How to Optimize Muscle Health & Quality | Dr. Gabrielle Lyon & Dr. Andrew Huberman

00:00:00.000 | Is it possible for somebody to have a lot of muscle, but their muscle health is poor?

00:00:07.460 | Yes.

00:00:07.860 | Okay.

00:00:08.700 | Conversely, can somebody have a moderate to low amount of muscle, but their muscle quality

00:00:14.140 | is high, or is that less common?

00:00:15.640 | Well, the first thing that you said is absolutely something that we see, is that in an individual

00:00:22.240 | that carries a lot of muscle and say they're inactive, there is a big discussion about

00:00:27.960 | how heavy individuals will have more muscle mass.

00:00:31.640 | But what we have to recognize is the health of that skeletal muscle is fat deposition can

00:00:36.760 | be visceral fat deposition, fat around the organs, and it can be also fat infiltrate into the

00:00:43.180 | tissue, like, not to gross anyone out, a marbled steak.

00:00:46.300 | And that's exactly what can happen to unhealthy skeletal muscle, which then affects its ability

00:00:52.100 | to contract, which also affects, there's a ton of mitochondria in skeletal muscle, it affects

00:00:56.680 | the efficiency of skeletal muscle.

00:00:58.720 | So yes, someone can have potentially more muscle, but more unhealthy muscle.

00:01:03.380 | Interesting.

00:01:04.240 | When you say a marbled steak, I think at the extreme, a wagyu, a raw wagyu looks like there's

00:01:11.540 | as much white fat in it as there is red meat in it.

00:01:15.840 | And it's a very different taste and texture.

00:01:18.420 | So that's what we're talking about.

00:01:19.740 | My understanding is those cows don't move around much.

00:01:23.020 | They're somewhat sedentary compared to, say, a free-range grass-eating cow.

00:01:28.400 | Is that right?

00:01:28.840 | Yeah.

00:01:29.180 | Okay.

00:01:29.440 | That's absolutely correct.

00:01:30.620 | Okay.

00:01:30.960 | So we want quality, healthy muscle, and then we can talk about muscle amount.

00:01:36.080 | And then the other thing that I'll say about it is part of what defines muscle health is

00:01:41.960 | that flux, that movement.

00:01:43.220 | So if you were to think about skeletal muscle like a suitcase, and an individual was, say,

00:01:48.900 | going on a trip for four days, but chooses to eat or pack for 30 days.

00:01:53.940 | We know these people.

00:01:55.300 | Yes, I know I'm maybe one of them.

00:01:56.680 | I have my suitcase here.

00:01:57.820 | I was only coming in for a day, but I may have packed for four days.

00:02:01.980 | Not sure what I was doing, but that's besides the point.

00:02:05.120 | When an individual is overeating calories, overeating carbohydrates, I had mentioned earlier

00:02:11.280 | that skeletal muscle, one of its primary roles is glucose disposal.

00:02:14.680 | And I'm sure we're going to get in the mechanisms of glucose disposal, whether it's

00:02:18.920 | insulin-dependent or insulin-independent, depending on if someone is moving or contracting

00:02:23.540 | that muscle.

00:02:24.680 | When an individual is eating food, carbohydrates, it gets stored in skeletal muscle as glycogen

00:02:32.400 | because, as we know, glucose at a high level is toxic to the body.

00:02:37.180 | So the body must move glucose out of the bloodstream into the cells.

00:02:41.140 | Now, what happens is there becomes this stasis.

00:02:47.320 | So if an individual is inactive and not exercising, then that skeletal muscle becomes

00:02:54.300 | overpacked.

00:02:55.020 | Skeletal muscle at rest burns primarily free fatty acids, which is interesting.

00:03:00.020 | Most people think about skeletal muscle as burning carbohydrates, but actually at rest, skeletal

00:03:04.860 | muscle burns fatty acids.

00:03:06.100 | As you can imagine, when that muscle is full and you are not exercising it, then the substrates

00:03:13.600 | have nowhere to go.

00:03:14.980 | And it remains in the bloodstream.

00:03:15.660 | And that would be a sign of unhealthy skeletal muscle, which then loops back to what you see

00:03:21.620 | in blood work.

00:03:22.160 | Elevated insulin, elevated blood glucose.

00:03:25.540 | Yes.

00:03:25.660 | Elevated free fatty acids, elevated branched chain amino acids, all of these things, which

00:03:31.440 | again, as skeletal muscle, as the metabolic sink, have nowhere to go.

00:03:34.700 | So I'm starting to get a picture where in order to have healthy muscle, we need to think about

00:03:41.360 | the feeding of that muscle, the providing of nutrients to that muscle, that is, as well

00:03:46.520 | as the use of that muscle.

00:03:47.800 | Let's start with the feeding or the providing of nutrients to that muscle.

00:03:52.420 | You mentioned that muscle at rest mainly burns fatty acids.

00:03:55.020 | It can store glycogen.

00:03:56.680 | How do we know when a muscle is full of glycogen?

00:04:00.760 | I mean, there's the visual representation of the muscle seems fuller as opposed to flatter,

00:04:06.040 | you know, but these are not specific or these are not precise terms.

00:04:12.640 | You know, how much carbohydrate does it take to fill all the muscle of the body with glycogen?

00:04:18.040 | And then what sorts of things perhaps deplete that?

00:04:22.260 | I think it's a great question.

00:04:23.060 | We know that when we're talking about glycogen, the liver stores glycogen, maybe 100 grams.

00:04:28.700 | And then skeletal muscle, depending on your size, for example, you might store much more

00:04:34.380 | muscle glycogen, whether it's for 500 grams compared to someone who is my size.

00:04:38.960 | And can we do the standard conversion of four calories per gram?

00:04:42.040 | So if the liver is 400 grams, you know, we just say, okay, there's about 1600 calories worth

00:04:47.400 | of energy there.

00:04:49.560 | So if I go out and I do some exercise and burn 1600 calories over time, does that mean

00:04:54.920 | that the liver is then completely depleted?

00:04:57.540 | So, well, the liver will deplete through an overnight fast.

00:05:01.540 | So the liver maintains blood glucose.

00:05:04.200 | So skeletal muscle doesn't maintain blood glucose directly.

00:05:07.280 | The way that you would leverage muscle glycogen would be through exercise.

00:05:12.180 | The way in which you would deplete muscle glycogen would be through more intensive exercise.

00:05:19.000 | And when you think about the foods and the way in which, you know, your original question

00:05:24.060 | is how would we know how much muscle glycogen or how much we need to refuel, I typically think

00:05:30.060 | about it as overall activity levels.

00:05:31.800 | So if someone is sedentary, then the current recommendation for carbohydrates would be 130

00:05:38.200 | grams.

00:05:38.940 | Per day?

00:05:39.240 | Per day.

00:05:39.720 | At four calories per gram?

00:05:41.260 | At four calories per gram.

00:05:42.640 | And is that both simple and complex carbohydrates, fibrous carbohydrates?

00:05:46.180 | Yes.

00:05:46.540 | It would just be overall.

00:05:48.100 | 130 grams.

00:05:49.040 | Yes.

00:05:49.220 | If they're completely sedentary.

00:05:50.400 | Yes.

00:05:50.740 | So just a little bit of walking, getting up, going to the computer, to the bathroom, to the

00:05:54.840 | car, et cetera, but basically sedentary.

00:05:56.600 | Yes.

00:05:56.940 | And the average American takes in 300 grams of carbohydrates a day.

00:06:01.420 | So more than double.

00:06:03.100 | And as you can imagine, this can distort metabolism.

00:06:08.680 | When we think about glucose disposal, the way in which I think about glucose disposal, if an

00:06:13.680 | individual is sedentary, is thinking about how many carbohydrates an individual can ingest

00:06:19.620 | at one time that would mitigate insulin response and would be able to be disposed of safely.

00:06:26.680 | And that number is between 40 and 50 grams of carbohydrates at a meal outside of exercise.

00:06:33.660 | The rest of carbohydrates would be earned through exercise.

00:06:38.540 | And through every hour of exercise, depending on the intensity, that could be between 40 to

00:06:46.020 | 70 grams, depending on how intense an individual exercise is.

00:06:50.140 | And that would be safely disposed of in a two-hour period.

00:06:54.580 | I mean, when you think about an oral glucose tolerance test, that's a 75-gram load.

00:06:59.760 | You assume within two hours that that blood sugar regulation should come back to a normal range.

00:07:05.400 | So at 40 to 50 grams of carbohydrate every two hours, does that mean that if somebody were to eat

00:07:13.600 | 40 to 50 grams of carbohydrates every two hours?

00:07:16.380 | Which they shouldn't.

00:07:17.200 | Which they shouldn't, right?

00:07:18.200 | But because you're going to quickly exceed that 130 grams per day.

00:07:21.960 | And even if exercising with resistance training, say, hard for an hour, which can afford somebody

00:07:29.720 | maybe, what, another couple hundred, 300 grams of carbohydrates?

00:07:33.620 | Probably not that much.

00:07:34.620 | Okay.

00:07:35.300 | You know, I think that if people care about body composition, which I would say everyone should,

00:07:41.580 | because you want to have an appropriate level of body fat and healthy skeletal muscle,

00:07:46.800 | then you wouldn't necessarily, unless you're doing some kind of cardiovascular activity,

00:07:52.080 | you're not using a ton of muscle glycogen, depending on how much you're training.

00:07:56.600 | And how much glycogen is the brain using?

00:08:00.040 | So that is a good question.

00:08:02.420 | The brain uses a lot of carbohydrates.

00:08:07.480 | That would be a primary source.

00:08:09.860 | When they come up with the numbers of 130, it's really based on brain and then the rest of the body.

00:08:16.060 | Can we safely say that for somebody that's thinking a lot, they need more carbohydrates?

00:08:20.960 | You could say that.

00:08:23.100 | Then your brain, yes, your brain is very metabolically active.

00:08:25.980 | Interesting.

00:08:27.200 | So we're kind of drawing rough estimates, not knowing people's body weight,

00:08:32.820 | not knowing their body composition.

00:08:34.060 | But what I'm arriving at here is, you know, if somebody does a little bit of cardiovascular training,

00:08:39.460 | maybe a little bit of light resistance training, I'm describing the activities of many people out there,

00:08:43.760 | maybe 250 grams of carbohydrates, you're kind of at the threshold.

00:08:48.620 | That's a lot.

00:08:49.200 | That's a lot.

00:08:50.280 | Four calories per gram of those carbohydrates.

00:08:54.420 | So let's say 200 grams of carbohydrates per day.

00:08:56.740 | But that's not a ton of calories overall.

00:09:01.300 | So what should the remainder of the calories be made up of?

00:09:04.120 | So, you know, I think what we're really talking about here is how do we design a nutrition plan

00:09:08.780 | for people to have healthy skeletal muscle?

00:09:11.120 | Right.

00:09:11.600 | And, you know, if I were to say, okay, what are we thinking about for the listener or for the people out there?

00:09:18.140 | They're thinking, you know, I really want to have a healthy body composition and healthy skeletal muscle mass.

00:09:24.060 | The way in which they would do that is, number one, you have to prioritize dietary protein.

00:09:29.280 | So we're talking about carbohydrates here, but carbohydrates shouldn't be the primary focus.

00:09:34.700 | Nobody has challenges getting carbohydrates in.

00:09:36.680 | 130 grams would be a safe recommendation.

00:09:39.420 | If someone is overweight or struggles with type 2 diabetes or any of these other metabolic conditions,

00:09:46.260 | there is evidence to support a lower carbohydrate intake.

00:09:48.940 | I mean, 130 grams is, you know, one little micro packet of pretzels on an airplane ride.

00:09:55.440 | You know?

00:09:56.200 | So that actually has probably closer to 37 grams of carbohydrates.

00:10:00.260 | Okay, good.

00:10:00.840 | Not that I had a pretzel packet before or threw one at Rob on the way in, but no.

00:10:04.860 | Right.

00:10:05.120 | Okay, so I'm way off there.

00:10:06.880 | So they have one of those, a bagel in the morning, and they shouldn't, but they do.

00:10:16.480 | And then they have some, you know, pasta at dinner.

00:10:19.320 | And so most people are probably exceeding that 130 grams by a huge margin.

00:10:23.420 | Yes, they are.

00:10:24.340 | And there's a couple things there that it's really important that you said is that individuals,

00:10:29.900 | when we're thinking about designing a plan for skeletal muscle health, that first meal

00:10:34.360 | is most important.

00:10:35.360 | That first meal of the day, having dietary protein will set you up metabolically for the rest of

00:10:40.820 | the day.

00:10:41.060 | And when you say first meal, and we'll talk a little bit later about intermittent fasting

00:10:45.040 | and, you know, I, for instance, eat my first meal at usually 11 a.m.

00:10:48.860 | It's just kind of how I'm wired.

00:10:50.900 | I've never wanted to eat breakfast first thing.

00:10:52.580 | I've forced myself to eat some eggs first thing in the morning from time to time, and it

00:10:55.940 | felt fine.

00:10:57.900 | But do you recommend that people eat a true breakfast, like within a certain number of

00:11:03.260 | hours of waking up for sake of muscle health and metabolic health?

00:11:08.880 | When we think about that first meal, I frankly don't care when you have it.

00:11:13.460 | One also has to understand that you're coming out of an overnight fast.

00:11:16.880 | If you are young and healthy, then the timing of that first meal likely doesn't matter because

00:11:22.800 | you are robust, your body is very efficient and capable to withstand protein degradation.

00:11:33.660 | It's able to withstand protein degradation and protein turnover, which is ultimately why

00:11:39.460 | we're eating.

00:11:39.980 | So that's one reason why we're eating.

00:11:41.260 | And we'll talk a little bit more about that.

00:11:43.360 | That first meal of the day, if you are young and healthy, the timing doesn't really matter.

00:11:48.640 | And I would say when it begins to matter is when you're older.

00:11:52.380 | When you are in your 60s, continuing to fast may be a negative, a negative for muscle health.

00:12:00.440 | That first meal of the day is important because we know that when you get between 40 and 50 grams

00:12:07.640 | of protein, that first meal of the day, you stimulate muscle protein synthesis.

00:12:12.160 | Muscle protein synthesis is by proxy what we use to measure as a marker for overall muscle

00:12:18.380 | health.

00:12:18.720 | Now, there's a lot of history here when we think about designing a meal plan.

00:12:24.000 | That first meal has between, we'll say, give it between 30 to 50 grams of dietary protein.

00:12:30.580 | That will do a number of things.

00:12:33.140 | Number one, it will stimulate skeletal muscle, what we would consider the health of skeletal muscle.

00:12:37.720 | It also will affect the brain.

00:12:39.500 | It'll improve satiation.

00:12:41.060 | You and I were talking previously.

00:12:42.580 | It releases a handful of gut peptides.

00:12:47.360 | Like glucagon-like peptide one, which later we'll talk about.

00:12:51.180 | GLP, yes, GLP, CCK, PYY, things that will affect appetite for that second meal.

00:12:59.500 | There's some very interesting research out of Heather Leidy's lab.

00:13:02.800 | Basically, when she put individuals, younger adolescents, on a meal of 30 to 40 grams of

00:13:10.560 | protein, they were much less likely to choose, say, donuts or something outside of what we would

00:13:18.460 | consider a healthy nutrition plan.

00:13:20.680 | Later in the day or in the same meal?

00:13:22.360 | Later in the day.

00:13:23.000 | It was essentially augmenting their willpower.

00:13:26.500 | Okay, so it sounds like for young people, they can delay breakfast if they want.

00:13:29.780 | For older people, probably not.

00:13:31.140 | But that the first meal of the day should include what you're calling dietary protein, 30 to 50

00:13:36.020 | grams.

00:13:36.460 | Yes.

00:13:36.920 | And maybe we should talk about the quality of that protein.

00:13:40.280 | Because I think a lot of people understand that there are meat proteins, there are plant proteins.

00:13:45.520 | How important is the quality of that protein?

00:13:49.540 | This tends to be a hot topic and somewhat very controversial.

00:13:53.780 | Great.

00:13:54.340 | Great for you.

00:13:56.520 | I know.

00:13:56.960 | Great for everybody.

00:13:57.840 | I mean, controversy on this podcast is embraced in the following way.

00:14:03.140 | We state what we know.

00:14:05.100 | We state what we don't know.

00:14:06.280 | And we are always happy to return to the conversation in a future time to adjust any stances based on

00:14:13.460 | the data and how we evolve as people.

00:14:15.840 | Okay.

00:14:16.920 | Well, I love that.

00:14:17.740 | Dietary protein, we speak about it as if it's one thing.

00:14:21.780 | But actually, it's 20 different amino acids, nine of which are essential.

00:14:25.940 | The rest we can generate in our body.

00:14:28.880 | And when we think about skeletal muscle, we think about the essential amino acids.

00:14:33.940 | And the essential amino acids primarily for skeletal muscle health are the branch chain

00:14:39.160 | amino acids, leucine being one of those.

00:14:41.820 | So leucine is uniquely stimulating to skeletal muscle.

00:14:47.540 | And when you have enough leucine, it triggers muscle protein synthesis.

00:14:51.780 | And when you say stimulating and muscle protein synthesis, I think a lot of people get a picture

00:14:55.960 | in their mind of a muscle growing.

00:14:57.280 | But you're not necessarily talking about that.

00:15:00.100 | You're talking about the organ that is muscle, that its health, its metabolism being cultivated

00:15:05.780 | so that it can do all the hormone endocrine related things and the glucose disposal related

00:15:10.540 | things that we'll get into in a bit more detail later.

00:15:12.400 | Is that right?

00:15:12.840 | Yeah.

00:15:13.080 | And so when you have a breakfast of 30 to 50 grams, you appropriately stimulate muscle

00:15:20.000 | protein synthesis.

00:15:20.700 | And one has to recognize that if you eat below that threshold, you do not stimulate the health

00:15:27.520 | of that skeletal muscle.

00:15:28.380 | You do not stimulate muscle in a way that would be necessary for outcomes that matter.

00:15:35.560 | And outcomes that matter are sarcopenia.

00:15:37.980 | Outcomes that matter are body composition, prevention of obesity.

00:15:41.740 | You must get this nutrition right.

00:15:44.780 | It's the thing that 100% of people do is eat.

00:15:47.400 | It's the thing that 100% of people do is eat.

00:15:48.060 | It's the thing that 100% of people do is eat.

00:15:48.400 | It's the thing that 100% of people do is eat.

00:15:49.400 | It's the thing that 100% of people do is eat.

00:15:50.400 | It's the thing that 100% of people do is eat.

00:15:51.400 | It's the thing that 100% of people do is eat.

00:15:52.400 | It's the thing that 100% of people do is eat.

00:15:53.400 | It's the thing that 100% of people do is eat.

00:15:54.400 | It's the thing that 100% of people do is eat.

How to Optimize Muscle Health & Quality | Dr. Gabrielle Lyon & Dr. Andrew Huberman

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