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    #163 - Layne Norton, Ph.D.: Building muscle, losing fat, and the importance of resistance training

    enMay 24, 2021

    Podcast Summary

    • Lane Norton's Journey: The Power of PerseveranceLane Norton's success in bodybuilding, powerlifting, and nutrition research stems from his commitment, dedication, and determination, demonstrating the importance of perseverance and deep understanding in achieving goals.

      Commitment, dedication, and determination are key factors in achieving success in various areas of life, as demonstrated by Lane Norton's journey in bodybuilding, powerlifting, and nutrition research. Despite not appearing naturally gifted, Lane's relentless pursuit of knowledge and improvement has led him to a deep understanding of training, nutrition, and the underlying biological mechanisms. Our conversation with Lane delved into topics such as hormones like IGF, growth hormone, and cortisol, and their roles in body composition and health. Despite not covering all intended topics in this episode, Lane has graciously agreed to return for a future discussion. Overall, Lane's story is a testament to the power of perseverance and the importance of a deep understanding of the subjects we're passionate about.

    • From bullying victim to weightlifter: Finding confidence and self-improvementWeightlifting provided a safe space for personal growth, offering measurable progress and a sense of fairness, even during self-guided training.

      The interviewee discovered his passion for weightlifting as a means to build self-confidence and overcome bullying during his childhood. He found solace in the gym, not just for physical benefits, but also for the measurable progress and sense of fairness it offered. Initially, his training was self-guided, relying on library books and high school classes. Later, he entered a drug-tested bodybuilding competition as a teenager, sticking to his personal ethos. Through consistent effort, he continued to make progress, eventually becoming a weightlifting enthusiast.

    • Meeting Dr. Joe sparks curiosity about human physiologyEncountering an evidence-based bodybuilding expert ignites desire for deeper scientific knowledge, despite past academic struggles.

      The encounter with Dr. Joe Klimzetski during a bodybuilding competition was a pivotal moment in the speaker's life. Dr. Joe's evidence-based approach to bodybuilding and focus on physiology sparked the speaker's curiosity and desire to learn more about the human body. Despite struggling with ADHD in school, the speaker developed effective study habits and went on to attend a high-quality college, where they had figured out their learning style. This experience with Dr. Joe and the challenges faced in education fueled the speaker's ambition to pursue a deeper scientific understanding, potentially leading to a PhD.

    • Overcoming adversity and seeking adviceFacing challenges and adversity can help develop strong study habits and lead to success. Seeking advice from mentors can provide valuable insights and set the foundation for future academic pursuits.

      Having faced adversity and challenges during his academic journey, the speaker was able to develop strong study habits and eventually succeed in his educational pursuits, including weaning himself off medication. Another key decision he made was to listen to the advice of a professor during his undergraduate studies, who suggested specializing in a more general science before pursuing a graduate degree in a specific area. This allowed him to build a solid foundation and eventually follow his passion for marine science in graduate school. Despite initial setbacks and fears, the speaker's determination and willingness to adapt proved to be valuable assets in his academic journey.

    • The benefits of specializing in a fieldSpecialize in a field to increase opportunities and gain expertise. Hard work, passion, and asking questions are key. Our perceived knowledge can be overestimated initially but decreases as we learn more, emphasizing the importance of continuous learning.

      Having a strong foundation in a specific field can open up more opportunities than starting with a more general degree. The speaker shared how switching from biology to biochemistry led him to various opportunities, including research positions and a career in bodybuilding. He emphasized the importance of hard work, passion, and asking questions. Additionally, the concept of the Dunning-Kruger effect was introduced, explaining how our perceived knowledge can be overestimated when we first start learning a subject, but as we continue to learn, our perception of our knowledge decreases. The speaker emphasized the importance of continuous learning and being open to new information.

    • Identifying True Experts: Uncertainty and Openness to LearningSeek out individuals who express uncertainty and are open to learning, as they are more likely to be true experts in their field.

      The pursuit of knowledge can be challenging due to the overwhelming amount of information available and the presence of individuals who may not truly understand the subject yet present themselves as experts. To identify those who truly know what they're talking about, look for those who express uncertainty and are open to learning. Additionally, debates are often unhelpful forums for gaining knowledge due to biases and the difficulty of determining which expert is more knowledgeable when both have more knowledge than the listener. The speaker's personal experience illustrates this challenge as they navigated their biochemistry degree and career aspirations, ultimately choosing to focus on nutrition due to personal interests and the prevalence of related questions.

    • The importance of consistency in muscle buildingConsistency in training, rather than natural abilities or early success, is crucial for muscle growth.

      Consistency and hard work, rather than natural abilities or early success, played a significant role in Lane's muscle building journey. Starting at a young age, Lane's focus was on maximizing muscle growth, but his weightlifting journey was interrupted by relationships. He started lifting seriously at 15, weighed 152 pounds at 17, and competed at 175 pounds at 19. He admired his older brothers, who had a natural gift of strength, but it wasn't until he saw their consistent dedication to training that he understood the importance of consistency in his own journey. Lane's gains were not rapid, but steady, and he credits this slow and steady progress as a key factor in his success.

    • Overcoming early setbacks in weightlifting builds resilienceStarting small and consistently showing up helps build resilience, leading to greater achievements despite challenges and injuries

      Early experiences with setbacks in weightlifting helped the speaker develop resilience, which enabled them to push through bigger challenges later in their career. They discovered that building muscle involved eating more calories and training consistently, and they were committed to putting in the work despite not having the genetically ideal body for bodybuilding. The speaker's stubbornness and ability to tolerate high training volumes helped them set a world squat record in powerlifting despite multiple injuries. They emphasize that confidence cannot be built out of nothing, and that starting small and consistently showing up is a key to building resilience.

    • Building discipline and perseverance through physical trainingDedicating oneself to challenging physical training can help build discipline, habit infrastructure, and lead to success in other areas of life. Authenticity and honesty are crucial in one's pursuits.

      Developing discipline and perseverance through challenging physical training can have profound effects on other areas of life. The speaker shared his personal experience of this, having dedicated himself to intense weightlifting training from a young age despite a lack of confidence. This commitment to training, even when it seemed insignificant at the time, helped him build the habit infrastructure and discipline necessary to succeed academically and professionally later in life. The speaker also emphasized the importance of authenticity and honesty in one's pursuits, especially in regards to using performance-enhancing drugs in bodybuilding competitions. The speaker's own weightlifting journey began modestly, with a 300 pound bench press in high school and a 315 pound squat, but over time he built strength and discipline that led him to impressive achievements.

    • Overcoming Injuries with Dedication and SupportWith the right mindset, dedication, and support, even serious injuries can be overcome and fitness goals achieved.

      With dedication, hard work, and the right guidance, even serious injuries like disc herniations can be overcome and one can continue to progress in their lifting career. The speaker shared their personal experience of dealing with multiple herniations, both cervical and lumbar, and how they were initially given a pessimistic outlook by medical professionals. However, they found motivation and support from coaches and physical therapists who encouraged them to push through the rehab process and regain their strength. Despite setbacks and ongoing issues, the speaker was able to hit PRs again and even win competitions. This story highlights the importance of perseverance and the right mindset in overcoming injuries and achieving fitness goals.

    • Understanding the relationship between tissue damage and painIdentify the source of pain, modify training regimen, take breaks, and consider resistance training for injury recovery

      While injuries can be debilitating, they don't have to be a death sentence for an athlete's career. In some cases, the pain may not be directly related to the tissue damage, but rather to the individual's ability to cope with the pain. The biopsychosocial model of pain suggests that tissue damage and pain are not always correlated. Therefore, it's essential to identify the source of the pain and modify the training regimen accordingly. This may involve adjusting the load, tempo, or exercise selection to reduce pain while still allowing for effective training. Additionally, taking a break from training, especially during stressful periods, can be beneficial for injury recovery. The research shows that if done correctly, resistance training can actually help alleviate low back pain. However, it's crucial to know your limits and modify your training accordingly to avoid exacerbating the injury.

    • Modify training routine instead of taking a breakContinue training with modifications to prevent detraining and potentially speed up recovery. Single-leg exercises can help alleviate pain and provide similar benefits to traditional multi-leg exercises. Balance powerlifting and bodybuilding to optimize training for your goals.

      Even when dealing with pain during training, it's better to modify your routine and continue training rather than taking an extended break. This approach can help prevent detraining and potentially lead to faster recovery. Additionally, focusing on single-leg exercises can help alleviate pain and provide similar benefits to traditional multi-leg exercises. However, the optimal balance between powerlifting and bodybuilding may vary, as both sports require strength but serve different purposes. In bodybuilding, the emphasis is on creating muscle tension and volume, while in powerlifting, mastering the major lifts is crucial for success. Ultimately, finding a way to train effectively while managing pain is essential for progress and maintaining a high level of performance in any athletic pursuit.

    • Bodybuilding and Powerlifting ChallengesExtreme dieting and intense training for bodybuilding or powerlifting can lead to energy deficits and mental challenges. Doing a powerlifting competition first and then prepping for a bodybuilding show may be optimal, but the optimal time between the two depends on individual circumstances.

      Extreme dieting and intense training for bodybuilding or powerlifting can lead to significant energy deficits and mental challenges. The speaker shared his experience of feeling so drained during his competition preparation that even simple tasks seemed impossible. He also noted the differences between the two sports: bodybuilding allows for more flexibility in training methods, while powerlifting requires lifting heavy weights in a specific order with no room for error. When considering attempting both, the order and minimum time between contests would depend on individual circumstances. The speaker suggested doing a powerlifting competition first and then prepping for a bodybuilding show, but the optimal time between the two would vary based on personal goals and dedication to lean body mass retention.

    • Impact of body fat on lean body mass loss during weight lossIndividuals with higher body fat percentages lose less lean body mass during weight loss due to larger energy reserves, but as body fat decreases, lean body mass loss increases. Diet breaks can help preserve lean body mass while still allowing for weight loss.

      The amount of body fat a person starts with significantly impacts the amount of lean body mass they lose during weight loss. For those with higher body fat percentages, such as those who are overweight or obese, they may lose very little lean body mass during weight loss due to their large energy reserves. However, as body fat percentage drops, the rate of lean body mass loss increases. For example, someone going from 15% to 7% body fat may experience minimal lean body mass loss, but someone going from 7% to 5% may lose a significant amount. To mitigate this, implementing diet breaks, or periods of eating at maintenance calories, can help preserve lean body mass while still allowing for weight loss. This is especially important for those aiming for very low body fat percentages, as the process of losing the last few pounds of fat requires much more effort and can lead to significant lean body mass loss. It's important to note that individual results may vary depending on factors such as genetics and body fat set point.

    • Body fat percentage influences lean body mass retention during weight lossBody fat levels and resistance training during weight loss impact the amount of lean body mass retained, with natural body fat set points playing a role.

      Body fat percentage can significantly impact the amount of lean body mass retained during weight loss. Bodybuilders, for instance, may have body fat percentages as low as 4%, but the exact amount of lean body mass they retain compared to others can depend on their natural body fat set point. Additionally, there is an inherent level of error in body composition measurements, and studies are limited in what they can measure due to their restrictive nature. As a result, the differences in lean body mass retention among individuals can be influenced by various factors, including natural body fat set point levels and the presence or absence of resistance training during weight loss. It's important to note that lean body mass is not the same as muscle mass and includes all nonfat tissues, such as skin, bone, and organs, as well as body water. Therefore, weight loss can result in significant water loss, particularly when glycogen stores are depleted.

    • Maintaining muscle during fasting with resistance trainingFocusing on big lifts during resistance training can help minimize muscle loss and maintain strength during fasting periods, especially for well-trained individuals. Consistency is key for effective results.

      During periods of fasting, focusing on resistance training, particularly the biggest lifts, can help minimize muscle loss and maintain strength. This observation may be especially effective for individuals who are already well-trained and not aiming for extreme hypertrophy or strength gains. However, it's important to note that this observation is empirical and not based on extensive scientific research. Additionally, maintaining muscle mass and strength while fasting requires consistency with resistance training. While it's possible to build muscle and strength while fasting, it may not be as effective as when consuming nutrients regularly. Ultimately, individual experiences and priorities play a significant role in the outcomes of fasting and resistance training.

    • Considerations for Building Muscle with Plant and Animal ProteinMonthly fasting breaks can aid muscle growth, plant and animal protein are similar in muscle building when total protein is equalized, and protein timing with resistance training and leucine may impact effectiveness

      When it comes to building muscle, both plant and animal protein sources can be effective, but there may be some considerations to keep in mind. First, taking a break from monthly fasting can be beneficial for muscle growth. Second, while randomized control trials suggest that plant and animal protein are similar in muscle building when total protein is equated, the studies may be underpowered and too short to show significant differences. Lastly, the timing of protein intake, particularly with regard to leucine and resistance training, may play a role in muscle protein synthesis and could impact the effectiveness of different protein sources.

    • Understanding muscle protein synthesis and leucine's roleLeucine triggers muscle protein synthesis by activating mTOR, but the duration and significance of the increase depend on meal type and timing.

      Muscle protein synthesis is the process by which muscles build new proteins from amino acid substrates, triggered by various stimuli like resistance training. Leucine, an essential amino acid, plays a crucial role in this process by activating mTOR, leading to an increase in muscle protein synthesis. However, the duration and significance of this increase vary depending on the type and timing of the meal, as well as the protein source. For instance, a complete meal with protein, carbohydrates, and fat can lead to an increase in muscle protein synthesis that peaks around 90 minutes post-meal and returns to baseline after three hours. These findings highlight the importance of understanding the intricacies of muscle protein synthesis and leucine's role in muscle growth and adaptation.

    • Protein turnover cycle during initial resistance trainingDespite increased protein synthesis and degradation during the first six weeks of resistance training, it's unclear if individuals are in a negative nitrogen balance due to lack of studies measuring both processes over an extended period. Further research is needed to understand the role of amino acid availability in muscle protein synthesis and degradation.

      During the initial phases of resistance training, both muscle protein synthesis and protein degradation increase robustly. This creates a protein turnover cycle, and it's only after six weeks of training that protein degradation decreases significantly, leading to muscle hypertrophy. However, it's important to note that none of the studies discussed have measured protein balance by assessing both protein synthesis and degradation over an extended period. Therefore, it remains unclear whether individuals are in a negative nitrogen balance during the first six weeks of training despite an increase in protein synthesis and degradation. The studies also did not consider the role of amino acid availability in muscle protein synthesis and degradation. Further research is needed to fully understand the complex relationship between training, protein turnover, and nitrogen balance.

    • The complexities of muscle growth from dietary proteinMuscle growth involves more than just deposited amino acids. Hormonal regulation and the balance between protein synthesis and degradation determine the net outcome.

      Muscle growth from dietary protein is more complex than just the deposited amino acids. Even if someone gains 50 pounds of muscle in a year, it would only require about 10 grams of amino acids per day. The actual fate of ingested amino acids is crucial, as much of it can be recycled instead of being deposited as new muscle tissue. This concept can be compared to the distinction between reesterification, lipolysis, and fat oxidation in a ketogenic diet. Just as fat gain and loss are not simply on or off processes, but rather a balance of different metabolic processes, protein synthesis and degradation also occur simultaneously. The hormonal regulation of these processes is intricate, with hormones like testosterone, cortisol, and estradiol all playing significant roles. It's essential to consider the overall balance of these signals to understand the net outcome on muscle growth.

    • Testosterone's Role in Muscle GrowthTestosterone binds with androgen receptors to increase muscle protein synthesis, while mechano-transduction drives muscle growth. Contrary to belief, systemic hormones like growth hormone and IGF-1 are not the primary drivers of muscle growth.

      Muscle growth is mostly intrinsically regulated, and testosterone plays a crucial role in this process. Testosterone binds with androgen receptors in the muscle cells, leading to an increase in muscle protein synthesis. Androgen receptor density may even increase to meet the demand for metabolizing testosterone. Contrary to popular belief, systemic levels of hormones like growth hormone and IGF-1 are not anabolic to skeletal muscle. Instead, mechano-transduction, or the translation of contractile force into a chemical signal, is responsible for muscle growth. The endocrine system, including growth hormone and IGF-1, plays a supportive role, but the primary driver of muscle growth is the muscle itself.

    • Growth hormone and IGF-1 have distinct roles in muscle growthGrowth hormone is involved in increasing energy use during exercise while IGF-1 stimulates muscle growth locally. Evolutionarily, muscle growth is a localized response to training, and phosphatidic acid may transfer tension to a chemical signal for growth via the mTOR pathway.

      Growth hormone and IGF-1, which is the integral of growth hormone, have distinct roles in muscle growth. Growth hormone, released endocrinely, is mostly involved in increasing lipolysis for energy use during exercise. On the other hand, IGF-1, which can be released autocrine or paracrine by muscle tissue itself, is highly anabolic and stimulates muscle growth locally. From an evolutionary perspective, it makes sense that muscle growth would be a localized response to the specific tissue being trained, rather than a systemic response. Additionally, phosphatidic acid, stored in the Z disc of the sarcomere, is believed to play a role in transferring mechanical tension to a chemical signal, ultimately stimulating muscle growth through the mTOR pathway.

    • Carbohydrates, Insulin, and Testosterone's Role in Muscle BuildingCombining carbs and protein post-workout may enhance muscle growth by reducing degradation and increasing synthesis. More research needed on complex relationship between carbs, insulin, and muscle growth.

      While testosterone and insulin play roles in muscle building, they primarily affect muscle growth at the transcriptional level and through protein breakdown respectively. Carbohydrates, on the other hand, may inhibit protein degradation but do not significantly increase muscle protein synthesis. Studies suggest that combining carbohydrates and protein after resistance training may be more effective in building muscle by reducing degradation and increasing synthesis. However, more research is needed to fully understand the complex relationship between carbohydrates, insulin, and muscle growth. Additionally, long-term studies on ketogenic diets and muscle building are limited, and the lengthy adaptation period to such diets may hinder significant muscle gains.

    • Nutrition and exercise complexities on ketogenic dietBuilding muscle on ketogenic diet is possible with dedication and proper training, but individual experiences and factors beyond psychological ones can influence the process and length of transition back to anaerobic metabolism.

      Understanding the complexities of nutrition and exercise, particularly in relation to specific diets like the ketogenic diet, requires careful consideration and nuance. While some generalizations can be made based on scientific consensus, individual experiences and outliers can vary significantly. For example, the idea that building muscle on a ketogenic diet is not possible is a simplification. While it may be more challenging to build muscle in the anaerobic state, it is still possible with dedication and proper training. Moreover, the length of time it takes for an individual to transition back to anaerobic metabolism after following a ketogenic diet can depend on various factors beyond just psychological ones. These factors could include genetic predispositions, individual nutritional needs, and the specifics of the diet itself. In the end, it's essential to approach nutrition and exercise with a clear understanding of the broader picture, while also acknowledging the importance of individual experiences and the complexities that come with them.

    • Considering Optimization vs. Possibility in Health and Fitness AdviceWhen evaluating health and fitness advice, distinguish between optimization and possibility, and understand what's being compared to maintain accurate perspectives.

      When evaluating health and fitness advice, it's essential to consider if the person is discussing optimization or just the possibility of doing something. For instance, someone may argue that a ketogenic diet isn't effective for building strength, but Dom D'Amato's achievements disprove that claim. Moreover, when comparing diets, it's crucial to understand what you're comparing them to. For example, a plant-based diet may appear unhealthy when compared to the standard American diet, but that doesn't mean it's not beneficial. Lastly, cortisol, a stress hormone, plays a significant role in muscle protein synthesis and training resilience. While extreme levels of cortisol can be harmful, physiological levels are necessary for the body to function optimally.

    • Cortisol's Role in Muscle Growth and Fat DistributionCortisol increases during exercise, aiding muscle growth, but long-term high levels hinder protein synthesis and may cause fat redistribution.

      Cortisol, a stress hormone, plays a complex role in the body, particularly in relation to muscle growth and fat distribution. During exercise, cortisol levels increase, but this may not be a bad thing, as cortisol is also associated with muscle hypertrophy. However, long-term, consistent high cortisol levels can have negative effects, such as impeding muscle protein synthesis and potentially leading to fat redistribution to unusual areas. It's important to remember that nutrients, including those often labeled as "good" or "bad," exist in context and that overall lifestyle and eating patterns are more significant factors in health than any single nutrient.

    • Focusing on individual nutrients oversimplifies understanding of disease incidentsConsider overall eating patterns and context instead of individual nutrients for a more accurate understanding of disease risks.

      Focusing on individual nutrients, such as high fructose corn syrup, for explaining disease incidents is oversimplified. Instead, we need to consider people's overall eating patterns. A study in Canada involving 100,000 people found that those with the highest meat intake had the same risk for cancer as those with the lowest meat intake, but only if they also had high levels of fruit and vegetable intake. This suggests that looking at the whole diet is crucial, as people who eat unhealthy foods often consume more than one unhealthy nutrient. Nutritional studies are limited, and it's challenging to generalize results to the average population due to the many variables involved. Acute and chronic effects, as well as localized and systemic responses, are not the same, and it's essential to understand these differences. Exercise, for instance, increases inflammation but also acts as a vaccine, making the body better at handling stressors. Therefore, considering the context and time course of nutritional and exercise studies is crucial. In summary, understanding the complexities of nutrition and exercise science requires looking beyond individual nutrients and focusing on overall eating patterns and context.

    • Consistency is key to losing body fat and maintaining overall healthConsistency in exercise, particularly resistance training, is crucial for losing body fat and improving health. Establish healthy habits to maintain muscle mass and overall well-being.

      Losing body fat is crucial for significant improvements in health and body composition, even surpassing the effects of dietary interventions. Exercise, particularly resistance training, plays a vital role in this process. Consistency is key to maintaining muscle mass and overall health, making it essential to establish healthy habits. The speaker emphasizes the importance of being deliberate and consistent, drawing parallels between building muscle and acquiring wealth. By focusing on habits and consistency, individuals can create lasting change.

    • Forming a new identity for weight lossSuccessfully maintaining weight loss involves adopting a new identity, seeing oneself as someone who practices healthy habits, and leaving behind old behaviors that hinder progress.

      Forming a new identity is crucial for maintaining long-term weight loss and making sustainable lifestyle changes. This concept resonated with Marie Speckley, who was inspired by the author's book to pursue her PhD. Speckley's research revealed that people who successfully kept off the weight had formed new identities, viewing themselves as individuals who exercised or ate healthily. Ethan Suplee, an actor who famously lost a significant amount of weight, echoed this sentiment, stating that creating a new identity is essential for shedding old behaviors that hinder progress. Whether it's related to nutrition, exercise, or other habits, embracing a new identity can make the process easier and more sustainable. However, it's important to remember that what works for one person may not work for another, and individuals should choose the form of restriction that feels easiest for them.

    • Consistency is key in fitness journeysStay committed to a sustainable routine, view setbacks as learning opportunities, and focus on long-term progress

      Consistency is key in achieving fitness goals, regardless of the specific diet or exercise routine. People often seek out like-minded individuals and assume everyone shares the same experiences and preferences, but in reality, everyone is unique. It's essential to find what feels easiest and most sustainable for each individual. The success of a fitness journey doesn't depend on motivation but rather on what one wants and the actions required to get there. Consistency is fundamental, and setbacks or challenges should be viewed as opportunities to learn and adjust rather than reasons to quit. It's important to remember that progress may not be linear and that comparing oneself to others can be misleading. Instead, focus on the potential for improvement and the long-term commitment required to reach goals.

    • Embrace progress despite imperfectionsConsistently making progress, even with imperfections, can lead to significant gains. Start taking action and explore advanced topics in future episodes with a membership program.

      Consistency and persistence in one's efforts can lead to significant progress, even when things are not perfect. The speaker emphasized the importance of starting and making progress, rather than being paralyzed by analysis and the overwhelming amount of information available. They also announced their intention to discuss more nuanced topics, such as creatine, occlusion training, and leucine signaling, in greater depth in a future episode. Additionally, they introduced a membership program that offers exclusive content and benefits for those interested in diving deeper into the topics discussed on the podcast.

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    • Why Morpheus recommends using a chest strap rather than an arm band [1:10:00];
    • The impact of consistent exercise, stress, alcohol, and other lifestyle factors on HRV [1:11:15];
    • Optimizing zone 2 training with Morpheus [1:18:15];
    • Using heart rate recovery (HRR) as an indicator of athletic conditioning and the balance between aerobic and anaerobic systems [1:22:45];
    • The importance of tracking HRV trends over time rather than focusing on data from a given day [1:29:00];
    • Effect of GLP-1 agonists on heart rate and HRV [1:34:45];
    • Where HRV belongs in the hierarchy of health metrics [1:42:00];
    • Parting thoughts [1:46:30]; and
    • More.

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    The Peter Attia Drive
    enJune 10, 2024

    #304 – NEW: Introducing quarterly podcast summaries - Peter shares his biggest takeaways on muscle protein synthesis, VO2 max, toe strength, gut health, and more

    #304 – NEW: Introducing quarterly podcast summaries - Peter shares his biggest takeaways on muscle protein synthesis, VO2 max, toe strength, gut health, and more

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    In this quarterly podcast summary (QPS) episode, Peter introduces a new format aimed at summarizing his biggest takeaways from the last three months of guest interviews on the podcast. Peter shares key insights from each episode, covering diverse topics such as protein and muscle building with Luc van Loon, toe strength with Courtney Conley, VO2 max with Olav Aleksander Bu, liquid biopsies for cancer with Alex Aravanis, gut health and probiotics with Colleen Cutcliffe, and road safety with Mark Rosekind. Additionally, Peter shares any personal behavioral adjustments or modifications to his patient care practices that have arisen from these engaging discussions.

    If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the episode #304 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

    • How Peter keeps track of his takeaways from each podcast episode [5:15];
    • Luc van Loon episode: fat utilization, muscle protein synthesis, dietary protein, aging and inactivity, and more [8:45];
    • Behavioral changes that have come about from the conversation with Luc van Loon [23:45];
    • Courtney Conley episode: importance of toe strength and the impact of dedicated foot training [26:45];
    • Olav Aleksander Bu episode: the importance of VO2 max for lifespan, and the practicalities of measuring and improving VO2 max [36:45];
    • Behavioral changes that have come about from the conversation with Olav [56:00];
    • Alex Aravanis episode: liquid biopsies for cancer detection [1:01:30];
    • Colleen Cutcliffe episode: the importance of gut bacteria balance, and the potential therapeutic uses of probiotics, particularly Akkermansia [1:16:45];
    • Mark Rosekind: the significant issue of road fatalities and injuries, their causes, and practical safety measures to reduce risks [1:27:00]; and
    • More.

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    The Peter Attia Drive
    enJune 03, 2024

    #303 - A breakthrough in Alzheimer’s disease: the promising potential of klotho for brain health, cognitive decline, and as a therapeutic tool for Alzheimer's disease | Dena Dubal, M.D., Ph.D.

    #303 - A breakthrough in Alzheimer’s disease: the promising potential of klotho for brain health, cognitive decline, and as a therapeutic tool for Alzheimer's disease | Dena Dubal, M.D., Ph.D.

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    Dena Dubal is a physician-scientist and professor of neurology at UCSF whose work focuses on mechanisms of longevity and brain resilience. In this episode, Dena delves into the intricacies of the longevity factor klotho: its formation and distribution in the body, the factors such as stress and exercise that impact its levels, and its profound impact on cognitive function and overall brain health. Dena shares insights from exciting research in animal models showing the potential of klotho in treating neurodegenerative diseases as well as its broader implications for organ health and disease prevention. She concludes with an optimistic outlook for future research in humans and the potential of klotho for the prevention and treatment of Alzheimer’s disease.

    Disclosure: Peter is an investor in Jocasta Neuroscience, a company working to develop klotho as a therapy for people with Alzheimer’s disease.

    We discuss:

    • Dena’s fascination with aging and how she came to study klotho [3:30];
    • Biological properties of klotho: production, regulation, decline with age, and factors influencing its levels [11:45];
    • Potential benefits of klotho on brain health [22:00];
    • The relationship between soluble klotho protein, platelet factors, and cognitive enhancement [33:45];
    • The role of platelet factor 4 (PF4) and it’s interaction with GluN2B in mediating cognitive enhancement [46:45];
    • Benefits of klotho observed in a mouse model of Parkinson’s disease [55:45];
    • Benefits of klotho observed in a mouse model of Alzheimer’s disease [1:03:00];
    • Promising results of klotho in primate models, and the importance of finding an appropriate therapeutic dose before moving to human trials [1:08:00];
    • Speculating why a single klotho injection has such long-lasting effects [1:25:30];
    • Potential cognitive benefits of klotho in humans, the impact of the KL-VS genetic variant on klotho levels, and the need for human trials to confirm these effects [1:27:45];
    • The interaction between the KL-VS genetic variant and APOE4 and how it impacts risk of Alzheimer’s disease [1:34:45];
    • The significance of klotho levels: studies linking lower levels to increased mortality and the broader implications for organ health and disease prevention [1:47:15];
    • Measuring klotho levels and determining an individual’s KL-VS status [1:52:15];
    • The promising potential of klotho for Alzheimer’s disease treatment, and the importance of philanthropy for funding research [1:58:00]; and
    • More.

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    The Peter Attia Drive
    enMay 27, 2024

    #302 - Confronting a metabolic epidemic: understanding liver health and how to prevent, diagnose, and manage liver disease | Julia Wattacheril, M.D., M.P.H.

    #302 - Confronting a metabolic epidemic: understanding liver health and how to prevent, diagnose, and manage liver disease | Julia Wattacheril, M.D., M.P.H.

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    Julia Wattacheril is a physician scientist and director of the Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) program at Columbia University Irving Medical Center. In this episode, Julia delves deep into the complex world of liver health, beginning with a foundational overview of liver physiology. She provides an in-depth look at how alcohol impacts liver function, breaking down the metabolism of ethanol and its detrimental effects. Julia then shifts the focus to understanding liver function tests and optimal enzyme levels, providing a detailed explanation of AST and ALT and elucidating why fluctuations in these levels may or may not be concerning. She provides a primer on the four major stages of liver disease, discussing risk and emphasizing the importance of early diagnosis. Julia highlights the role of liver disease in increasing the risk of cancer and cardiovascular disease and covers in detail the various strategies for diagnosing, treating, and preventing the progression of liver disease.

    We discuss:

    • Julia’s training, the importance of liver health, and the challenges and innovations of hepatology [3:15];
    • The complex and crucial functionality of the liver, its four most essential functions, and more [8:45];
    • Liver injuries: historical and evolving understanding of causal factors, and the progression to liver diseases and cancer [13:15];
    • How the liver metabolizes nutrients and what happens in the presence of excess calories or alcohol [24:45];
    • Methods of diagnosing liver disease and how insights guide treatment and management strategies [33:30];
    • The poisonous nature of ethanol to the liver [40:30];
    • Varied responses to alcohol, damaging effects of alcohol beyond the liver, and the process of advising patients on their alcohol consumption [47:15];
    • Understanding liver enzymes AST and ALT—interpreting levels, lifestyle factors that affect them, and diagnostic approaches [58:30];
    • Interpreting liver function tests for fatty liver disease, and the challenges of diagnosing liver pathologies, particularly in children versus adults [1:13:15];
    • Comprehensive liver health assessments via imaging and various diagnostic tools to prevent overlooking potential liver pathologies [1:18:45];
    • Potential impact of recreational drugs, statins, and other medications on liver function test results [1:26:45];
    • Shifting nomenclature from NAFLD to MASLD to reflect accuracy in the underlying pathophysiology and understanding of liver diseases [1:30:30];
    • Pathophysiology of MASLD, the need for proactive screening, and the significance of liver fat percentage as an indicator of metabolic health [1:36:30];
    • The importance of screening for rare conditions alongside common metabolic diseases associated with fatty liver accumulation [1:42:45];
    • Practical strategies for managing MAFLD [1:45:30];
    • The impact of fructose consumption on liver health and the challenges of disentangling its effects from other factors like obesity and insulin resistance [1:52:45];
    • The potential of GLP-1 agonists for the treatment of MASLD [1:57:45];
    • How the four stages of liver disease have evolved [2:00:30];
    • Increased cancer and heart disease risk associated with early-stage MAFLD [2:05:15];
    • Emerging drugs and therapies for addressing fat accumulation and fibrosis related to MAFLD [2:12:15];
    • Peter’s major takeaways [2:18:45]; and
    • More.

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    The Peter Attia Drive
    enMay 20, 2024

    #301 - AMA #59: Inflammation: its impact on aging and disease risk, and how to identify, prevent, and reduce it

    #301 - AMA #59: Inflammation: its impact on aging and disease risk, and how to identify, prevent, and reduce it

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    In this “Ask Me Anything” (AMA) episode, Peter delves into the often misunderstood concept of inflammation. He first defines inflammation and differentiates between acute inflammation and chronic inflammation, the latter of which is linked to aging and a plethora of age-related diseases. Peter breaks down the intricate relationship between chronic inflammation, obesity, and metabolic health, and highlights the signs that might suggest someone may be suffering from chronic inflammation. From there, the conversation centers on actionable advice and practical steps one can take to manage and minimize chronic inflammation. He explores how diet plays a crucial role, including the potential benefits of elimination diets, and he examines the impact of lifestyle factors such as exercise, sleep, and stress management. Additionally, he discusses the relevance of food inflammatory tests and concludes by examining the potential benefits and drawbacks of drugs and supplements in managing inflammation.

    If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed or our website at the AMA #59 show notes page. If you are not a subscriber, you can learn more about the subscriber benefits here.

    We discuss:

    • Defining inflammation (and the cultural impact of Napoleon Dynamite) [1:45];
    • Acute vs chronic inflammation [8:00];
    • The connection between chronic inflammation, aging, and age-related diseases [11:00];
    • The impact of inflammation on metabolic health [18:30];
    • Understanding and diagnosing chronic inflammation: blood tests and other approaches, and challenges with measurement [20:00];
    • Factors that contribute to low-level chronic inflammation [28:00];
    • Minimizing inflammation through diet [29:45];
    • The important role of fiber for gut health and inflammation [33:45];
    • A closer look at the impact of trans fats and saturated fats on overall health [34:45];
    • Why Peter prefers dietary fiber from food sources over supplements [38:30];
    • Debunking “superfoods”: emphasizing proven methods over marketing claims for reducing inflammation [39:00];
    • Is there any value in over-the-counter food inflammatory tests? [42:30];
    • Food elimination diets: how they work, symptoms and markers to watch, challenges and limitations [45:15];
    • Identifying dietary triggers for gut-related symptoms through low-FODMAP diets like the “carnivore diet” [51:15];
    • Dairy: the complex role of dairy on inflammation and individual responses [55:00];
    • Wheat: the complexities and conflicting evidence around wheat's inflammatory effects [57:45];
    • How exercise influences inflammation [1:02:00];
    • How sleep quality and duration impacts inflammation [1:07:00];
    • The potential impact of chronic psychological stressors on inflammation [1:13:00];
    • The impact of oral health on inflammation and overall well-being [1:15:00];
    • The role of medications in managing chronic inflammation [1:18:15];
    • Supplements: evaluating the efficacy of various anti-inflammatory supplements [1:22:15];
    • Parting thoughts and takeaways [1:27:00]; and
    • More.

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    The Peter Attia Drive
    enMay 13, 2024

    #300 - Special episode: Peter on exercise, fasting, nutrition, stem cells, geroprotective drugs, and more — promising interventions or just noise?

    #300 - Special episode: Peter on exercise, fasting, nutrition, stem cells, geroprotective drugs, and more — promising interventions or just noise?

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    In this special edition celebrating 300 episodes of The Drive, Peter discusses a variety of popular topics and health interventions and classifies them based on their level of evidence and relevance using the following categories: proven, promising, fuzzy, noise, and nonsense. Peter first delves into the topic of geroprotective molecules, covering rapamycin, metformin, NAD and its precursors, and resveratrol. Next, he explores the significance of metrics like VO2 max and muscle mass, as well as emerging concepts like blood flow restriction and stem cells. The conversation extends to nutrition, addressing questions surrounding long-term fasting, sugar consumption, sugar substitutes, and the contentious role of red meat in cancer. Peter not only provides his current stance on each topic—most of which have been covered in great detail in the previous 300 episodes—but also reflects on how his opinion may have evolved over the years.

    We discuss:

    • Defining the categories of “proven, promising, fuzzy, noise, and nonsense” [3:15];
    • Rapamycin [9:30];
    • Metformin [17:00];
    • NAD and its precursors [24:30];
    • Resveratrol [32:45];
    • The importance of VO2 max, muscle mass, and muscular strength for lifespan [38:15];
    • Blood flow restriction (BFR) training [44:00];
    • Using stem cells to treat osteoarthritis or injury [51:30];
    • Fasting as a tool for longevity (and why Peter stopped his fasting protocol) [55:45];
    • The energy balance theory [1:06:30];
    • The idea that sugar is poison [1:12:00];
    • The idea that sugar substitutes are dangerous [1:22:15];
    • The debate on red meat and cancer [1:28:45]; and
    • More.

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    Special episode with Dax Shepard: F1 and the 30th anniversary of Ayrton Senna’s death

    Special episode with Dax Shepard: F1 and the 30th anniversary of Ayrton Senna’s death

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    This is a special episode of The Drive with Peter’s friend and fellow car enthusiast Dax Shepard. In this podcast, which commemorates the 30th anniversary of the death of Brazilian Formula One legend Ayrton Senna, Dax sits down with Peter to better understand what made Senna so special and why Peter remains an enormous fan. This conversation focuses on Senna’s life, the circumstances of his death, and his lasting impact and legacy on the sport of F1.

    We discuss:

    • Peter’s interest in motorsports began as a child [2:30];
    • The drama and dangers of F1 [6:00];
    • What made Senna special [13:00];
    • What Senna meant to Brazilians [24:00];
    • The cause of the fatal crash [28:15];
    • Why Peter is obsessed with Senna [40:30];
    • Being the best versus having the best record [43:30];
    • Senna’s unique driving style and incredible intuition about automotive engineering [46:30];
    • Back to the day of the dreadful race [53:00];
    • What Peter believes caused the crash [1:02:45];
    • Views on dying young, in the prime of life [1:13:00];
    • Senna lives on in his foundation and in safety changes adopted by F1 [1:21:00];
    • Statistics aren’t enough for fandom, and why people like who they do [1:24:15];
    • The biggest difference between F1 today and F1 in the 80s [1:28:30];
    • Senna’s driving superpower [1:30:30];
    • The fastest drivers currently in F1 [1:38:30];
    • Current F1 obsessions [1:45:00];
    • How hard it is to do what the top F1 drivers do [1:50:15];
    • Dax’s love of motorcycles and his AMG E63 station wagon [1:52:15];
    • Awesome Senna mementos from Etsy [2:01:15];
    • What makes specialists interesting, and Max’s devotion to F1 [2:10:15];
    • What Senna might have done if he had not died that day [2:14:00];
    • Michael Schumacher and Max Verstappen are also top F1 drivers [2:17:30];
    • Interlagos in Sao Paulo Brazil is always an incredible experience [2:18:45]; and
    • More.

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    #299 ‒ Optimizing muscle protein synthesis: the crucial impact of protein quality and quantity, and the key role of resistance training | Luc van Loon, Ph.D.

    #299 ‒ Optimizing muscle protein synthesis: the crucial impact of protein quality and quantity, and the key role of resistance training | Luc van Loon, Ph.D.

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    Luc van Loon is an internationally renowned expert in skeletal muscle metabolism. In this episode, Luc starts with an exploration of the roles of insulin and triglycerides in endurance exercise, highlighting their impact on skeletal muscle metabolism, and he offers profound insights into the significance of protein in this context. He elucidates how different protein types and forms influence muscle protein synthesis rates, exploring the nuances of protein absorption, digestibility, amino acid quality, and their implications for performance and recovery. Delving deeper, he differentiates between animal and plant protein sources, unraveling the distinctive properties of various protein types, from the differences between whey and casein to the emerging trends in collagen protein supplementation. Moreover, Luc dissects the intricate connections among physical activity, lean muscle mass, muscle protein synthesis induced by resistance training, and dietary protein.

    We discuss:

    • Luc’s background and insights about fuel selection during exercise [3:30];
    • Fuel utilization during endurance exercise [9:30];
    • Fat metabolism, intramuscular lipids, and the nutritional dynamics of endurance sports [17:15];
    • The optimal window for replenishing intramuscular fat stores and glycogen post-exercise [25:15];
    • Luc’s interest in protein metabolism and exploration of amino acids' dual role as building blocks and signaling molecules in driving muscle protein synthesis [32:15];
    • How protein metabolism differs between sedentary individuals and those engaged in predominantly strength training or endurance training [38:45];
    • The basics of how proteins are digested and absorbed, and how muscle protein synthesis is measured [50:30];
    • How factors like food texture, cooking methods, and protein composition impact muscle protein synthesis, and the importance of protein distribution throughout the day [59:45];
    • Differences in whey and casein proteins, and the ability of ingested protein to stimulate muscle protein synthesis [1:03:30];
    • Dietary protein distribution and quantity for the maximization of muscle protein synthesis [1:09:00];
    • Muscle loss with age and inactivity and the importance of resistance exercise to maintain type II muscle fibers [1:17:15];
    • Differences between whey and casein proteins, and the importance of both quantity and quality of protein sources [1:28:30];
    • Optimizing muscle protein synthesis: exercise, timing of protein intake, protein quality, and more [1:37:00];
    • How to preserve muscle while trying to lose weight [1:46:00];
    • Anabolic resistance and overcoming it with physical activity [1:55:45];
    • Importance of protein intake and physical activity in hospitalized patients [2:06:30];
    • Reviewing the efficacy of collagen supplements [2:13:30];
    • Plant-based diets: how to ensure a balance of amino acids, and other considerations [2:20:30];
    • Future research: understanding protein metabolism in the brain [2:23:45]; and
    • More.

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