100 straight armed, you're saying a partial rep from straight to say 90 degrees is more effective than

02:23:12.900 if you just do the top of the bicep. And let's assume you do the same range, but because at the

02:23:18.160 shorter range, you're not seeing presumably as much adaptation or recruitment by the muscle?

02:23:23.620 Presumably, although the bicep might be a little bit different because you would actually have to

02:23:28.620 be on like an incline bench to truly get the stretched range of motion because otherwise in

02:23:33.180 a traditional dumbbell curl, the top end is actually the more difficult component of the rep.

02:23:38.440 Whereas if you pre-stretch it, now you can make that bottom part a little more difficult. So,

02:23:43.640 but if we think about something like a squat, like a partial range of motion squat,

02:23:48.160 if you're doing a partial range of motion in the bottom half, that is not going to be easy.

02:23:53.040 So I think it's more about working the muscle in the difficult regions, but the stretch component

02:23:58.440 does seem to be important. So what I would say is that I really am a big fan of like something like

02:24:03.520 a hack squat for leg development. If you don't care about being strong on free squats, because if you

02:24:10.420 get a good machine, you can take it through a really full range of motion. You can really get a good

02:24:15.660 stimulus for the quadriceps and some of the rest of the leg muscles. And it's not crazy fatiguing.

02:24:21.820 So something like that, a leg press, there's also like really good pendulum squats. I really like a

02:24:26.740 good pendulum squat. If anybody's ever tried that. What's that? So it's kind of like you sit in a seat,

02:24:32.120 it's on an arm. So if there's a pivot here and the weight is loaded here and you get in here,

02:24:39.060 hopefully I'm displaying this. And then as you go down, the weights here, basically as you get

02:24:46.680 lower, are your hands loading in front or are you loading? Yeah. Yeah. They're right here. As you're

02:24:52.060 getting lower, it gets a little bit easier because of the pendulum. And then as you get higher, it gets

02:24:58.460 harder, which actually works on your strength curve because the hardest part of the squat is near the

02:25:03.100 bottom and the easiest parts near the top. So I really like those two, because those are exercises

02:25:08.320 you can really work through a nice full range of motion and create a lot of stimulus. And like I

02:25:14.880 said, I think full range of motion or training in that stretched position is very, very important.

02:25:21.100 And so I usually like to have two main exercises for a big muscle group like that. You probably don't

02:25:27.120 need it. You probably could just do hack squats for five or six sets, that sort of thing. But people

02:25:32.880 like variety. And I would keep those between, you know, a six and an eight RPE most likely,

02:25:37.680 and then go to a leg extension and leg curl and those sorts of things. And well, I'd probably do

02:25:42.520 an RDL, some sort of RDL because it's not as fatiguing as a deadlift, but you're still activating

02:25:47.600 similar muscles. Once again, keeping that between a six to eight RPE. Are you going to coach that with

02:25:53.200 obviously one leg? Are you going to do ipsy or iso grab on the kettlebell?

02:25:58.240 I would probably do a barbell, honestly, and do both legs. If we felt like there was some imbalance or

02:26:03.600 something like that, or they just wanted some variety, you could do single leg. If muscular

02:26:08.040 hypertrophy is the primary goal, you can create more stimulus using both legs at the same time.

02:26:13.920 Then doing some isolation stuff, low rest periods, higher reps, 10 to 20 repetitions,

02:26:20.440 going to a little bit higher RPE, you know, like a nine, an eight or nine RPE. I think those are fine.

02:26:26.380 And then if somebody said, you know, I just got to take a set to failure. It's part of my credo. I came

02:26:30.920 from the eighties bodybuilding. I said, great. Take the last set of the last exercise of an

02:26:35.760 isolation to failure and go nuts, do something like that. And that might be how I build out a leg

02:26:40.900 session. The bigger compound exercise is a little bit lower reps, maybe five to 10. Then as we progress

02:26:47.620 through more isolation, going into the higher end of the rep range and maybe taking some a little bit

02:26:52.620 closer to failure. And is he going to do this two or three times a week? So frequency, interestingly,

02:26:58.940 I think that the meta-analyses so far haven't been sensitive enough to pick it up. But what it says

02:27:05.400 is that for legs, it doesn't matter. One time a week is enough, but for upper body two times a week,

02:27:10.440 I think probably multiple times a week for both is beneficial.

02:27:14.040 Your PH3 program is about five days a week, right?

02:27:17.160 So it's five days a week, three days of squatting, two days of deadlifting, three days of bench pressing,

02:27:22.060 and also accessory on those days as well. What I will say is for the most part,

02:27:26.980 frequency is more of a tool to distribute volume than it is an individual hypertrophy stimulus.

02:27:33.580 But it does seem to me that it would make sense. And again, a lot of people, scientists have gotten

02:27:39.260 in trouble saying, well, this just makes sense. But it would seem to me that if you have a muscle

02:27:43.880 protein synthesis response, especially in trained individuals, that's only 16, 20, 24 hours,

02:27:49.580 that multiple doses of that are probably better than just doing one dose and thinking you've got it

02:27:55.060 all. So again, I think part of that's just, we don't have enough studies yet and we don't have

02:27:59.480 the sensitivity to detect that. And also the studies are so heterogeneous in terms of the population

02:28:05.300 that's used, their training status, the type of exercises that are used, how RPE is measured,

02:28:11.600 how intensity is measured, how volume is measured. It's really hard to get good meta-analyses of these

02:28:16.900 sorts of things. The amount of hypertrophy research that's come out in the last five to 10 years

02:28:21.160 is literally an explosion compared to pre-2010. I think I read one meta-analysis on hypertrophy

02:28:29.360 from resistance training in the entire time I was in graduate school.

02:28:33.720 Are there a couple that we should link to in the show notes here that are,

02:28:36.840 if someone's going to say, look, I'm willing to wade through two meta-analyses on this,

02:28:40.800 are there a couple you'd recommend?

02:28:42.300 Some of that would be some of the stuff that's been done by James Krieger and some other folks that

02:28:46.460 really kind of looks at, all right, like set number and volume and those sorts of things.

02:28:51.460 But for this guy, I mean, really putting out like an actual program day-to-day is difficult just

02:28:57.520 because it's a lot of it boils down to personal preference in terms of how I'm going to program it.

02:29:01.640 And presumably you'll get feedback, right? So you might say like, this is what we'll start with,

02:29:05.540 but we're going to modify it after this first cycle. Let's talk about his nutrition now.

02:29:10.560 Let's pretend that you assess him. So I forget what I said he weighs. Let's make up a weight. He's

02:29:14.800 175 pounds. He's 180 pounds. I don't know, whatever. And I think we said he's 20-ish percent

02:29:20.300 by DEXA, low 20s. And let's say he's eating 120 grams of protein a day. So right off the bat,

02:29:26.180 you're going to say, hey, you're a little light on protein. This guy is going to be willing to

02:29:29.820 eat anything you say. Where do you want him? Do you want this guy at 180 grams a day, 200 grams a day?

02:29:35.080 What was his body weight again?

02:29:36.100 Let's say 180.

02:29:37.280 If he likes protein, I would say you're not having any downsides to having 200 grams a day.

02:29:41.800 And that's a nice number to shoot for. So I would probably start somewhere around there.

02:29:46.100 Making sure his calories are adequate as well for facilitating recovery and enough carbohydrate

02:29:50.800 and whatnot. In this guy's case, because he really wants to gain lean mass,

02:29:55.640 how do you think about cycling him in terms of making him hypercaloric? I mean,

02:29:59.740 where are you trying to put his energy balance? How much weight do you want him gaining?

02:30:03.620 Since he's been training for a long time and he's older, the likelihood that he's going to be able

02:30:08.880 to gain lean mass without at least some body fat is probably pretty low. I get this all the time

02:30:14.160 for people. I want to gain muscle and lose fat at the same time. Well, if you're our subject A,

02:30:19.220 the lady who'd never trained before, absolutely. I mean, you heard me. I was like, yeah, we can

02:30:23.320 recomp her. No problem. She's going to gain some muscle, lose some body fat. When you've been

02:30:27.440 training for a long period of time, you have to have everything lined up just to gain ounces of lean

02:30:33.300 body mass. Part of lining that up is also a slight caloric surplus. There is a new meta-analysis

02:30:40.700 that came out that showed that an energy deficit, it's not quite the same thing, but they did show

02:30:45.960 an energy deficit impairs lean body mass accrual. It makes sense because we do see in an energy

02:30:50.680 deficit decreased rates of basal protein synthesis. So it makes sense. I mean, if you are in an energy

02:30:58.400 deficit, from a mechanistic perspective, it activates AMP kinase, which was an inhibitor of

02:31:03.360 mTOR. It makes sense. It also makes sense from a teleological perspective that if you don't have

02:31:08.600 excess energy, this remodeling is extremely energy expensive. Why would we want to create more of it

02:31:16.680 if we don't have the energy to support it? So a protein sparing fast isn't necessarily going to

02:31:24.060 save you from losing lean mass. It might be better than a carb fast. In other words, if you're going

02:31:31.480 to eat a thousand calories a day, you're probably better off having them be as much protein as

02:31:35.640 possible. But just because you have 200 grams of protein in your diet, if the calories are

02:31:40.340 exceptionally low, you're probably losing lean mass. Is that how I'm hearing you?

02:31:44.680 A day of an energy deficit is not something I'd really be worried about.

02:31:49.280 No, no, but I'm saying let's say somebody took this approach and said, look, for two weeks,

02:31:52.700 I'm going to go a thousand calories a day, virtually all protein in an effort to get as lean as possible

02:31:58.860 without losing lean mass. You might be able to not lose lean mass, but the likelihood you would

02:32:04.220 gain lean mass is very, very low for somebody who's been training for a while. It's one of those things

02:32:09.440 that the more advanced you get, the more things you have to have lined up correctly to continue to

02:32:15.580 push, especially if you're drug free. And you can do it in sprints. You can do it in different

02:32:21.160 sections. I went from, I was in the 230 pound class back in 2019. And then I just started to

02:32:28.000 drop back down to my original weight class of 205 pounds. I did that over the course of about

02:32:32.640 a year, but that was taken in sprints. I would do fat loss sprints, for example. So I would do like

02:32:39.980 two or three weeks of like a pretty aggressive deficit, like 750 to a thousand calories a day.

02:32:44.880 And I'm sorry, this is for powerlifting.

02:32:46.260 Yeah, that was for powerlifting.

02:32:47.900 And what body fat is your performance at its best? Because you obviously don't want to be

02:32:51.920 powerlifting at 7% body fat.

02:32:54.140 I'm still pretty good at seven.

02:32:55.520 Really?

02:32:55.700 I still maintain pretty well. Yeah, I still maintain pretty well. Maybe not quite as good. I can still

02:33:01.180 perform well at seven. But if I have a couple of days where I'm not dialed in, I'll start to feel

02:33:05.900 it. I'm right on that edge. I'm teetering on that edge at seven, on calipers that is. So I did it

02:33:11.600 over the course of the year and I did it in sprints. So I would do three weeks, lose like target trying to

02:33:15.740 lose five, six pounds. And then I would go to maintenance for like at least as long. And I

02:33:20.400 kind of built that into my lifestyle. I really liked that for a lot of clients. Actually, a lot

02:33:24.800 of our team violin coaches use a lot of what we call diet breaks where the people were eating at

02:33:28.500 maintenance. So it's like, okay, vacation coming up, diet break for two weeks. Everything looks like

02:33:33.480 it's going to be normal for three, four weeks. Boom. Let's do a fat loss sprint. So coming back to

02:33:38.160 building muscle, I'll do sections of, okay, I'm overfeeding in this slight caloric surplus for about

02:33:43.640 eight weeks. Okay. We gained three pounds of body weight. I'm going to maintain for a little while

02:33:50.440 just to make sure it doesn't get too out of hand in terms of body fat level. Now I've kind of got

02:33:54.840 adjusted this. Now I'm going to do another six to eight weeks. But what I'll tell people is if fat

02:33:59.720 loss should be slow, at least for people who are well-trained, if fat loss should be slow to retain

02:34:06.440 lean body mass, then weight gain should be snail's pace. What's a rule of thumb for this guy then? If

02:34:14.340 he's going to gain five pounds of total body weight of which we're going to hope three is lean, two is

02:34:21.720 fat. Is that a good goal? Yeah. How long would you want him to take to gain five pounds? Probably at

02:34:27.440 least 12 weeks. Okay. So he's doing that once a quarter. But it might be something more like where

02:34:33.060 it's six months, but there's 12 weeks where we get them up five pounds. And then we say, okay,

02:34:38.560 let's trim a little bit of this fat back off that we put on. We lose three pounds. Then we do another

02:34:45.340 gaining cycle. What tends to happen is the composition gets a little better each time.

02:34:51.200 Now this is completely anecdotal, my coaching experience, but when you put on weight and we see

02:34:58.200 this in studies for trained people, it really depends, but it's somewhere around 50, 50 lean mass

02:35:05.140 to fat mass, sometimes even 40, 60, if you're really well-trained. So 40 lean, 60 fat.

02:35:11.200 Wow. So the implication by the way, is when you're gaining weight, you're getting fatter by body

02:35:15.320 composition because you're presumably starting out at less than 50% body fat.

02:35:20.100 Well, it depends on the training status and a whole host of other factors.

02:35:23.020 So that's an important thing for you to tell this guy, which is, hey, if you're going to be

02:35:27.880 rigorously following body comp, don't be disappointed if your body fat goes up in that cycle.

02:35:35.240 We're playing the long game here. It's like investing. You're taking money away from you

02:35:39.640 now in this immediate moment that you could have. So hopefully you have more money later.

02:35:43.920 The good thing is that when we lose body fat for resistance training, we tend to lose mostly

02:35:49.460 from body fat. So if we're doing this cycle over time, hopefully each time it gets a little better.

02:35:55.460 Now, there are limits to this. Eventually you bought up against your genetic limit of

02:35:59.780 probably your genetic limit. What I always say is you never really know if you're at your genetic

02:36:03.080 limit. And what I always tell people is I show them this picture of me at 21 years old,

02:36:08.080 where I'd been resistance training hard for three and a half, four years, where most people say you

02:36:12.540 hit your genetic limit somewhere around there. And I show that picture. And I show a picture of me

02:36:17.840 now at age 40. And I mean, the difference in my leg musculature and my overall musculature

02:36:24.720 is enormous. But if you had just gone year by year, you would have seen very little difference.

02:36:32.080 And so what I'll tell people is you might think you're at your genetic limit, but you're probably

02:36:35.900 not. It's probably more like an asymptote. You're familiar with an asymptote? You never really hit

02:36:41.140 like a hard cap limit, but the gains become so minimal that it's almost not measurable.

02:36:47.700 Yeah. I think when it comes to this kind of person, one really focusing on, okay, making sure that they

02:36:54.180 can do a lot of resistance training because it is going to take quite a bit of a stimulus to get

02:36:57.800 them there. Focusing on stimulus versus fatigue. So doing high stimulus, low fatigue movements so that

02:37:02.980 they can accumulate enough volume without overreaching all the time. Because if they can train for 12 weeks

02:37:07.720 without needing a taper versus six weeks, I mean, that's more stimulus. And then putting them in a

02:37:11.980 very slight caloric surplus. And when I say slight caloric surplus, I'm talking about 100 to 200

02:37:15.960 calories a day over their maintenance. And now what does that look like? Well, that means that

02:37:20.480 you're going to have weeks where you don't gain anything. Anybody, I don't know if you've ever done

02:37:23.920 this, Peter, like try to do a super lean gaining phase. What tends to happen is people get really

02:37:27.760 frustrated because the weight comes on so slow that they end up just throwing down a bunch of

02:37:31.720 calories so that they can say they gained the weight and it doesn't go well. And what tends to

02:37:36.420 happen is weight gain comes on in chunks. Just like weight loss tends to happen in chunks,

02:37:40.760 weight gain tends to happen in chunks. You can be stable, stable, stable, even though you're in a

02:37:44.480 calorie surplus. And all of a sudden, boom, your weight's up two pounds randomly and it sticks.

02:37:49.440 And we don't have all the explanations for why it happens that way, but just know that that's normal

02:37:55.120 for those listening. And again, don't look at, oh, I gained two pounds from the past three days.

02:38:03.300 It's not going down, it's staying. Look at the fact that you've been doing this for four weeks

02:38:09.280 now and you gained two pounds on average. So you're right in line with what the goal was. So you want

02:38:15.800 to look at that monthly, month to month average in a gaining phase and say, okay, am I hitting my

02:38:21.820 milestones in terms of like the overall rate of progress? And try to not worry too much about those

02:38:27.940 little things. I don't know how we did this again. We're at this point where I've got through about

02:38:32.380 a third of what I wanted to talk about, but nevertheless, there is one other thing I wanted

02:38:36.200 to kind of talk about. And it actually feeds really nicely into this case study of this man

02:38:40.780 and this woman, which is that of kind of the most important supplements or the supplements we most

02:38:45.200 hear about. And what is their utility for the purpose of hypertrophy training? So let's start with

02:38:52.900 the most common of these, which is protein. We talked about it already. You alluded to the fact

02:38:57.180 that this woman might not be able to get enough protein in actual food. So you might talk about shakes.

02:39:01.420 So where does whey protein stack up in the hierarchy of proteins? And should we be looking

02:39:07.200 at other sources? Top of the list, whey protein, high in leucine, high in branched amino acids,

02:39:12.940 high in essential amino acids, generally tastes good, generally well tolerated. I will say if it's

02:39:19.840 a straight whey concentrate, a lot of people have difficulty tolerating a straight whey concentrate,

02:39:24.640 but a blend of concentrate and isolate is what most proteins out there are. And most people can

02:39:29.360 tolerate them well. What's the source of protein in whey? Where does it actually come from?

02:39:34.100 From cow's milk, if you centrifuge off the fat, so if you centrifuge off the fat and then you take

02:39:41.480 what's left over, you precipitate out the casein, the non-soluble fraction of cow's milk, the soluble

02:39:50.680 portion that's left over is whey. It's what's called whey. And mostly consists of proteins called

02:39:55.540 lactalbumins. It's just a very high quality, easy digestible, very bioavailable source of protein.

02:40:01.720 In terms of muscle protein synthesis, it's the tip tops. It always scores the highest. In our

02:40:07.000 research, it was always the highest. It was no statistical difference from egg, but when we did

02:40:11.240 it versus egg, it was always just like a little bit better. So my guess is if you had a high enough

02:40:16.220 subject number, you could maybe pick out some statistical difference.

02:40:19.640 Is there a brand that you favor or are there brands that you think are the best brands to go

02:40:25.060 for? Incoming shameless plug. So I actually have my own supplement line called Outwork Nutrition.

02:40:30.320 Outwork?

02:40:31.280 Outwork.

02:40:32.040 Okay.

02:40:32.780 We have a whey protein isolate. The reason we did an isolate, a little bit more expensive than like a

02:40:37.860 concentrate isolate blend, but there are people with lactose intolerance. There are people with

02:40:42.680 a sensitivity to the lactalbumins. And so an isolate is generally well tolerated.

02:40:48.620 Some people with really high sensitivity to the lactalbumins can't tolerate an isolate.

02:40:53.720 And if that's the case, they could probably do a hydrolyzate, which is a little more expensive and

02:40:58.380 doesn't taste as good, but still a good option for those that have really sensitive GIs.

02:41:03.560 Like I said, an isolate is generally tolerated well by people and ours is called Outwork Nutrition

02:41:08.980 Build. So it's just low carbohydrate, low lactose, low fat, high protein, high leucine.

02:41:14.140 So I think our leucine content's over 11%, I think it's actually 12%, which is very high.

02:41:19.720 And then the carbohydrate content, depending on vanilla or chocolate, is like one to four grams.

02:41:25.580 And then the fat content is less than a gram of fat. In fact, the vanilla is zero.

02:41:29.920 Are there any other brands that you would say, hey, I trust that brand? One of the things that

02:41:34.000 I think as we talk about supplements, you always got to be careful.

02:41:36.060 What would be three other brands that you would put in your body?

02:41:39.960 Legion, they make good stuff. And I think some of the big companies, Optimum has been doing protein

02:41:45.480 for years. And most companies are sourcing the same stuff. To me, a good company is somebody that

02:41:50.840 markets responsibly. But then another one, EAS has been making stuff for years and they make stuff

02:41:55.940 that's very, very third-party tested, all that kind of stuff. There's a bunch of good companies out

02:42:01.000 there. What I would say is make sure nobody's using a proprietary blend. Proprietary blends are usually

02:42:05.440 just a way for people to hide stuff. Two, make sure that nobody is doing what's called nitrogen

02:42:10.560 spiking. So what you can do to pump up the protein and nitrogen content of some of these proteins

02:42:16.820 is add individual amino acids that have nitrogen that are actually lower cost than just the protein

02:42:24.020 itself. They actually put creatine in some of these. Not that creatine isn't good. Creatine does work,

02:42:30.340 but you're not taking away protein necessarily to get creatine. You take creatine to get creatine.

02:42:34.320 And they do that because it's actually cheaper. It pumps up the protein content.

02:42:40.380 And how would you know that when looking at the label?

02:42:42.560 Oh, it's on the label. For example, I think they spike with glycine too. So if you look on the label,

02:42:47.280 it might say whey protein, sweeteners, preservatives, or glycine. Well, that's nitrogen spiking. So I would

02:42:54.320 make sure that companies aren't doing that. And to me personally, I mean, even if a company makes a good

02:42:59.140 product, if they make insane claims, I mean, I would love to say that our protein is the most

02:43:03.700 anabolic protein on the market. But the fact of the matter is it's a high quality whey protein isolate

02:43:08.380 at a competitive price point that tastes really good. And you can get another whey protein isolate

02:43:13.560 that would build just as much muscle. So I'm not going to claim that. The ethical side of me says,

02:43:18.260 just look for something that's promoted responsibly. Yeah, those other companies are

02:43:21.400 just fine and I would recommend them.

02:43:23.100 So let's look at a subset of that. Is there utility in using branch chain amino acids specifically in

02:43:29.180 workouts where these are typically coming as far lower doses, right? There's only three branch

02:43:34.460 chain amino acids and they're typically giving you five grams per serving. Any utility in the

02:43:38.840 in-workout BCAA? So this was something that I've changed my mind on. And I will tell people like

02:43:44.560 my PhD specifically is on leucine. I mean, it's right back there. It says leucine right on the cover,

02:43:50.460 is one of the words. And I used to say, hey, I think supplemental branch chains are useful.

02:43:56.040 I can't support that anymore. If you're getting enough total protein in, it doesn't seem to be

02:44:00.820 a benefit to supplemental branch chain amino acids. The only thing I would say that there might be

02:44:04.940 something is they may reduce muscle soreness, but it's never been compared straight up with like a

02:44:10.280 comparable amount of whey protein. So it's possible that that's just a protein effect. The only case I

02:44:15.940 could really make besides maybe soreness is also for people who just cannot get high quality protein

02:44:23.560 in. So for example, if you're a vegan and you say, I don't want to take whey protein and I can't take

02:44:30.680 XYZ and my stomach doesn't tolerate these proteins and I want to pump up the quality of my meal,

02:44:36.880 then supplemental branch chains could make an impact. And we actually did a study in our lab

02:44:40.640 where we looked at whey protein versus wheat protein. We saw that whey protein obviously had

02:44:45.680 a much bigger response in muscle protein synthesis compared to wheat.

02:44:48.720 That's obviously gram per gram, right?

02:44:50.500 Gram per gram. Yeah. Isonitrogenous. But when we added leucine to match the leucine content of the

02:44:58.100 whey, we actually got the exact same response. So if you're somebody who's plant-based and you're

02:45:02.640 concerned that you're not getting enough high quality protein, you could actually add supplemental

02:45:06.180 branch chain amino acids to your meals or your protein, and you would pump up the protein

02:45:10.620 quality doing that. But obviously the best outcome is just getting it through diet or shakes. And then

02:45:14.700 if you have to add supplemental branch chain, you can.

02:45:17.080 Any role for supplementing leucine specifically? So if someone says,

02:45:21.380 Lane, I'm buying your brand, I'm consuming it. I'm just going to add five grams of leucine every time.

02:45:26.020 And by the way, leucine tastes horrible.

02:45:28.580 Horrible.

02:45:29.100 It's literally one of the worst tasting things on the planet.

02:45:32.040 No, I just don't think there's a benefit to it. I wish there was. I did my PhD thinking I'm going to

02:45:36.680 find the secret anabolic trigger and just get enough protein.

02:45:41.360 You mentioned it already, creatine monohydrate, very popular. Back in the day when I was a kid,

02:45:46.640 it was 30 grams a day loading and then a maintenance phase. I think these days people

02:45:50.820 are kind of just doing five grams a day every day.

02:45:52.920 What you're looking to do is saturate your phosphocreatine stores in your muscle cell.

02:45:57.160 And you can do that through loading or you can do it through maintenance phase. If you do it

02:46:00.040 through loading, it'll saturate in five to seven days. If you do it through maintenance,

02:46:04.400 it'll take about three to four weeks. Downside to loading, more GI discomfort,

02:46:09.960 more bloating, more just overall discomfort, but you get saturated faster.

02:46:15.500 Downside to maintenance, just takes a little bit longer to get the benefits. That's all.

02:46:19.820 What are the main benefits of creatine? Are they on the strength side,

02:46:23.220 the hypertrophy side, the recovery side?

02:46:25.500 All above. It increases lean body mass, increases strength, exercise performance.

02:46:29.820 There's a possibility that there's cognitive benefits as well, interestingly, we're finding

02:46:33.960 out. But I would tell people, do not get caught up in the hype of these other forms of creatine.

02:46:39.680 Creatine monohydrate has been shown to saturate the muscle cell 100%. You cannot get more than 100%.

02:46:48.060 And the other forms of creatine are simply in existence to remove more money from your wallet.

02:46:54.800 I use the comparison of big screen TVs. My first big screen TV I bought, it was 42 inches.

02:46:59.960 Big screen. LCD screen. I bought it in 2008 and it was $1,000. What would that go for now?

02:47:06.420 You could probably get it for 200 bucks.

02:47:07.760 100 bucks, yeah.

02:47:08.440 Yeah. Here's a stick of gum. Can I have that 42 inch screen TV? Sure. Why? Because everyone makes

02:47:13.820 them and there's such a competitive market that the margins are this big. So what does everybody

02:47:21.040 have? Everybody has creatine in their supplement line. The margins are so thin, nobody makes money

02:47:26.600 on straight creatine. They have to come up with other forms of it to justify charging you

02:47:31.580 more. And you'll hear things like, well, our creatine doesn't bloat you or our creatine

02:47:35.220 doesn't cause water retention. Well, I would tell you that the water retention, hydrated

02:47:39.000 cells and anabolic cell, the water retention from creatine is inside the muscle cell, which

02:47:42.700 is a good thing. And there's research studies to show this, that it does not increase extracellular

02:47:46.800 water. That's actually intracellular water. So are you saying that your creatine is not

02:47:50.900 anabolic then? And then you have things like buffered creatine. You don't need to buffer

02:47:55.540 creatine. Creatine is stable in stomach acid. And then there's creatine ethyl ester, which

02:48:00.040 has actually been shown. So there's just a ton of marketing nonsense.

02:48:02.900 Yeah. Creatine trimalate. Do you make a creatine supplement?

02:48:05.940 We have a supplement called recovery and creatine is one of the ingredients there. So there's

02:48:11.060 five grams of creatine monohydrate. Is that a daily thing someone should have even on their

02:48:14.980 non-lifting days? Probably don't need to take it on your off days from lifting.

02:48:19.280 If you're doing cardio on a non-lifting day, do you benefit at all from creatine there?

02:48:24.600 There's no real studies to know. What I would say is it's very cheap. You're not really missing

02:48:29.120 out on anything by having an extra dose. So I would say take it daily. If your budget is really

02:48:34.760 rail thin, then take it on the days you train. Any other brands that you respect and just trust

02:48:40.320 that they're not doing any nonsense, which is basically the same? Look for the no claims and

02:48:44.040 the trusted brands. No crazy claims. No pushing other forms of creatine is better.

02:48:49.260 No proprietary blends. One of the best ways to know. The great thing is there are a lot of good

02:48:53.920 companies out there that are marketing more responsibly now. Okay. Last one, nitric oxide

02:48:59.200 or these nitric oxide boosters. I remember this was one of the things that got so much attention.

02:49:04.960 I want to say like 10, 15 years ago. Truthfully, I don't know how much attention it's got now,

02:49:08.960 but I did see a paper about it recently, which is what made me think about it again.

02:49:13.240 Nitrates and nitrites do appear to enhance exercise performance. Beetroot juice and those

02:49:18.580 sorts of things and sources of nitrites. So there was a recent meta-analysis looking at this and the

02:49:24.060 effect size was actually pretty impressive for power. It was like 5% or something. It was huge,

02:49:29.580 wasn't it? Yeah, yeah, yeah, yeah. Really impressive. 5%, which I mean, that's the difference between first

02:49:34.240 and last if you're talking about the Olympics. The effect size was a 0.42, which isn't considered a large

02:49:39.360 effect size, but it's approaching a modest effect size, which for supplements is really impressive.

02:49:44.280 I mean, that's on the order. I don't know offhand creatine effect size in the meta-analysis, but

02:49:49.440 it's got to be close to that. What I will say is a lot of supplements appear to not have in them what

02:49:56.320 they say they have in them in terms of these nitrates. The other thing I will say is like something

02:50:00.420 like citrulline malate, it can be recycled into arginine and then into nitric oxide. So citrulline malate

02:50:08.420 or citrulline specifically actually increases blood nitrate levels more than arginine itself.

02:50:18.120 So it actually increases nitric oxide more than arginine. And arginine is the direct substrate.

02:50:22.580 That's because citrulline is actually much more bioavailable, whereas arginine is mostly extracted

02:50:27.620 by the splenic tissues, the gut and liver. So you're actually better off taking citrulline,

02:50:32.500 which is in our pre-workout, of course. So there's another shameless plug. But really,

02:50:38.520 if you're looking at citrulline specifically, six to eight grams at a dose.

02:50:43.940 And this is more to increase performance than hypertrophy. Is this going to...

02:50:48.100 Presumably, if your performance goes up, you have more stimulus. You might see the gains there.

02:50:52.500 There is some evidence that citrulline can actually stimulate mTOR, but I'm not sure it's

02:50:56.420 enough to actually create hypertrophy on its own. So were you consuming something besides water or

02:51:02.380 electrolytes in the workout? You've obviously got a pre-workout. So the citrulline would be before,

02:51:07.160 obviously the whey would probably be after. Where's the creatine falling, post or pre?

02:51:11.780 The timing doesn't seem to be real important. There does seem to be a little bit better response to

02:51:18.520 after. Not sure why, because it really, to me, with the mechanism, it shouldn't matter because it's a

02:51:24.160 long-term thing. But that's actually why we included the creatine in our recovery product and

02:51:28.920 not the pre-workout for a couple of reasons. One, it's not an immediate effect from creatine. So you

02:51:34.300 might as well take it post. It might be a little bit better effect post. So there you go. And then

02:51:39.460 in the pre-workout specifically, there's a couple of things in there that are already semi-gut irritants

02:51:44.680 for some people. And creatine can be a gut irritant for people. We didn't want to compound those too

02:51:49.440 much. So that's why we kind of separated it from our pre-workout. But there's a lot of pre-workouts

02:51:54.280 that do have creatine in it. And especially when you pair it with a large dose of caffeine,

02:51:57.860 it can just really give people a lot of GI discomfort if you're not careful.

02:52:02.240 So then in workout, are you drinking something?

02:52:04.440 I usually just, people are going to laugh, but I'll do like a Gatorade Zero or something like that,

02:52:08.700 you know, in water. I've looked at the intro workout stuff. If you're working out for two,

02:52:13.560 three hours at a time, maybe it's useful to get some glucose and carbohydrate in to maintain

02:52:19.200 performance. But I think bodybuilders or weightlifters tend to overestimate like how difficult

02:52:24.720 their workouts actually are. You only need to worry about glycogen resynthesis, the speed of which,

02:52:30.400 if you're somebody doing multiple events per day, if you're a bodybuilder, you're going to be 24 hours

02:52:34.400 to your training in any way. You're going to resynthesize that glycogen as long as you need to get

02:52:38.040 enough total carbohydrates. So I'm not real huge on intro workout nutrition, as long as we're not

02:52:43.800 talking about really long workouts or we're not talking about multiple sessions per day.

02:52:47.920 Well, Lane, I've taken us way past our time, but as always, super enjoyable. Can't wait to do it

02:52:53.440 again. There's a lot of stuff to follow up on here. So the show notes, we'll have a ton of the

02:52:57.940 detail we've talked about in offline. You and I can connect and make sure we've got the links to some

02:53:02.080 of the things we spoke about. So thanks again, man. Appreciate it. And congrats on being by the water.

02:53:06.580 Thanks, Peter. I appreciate it, man. Really enjoyed it.

02:53:36.580 This is a great way to catch up on previous episodes without having to go

02:54:06.500 back and necessarily listen to everyone. Steep discounts on products that I believe in,

02:54:11.900 but for which I'm not getting paid to endorse and a whole bunch of other benefits that we

02:54:16.020 continue to trickle in as time goes on. If you want to learn more and access these

02:54:20.040 member-only benefits, you can head over to peteratiamd.com forward slash subscribe.

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02:55:50.200 Thank you for asking.

02:56:03.020 Thank you.

The Peter Attia Drive - May 02, 2022

#205 - Energy balance, nutrition, & building muscle ｜ Layne Norton, Ph.D. (Pt.2)

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