Hey everyone, welcome to a sneak peek ask me anything or am a episode of the drive podcast. I'm your host Peter attea at the end of this short episode. I'll explain how you can access the AMA episodes in full along with a ton of other membership benefits. We've created or you can learn more now by going to Peter Atia m.com forward slash.
Subscribe. So without further delay. Here's today's sneak peek of the ask me anything episode. Welcome to a special am a episode of the drive. We know that at times. Our interviews can be quite Technical and one of the most common requests we hear is that listeners would love to hear some reason of episodes we've done as such we are testing out a new style of am a for this episode before I get to it. I want it to sort of
Wayne to you how I interact with my podcast as you all know, I'm sure we have an amazing team of analysts who helped me prepare for each and every episode of the drive. So I'm typically going into an interview with anywhere from 10 to 20 pages of single-spaced notes that have me very familiar with the topic of discussion and lay the groundwork for where we're going to go during the interviews. Of course, we might not be able
To see this because hopefully the camera is on the guests and not me. I am typically feverishly taking notes because I'm learning as the podcast is going at the end of every podcast. I typically take the most important things that I have learned and I transcribe them on to 5 by 8 inch cards any podcast might have somewhere from one two, three or four of these cards filled out and you can imagine someone doing this back in the way that you would make a crib sheet in college. Very small, right?
But nothing that's on there is wasted and sometimes there's diagrams tables Etc. Well, it kind of occurred to us that people might want to see what my takeaways are from a podcast and so in this episode what we're going to do is look back at the last quarter's podcast and I'm going to share my notes from the podcast in other words. I'm going to share what I learned personally and what I think for the
most important insights in addition to that. I'm going to comment where applicable if any of these learnings have led to a behavior change in me and or with my patients in this particular summary am a we cover the following podcasts Luc Van Loon Courtney Conley Olive Alexander boo. Alex are ravenous calling cutcliffe and Mark rosekind and through these episodes. We speak about topics such as protein building muscle VO2.
Acts the importance of toe strength and lower leg strength liquid biopsies and cancer the gut microbiome and probiotics and how to mitigate the risks of Automotive deaths. I want to be clear. I don't think that this podcast is even remotely a substitute for having listened to those podcasts. In fact, if you were only listening to this having not listen to that the information that I spit out will be kind of jarring and might lack some context. So my real hope is that this is viewed as an adjunct to
being able to listen to the podcast furthermore. It might serve as a reason to go back and listen to a podcast especially if you haven't listened to it and what I talk about piques your interest as this is a new episode style for us if you liked it and if you find Value in this conversation, please let us know because I think we'd continue it. Obviously if people don't find this interesting there's no need for us to do it and we could go back to regular amas. But our intuition is that if this is indeed valuable of once quarterly summary might
Of value to you as well. If you're a subscriber and you want to watch the full video of this podcast, you can find it on the show notes page. And if you're not a subscriber, you can watch the sneak peek of the video on our YouTube page. So without further delay. I hope you enjoy this special episode summary am a of the drive Peter. Welcome to a special am a how you doing very well. Thank you.
Before we get started. There's a question. I've been forgetting to ask you but now that the McLaren Senna Lego is officially available. How many have you put together? I'm actually really embarrassed to answer that question. I have not put any together, but I have bought for so I don't know which of these statements is more ridiculous. You're building a fleet when the time comes exactly. I'm creating a generational supply of McLaren.
MP4 for Legos, and of course, I'll build a few along the way but the goal is like to have one to build with every child every grandchild every random kid that comes to my door when I'm 80 trick-or-treating. Hey, you want to come in and build an mp4 for with me like a creepy old man such a specific request for the trick-or-treaters. I don't have any candy for you. But let me tell you what I got, but I got some Legos you can also build them with the police.
Who then show up about 30 minutes later. So just keep an extra few in the back. Yeah, I'm just accumulating. I love it. So for today's AMA we're going to do something a little different and it kind of stems from one of the things we hear a lot is we know sometimes our episodes can be Technical and with that people love to kind of understand not only like summaries of that besides but also what you take away from them. And so with that said you kind of want to walk people through how this
Style came about and how we're thinking about it. Yes. So I appreciate the fact that our podcasts are long and obviously quite deep that's by Design and I personally don't even have time to go back and listen to most of them which is a bit of a shame because despite what people might assume I'm not capable of assimilating everything that comes out of a podcast so, you know in the past year or so being cognizant of that. I have got into a habit which is during the
It itself. I am feverishly taking notes when the guest is speaking. Luckily. I'm able to do this off camera. So you generally don't see that. I'm doing that. But that seems to me the best time for me to get the inside out of the episode. What I then do is immediately following the podcast almost always on that day. Maybe letting it go one more day, but usually on that day I take out these five by eight cards I have and I
And resynthesize everything from my prep and the notes that I took during the podcast on to 5 by 8 cards and here the goal is to really minimize the cards because I want the cards to be the highest yield thing imaginable that six months or six years from now. I would go back to and that captures the Salient essence of what I learned and in particular it's always with an eye towards something that I didn't know before or something that maybe I knew but didn't realize how important
It was and obviously I'm always looking for something that's going to change my mind or change my practice. Okay, so fast forward to a month ago. We were sitting around with the podcast team and I don't know I almost just mentioned in passing that I did this and I think you guys decided Well, can you read a couple of your cards to us? I remember we sat there on a call and I just rattled off a bunch of cards and I think your eyes kind of opened up like saucers and you thought why would we not
Share this with people. This is valuable. So I think that's what got us here. Yeah, and I think for the listener viewer how we're going to kind of break it up is we'll look at some recent episodes we've done and kind of look at it from two Realms one of what you think are the most important takeaways insights your biggest learnings. And then the second is if you've changed your mind change your behavior how you work with yourself work with your patients anything of that nature as well. And so we'll kind of hit those two prongs.
For each the last thing I'll say is I think we're excited about this type of episode because we thought it was really interesting during our conversation, but for listeners and viewers if you like it or don't like it let us know because it's one of those we can always continue to do in the future because we clearly have no shortage of episodes coming up. I would like to reiterate that point. I mean, it's a bit of work to put this together. It seems to me that it's worthwhile. So if folks like this, they should let us know because I could easily see doing this quarterly.
If folks think this is not valuable enough, then I'll keep my notes to myself and I'll still be doing it because it's valuable to me. Yeah, you can put the notes by the McLaren Legos. You haven't dropped yet. Perfect. So the first episode we're going to hit was I'm just an awesome episode 4 great guy Luc Van Loon. So do you want to walk through? I mean that was an action-packed episode on a topic protein, which I know you're very passionate about we've talked a lot about but I think some of the insights that came from there were
very interesting. And so I think let's just start with Luke's episode and kind of go through what were some of the biggest insights takeaways learnings that you have from that conversation. Yeah again, please don't confuse what I'm about to say with any sort of substitute for listening to the episode. In fact, if you haven't listened to the episode, it will feel very out of context and maybe even jarring for me to just give you my bullet points. I will preface it by saying one thing with respect to Luke's episode, which is this
Isn't the first or even the second or even the third episode we did where we focused very heavily on protein and yet despite that the richness of this episode surprised me. So with that said we talked a lot about something called the fat athletes Paradox and by fat, I mean fat / athletes Paradox. So this is this idea that when you look at the muscle of an athlete and you look at the muscle of someone with type 2 diabetes, so you're looking at
at two opposite ends of the metabolic Spectrum, you're going to see large stores of intra Maya cellular lipids. You're going to see large stores of lipid within the muscle. I remember hearing this before but I think what came into Focus for me was the idea that this is one of the limitations of static information because in the case of the person with type 2 diabetes that intra- cellular lipid store is indeed just that it is a
Depot it is a place where excess energy is seeping out of seeping out of adipose tissue and remaining stored in the muscle. And in fact as we saw in our podcast couple of years ago with Gerald Schumann, that's one of the Hallmarks of the Cascade of events that leads to insulin resistance. So the question is why aren't athletes not insulin resistant the exact opposite of that and it comes down to the fact that for athletes that is less a storage Depot and more.
Or a state of flux. So for the athlete the intra Maya cellular lipid is indeed a fuel source, and it's being turned over rapidly. So that's the key takeaway there. That's really big. So it's that just because you have triglyceride in the muscle on a biopsy. If you biopsied the muscle of an athlete and of the diabetic you're going to see high amounts much higher amounts of fat than you would see in a non Elite athlete.
But it's important to understand one is a constant flux that's being used to prime the pump and the other is obviously a pathologic findings. That's the other point there as well, which is that the reason the athlete has that storage of fat. So readily available is it it's an immediate access at that low end aerobic fuel point. So if you again think about Zone 2 we talked about that a lot. The idea is the minute you jump into that Energy System. You want to make sure that you're
and lipid and not burning glucose. So moving on from fat and that athletes Paradox. The next thing I made note of here was the idea that amino acids are signaling molecules in and of themselves. Now, this is relevant because it speaks to the fact that the ingestion of protein by itself stimulates muscle protein synthesis even in the absence of activity. So, how does this work? And why is this relevant so
Amino acid signals mtor. We understand that of course mtor is the master nutrient sensing molecule and the activation of mtor signals muscle protein synthesis, even in the absence of activity. Now when you combine protein intake with exercise, you're going to get more muscle protein synthesis, but what I remember and I made note here is Luke made this analogy of it's like the bricks calling the bricklayers. I thought that was very clever another point and this was actually brought up by laying.
In in one of our first podcast where Lane talked about sort of the isotope labeling of amino acids to understand the flux of amino acids talked about how there are about 300 grams of amino acids being utilized per day and most of this is actually recycled and dodging SME no acids. So what do I mean by that? So if 300 grams of amino acids each day are being utilized you're not eating 300.
Per day, so what's happening? You might be eating 150 grams per day. So that's the eggs oddness input. The muscle itself is turning over and part of what's being turned over is being re Incorporated. So that much I knew I don't think I knew that it was 300 grams or if I did I'd forgotten but this is what was really wild to me was that it takes somewhere between 50 and 100 days for the complete turnover of a muscle in other words if I look at a muscle on my body today, I looked
Down at my bicep. It's a little bit interesting to think that 100 days ago. It was made up of completely different amino acids. So in other words in two to three months, you are completely turning over every muscle in your body Luke mentioned later in the podcast that that turnover is even more rapid in the brain to the tune of about 30 days. Try to let that sit with you in your brain that 30 days ago.
Month ago the actual structure the proteins that make up your brain. We're totally different set of amino acids. We talked a little bit about the difference between bodybuilders and endurance athletes. So bodybuilders when they are undergoing muscle protein synthesis, obviously based on the nature of the training stimulus, you're seeing more myofibrillar protein synthesis in the type to fibers whereas endurance athletes obviously based on the nature of their training stimulus.
You're seeing an increase in two things mitochondrial protein synthesis and capillary density. Again. This is occurring in the type 1 fiber. So I'll restate that bodybuilders are getting bigger muscles more contractile Force. Myofibrillar protein synthesis is occurring in the type to fiber the athlete is increasing mitochondrial protein synthesis and capillary density in the type 1 fibers and editorial comment on top of that. We want both of those things to occur. Both of those things should be the desired.
Come and therefore that's why we want both types of training another very interesting discussion. We had was on the idea of what drives muscle protein synthesis. So he listed for things and I think this is a very helpful guide as you start to think about protein choices you're making so the first is what is the digestibility of the protein? So here we make a big contrast between plant protein and animal protein. This is where animal protein has.
An enormous advantage over plant protein and that it is far more digestible. Now, there are things that you can do about that. We've talked about this right. So if you want to eat or get the majority of your protein from Plants, that's fine, but you will need to accommodate that by for example cooking it making sure it's cooked and or eating sources that have higher amounts of certain amino acids, which we'll get to in a second. The second is the rate of digestion. So not just the digestibility, but now what's the rate of digestion so here?
Take perhaps the most potent type of protein which would be say beef protein or something like that. There's a significant difference between ground beef and steak. So the rate of digestibility is obviously greater for ground beef than steak similarly way versus KC. Mmm, they're both milk proteins, but way has a much higher rate of digestibility that case here again here is where you'd see cooked versus wrong amino acid composition is now the third Factor here, so,
An example would be collagen versus Wei Wei has a much higher quality amino acid composition than collagen collagen tends to be rich in a handful of amino acids if my memory serves me correctly. I think it's Glycine and Proline and way of course has a more distributed wealth of amino acids. And then of course the fourth and final component here is What's the total amount of protein that's being consumed the more protein that's being consumed the more muscle protein synthesis quick.
Miron the milk proteins we did talk about this, right so milk protein is about 80% Casey and 20% way. So way much more rapid case Ian much slower digestion profile both are valuable. We spoke about this. There is a study that Luke was a part of I think we've written a newsletter on it talking about how much much larger doses of protein could contribute to muscle protein synthesis in a study that was using Casey and because of this long lag in
Which it was dragged out he mentioned that plant protein is specifically low in lysine and methionine. And so if you're going to eat plant protein, you're going to have to probably look for ways to supplement those if you want to maximize muscle protein synthesis. Okay, we have more notes from this podcast. This is a bit longer than normal truthfully. But again, there is so much here a very powerful image in my mind from this podcast was the idea that when you look at the graphs that describe loss of muscle in the elderly.
Everybody's familiar with these graphs look like which is they start out here and they drop down here. And for those listening to me, it's kind of like a smooth curve that drops like a stone. Usually once people are in the eighth decade of life in their mid 70s and he made such a fantastic point which is if you look at this at the population level, which is always how the data are presented. It appears to be a physiologic phenomenon. What does he mean by that a physiologic phenomenon?
Is an inevitability it's physiologic you're going to lose muscle as you age and it occurs on this nice beautiful smooth curve and he said but if you actually look at the individual level that's not at all what it looks like. It's actually a graded step function. So again, if you're watching me, this is easier to see it's here's your muscle mass and then boom a big drop and then you stay there for a little while and then boom a big drop and Away you go and Away you go and he said what it really comes down to the individual level.
Is a series of discrete periods of inactivity that result in sudden relatively speaking meaning over a period of months or weeks big drops in muscle mass that are never recovered and I'll tell you it's been a while since that episode I think about that every minute of every day and I'm only in my 50s and I keep thinking what do I need to do to make sure I don't experience one of these two week or two month episode.
Odes that's going to result in an irreversible loss of muscle mass. And again, it really comes down to how do you not get injured and even if you don't have an injury, how do you make sure you're staying active while this gets to another important thing we discussed which is the idea of anabolic resistance again, this has come up over and over on various podcast that I've done on this topic. And basically we talked about the two drivers of this which are aging and inactivity. So it's
Crystal, clear that inactivity and age drive this so the question is is it one or the other is one simply a proxy for the other Etc. He offered great ideas for why baby both of these things play a role. So let's start with inactivity. This is the easier one to test because you can actually do an experiment so you could take young people who ordinarily would not experience antibiotic resistance and you can render them inactive and there's very elegant experiments done where you take young people and
You put one leg in a cast for a period of time and of the experiment he talked about was one week. So this is beautiful because each person is their own control. So young person one leg in a cast one leg not and just in one week. There is a 35 percent difference between the active and inactive leg in a young person with respect to muscle protein synthesis and therefore anabolic resistance. So again that very compellingly says inactivity plays a huge
But that doesn't mean that aging inherently doesn't also account for some of this and there are lots of hypotheses that he put forward. Is there a decrease in amino acid uptake a decrease in gut absorption a decrease in the circulation of amino acids something called splanchnic sequestration going up. So basically losing amino acids to the splanchnic system in the GI tract reduction of perfusion, of course, that's true elsewhere in the body. So maybe it's true here.
And lower muscle uptake finally lower mtor signaling. It certainly is listed as one of the Hallmarks of Aging that nutrient sensing goes down boy. I've got even one more set of notes here, but I'm going to just go for it because I think it is pretty important. I made a table while we were talking about the difference between myofibrillar muscle protein synthesis and muscle contractile tissue protein synthesis in response to the following stimuli exercise.
Dairy protein so whey and casein and collagen protein which again you may recall a second ago. I said look collagen protein is not a complete protein. It's mostly just got a couple of amino acids in it. And when you look at exercise, you see that it gives a huge increase in both myofibrillar muscle protein synthesis and muscle contractile tissue when you look at Dairy protein you get a big increase in myofibrillar.
But not in contractile and I think that's not surprising and when you look at collagen protein, it's relatively small on both. So what this highlighted for me and the reason I made these notes was total protein quality plays a big role in myofibrillar protein synthesis and exercise plays the biggest role in generating contractile tissue protein synthesis. So at the risk of maybe doing a bit more, but I apologize. I probably took more notes on that podcast than most.
Others those were the Salient points that I took away from the podcast with Luke you hinted at a few things there in terms of like Behavior changes or what you're thinking about one of which is just consistently thinking about the importance of always training and not taking time off whether that's by choice. Meaning you're going on a trip before life gets in the way and you decide not to train or by not dry ice which is like an injury and you're not able to train. So if you think about anybody
Behavior changes that you've made in either your training protein consumption how you look at that throughout the day since that episode what's jumped out to you? Yeah, a few things you've already mentioned a couple another one is for really long endurance activity, which I still do some of maintaining dietary fat matters in that pathway that we talked about at the outset where you want to maintain intra Maya cellular lipids. So again, not an issue for me personally because I've never
Or ever been a fat a low-fat diet guy, but it's worth keeping in mind for athletes out there who tend to be lower on their fat consumption. You are depriving yourself of a pump Prime. Obviously, we talked a lot about the need for activity. I guess the two other things I'd say before we leave this our I have been using time restricted feeding a little bit more lately in myself, but I'm always making sure to get protein. Well, I'm in that.
Non feeding window because again, I don't believe there's like a particular magic to not eating for 18 hours a day. It's just a tool to calorically restrict. And so I don't care if I get another couple hundred calories of protein during that window. I guess the final Point here was really for my wife who is really adamant about her collagen protein drink in the morning and I think I feel a little more comfortable telling her. Hey, there's something wrong with drinking your collagen protein and if you happen to really love that formulation or whatever.
Knock yourself out, but it's also not a very complete protein. So maybe at a minimum supplemented with something else but clearly consuming a collagen protein is not a superior protein. I think that is definitively true one last piece on look before we move on as there was one quote. He said which I thought was just really really good and succinct and I'll read it and then it's you know, we can talk about it, which is he said I've had a lot of people in my life asking me how important is it whether I take my protein shake before or after the
Training session but I never had someone come up to me and say look how important is it. If I skip one training session or miss one training system consistent training as the benefit consistent training so that every meal is a greater impact on your muscle protein synthesis, and I thought that was really good because we see a lot of questions come through and sometimes people may over think potentially protein and when to take it and when not to but for him to say whether you consume before or after the biggest thing is just always
SB training always be consistent and never take time off. I thought was a really good point for people to kind of remember. Yep. Yep. All right, let's move on to the podcast with Courtney Conley. Thank you for listening to today's sneak peek. Am a episode of the drive. If you're interested in hearing the complete version of this am a you'll want to become a premium member. It's extremely important to me to provide all of this content without relying on paid ads to do this. Our work is made entirely possible.
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