Episode #29: Gaining Muscle (& Brain) While Losing Weight with Age – Sarcopenic Obesity & Optimal Body Composition

Apr 30, 2018

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According to Dr Gabrielle Lyon losing muscle is tantamount to losing brain tissue which is one of the core processes that occurs in Alzheimer’s.

Dr. Gabrielle Lyon is a Functional medicine physician focusing on Muscle-Centric Medicine. She leverages evidence-based medicine with emerging cutting-edge science to restore metabolism, balance hormones and optimize body composition.

Prior to her foray into medicine, Dr. Lyon was a national semifinalist in Fitness America, and a professional fitness model. Dr Lyon currently works as a practicing physician in New York City. She recently co-authored a chapter in a textbook, the Chapter is entitled “Metabolic Interventions for Sarcopenic Obesity.”

In this Episode You Will Learn:

What is sarcopenia?
Sarcopenia is age-associated loss of muscle mass and function.
When sarcopenia AND obesity are both going on in someone they compound each other.
Dr Lyon maintains that there are signs of muscle loss long before actual sarcopenia sets in.
Interestingly, obesity is somewhat analogous to aging in that both are low grade inflammatory/catabolic/breakdown states where healing becomes more difficult.
Dr Lyon’s Ideal Body Weights
-Women 15-20% body fat
-Men 12-15%
How does this get diagnosed or assessed?
DEXA scan
Gait Speed
  • time yourself to see how long it takes you walk 4, 5, or 10 meters
  • repeat this twice (walking at a comfortable pace for you)
  • an average speed of <0.8meters oer second
BIA (what are the magic numbers on BIA)
Hormone Lab Patters Are Often as Follows
  • LOW: estrogen, total testosterone, SHBG, DHEA, Free thyroxine 3, growth hormone, Insulin-Like Growth Factor 1,
  • INCREASED: prolactin, cortisol, Free thyroxine 4, reverse thyroxine 3, leptin and insulin resistance.
  • Secondary hyperparathyroidism sometimes because of low vitamin D levels
When Leptin is higher than 10 Dr Lyon notices that people respond well to time restricted eating 2-3 times per week. If higher than 30 she likes them do 24-hour fast once a week (can drink water and coffee, under medical supervision of course).
Women’s muscle changes as they age. Muscle changes to Type 2 fibers, bulky and strong, and then begins to atrophy. Many aging women tend to lose muscle mass as they age. Dr Lyon notes that many women have under performing (low) thyroid. Thyroid, among other hormones, are important for muscle building, tendon tissue homeostasis (eg alot of musculoskeletal type injury).
Dr Lyon goes into detail on where the RDA’s recommendations for protein were derived from and how and why she disagrees and other noted experts with them.
Dr Lyon suggests a protein intake of 1.5grams per kg of body weight for optimal muscle in aging. This is nearly DOUBLE than the RDA recommendation.  The reason for this is to activate a muscle/protein building pathway (ie the “insulin mTOR-metabolic pathway”) in the body that will not activate without this.  The protein should be distributed over the course of a day (eg 3 times per day) with the right amount and enough of it. At least 30 grams with each of your 3 meals would be  the minimum to engage the muscle building pathway. These should typically be spaced about 4 hours away from each other.  90 grams might be the lowest someone would go in order to engage the MTOR-based muscle building pathway.
With age reduction of protein absorption, increased splanchnic extraction gives rise to needing to intake higher amounts of protein.  2.5grams of leucine equates to about 4-5 grams of something protein in something like chicken or beef or fortified amino acids powders. mimize carbohydrates to 30-45 grams with meals to reduce your insulin response as carbohydrates are made during your body’s breaking down protein.  Aging men with healthy kidneys may consider getting up to 40-50 grams up to three times per day.
Leucine helps generate Glutamine and Arginine and other elements related to the immune system, blood pressure regulation, and other critical functions
Rice/Pea protein are often fortified to have good numbers of branched chain amino acids (leucine importantly included among them).
Dr Lyon Exercise Fundamentals
Upper Body Resistance
-Bench press
-Push ups
-Pull ups or rowing maching
Lower Body Resistance
-Squat
-Deadlifts
General Cardioaerobic
-1-2 days per week of 12-20 minutes of interval sprints, rowing or skiing
Note: Dr Lyon’s approach represents one important approach to muscle synthesis in aging. There are other formidable opinions on the impact of amino acids, high protein diets and aging that were not covered in this episode.

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