[@PeterAttiaMD] 365 ‒ Training for longevity: A roundtable on building strength, preventing injury, protein, & more

Link: https://youtu.be/ac0Nm71GpOY

Short Summary

This podcast episode, featuring Dr. Gabrielle Lyon, Michael Boyle, and Jeff Cavalier, underscores the critical role of resistance training for overall health, lifespan, and quality of life. Despite its proven benefits, only a small percentage of Americans consistently engage in it due to lifestyle barriers, misconceptions, and a lack of appreciation for its importance, emphasizing the need for accessible education and a focus on practical, sustainable approaches. The experts advocate for muscle-centric medicine, intelligent and safe training practices, and prioritizing the synergistic role of nutrition for optimal well-being throughout the lifespan.

Key Quotes

Here are 5 direct quotes from the YouTube video transcript that I found particularly insightful, data-driven, or opinionated:

1. Jeff Cavalier: "I've mentioned before, you can build a great body on six exercises. Literally, the row, squat, deadlift, bench, pull-up, curl, done. Like, you've got everything you need. You don't have to complicate it if you keep trying to get stronger at those exercises."
2. Mike Boyle: "You don't know you're losing the battle until it's too late."
3. Gabrielle Lyon: "Skeletal muscle health is really what we're talking about."
4. Mike Boyle: "Coaches want kids to specialize earlier and earlier. If you look at most of these people that are telling you that kids need year- round sports are people who are making their living from year- round sports."
5. Gabrielle Lyon: "Is not sex specific. It's body weight specific. The minimum amount of protein I would ever recommend would be 100 gram at a minimum. Men or women that would be the starting place..."

Detailed Summary

Okay, here is a detailed summary of the YouTube video transcript provided, using bullet points:

I. Introduction and Guest Introductions:

• The video is a round table discussion on resistance training hosted by Peter Attia on The Drive Podcast.
• Attia introduces the three guests: Dr. Gabrielle Lyon (geriatric and nutritional sciences physician), Michael Boyle (strength and conditioning coach), and Jeff Cavalier (physical therapist and YouTube creator).
• Gabrielle Lyon discusses her focus on muscle-centric medicine, highlighting the importance of skeletal muscle for overall health and wellness, writing the NY Times best seller called Forever Strong, and a recently accepted paper on muscle mass and sexual function.
• Michael Boyle describes his 43-year coaching career in various sports, including the NFL combine training, NHL, and the Red Sox. He now coaches his son and a wide range of clients from young athletes to elderly individuals.
• Jeff Cavalier discusses his background as a physical therapist, his work with the New York Mets, and his transition to creating a YouTube channel to educate and empower people to move more athletically in daily life. He is motivated to stay in shape to keep up with his young twins.

II. Resistance Training Participation and Barriers:

• The discussion begins with the question of how many people in the US engage in resistance training.
• Estimates suggest a large percentage of Americans are not resistance training regularly. It is suggested 70% of people do not meet the criteria for any exercise. But more likely 5-15% of Americans regularly resistance train.
• A statistic is mentioned that only 20% of people who sign up for online training programs actually finish them.
• Attia emphasizes the incredible benefits of exercise, especially resistance training, on lifespan, quality of life, and chronic disease risk reduction.
• Boyle suggests the biggest barrier to exercise is "life" - lifestyle, jobs, and people adding hours to their day. Some people may lack the economic freedom to devote time to exercise.
• He notes that people often don't realize they are losing the battle with their health until it is too late.
• Lyon points out the cultural aspect, where society prioritizes comfort, and movement isn't seen as essential. She observes that women have not traditionally focused on strength training. Also cultural norms and self-imposed limitations (e.g., thinking they can't lift certain weights).
• Cavalier suggests that some people are simply not inclined to enjoy the stress of exercise, but discipline and motivation can be learned. Seeing results can be a strong motivator. People often overestimate the commitment required.

III. Practical Approaches to Resistance Training:

• Boyle states that many people who come to his gym have never engaged in intelligent strength training.
• Boyle says he focuses on getting clients to show up consistently (two days a week). The goal is that clients should not be crippled the next day.
• Boyle's programming involves foam rolling, stretching, dynamic warm-up, medicine ball work, power training (jump training), resistance training (36 minutes), and conditioning. The entire session takes about an hour. Slow and steady wins the race.
• Progress is made by advancing weight, reps, or sets.
• Adult clients in Boyle's gym don't use barbells and do mainly unilateral exercises.
• Lyon addresses a hypothetical 50-year-old runner, emphasizing that even lean individuals can benefit from resistance training to improve glucose metabolism, increase muscle mass, and enhance dietary flexibility. She points out that it enables people to have more dietary flexibility.
• Cavalier discusses working with people who aim for very low body fat percentages, achieved primarily through consistent nutrition. Sacrifices are necessary, but it doesn't necessarily require extreme measures like only eating boiled chicken and broccoli. He recommends striving for consistency above 90% with meals.
• It is a "sore spot" for Cavalier that the average person believes exercise leads to looking jacked, the public underestimates the role of nutrition.

IV. Nutrition Details:

• Cavalier recommends 5 meals a day to manage hunger and improve portion control, particularly for athletes.
• He emphasizes the importance of protein in every meal and snack and states, "Protein should be the cornerstone of all of our meals and snacks because we don't get enough."
• Cavalier's daily diet consists of oatmeal, egg whites, a protein shake, a chicken wrap or cereal with yogurt, jerky, and a dinner that may be late at night.
• Lyon elaborates on protein, explaining that it consists of 20 amino acids, 9 of which are essential.
• She highlights the importance of leucine for muscle protein synthesis. The optimal health amount is 8-9g/day.
• Lyon recommends a minimum of 100 grams of protein per day for both men and women, adjusting for body weight.
• Lyon distinguishes between high-quality (animal-based) and lower-quality (plant-based) protein sources. She recommends using plant food for fiber and phytonutrients. High-quality protein is eggs, dairy, fish, and chicken.
• For overweight patients, she bases protein recommendations on their target body weight at 16% body fat.

V. Unilateral Training and Squatting Controversies:

• Boyle discusses his shift away from bilateral squatting, citing back problems and the benefits of unilateral training.
• He mentions research on the bilateral deficit, where individuals are often stronger on one leg than on two.
• Boyle theorizes that the body is neurologically geared towards unilateral movement. He suggests high levels of bilateral exercises might make you less athletic.
• Cavalier acknowledges the possibility of teaching someone to squat safely at an early age but agrees with Boyle that single-leg training can offer comparable benefits, especially with the aging population.
• Cavalier's preferred lower body exercise is the reverse lunge with a barbell or dumbbells.
• Lyon discusses her own injury experiences and how they led her to focus on single-leg movements.
• Boyle uses the "car door slamming" analogy to highlight the irrational attachment to squats, even when they cause injury.
• Boyle mentions eliminating barbell squats and deadlifts in the adult program to eliminate the risk-factor of the exercises.

VI. The "Iron Graveyard" and Exercise Alternatives:

• Cavalier discusses the concept of the "iron graveyard" – exercises he considers too risky for the benefit they provide.
• He mentions the upright row, chest fly, and Cuban press as exercises with safer and equally effective alternatives. Upright row is a garbage exercise and chest fly and floor fly can eliminate risk of the shoulders.
• The importance of education and re-education on proper exercise form is emphasized.

VII. Youth Sports and Specialization:

• Attia raises concerns about the trend of early sports specialization for kids.
• Boyle strongly advises against early specialization, advocating for broad sampling of sports and activities to develop general athletic attributes.
• He says that people who advocate year-round sports are the ones who financially benefit from it. "Follow the money."
• Boyle stresses that multisport athletes tend to excel in the long run.
• He emphasizes the importance of building character through sports and using them as a tool for lifelong activity.
• Lyon echoes the concerns about injuries and the lack of questioning of this model.
• Cavalier discusses that coaches and parents overemphasize the importance of sports. It is a destructive mindset that leads to early drop out.

VIII. Strength Training and Menopause:

• The conversation shifts to strength training for women transitioning through menopause.
• Lyon recommends that women be fit before pmenopause and menopause and says HRT and MHT are viable options.
• She says good program is good programming and progressive stimulus is progressive stimulus and there isn't variation in evidence.
• Boyle emphasizes the importance of continued strength training and conditioning for women during this period. Females won't push themselves because they worry about getting too big.
• Cavalier notes the biomechanical differences in women (Q angle) and the impact of hormones on joint laxity, requiring careful coaching.

IX. Starting Age for Strength Training:

• Boyle draws a hard line at age 11 for beginning strength training at his gym, emphasizing the importance of letting kids be kids.
• He says, "I don't want to be in the childhood stealing business."
• He states it is important that doctors spread that the myth that strength training stunts growth is not true.
• He also states it is a myth that you can damage your growth plates in children.

X. Recent Changes in Belief and Practice:

• Attia asks each guest what they have changed their mind on in the last 5 years.
• Lyon states that body fat percentage is not nearly as important as we think it is and that intramyocellular lipid (IMAT) is going to be much more predictive of disease.
• Boyle states it is digestive health. It is the most neglected area of health because we don't want to talk about it. People need to focus more on fiber.
• Cavalier states two things:
  1. Being a dad. He is able to prioritize time with his kids
  2. Balance training. People are going to probably have to spend more time focusing on because it gets worse as you get older.

XI. Final Thoughts:

• Attia reiterates the theme of the inevitability of aging but highlights the importance of training to slow the rate of decline.
• He emphasizes the importance of specific, targeted training that may not be obvious or intuitive.
• All speakers encourage incorporating more strength and mobility work to promote longevity and quality of life.

This detailed summary should provide a comprehensive overview of the topics, arguments, and information discussed in the provided YouTube video transcript.