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"chunkTitle": "Improve Fitness Tools",
"episodeTitle": "Science-Supported Tools to Accelerate Your Fitness Goals | Huberman Lab Podcast",
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} | Andrew Huberman: Okay, let's talk about the tools to improve your fitness. The first tool is to mesh your Zone Two cardio with your daily activities. So for those of you that don't know, zone two cardio is the type of movement that we typically call cardio exercise that elevates your heart rate somewhat, increases your breathing somewhat, but that still allows you to carry out a conversation without having to pause or to gasp in order to complete your sentences. Okay? So that's a general rule of thumb for Zone Two cardio. Now, for those of you that use a fitness tracker, you can monitor whether or not you are in Zone Two cardio very precisely. But if you're like me and you don't use a fitness tracker, it's very easy to know if you're in Zone Two cardio because again, it's that level of output that puts you right below, or somewhat below the threshold where if you were to exert yourself with any more intensity that you wouldn't be able to complete your sentences.
Andrew Huberman: Now, this could of course be evaluated by jogging with someone or walking with someone or hiking with someone and carrying out a conversation if somebody isn't available. You could of course do this by trying to speak out loud and have a conversation with yourself. Or if you want another way to monitor whether or not you're in Zone Two cardio without having to use a fitness tracker, you could simply ask yourself whether or not you are maintaining a level of output that increases your heart rate and your breathing, but that allows you to maintain purely nasal breathing the entire time. Any of those approaches will tell you more or less whether or not you're in Zone Two cardio. Now, the scientific data tell us that we should all be getting anywhere from 150 minutes to 200 minutes per week minimum of Zone Two cardio for sake of cardiovascular health, cerebral vascular health, and a number of other aspects of health that are important essentially to everybody for health span and lifespan.
Andrew Huberman: Now, many people, including myself, schedule Zone Two cardio into their weekly fitness regimen. So for me, I have one day a week. For me, it falls on a Sunday where I go out for a jog that lasts anywhere from 60 minutes to 90 minutes. It's a slow jog. I can maintain nasal breathing the entire time or have a conversation with somebody else or myself the entire time if I like. Or sometimes it consists of a hike by myself or with other people. And sometimes those hikes extend anywhere from an hour to 4 hours, depending on the circumstances, et cetera. I will mention that whenever possible, I try and do that once a week, zone Two cardio session out of doors because I like being in nature and I like getting sunlight and I like getting fresh air. Now, during the discussion with Dr. Andy galpin I explained how I get my zone two cardio and I acknowledged that that once a week session doesn't always allow me to reach that 150 minutes to 200 minutes minimum threshold of zone two cardio per week. Sometimes it does, sometimes it doesn't. And his response to that was very reassuring. |
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"chunkTitle": "Fitness Tools",
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} | Andrew Huberman: Welcome to the Huberman Lab podcast, where we discuss science and sciencebased tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today we are discussing ways to improve your fitness. In particular, we are going to discuss tools that you can incorporate into your existing fitness routine that will allow you to make significant improvements without having to invest a lot of extra time. Most all of the tools we are going to discuss today were gleaned from the six episodes that we did with Dr. Andy Galpin. We provide a link to those full episodes in the show. Note captions of course. Now those episodes included a very large number of protocols, everything from how to build a fitness routine to how to enhance recovery, nutrition, and supplementationbased tools and routines aimed specifically at strength or hypertrophy or endurance or building anaerobic capacity.
Andrew Huberman: What I've done is to select key protocols from those episodes that I myself have started to incorporate into my existing fitness routine and that I think will be especially beneficial and frankly, fun for you to incorporate into your fitness routine. Now, a little bit later in this episode, I review the key components of any fitness program, that is, the number and type of cardiovascular training sessions and resistance training sessions that are essential for everyone to include as a template or a foundation for their overall fitness program. Now, a little bit later in the episode, I will be sure to review what are the essential components of any fitness program. So the number and type of resistance training sessions, the number and type of cardiovascular training sessions, as well as some of the elements of how those are arranged to ensure proper and adequate recovery between sessions so that you can continue to make ongoing progress.
Andrew Huberman: However, the bulk of today's discussion is going to focus on tools that you can use again very easily, very quickly, in some cases even saving you time during your fitness regimen, in order to improve all aspects of your fitness your endurance, your muscular endurance, your anaerobic capacity, your recovery, your strength, your hypertrophy. And in describing these tools to improve your fitness, it also provides an opportunity for each and all of us to step back from our existing fitness routine and ask whether or not it's really checking off all the boxes. That are necessary, as well as where we can be more economical with our time and our efforts in order to reach our specific goals related to exercise and performance. So, by the end of today's episode, you can be sure that you have at least one and as many as twelve tools that you can incorporate into your existing fitness routine, again without adding much additional time or effort that are sure to accelerate your progress. |
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"chunkTitle": "Maximize Your Workouts",
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} | Andrew Huberman: Now, another tool that's wonderfully effective, not just for your workouts, but for all areas of your life, is if you are going to bring a smartphone to your workouts to set some boundaries around what you're going to listen to and do with that smartphone during your workouts. I see people texting, I see people doing selfies, I see people having phone calls, I see people I presume listening to music or podcasts. Look, I am not the smartphone police, nor are you. And everyone has a right to use their smartphone in the way that they choose is best for them in order to distract themselves or focus themselves or enrich their life. Look, it's a free world, of course, more for some than for others, but you can do what you want with your smartphone. However, if your goal is to improve your fitness, one of the more powerful things you can do with your smartphone is to decide before you cross the line into your workout what you're going to listen to or do with that phone or not. So for me, I like to designate a playlist of music for that particular workout and then I just stick to that playlist.
Andrew Huberman: I might repeat songs that I like a lot or if someone talks to me while the music's playing, I might go back and restart a song if they distracted me, that sort of thing. Although I do my best to not get into too much social chitchat during workouts. But I'm friendly and it's nice when people come over and say hello. I sometimes work out with other people, in which case I don't use headphones, I don't use a smartphone. But setting a playlist or two, designating a podcast or two, designating an audiobook or two, whatever it is that you're going to listen to to really decide what that's going to be before you do your workout. The reason I say this is that I observe a lot of people and frankly, I've observed myself under conditions where I'm suddenly in a text communication or I'm bouncing between albums or between podcasts or between whatever it is on the phone. To the point where rest intervals aren't being controlled well. |
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} | Andrew Huberman: Well, it turns out if you look at the literature on creatine and athletic performance, and if you look at the literature on creatine and cognitive performance, because as some of you already know, breathing is a fuel, or the phosphocretine system is a fuel system for the brain as well. And if you look at the studies on creatine, they almost always gauge the amount of creatine to give an individual based on their body weight. So you don't have to get really specific about this. But if you weigh, say, 185 pounds to 250 pounds, you can get away with and probably should be taking 10 grams or so of creatine per day, which is what I do. Whereas if you weigh less than that, 5 grams or maybe even 3 grams is sufficient. Now, I discussed this with Dr. Andy Galpin during that series, and one of the things that I've started to do since the closure of that series is to take more creatine per day. So now I'm taking ten, sometimes even as much as 15 grams per day of breathing. Again, this is powdered creatine monohydrate.
Andrew Huberman: My stomach tolerates it very well, but frankly, I don't tend to get stomach aches or gastric distress from pretty much anything, unless it's some form of food poisoning, which is exceedingly rare for me. So. Some people out there find that creatine really disrupts their gut and they need to take it with food, or they really need to slowly increase the amount of creatine that they're taking each day. I find that I can put ten, even 15 grams of creatine into a whey protein shake or into some water with a little bit of lemon juice just to make it taste a little less chalky. Drink that. And I don't have any gastric distress from that. So you'll need to find what works for you. But the point here is, if you're going to take creatine, you don't just want to, quote, unquote, take creatine one scoop per day. You really want to adjust the amount of creatine that you're ingesting according to your body weight. And I would give you a very specific formula of x grams of creatine per kilogram or pound of body weight. But believe it or not, no such specific recommendation has ever been published in the scientific literature.
Andrew Huberman: At least I couldn't find it in a way that's consistent with all the other papers, meaning you see a lot of variation. So what I'm talking about here is if you weigh 185 pounds or so, okay, plus or minus five pounds, out to about 250 pounds, ten to 15 grams of breathing per day is probably more appropriate for you than is 5 grams, meaning it's going to be more effective for enhancing physical performance and perhaps again, perhaps even cognitive performance as well. And if you're somebody who weighs 180 pounds down to, say, 130 pounds, 5 grams of creatine per day is probably sufficient. The point here is, if you are taking creatine, again, not everyone has to take creatine. There's no law that says that you have to take creatine. Some people don't like it. I know some people fear it's going to make their hair fall out. We already talked about that in previous episodes and the lack of data to support that idea. But I realize some people steer away from creatine for whatever reason. But if you decide that taking creatine is right for you, adjust the total amount of creatine that you take according to your body weight. |
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} | Andrew Huberman: It's certainly not as intense as the workout that you just did. Maybe you were even feeling really calm from a nice long jog, or you had a particularly good workout that day, and you're feeling really happy. So you're enjoying the high, so to speak. Well, when you do three to five minutes of what's often called down regulation breathing after a workout, it allows you to recover and to induce the adaptation that you've been after, the one that you actually train for much more quickly. I can't tell you how many people I know who start to incorporate this into their workouts find that they recover far better from their workouts, which might seem a little bit surprising. Why would it be that just three to five minutes of some activity would enhance recovery to such a great degree? And that's because typically people don't bookend their workouts. They finish their workouts. And of course, they're not continuing to lift weights or run, but they move about their day and their life, even if it's preparing a meal in a way that the level of stress, and therefore stress hormones.
Andrew Huberman: Things like cortisol, adrenaline, things that, by the way, are excellent to elevate during a workout, things like inflammatory markers, which, by the way, are great to enhance during a workout that actually happens during a workout. You have a massive increase in inflammatory markers, which might seem bad, but all of those things are enhancing the adaptation that you're seeking. But as soon as those workouts end, you want to shift into recovery mode. And this three to five minutes of down regulation breathing is a terrific way to do that. There are a couple of different patterns of breathing that will work best, but all of them emphasize exhales. Okay, I want to repeat that. All of them emphasize exhales. So, for instance, you could just choose slow, deliberate breathing. How does that emphasize exhales? Well, ordinarily when we breathe, we inhale actively and we exhale passively. Whenever we deliberately breathe more slowly, we are actively exhaling. So active exhales really promote the calming response in brain and body.
Andrew Huberman: The other thing you could do, which many people are now doing, is to do a repeated round of physiological size. So the double inhale through the nose, long exhale through the mouth, but repeated for, say, three minutes. That's another version the other thing you could do is simply to notice your exhales and to emphasize your exhales, make them longer and more vigorous than your inhales. Now, you don't want to turn this into a breath work session where you're doing pranayama or kundalini breathing or something of that sort. The idea is to calm down. So anytime you're extending your exhales, you're actively exhaling. You're trying to slow your breathing down overall, you're going to shift yourself in the right direction. So rather than complicate this type of tool, the best thing you can do is just focus on those exhales, slow your breathing overall, use physiological size if you want, or simply sit in your vehicle or if you have to drive home while doing this extended exhale type of down regulation.
Andrew Huberman: Ideally, you would take a couple of minutes and just shift your whole system by not driving, closing your eyes, and just sitting in your car stationary. Of course, don't drive with your eyes closed or bike with your eyes closed. Just simply calm down, extend your exhales and shift from the workout to the recovery mode, which is where the progress is going to arrive. |
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} | Andrew Huberman: Okay, you could lean back against the wall a little bit harder if you wanted to gain some extra support and continue. But the idea here is that you're going to go not necessarily to muscular failure, but to the point where you can't continue to sit in that wall sit position. You could also simply do this as an air squat down to the bottom position where you're comfortable, and then you don't want to rest down there. Meaning you want to maintain some tension in your quadriceps and other muscles of your lower body so that you're actively trying to support yourself in the seated position, but without a seat below you. That can be done again, while on a speaker phone conversation that can be done at random throughout the day. You can just decide, okay, I'm going to do a wall sit now, and I'm going to time myself, I'm going to see how long I can do this for. Or you could decide to do a plank. I've done this while on a phone call. Sorry if it was you that I was talking to, but I put the phone on speaker and just gotten into a plank position, and then I'll just have the conversation in the plank position.
Andrew Huberman: I don't fight to maintain that plank position past the point where I could continue to have a conversation. So, again, this is a type of exercise that one is trying to incorporate into their daily routine. If you wanted to dedicate a specific amount of time just to doing these exercise snacks, you could. But it's far more reasonable to assume that people will incorporate these into their daily routine more regularly. If you can incorporate it truly into the other aspects. Of your routine, like work. You do this while watching TV or listening to a podcast. One form of muscular endurance exercise snack that's really terrific and is a bit of a challenge that's fun is to just simply see how many pushups you can do. And we talked about proper pushup form during the episode series with Dr. Andy Galpin. But here what we're talking about is chest all the way to the ground. So it touches the ground, then pushing up till your arms are completely straight, that's one push up and then continuing in piston like fashion, meaning you're not pausing at the top and taking a bunch of breaths.
Andrew Huberman: You're not going to a plank position, in other words, but continuing to do as many push ups as you can to see whether or not you can enhance that number over time. And in any case, just to simply get your body working to engage the muscles of your chest, your shoulders, your triceps and your core, et cetera, and to do that every once in a while. So instead of needing somebody to say drop and give me 20, just see whether or not at some point, any point throughout the day, you can get into a push up position, do your maximum number of pushups, and then just mentally note that number to yourself. Again, these exercise snacks serve multiple roles. They're designed to get you moving, to get your heart rate going, to maintain or enhance your fitness in other domains of fitness. And this is very important to not take too much time out of your schedule.
Andrew Huberman: In fact, like zone two cardio, right, being the type of movement that you're just going to do a lot throughout the week, carrying groceries, et cetera. As we discussed earlier, these exercise snacks are designed to be incorporated into your daily life. And I must say that having started doing these after recording the series with Dr. Andy Galpin, I've noticed two things. First of all, including these exercise snacks at least once a week and more like three to five times a week for me. So that's one exercise snack done three to five times per week has definitely correlated with improvements in my fitness in other domains of fitness strength, hypertrophy, long distance endurance, et cetera. Now, I've changed a number of other things as well as a consequence of that series with Dr. Andy Gallup. And so I can't say for sure that it's the exercise snacks per se that are causing all those positive shifts.
Andrew Huberman: I have to imagine that it's not just the exercise snacks, but they've become an important part of my routine. And that relates to the second point, which is that the exercise snacks are designed to be fun and easy and so I really enjoy doing them so much so that if I don't do one for a couple of days, I start to crave them a little bit, kind of like the other kind of snack. |
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} | Andrew Huberman: Note caption to this episode, I do want to point out that you don't just jump right into heavy sets of three to five repetitions. You need to warm up adequately. For some people that warm up will be higher repetition sets, so say ten to twelve repetitions with just the empty bar or a lightweight, and then adding a little bit of weight and doing eight repetitions and maybe six repetitions. And then your work sets, as they're called, of three to five repetitions. Or perhaps you're like me and you prefer to do low repetition warm ups. So this was also something that I discussed with Dr. Andy Galpin, and that for me has made a tremendous positive impact on all my resistance training, regardless of whether or not it is low repetition or higher repetition. And that's to do a brief warm up set that is somewhere in the range of six to eight repetitions, very light, just to get familiar with the movement.
Andrew Huberman: Then to do a second warm up set that includes some load on the bar or the free weight or the machine, and then a second warm up set. Again, this could be free weights or machines that incorporates a bit more load but still keeps the repetitions low. So in the four to six repetition range, and then maybe especially if it's at the beginning of the workout and my core body temperature isn't elevated yet, I'll do a third warm up. But that third warm up, which of course is going to be progressively a little bit heavier than the first or second warm up, is still going to fall within the low repetition range. So just two to four repetitions for me, including a few more warm up sets with progressively heavier weight on each warm up, but still keeping the total repetition count low. So somewhere in the range of two to six repetitions has been very beneficial for improving my work output during the so called work sets, regardless of whether or not I'm training in the three to five repetition range, or whether or not I'm training in the six to 15 repetition range.
Andrew Huberman: I know for some people this might be kind of surprising. How is it that my work sets are actually higher repetition than my warm up sets? Or put differently, how and why is it that my warm up sets are lower repetition than my work sets? And that's because I fall into this category of people that tends to fatigue pretty quickly when doing resistance training. So for me, keeping the repetition count on any individual warm up set pretty low has allowed me to really improve my strength output and really improve my strength and hypertrophy training when I shift to the so called work sets. |
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} | Andrew Huberman: Maybe even leg extensions and leg curls, which are isolation exercises, of course, to really restrict oneself to those three to five repetition ranges that take you to failure or near failure. I listed off the benefits of doing that that I experienced, and I'm confident that you will also experience a lot of benefits. So just to remind you what some of those benefits are, you get stronger, which feels great, that occurs within your weight workouts, but it also carries over to your endurance training sessions. I also noticed that when we're returning to higher repetitions for resistance training so after twelve weeks shifting away from three to five repetition ranges and going back to training in the six to ten repetition ranges mainly occasionally up to twelve or 15, but really mainly restricting to six to ten repetitions that you can move much heavier weights in good form and thereby induce more hypertrophy while still also continuing to gain some strength. And another benefit was again reduced soreness compared to when training with higher repetition ranges and more mental freshness.
Andrew Huberman: I guess the only way to describe it when training in those lower repetition ranges. I don't know about you, but when I finish a really hard, hour long resistance training session done in the six to twelve repetition range, there's a certain type of mental fatigue that even if I eat properly afterwards, even if I hydrate properly, that it tends to SAP a bit of my mental energy later in the day. But that the training at the three to five repetition range did just the opposite. It actually enhanced my focus and my cognition, my overall levels of physical energy, which is great because it allows you to do all the other things that we're required to do throughout the day. And by the way, it'll also allow you to get more of that zone two cardio. So if you want more details on the three by five protocol, again that's timestamped in the relevant episode on Strength, Strength, Strength and Hypertrophyenhancing tools with Dr. Andy Galpin, I'll also provide a link to that specific timestamp in the show. |
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} | Andrew Huberman: I actually felt much stronger during my cardiovascular training as I got much stronger moving these heavier weight loads for low repetition sets. And then the third specific benefit that I noticed is that when training heavy for three to five repetitions per set, I didn't get sore. And this, to me, was an incredible benefit. Because typically when I train in the six repetition to 15 repetition range and I take those sets to failure or near failure, I do experience some soreness the next day. Ordinarily that soreness isn't so intense that it prevents me from doing any of the other sorts of workouts that I do. And for those of you that have visited that foundational fitness program protocol, you know that I hit each major and minor muscle group once per week directly as well as once per week indirectly. That's the overall structure of that program in order to allow sufficient recovery between those resistance training workouts to be able to make continual progress.
Andrew Huberman: Now, by training in this three to five repetition range that Dr. Andy Galpin suggested, I was able to improve my strength, improve my cardiovascular output, reduce soreness, I also just felt better overall. I had a lot more energy after those workouts than I typically do after my resistance training sessions. When I use higher repetition ranges, there are just a number of different things that made me feel, wow, this is really a powerful protocol. And of course, moving heavier weights in the gym feels good too. It feels good to get stronger. At least there's a positive feedback loop there for me and I think for most people. And I should also mention that for those of you that are averse to doing heavier resistance training in this three to five repetition range because you fear that it will make you too big or too bulky, training in the low repetition ranges is actually more geared towards increasing strength and is shifting away somewhat from increasing hypertrophy or muscle size. So that's a great benefit for those of you that want to be strong and also want to maintain cardiovascular fitness, but you don't want to add muscular size. And of course, for all of you that want to add muscular size, it's well established that increasing your strength will allow you then to return to patterns of hypertrophy training that will allow you to use heavier weights and therefore induce greater hypertrophy. So there are so many reasons to incorporate these strength training protocols. So the way that Dr. Andy Galpin suggested one do it, and was the way that I did it, is to use this three by five protocol. |
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} | Andrew Huberman: Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is, however, part of my desire and effort to bring zero cost to consumer information about science and sciencerelated tools to the general public. In keeping with that theme, I'd like to thank the sponsors of today's podcast. Our first sponsor is Element. Element is an electrolyte drink that has everything you need and nothing you don't. That means plenty of salt, sodium, magnesium, and potassium the electrolytes, but no sugar. Having adequate electrolytes is absolutely critical to cellular function, in particular the function of neurons. In order for your neurons to function properly, you need electrolytes in your system and you need to be well hydrated. There's a lot of research to support the fact that if you are even mildly dehydrated that your cognition suffers, your physical performance suffers, and your sleep can also suffer. So getting adequate electrolytes and hydration is key, and Element allows you to do that.
Andrew Huberman: I typically mix Element into 16 to 32oz of water and drink that first thing in the morning. I'll also drink another one during exercise and sometimes another one after exercise as well, especially if I've been sweating a lot or it's a particularly hot day. If you'd like to try Element, you can go to Drinkeelement.com Huberman, and that's spelled Lmnt.com Huberman, and you can claim a free sample pack with your purchase. Again, that's drinkeelement Lmnt.com Huberman to claim a free sample pack. Today's episode is also brought to us by Helix Sleep. Helix Sleep makes mattresses and pillows that are of the absolute highest quality. I've talked many times before on this podcast about the fact that sleep is the foundation of mental health, physical health, and performance. And I say that because when we are not sleeping well or enough, all of those things suffer. Conversely, when we are sleeping well and we're sleeping enough, all of those things improve.
Andrew Huberman: One of the key elements to getting a great night's sleep is to have the proper mattress. Helix Mattresses are different because they are customized to your unique sleep needs. So if you go to their website and take a brief two minute quiz, they will match you to a mattress that's ideal for your sleep needs. The quiz asks questions such as do you sleep on your back? Your side of your stomach? Perhaps you don't know that's fitness tools, or do you tend to run hot or cold during the night? Things of that sort that allow them to match you to a mattress that will give you the best possible night's sleep? I've started sleeping on a Helix mattress a few years ago, and it has vastly improved my sleep. If you're interested in upgrading your mattress, you can go to Helix Sleep Huberman to take that two minute sleep quiz, and they'll match you to a customized mattress. You can also get up to $350 off any mattress order and two free pillows. Again, if you're interested, you can go to Helix Sleep Huberman for up to $350 off and two free pillows. |
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} | Andrew Huberman: Now, the final tool that I want to review for improving your fitness comes from the category of nutrition. I've done lots of episodes about nutrition already on this podcast. We've done episodes about intermittent fasting. I did a long interview episode with Dr. Lane Norton where we discussed all the ins and outs of nutrition as it relates to fat loss, muscle gain, fitness in general, lifestyle in general. So check out that episode where you will learn his philosophy on nutrition, which, frankly, is the one that I largely subscribe to. It, of course, obeys the laws of thermodynamics calories in, calories out being fundamentally important, but also gets into all sorts of details about which sources of protein are most effective, and bioavailable, how much protein you can incorporate into your muscles after training, et cetera. All of that is included in that episode. With that said, the series on exercise with Dr. Andy Galpin also included an episode on nutrition. And while having the discussion for that episode and then listening to that episode again, I realized that while certainly I've gotten a number of things right about my nutrition across the years, there are a few areas where I could probably do better without much effort in ways that could really enhance my fitness. And the thing that I'm referring to is that for me, my first meal of the day lands somewhere around 11:00 a.m., maybe twelve noon. Sometimes I'll eat an earlier breakfast, but most typically I hydrate and caffeinate and train in the morning. And then I eat sometime around eleven or twelve. And then I eat my last meal of the day sometime around 830 or nine. And as some of you already know, I tend to organize my meals such that meals during the early part of the day tend to lean more toward protein and fibrous carbohydrates. So things like meat and salad, or chicken and salad, fish and salad, and maybe a little bit of starch. And the meals that I eat later in the day tend to be more starch focused and more vegetable focused. So things like pasta, rice, et cetera, later in the day because it helps me sleep. And the architecture of all that is really about energy and focus, I find I can focus a bit better and I have more energy throughout the day when I have my first meal at around eleven or twelve and I keep the total amount of carbohydrates that I ingest during the day moderate. |
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} | Peter Attia: Actually, no, I correct that both Fsh and LH will go down on a.
Andrew Huberman: High enough dose just as a mention. And here I'm not making recommendations, but one supplement I've talked a lot about publicly is Fidojia Agrestis, which is this weird Nigerian shrub.
Peter Attia: This on Tim's podcast.
Andrew Huberman: On tim's podcast and Joe's podcast. And, you know, there was a bit of a backlash because it does turn out that at high doses in rodent studies, it can cause some toxicity to the testes, but at lower doses, it does seem to increase luteinizing hormone. And after talking about this, a number of people went out there, did pre and post blood work, and the consistent effect seems to be an increase in luteinizing hormone. There's a noticeable effect on testicular size and volume. So a lot of people take this and be like, oh, their balls are getting bigger, and so they get all excited that something good is happening. But we don't know the long term safety and efficacy of something like fidojia, whether or not it needs to be cycled.
Peter Attia: This is why I'm also very leery of the supplements in this space, because at least when we're using Hcg or testosterone, we have so many years of data, you have to remember how many women are using this stuff for reproductive medicine. So I think the FDA has a lot of faults. I think I have an entire podcast devoted to the corruption of the FDA and all of the mistakes that have been made with respect to their oversight in especially generic drugs. But it's way more regulated than the wild, wild west of nutty supplement land.
Andrew Huberman: Absolutely. I think that the reason for talking about things like Tongad and fidojia was to provide some intermediate discussion between doing all the correct things, but no supplementation or hormone therapy and then going straight to hormone therapy. It's sort of like the leap from I can't focus very well to Ritalin without a real diagnosis of ADHD, to, oh, well, maybe some things like alpha GPC, low doses of nicotine. Right.
Peter Attia: But.
Andrew Huberman: I agree entirely. I mean, the sourcing is important. The dosages are worked out empirically on an individual basis, and there aren't randomized control trials.
Peter Attia: There just aren't yeah. Have kind of like a seven. This is another Peter principle, right? So I got a lot of patients that come into the practice, and during our intake, we go through, what drugs and supplements are you taking right now? And a lot of people come in, I'm not taking anything. Peter, you're in charge now. Tell me what you think. And then you get a lot of people that come in and they're like, we're going to need an extra few pages for this part of the documentation. |
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} | Peter Attia: Ansel Keys acknowledged this in the 1960s. Dietary cholesterol plays no role in serum cholesterol. Again, it took the American Heart Association another 60 years to figure that out. But even now, they acknowledge that dietary cholesterol has no bearing.
Andrew Huberman: So why is it that it's pretty easy to find studies, or at least people who are highly credentialed from good institutions claiming that eating saturated fat saturated fat is different. Saturated fat and red meat, things that are rich in cholesterol, to be more specific, is bad for us in terms of eventual LDL.
Peter Attia: So this is two different things. So saturated fat consumption in many people will raise LDL cholesterol. So it's important to differentiate between the what is saturated fat? So saturated fat, of course, is a fatty acid, just so people understand. Totally different molecule from cholesterol. Cholesterol is this very complicated ring structure, multiple rings stuck together, SFA. Saturated fat is just a long chain fatty acid that is fully saturated, meaning it has no double bonds and it can exist in isolation. It can exist in a triglyceride, tricoglyceride or a phospholipid or all sorts of things like that. So when we eat foods that contain fat, basically there are three distinctions for that fat. Is it saturated? Is it monounsaturated, one double bond? Or is it polyunsaturated two or more double bonds? The observation that eating saturated fat raises cholesterol is generally correct. But again, now it makes because if we're going to start talking about LDL, we have to explain what LDL is.
Peter Attia: This is another one of those things that's just so grossly misunderstood that it makes having discussions about this very complicated. Let's go back to the cholesterol problem. So every cell in our body makes cholesterol. And almost without exception, they make enough. There are a handful of times, however, when a cell needs to borrow cholesterol from another cell. Okay, so how would you do this? Right, so if you're playing God for a minute and you want to design a system, you have to be able to transport cholesterol from one cell to another. The most logical place you would transport this is through the circulation. And the problem with circulation is it's water. Plasma is water. So now you have this problem, which is I want to transport cargo that is hydrophobic in a hydrophilic medium. Can't do it. So if you think about all the things that we transport in our blood sodium, electrolytes, glucose, things like that, they're water soluble. It's easy. |
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} | Peter Attia: It's got to be able to kind of move in this way to mesh with other cells. It also has to accommodate having porous structures that traverse its membrane to allow ions and things like that to go across. And it's cholesterol that gives the fluidity to that membrane. It's also, as you're alluding to the backbone of some of the most important hormones in our body. Estrogen, progesterone, testosterone, cortisol. So we have this thing super important. Okay, then let's talk about can you get cholesterol in your diet? Yes, you can eat foods that are rich in cholesterol. What was known in 1960, but somehow escaped everybody's imagination until finally the American Heart Association acknowledged this a few years ago, is that the cholesterol you eat does not really make it into your body. And the reason for that is it's a sterified. And not to get too nerdy, but I really think it's important people understand how this thing works. So we have cells in our gut and enterocytes.
Peter Attia: They're the endothelial cells of our gut. Each one of them has basically two transporters on them. So the first is called the neiman pick C, one like one transporter. The second is called the ATP binding cassette G. Okay, the neiman pick C, one like one transporter will bring in any sterol cholesterol, zoo, sterol, phytosterol, any sterol that fits through the door will come in. Virtually all of that is the cholesterol we produce that gets taken back to the liver, that the liver packages in bile and secretes. So that's what AIDS in our digestion, which is another thing I should have mentioned earlier. In addition to using cholesterol for cell membranes and hormones, we wouldn't be able to digest our food without cholesterol because it's what makes up the bile salts. So our own cholesterol is basically recirculated in a pool throughout our body. And this is the way it gets back into the body. It's through this nemen pixie one like one transporter.
Peter Attia: When it gets in there, the body this is the checkpoint of regulation. This is where the body says, do you have enough cholesterol in the body? Yes or no? If yes, I will let that cholesterol make its way into the circulation so it'll go off the basilateral side of the cell, not the luminal side, into the body. Alternatively, the body says, you know what? We have enough cholesterol. I'm going to let you poop this out. And now the ATP binding cassette will shoot it out. It'll go back into the luminal side and away it goes. So all of the cholesterol in our body is not asterified, meaning it doesn't have that big bulky side chain attached to it. The cholesterol you eat is asterified, and an asteroid cholesterol molecule simply can't physically pass through that nemen pixie one like, one transporter. Now, we probably manage to de esterify ten to 15% of our dietary cholesterol. So in other words, there are small amounts of dietary cholesterol that do make their way into our circulation, but it represents a small fraction of our total body's pool of cholesterol. Again, this was known even by Ansel Keys, the guy who turned fat into the biggest boogeyman of all time. |
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} | Andrew Huberman: There is tremendous debate about whether or not dietary cholesterol directly relates to or does not relate to serum cholesterol, LDL and HDL. Here's my answer. Well, let me put it this way. There are people that argue I'm certainly not arguing there are people that argue that if one eats a ton of saturated fat that LDL goes up and down.
Peter Attia: Okay, but that's not dietary cholesterol per se.
Andrew Huberman: No, not dietary cholesterol per se. And then there are people that argue that any increase in saturated fat intake is going to be bad, that you already synthesize enough cholesterol for hormone production, et cetera. I'd like to talk about this in terms of how one should read their charts. My LDL is in what I'm told is healthy range. My HDL is in what I'm told is healthspan range. I do try and not overeat things like butter, cheese, and red meat, but I do eat some of those things and I feel pretty good. But most people are operating under the assumption that eating saturated fat is bad and you only do it insofar as you want to taste it. And then, of course, there's a small group of people that love to eat organs and meats and really pack cholesterol and would argue that doesn't matter if your LDL is 870, it's not going to impact your health. What's the reality around LDL, HDL, dietary cholesterol, saturated fat, at least in your view?
Peter Attia: So first, let's differentiate between cholesterol and fat just for the listener, because we use them. I don't want to make sure people understand. So cholesterol is a really complicated molecule. So it's a ringed molecule. God, I used to know exactly what its structure was, but it could have 36 carbons, for all I remember. It is a lipid. So it is a hydrophobic molecule that is synthesized by every cell in the human body. It is so important that without it, if you look at sort of genetic conditions that impair cholesterol synthesis, depending on their severity, they can be fatal in utero. So, in other words, anything that really interferes with our ability to produce cholesterol is a threat to us as a species. And the reason for that is cholesterol makes up the cell membrane of every cell in our body. So, as you know, but maybe the listeners don't. Even though a cell is a spherical thing, it has to be fluid, right? It's not just a rigid sphere like a blow up ball, right? |
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} | Andrew Huberman: And the reason is, ever since going on podcasts and talking about this stuff and talking about it on this podcast, people will send me their numbers, they'll send me their charts, and then they'll send photos of themselves. And I can tell you, while I'm not a clinician and I haven't done fancy statistics on it, there is very little correlation between someone's absolute testosterone and how they appear. I mean, some of these guys look really lean, really strong, and they'll say, oh, total testosterone is 554 80. Right? And then other people testosterone is 860. But you'd look at them and you think, oh, they kind of gave kind of a doughy look to them. And so it's got to be this free testosterone thing. Plus estrogen, et, Peter training and nutrition too.
Peter Attia: Right. For all this talk about testosterone, which I enjoy talking about, and I enjoy talking about the data on long term health consequences of testosterone because it's another controversial topic, I also think people kind of overstate its importance. I agree. And I think there's a group of people who think, if I could just fix my testosterone, everything will be better and it's sort of like no, actually, that's not true at all. Really, the only purpose in my mind of fixing testosterone is to give you the capacity to work harder. It's really going to help you recover more from your workouts. This should just give you a greater ability to experience muscle protein synthesis. So if I just give you a bunch of testosterone and you sit on the couch and your nutrition doesn't change and you're not exercising anymore, you're not going to experience any benefits of this thing? I mean, my testosterone level has fluctuated quite a bit throughout my life. And when I think about as an adult, not sort of including when I was sort of a fanatical teenager, but as an adult, when was I at my absolute most insane physique?
Peter Attia: Like, my best performance on a Dexa scan would have been 30. I was 38 years old by Dexa. I was 7%. Body fat, my fat free mass index was like 23.223.3 kg/meter squared. I mean, I was huge, strong and totally ripped. My testosterone was in the toilet. I was over training like crazy. I was exercise probably 26 hours a week, killing it in the gym, swimming like a banshee, cycling like my life depended on it. Grossly overtrained, low t, but physically looked like twice the guy I am today. Today my tea is probably twice as high as it was then. Now, you could say, Well, Peter, what if you took tea back then? How much better could you have been? Sure, but but again, I think the take home is just giving somebody tea doesn't do much of anything. It probably helps on the insulin resistance front without any other thing. But to me that's a waste that's squandering the gift that it is giving you, which is the ability to do more work and capture the benefit of it via muscle protein synthesis.
Andrew Huberman: I agree. And I think that the psychological effect of testosterone, whether or not it's exogenous or endogenous, is it makes effort feel good at some level, it really seems to do that. And Sepulski tells me the main reason, or mechanistically, the main reason that it can do that is by adjusting levels of activity in the amygdala.
Peter Attia: Interesting.
Andrew Huberman: And so there's some interesting imaging there. I'd love to chat more about the cholesterol pathway and I know this is a huge landscape as well, but I think we're doing a good job of diving in deep, but not getting stuck in the underlying currents at all. |
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} | Peter Attia: Well, again, it depends if, when we say TRT, if you're in your twenty s and there's no other way, I would hope you would be steered toward Hcg to at least preserve testicular function. Now, again, we don't actually know if Peter being on Hcg for ten years, your pituitary will still work.
Andrew Huberman: You won't be able to make your own luteinizing.
Peter Attia: Exactly. So it might be the case that you're going to need something upstream of that, like Clomid to kickstart it. But again, I don't want anybody who's listening to this, who's using Clomid for fertility to think that there's anything wrong with it. My concern over this became like, if you're going to be on this for ten years. Is it problematic? Not if you're using this for a course of IVF or something like that. So, again, if we felt that someone's pituitary was not working, I would be happy to put three months of clomid on them to kind of try to see if we could blast it back.
Andrew Huberman: Do you have men cycle on and off testosterone at these low dosages? Are they taking a month vacation from it every month?
Peter Attia: Yeah, it totally depends. I was talking to a patient yesterday where we're going to do we just decided to change a cycle eight weeks on, then eight weeks on hcg. Eight weeks on, then eight weeks on hcg. So that's going to be a cycle that maintains his testosterone level, but fluctuates between endogenous exogenous, endogenous exogenous. Sometimes we'll just do testosterone on, off, on, off, and there it's like, how much can he replenish naturally? But understanding his T will dip during.
Andrew Huberman: Those off cycles, seems to me there's a tremendous incentive for somebody to develop a molecule that can directly target Shbg peptides, oxandrolone Anivar. Right. If you one could just drop SHPG just the tiniest bit, it seems like one could adjust the free T in a way that would be great. I don't know why that molecule is so hard to target, but somebody ought to do it. The chemistry can't be that hard.
Peter Attia: I talked with Patrick Arnold about this many years ago. I wish I could remember what his idea. He had a comment about this that at the time made sense, and I don't remember what it was because I had that thought too, like, man, especially for that subset of guys who have normal testosterone, but they're just overbinding it.
Andrew Huberman: I'm really glad that you brought up this issue of total testosterone versus free tea. |
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} | Peter Attia: Yeah, we just say, Why risk it? Like, we'd rather use Hcg just on its own. Yeah, just wait. Just wait till you're done reproducing bank sperm. Wait till you're done reproducing before we go to testosterone.
Andrew Huberman: What are some of the benefits and what are some of the cautionary notes with appropriate TRT meaning of the kind of contour that we're talking about here? A lower dose with the yes or no low estrogen control, what generally people report, how do they feel, what does it allow them to do that they couldn't do or feel before? And then in terms of what are the markers to look for, is it LDL, blood pressure, water retention, acne, those kinds of things? Are there some other things?
Peter Attia: It depends on the doses.
Andrew Huberman: Right.
Peter Attia: I mean, again, we're using these in really low doses. So it's pretty rare that we'd have a patient on more than 100 milligrams a week of testosterone. I think, for comparison, like a bodybuilder could easily take 500 to 1000 during a high growth phase.
Andrew Huberman: I know some of these guys, they go ballistic or they're doing moderate levels of testosterone sibinate, but they're also taking Dianabolicandrolone Sarms and a bunch of other things. I mean, their stacks are kind of ridiculous. I mean, no disrespect to that sport, but people like crazy in that sport.
Peter Attia: Right now, outside of physiology.
Andrew Huberman: Yeah, and I think for 99% of people listening, they hear bodybuilder and they just go like, why would somebody do that anyway?
Peter Attia: Right? I think that's the typical the point is a lot of but we owe those guys a great deal of gratitude because they've shown us the boundaries, including the women. That's right. Those bodybuilders have taught us a lot about what happens. And so, yeah, the bloating, the water retention, acne, hair loss, hair growth, all of those things, we understand. The truth of it is we just don't see those things in our patients.
Andrew Huberman: But 100 milligrams per week is a very low output.
Peter Attia: But it's a physiologic dose. The reality of it is it's enough for most people. I mean, probably the highest we've ever had to go is maybe 70 twice a week.
Andrew Huberman: What's the youngest patient you've ever had to put on TRT?
Peter Attia: Actual testosterone? Probably. I ask you a question. I'm thinking about maybe 40.
Andrew Huberman: I think that's great for people to hear because I know that a lot of guys in their 20s are thinking TRT is the way to go. And I would argue, unless you're doing everything else right and you're still hypogonadal and you're really struggling, put that time off because also the fertility issue you want to delay. |
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} | Andrew Huberman: Now I understand why you don't prescribe Clomafine because of this potential Dysmor link. What about testosterone therapy? So less frequent, lower doses less, or no estrogen inhibition or aromatase inhibition.
Peter Attia: We're only using an aromatase blocker, and we use aromatix when we do it's just to get that estradiol into the range we want. I like to see it between 30 and 50. That's the sweet spot. And I don't know, I would say like a third, maybe not even a third. I'd say probably 20% of men require a micro dose of nastrozol to get into that range. Most do not. And I'd rather err on the side of being a little high than a little low. So I never really want to be below 25. Sometimes it's just below 25 and it is. It is what it is. That's fine, but but if we're suppressing it to below 25, I never want to be in that zone. And then yes. So TRT is ultimately giving testosterone. Cipionate is usually what we use injectable.
Andrew Huberman: So it's supposed to creamer Pellet.
Peter Attia: Correct. I used to use Pellets with women for some who were really adamant about the convenience of it, but for a bunch of reasons, I'm mostly not doing that. And I've never been a fan of Pellets.
Andrew Huberman: In men, you can't control the dosages once it's in.
Peter Attia: Right, I know the dose. Yeah, that's obviously a problem. But I don't think there's a big difference between putting a Pellet into a man and a woman. So when you're putting an estrogen Pellet into a woman, it's that big. When you're putting enough Pellets into a man for six months of testosterone, it's two sums of Pellets that are longer than my finger. So you're putting, like a V where.
Andrew Huberman: Are you putting this?
Peter Attia: You're putting it into the gluteal fat. So it's just a more morbid procedure. And I don't think it's necessary. I think if you know how to manage it through sort of the injections yeah. Well, especially now, if you're doing we're having them do sub Q injections anyway, so it's not im. They're using five eight inch to a one inch 25 gauge needle, which is about the smallest needle you can push the oil through once to twice a week, depending on and by the way, if they're real needle phobes, we use Ziosted, which is a preloaded pen.
Andrew Huberman: And are you having all men take Hcg to maintain fertility and testosterone? Got it.
Peter Attia: And by the way, we do not like to use TRT in men who we don't like to use testosterone, specifically in men who still want to maintain fertility. We just steer them away from that.
Andrew Huberman: Because total sperm count goes down. |
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} | Andrew Huberman: People who travel with a suitcase that you can hear as they walk through the airport from all the pills.
Peter Attia: So I give these patients a little homework exercise, which is you have to answer these seven questions for every supplement you take. And here's the spreadsheet, and let's talk about it. And it basically just runs through it's, basically walking you through the logic of why do you take this molecule? And I think for many people, when they do that, it's very sobering, right? A lot of them will come back and be like, you know what? I don't think I can come up with any reason along this really rigorous line of thinking as to why I'm taking 80% of this stuff.
Andrew Huberman: Well, I know people, and actually, we know some of the same people who are fanatic about, like, red light, red light on the testes, sunning their testes, putting ice packs on their testes. It's kind of all over the place. The number of things that people are trying and doing in order to increase testosterone output from their testes is pretty remarkable. And that said, among some of the women I know, the number of things that they're doing to try and promote longevity and fertility, and in particular skin health, hair health, and nail health is also kind of outrageous. Everything from collagen to red light therapies, which may actually have some efficacy in certain cases. But as an interesting there's a hunger there, right?
Peter Attia: Oh, for sure. One of the things that I hope gets a lot more attention is the use of rapamycin for preserving ovarian health. So the animal literature on this is pretty impressive, right? So in mouse models, rapamycin will preserve ovarian life. It makes sense, right? I mean, it totally makes sense why the most potent geoprotective molecule we have would also preserve and extend ovarian life, at least in mice. So I'd love to see the clinical trials done in women to test this hypothesis.
Andrew Huberman: I definitely want to come back to this because that's a key thing. I know that a lot of people are interested in female fertility out there, including their male partners. |
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} | Peter Attia: They just move back and forth in our blood with no chaperone. But when you want to move cholesterol, you have to package it in something that's hydrophilic. That something is called a lipoprotein. So we have these spherical molecules that are lipid on the inside, protein on the outside, apolipoprotein B. Inside. They contain cholesterol and triglycerides. So now you've got the spherical thing, triglyceride cholesterol on the inside. And it's chaperoned by a hydrophilic molecule that allows it to move through our circulation. And apolipoprotein b exist in different densities. So if you run these out on a gel electrophoresis plate, you'll identify different densities. The density is a function of how much protein and how much lipid is in it. So the highest density of this is called a high density lipoprotein. And the lowest density of this is called a very low density lipoprotein, a LDL. And then next to that you have an LDL, a low density Apolipoprotein B. Then next to that you have an ideal.
Peter Attia: An intermediate density apolipoprotein B actually goes LDL ID LDL. But anyway, so when people say my LDL is high or my LDL is 100, what are they saying? They're saying the cholesterol concentration of my LDL particles is 100 milligrams per deciliter. So the total cholesterol concentration you have in your circulation is that number that says total cholesterol. So if someone's blood panel says my total cholesterol is 200, it means that if you take all the lipoproteins in their circulation, bust them open and measure the cholesterol content, it's 200 milligrams per deciliter. And for all intents and purposes, because the IDLs are so short lived, that's basically the sum of your LDL cholesterol, your VLDL cholesterol and your HDL cholesterol. Those three things sum to your total cholesterol.
Andrew Huberman: What about LDL little A that you mentioned earlier?
Peter Attia: LP Little A is yeah, he's another actor. He is a special type of LDL that, again, in sort of ten to 20% of the population is a really bad actor. So that's an LDL that has another apolipoprotein on it called apolipoprotein Little A.
Andrew Huberman: Got it.
Peter Attia: The other thing I'll just say on this, because earlier I mentioned apob, there are two broad families of lipoproteins. There are those that are wrapped in APO B's and those that are wrapped in apoas. The apoa family is the HDL family, the apob family is the VLDL idl LDL family. |
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} | Peter Attia: In fact, maybe it wasn't known. I suspect it is inhibiting the enzyme, which I think is called Delta 24 desaturates, that turns Desmol into cholesterol. Makes sense. If you inhibit that enzyme, you're going to see a rise in Desmondrol. This wouldn't have been a concern to me if not for the fact that Tom Dayspring, who's one of the physicians we work with, who's one of the world's experts in Lipids, pointed out a very obscure story, which was that the very first drug ever approved to treat cardiovascular disease, at least to treat hypercholesterolemia, was a drug that attacked the same enzyme. So this was in the early 1960s, I believe, maybe the mid sixty s, this drug was approved and it lowered cholesterol and it was approved on the basis of lowering cholesterol. Now today, no drug for ASCVD is approved on the basis of it lowering cholesterol. That's not a high enough bar. You have to reduce events actually have to show that you're preventing heart attacks and death. But at that time it was like, hey, it lowers cholesterol, it's got to be good.
Peter Attia: Well, in the late 60s it was pulled from the market because events were going up. So cholesterol was coming down, events were going up. How could that be? We don't know. What we are suspecting is that Desmondrol, which is still a sterile, was potentially more damaging and created more oxidative stress in the endothelium in the sub endothelial space than cholesterol.
Andrew Huberman: I see.
Peter Attia: Which would at least suggest to us, and again, we're taking a lot of leaps here, that maybe having high Desmol, very high Desmond is not a good thing. And so once we kind of pieced all that together a few years ago we were like, yeah, we're just not going to prescribe clomid anymore. And we then switched to Hcg, which we used to use sometimes instead of clomid, but it's more cumbersome to work with. It needs to be refrigerated. It's a much more fragile molecule.
Andrew Huberman: Yeah, I think we talked about this once. It's almost like if you accidentally knock over the little bottle, it's basically gone bad. Travel with it is very travel with it.
Peter Attia: It's a needle. It's an injection sub queue. So easy to administer it's not im or anything like that, but it's just more of a hassle factor. But that said, it has the benefit that Clomid does, which is it preserves testicular function, it preserves testicular volume. So bodybuilders will often use this in their post cycle therapy as a way to kind of recover function. And we would just use it now as ongoing therapy for a guy who still has testicular reserve.
Andrew Huberman: So, on its own, no testosterone, no aromatase inhibitor, nothing. Just a way to crank out a bit more testosterone from the testes.
Peter Attia: Maybe some additional Hcg is a different model. Hcg is just an analog of luteinizing hormone. So it's basically like giving them luteinizing hormone.
Andrew Huberman: So it's going to crush endogenous luteinizing hormone levels. Right?
Peter Attia: Because of that, actually, yeah. You don't really see much of an impact on LH, but you do see endogenous testosterone production go down. |
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} | Peter Attia: Most of our patients do not take aromatase inhibitors. It's not needed. It's really only the high aromatizers that need it. When we'll talk about testosterone, we'll talk about dosing there because I agree, the more frequently you can take it, the better. And frankly, you don't need to go more frequently than twice a week because it's so slow. Yeah, the half life of the drug is I think it's about three and a half days. Is the plasma half life or something like that? It could be off a little bit, but twice week dosing is really nice. So if you go to a testosterone clinic that's giving you 200 every two weeks, 50 twice a week is the same total dose, which, by the way, is a physiologic dose, that's not going to give somebody any of the side effects you would see. You're not going to get acne with that. You're not going to get gynecomastia. You're not going to get anything. The only real side effect you get from that is you will get testicular atrophy that is enough to suppress yeah.
Andrew Huberman: To maintain fertility. What do you typically do for well.
Peter Attia: So I'll finish the story on Clomid because we currently do not use Clomid. And that's due to a really interesting observation that we made that I don't think has been reported in the literature yet, which is that clomid was increasing levels of a steroid that we also happen to measure called desmorol.
Andrew Huberman: I'm not familiar with that.
Peter Attia: So in the way that cholesterol is made, it's made by there's two pathways that make cholesterol. So it starts with two carbon subunits like acetylCoA, and it kind of marches down a pathway. bifurcates and cholesterol is the finished product of both. But in one of those pathways, the molecule right before cholesterol is called Desmorol. In the other pathway, it's called testosterone. So we constantly measure testosterone and Desmorol because we want to know how much cholesterol is being synthesized in the body, not just what your cholesterol is. We want to know how much cholesterol you reabsorb. And those markers are really important to us when we're looking at cardiovascular disease risk. So when we gave patients Clomid, we were noticing an almost universal rise in their Desmond levels. Now, the most obvious explanation for that, though the last time I looked, I couldn't find clear explanation for this in any of the clinical, like the clinical trials that led to the approval of Clomid. So I don't know if it was described. |
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} | Peter Attia: Correct. Yeah. I mean, I think the easiest way to go about doing this is just give the hormone that's missing without attention to where the deficiency is. Why this becomes relevant is if you have a 35 year old guy whose testosterone is low, but you can demonstrate that it's low because he's not getting enough of a signal from the pituitary. Why would you bother giving him more testosterone when he has the capacity, he has the Ladig cells and the sirtooli cells to make testosterone? He just needs the signal. Sometimes, though not always. Just a course of Clomid can wake him up and he's back to making normal testosterone.
Andrew Huberman: So he'll do this three times a week, 50 milligrams, three times a week for a short course?
Peter Attia: Yeah, we would do it for eight to twelve weeks and then we reevaluate.
Andrew Huberman: And estrogen and testosterone will increase in parallel?
Peter Attia: Yes. And again, it depends. Aromatase activity is dependent on how much body fat you have and genetics. And if estradiol gets too high, we think if it gets over about 55, 60, we will give micro doses of an astrozol. But it has to be real micro doses. I mean, you cannot pound people with an Astrozole to, to give you perspective, the the sort of on label use, like if you just go to a pharmacy and order an Astrozole, you're going to get 1 MG tablets. Like we can't give anybody a milligram.
Andrew Huberman: They'll feel like garbage.
Peter Attia: We have to have it compounded at 0.1 milligrams, and we might give a patient zero one, two to three times a week. That would be a big dose of an astrozole.
Andrew Huberman: Yeah, I think that the typical TRT clinic out there is giving 200 milligrams Peter mill, one mil, 200 milligrams of testosterone once every two weeks, and then hitting people with multiple milligrams of an astrozole, and they're all over the place.
Peter Attia: I've never really understood. I mean, I guess I shouldn't be surprised, but it kind of blows my mind that these TRT clinics are up all over the place, given how bad I mean, I see the results because I have patients that come from them, and I don't understand why they're so incompetent.
Andrew Huberman: I actually think it's worse than that. I think that they simply don't understand and don't care because it's a pill mill and it's a money mill. I think that nowadays it seems almost everybody who's doing TRT is taking lower doses more frequently every other day or twice a week, dividing the dose and being very careful with these estrogen or aromatase blockers. |
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} | Andrew Huberman: We've talked a little bit about the fact that some people taking things like an astrozole to reduce aromatase activity can potentially run into trouble because they think, oh, well, more testosterone good, lower estrogen bad. And then they end up with issues like joint pain, memory issues, and severe drops in libido. And I think a lot of the.
Peter Attia: Reasons and even fat accumulation. So if estrogen is too low, you can develop adiposity in a way that you wouldn't otherwise. There's a great New England Journal paper, it's probably ten years old now that looked at, I believe it was five different doses of testosterone cipionate. So these men were chemically castrated and divided into ten groups. It's pretty remarkable somebody signed up for this study. Yeah. So you were with and without anastrozol and five doses of testosterone. Okay. So now you basically had five testosterone levels plus or minus, high or low estradiol. And the results were really clear that the higher your testosterone and the more your estradiol was in kind of that 30 to 50 range, the better you were. So if estrogen was too low, even in the presence of high testosterone, the outcomes were less significant.
Andrew Huberman: And this is 30 to 50 nanograms per deciliter, not 30% to 50% of one's testosterone. Okay, great.
Peter Attia: Okay.
Andrew Huberman: But Clomid is we have not talked a lot about Clomid. I'd love to get your thoughts on Clomid.
Peter Attia: So Clomophine is a fertility drug. It's a synthetic hormone. It's actually two drugs, m, Clonafine and I forget the other one and it tells the pituitary to secrete Fsh and LH. The advantage of Clomid is it's oral, and it's meant to be taken orally. So a typical starting dose would be like 50 milligrams three times a week. And if you do that, you'll notice in most men, especially young men, fsh LH goes up. In any man, the Fsh and LH go up. But if a man still has testicular reserve, he'll make lots of testosterone in response to that. Because that's the first order question we're trying to answer. Is your failure to make testosterone central or peripheral?
Andrew Huberman: Yeah. And I think I just want to point out again, correct me if I'm wrong, but my understanding is that a lot of the drugs that we're talking about, the synthetic compounds, testosterone, estrogen, things related to growth hormone, et cetera were discovered and designed in order to treat and exercise me, in order to isolate and treat exactly these kinds of syndromes, whether or not it was the hypothalamus, the pituitary or the target tissue, the ovaries or the testes. Correct? |
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"chunkTitle": "Testosterone Replacement Therapy",
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} | Andrew Huberman: Luckily, my prostate specific antigen is low, and Dht, the things I know can reduce it are things like finasteride, propecia, things like things that people take to try and avoid hair loss can dramatically reduce Dht and lead to all sorts of terrible sexual side effects, mood based side effects, et cetera. I'm not aware of anything that can be taken in supplementation form that can really profoundly drop.
Peter Attia: We don't spend much attention on it anymore, basically. I used to have a much more complicated differential diagnosis eight years ago. I would drive patients nuts with the whiteboard diagrams I would draw for them, and in the end, I think they were just like, dude, just what do I need to take? Today we take a much more simple approach. So the first question is, should you or should you have your free testosterone be higher? That's the metric I care about, is free testosterone is the first most important. The second most important is estradiol.
Andrew Huberman: And sorry to interrupt you. You said if you look at your total testosterone, you want the free T to be about 2% of your well, it should be.
Peter Attia: I might not change that anymore. So, in other words, if a guy's at 1%, then I know I have to really boost his total testosterone. If he's only going to get one to one and a half percent of it converted to free, I need to boost him. And that's why I don't care if he's outside the range. I'll have a guy who's free tea. I might have to get a guy's total T up to 1500 to get his free T to 18.
Andrew Huberman: I see. So free T is the target.
Peter Attia: I like, free T is what we treat.
Andrew Huberman: And do you still use antivirxandro? Sorry. To try and lower SHPG because it's too potent?
Peter Attia: No, because it's just too complicated for patients. It's a drug that can't be taken orally, so you have to take it under the tongue, like Atrocious or something. Right. But then I had one patient once who, even though we told him about 87 times, that he was, like, swallowing the anivars and his liver function, and he was like, we're talking ten milligrams, three times a week as a tiny dose and three months of him or whatever, two months of him swallowing that every time. Tripled his liver function test. So I was like, it's just not worth the hassle of doing this for perfection. In reality, we can fix this another way. So the first order question is, do we believe clinically you will benefit from normalizing your free testosterone or taking it to a level that's call it eighty th to ninety th percentile? So upper normal limit of physiologic ranges? That's the first order question. And that's going to come down to symptoms and that's going to come down to some biomarkers.
Peter Attia: I think there's two years ago was it two years ago or maybe a year ago? Very good study came out that looked at prediabetic men. You've probably talked about this study and looking at insulin resistance and glucose disposal with and without testosterone. And the evidence was overwhelmingly clear. Testosterone improves glycemic control. Testosterone improves insulin signaling. This shouldn't be surprising, by the way, given the role muscles play as a glucose reservoir and a glucose sink. So now I include that as one of the things that we will consider as a factor for using testosterone. Now, again, it's not the only one. So you can accomplish that with exercise, you can accomplish that with these other things, but then you get into a little bit of the vicious cycle of will having a normalized testosterone facilitate you doing those things better? So let's just assume we come to the decision that this person is a good candidate for testosterone replacement therapy.
Peter Attia: The next question is, what's the method? We're going to do it? Are we going to do it indirectly or directly? Now, we used to use a lot of Clomid in our practice and have you talked about Clomid on the I.
Andrew Huberman: Haven'T talked too much about it, no. |
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} | Peter Attia: So then the same as with estradiol, so except in the opposite direction. So higher estradiol is higher Shbg. So, again, occasionally you'll see a guy with normal testosterone, but he's a very high aromatase activity person, so he has a lot of the enzyme that converts testosterone into estradiol. You can lower estradiol a bit with an aromatase inhibitor and that can bring down Shbg. Now, again, these things individually are rarely enough to move the needle. The last is thyroxine. So if you have a person whose thyroid is out of whack, you have to fix that before you if their T four is out of whack, you're going to interfere with SHPG. There are also some supplements, which I think you've probably talked about these on the podcast. I feel like I've heard you talk about these on the podcast.
Andrew Huberman: Yeah, there are a few that will adjust. There is this idea now, there's a much better review that just came out. I'll send it to you. I'd love your thoughts on it and I've been perusing it line by line, but I love input from experts like you on the use of Tonga Ali for reducing Hpg. In my experience, it does free up some testosterone, by which mechanism it isn't exactly clear and the effects aren't that dramatic. They're probably multiple effects. For all we know, it increases libido and it does generally by way of increasing estrogen slightly, which can also increase libido in some individuals. So we don't know the exact mode of action. So we've talked about a few. The one that a few years back people were claiming could reduce Shbg was stinging nettles. Stinging nettle? Well, urinating seems to be coming up multiple times on this podcast, for whatever reason. Stinging nettle extract. I took the the most pronounced effect of that was you could basically urinate over a car. And when taking SHPG, what the underlying mechanism of that was, I do not know.
Andrew Huberman: I took it for a short while. It didn't drop my SHPG very much, but it did drop my Dht sufficiently so that I stopped taking it. I do not like anything that impedes Dht. I don't care if my hairline retreats. I don't care about any of that. Dht to me, is something to be coveted and held onto because you feel so much better when your Dht is in the appropriate range. And love your thoughts on that.
Peter Attia: Yeah, it really depends on the guy, and it depends on what risk you're trying to manage. Right. So prostate size starts to become one of the issues with Dht. |
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} | Peter Attia: A micro dose of this has to be small enough that it doesn't impair your body's ability to make testosterone. But Anivar has such a high affinity for Shbg that it basically distracts your Shbg from binding your testosterone, freeing up testosterone. That's exactly right. So the goal was, how do I just give you more free testosterone? So if a patient shows up and they've got a total testosterone of 900 nanograms per deciliter, which would place them at depending on the scale you look at, the scale we look at, that would place you at about the 70th percentile. But your free testosterone is eight nanograms per deciliter, so that's pretty bad. That means you're less than 1% free. A guy should be about 2% free tea. So that dude should be closer to 16 to 18 nanograms per deciliter. So in that situation that I just gave you, his Shbg is really high. His Shbg is probably in the 80 to 90 range.
Andrew Huberman: That's very high. Yeah, because I think the upper range is somewhere around 55, 56.
Peter Attia: Exactly. So we would first backstall for what's driving is Shbg. So there's basically three hormones. So genetics plays a huge role in this. There's no question that just out of the box. People have a different set point for Shbg. Mine is incredibly low. My SHPG is like kind of in the but from a hormone perspective, there's basically three hormones that run it. So estradiol being probably the most important, insulin and thyroxine. So we're going to look at all of those and decide if any of those are playing a role. So insulin suppresses it. So this is actually the great irony of helping a person get metabolically healthy is in the short run, you can actually lower their free testosterone, all things equal, because as insulin comes down, Shbg goes up and if testosterone hasn't gone up with it, you're lowering free testosterone.
Andrew Huberman: So somebody who goes on a very low carbohydrate diet and attempt to drop some water and drop some weight is going to increase their SHPG.
Peter Attia: Yeah, if their insulin goes bind up.
Andrew Huberman: Testosterone, less free testosterone. I can tell the carnivore diet people are going to be coming after me with bone marrow in hand. But then again, after this discussion extends a little further, I'm sure the vegans will be coming after me with celery stalks. |
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} | Andrew Huberman: When one looks on social media and the internet, there seems to be a younger and younger cohort of guys, people in their teens and 20s, showing up to the table thinking that injecting testosterone, cipionate or taking Anivar or whatever it is, is going to be the right idea. There mainly seem to be focused on cosmetic effects. I'm not a physician, so I can't say whether or not they were actually hypogonadal, et cetera. But it seems to me again, correct me if I'm wrong, but it seems to me that similar to the Attia rule as it relates to longevity that we could come up with a broad contour rule in which if a male of any age is not trying to get decent sleep, exercise appropriately appropriate nutrition, minding their social connections, et cetera, et cetera. The idea of going straight to testosterone seems like a bad idea.
Andrew Huberman: That said, just like with depression and antidepressants, there is a kind of a cliff, after which low enough testosterone or low enough serotonin prevents people from sleeping, exercise, social connection, et cetera. So I do want to acknowledge that. But with that in mind, how do you think about, and perhaps occasionally prescribe and direct your patients in terms of hormone hormone replacement therapy? Men, person in their 30s, person in their 40s who's doing almost all the other things correctly. What sorts of levels do you think are meaningful? Because the range is tremendous. In terms of blood tests, 300 nanograms per deciliter. I think on the low end. Now, in the US. All the way up to 900 or 1200, that's an enormous range. What are some of the other hormones you like to look at? Estrogen dht and so on.
Peter Attia: Lots unpacked there. So let's start with the ranges. Right. So the ranges you gave are for total testosterone, of course. And we don't spend a lot of time looking at that the way we used the way we you know, I used to spend more time looking at total and free when I had when I used more tricks to modulate it. So I'm actually far more simple in my manipulation of testosterone today than I was six or seven years ago. Six or seven years ago, we would use a micro dose of Anivar to lower Shbg in a person who had normal testosterone, but low free testosterone.
Andrew Huberman: What was a low dose of Anivar in that context?
Peter Attia: Ten milligrams Subling, two to three times a week.
Andrew Huberman: Anivar basically being Dht oxandrolone.
Peter Attia: Exactly.
Andrew Huberman: And again, we're not recommending this, actually. If you're playing a competitive sport can get you banned from that sport. It can also get you banned from having children if you do it incorrectly. |
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} | Peter Attia: The most potent drug of the lot is the PCSK nine inhibitor. So PCSK nine is a protein that was discovered in the late ninety s, I believe is responsible for the degradation of LDL receptors. This was first discovered in people who had a condition called familial hypercholesterolemia or FH. So these are people that have incredibly high cholesterol. Typically their total cholesterol level is 300. Their LDL cholesterol is typically north of 200 milligrams per deciliter. This is a disease that is defined by the phenotype, not the genotype. So the phenotype has a very clear definition which I basically just gave you the genotype is there's a million paths to get there. There's over 3000 mutations that are known to produce that phenotype. This was discovered to be one of them in people who had hyper functioning PCSK nine this protein was just constantly hammering and destroying the LDL receptors. And so their LDL would be huge and by extension their total cholesterol would be. So in 2006, Helen hobbes and colleagues discovered an opposite group of population people who had LDL cholesterol naturally of ten to 20 milligrams per deciliter which would be an ApoB of about 20 milligrams per deciliter and who never got heart disease.
Peter Attia: They were immune to heart disease no matter how long they live. And they had the opposite. They had hypo functioning PCSK nine and so that was 2006 in the new england journal of medicine that basically got a whole bunch of drug companies hot on the trail of producing a drug to mimic it. So now we have these antibodies and they're wildly effective.
Andrew Huberman: What percentage of your patients over 45 do you have on either a statin or on one of these other?
Peter Attia: Well, often it's in combinations and I would say 80% we have to remember what our objective is we're in the business of trying to make sure people live as long as possible and you have to take a sort of world view of this right? What's the most prevalent cause of death globally? Say cardiovascular disease how close is it? So the last year before COVID COVID kind of messes up these numbers a little bit. But if you go to 2019, 18.6 million people died of heart disease. Number two cancer. 10 million. Nothing's in the zip code of atherosclerosis. And if you remember what I just said if you took everybody in their twenty s and reduced them to a level of that of a child you'd make as CBD an orphan disease.
Andrew Huberman: Why don't we hear more about this? I realize there's some nuance it's not straightforward it's not as simple as saying eat less cheese, red meat and watch your LDL get on a statin but why do we hear so little about ApoB in the general discussion? Social media is such a skewed landscape as we know people shouting into tunnels of varying clarity some are beautiful bronze tunnels with clean walls and others are sewer lines right? And they all converge in the same place as we know but why do we hear so little about this? I mean I'm not on a statin but now I'm beginning to think that maybe that might be a good idea to consider one of these other compounds I don't know the last time I looked at my ApoB specifically I'm guessing my physician did but why don't we. Hear more about this? |
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"chunkTitle": "Enhancing Endurance",
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} | Andrew Huberman: Okay, so let me give you an example of an exercise snack for enhancing your long duration endurance. Twelve minutes or longer. And this is the sort of thing that if you are going to incorporate into your routine, and I highly recommend that you do, can essentially be done anytime with no warm up. A good example of an exercise snack of this type would be to suddenly stand up from your desk and to do 100 jumping jacks. Now, depending on how fit you are and how fast you do those jumping jacks and how wide and tall you do those jumping jacks. Meaning? Are you doing these kind of little things where your hands don't actually meet and your hand, like, parting your legs just a little bit? Or are you doing full jumping jacks where you're really jumping and setting your feet out as wide as you comfortably and safely can and then bring your hands together? It could take you anywhere from 30 seconds to 90 seconds. Okay? So in the case of jumping jacks, you may end up doing this for 90 seconds, but the point is to simply do 100 jumping jacks. Or if that takes too long, you could even do just 25 or 50 jumping jacks.
Andrew Huberman: The point is that it's going to get you moving your muscles, it's going to get your heart rate up even if you're very, very fit. If you're doing these fast enough and you're doing them with proper form, it's going to get your heart rate up and then you're done. You can sit back down to your desk or you can continue to walk through the airport. Yes, I've done these in the airport. Typically not while walking toward my gate, but at the gate, but occasionally I'm feeling lethargic or I haven't had the opportunity to train that day and perhaps I won't get the opportunity to train. So I'll do something like 100 jumping jacks while facing the window. So it feels a little less awkward facing people while you're doing them. And of course you don't have to do jumping jacks. An equally effective type of exercise snack is to find a stairwell and to simply go up that stairwell as fast as you safely can for 20 to 30 seconds. So perhaps just find the bottom of a stairwell and go up that stairwell as quickly as you can and perhaps go down as quickly as you can and just keep doing that for about 20 to 40 seconds and then you're essentially done.
Andrew Huberman: You could also opt to pick some distance away from your car in the parking lot, assuming you're not carrying any heavy bags or anything, and simply run to your car. So 20 to 30 seconds of not necessarily all out sprinting, you don't want to injure yourself because again, this is done without a warm up. These exercise snacks are designed to be inserted into your day and into your week essentially at random. You could plan them if you want, but anytime you feel inspired, or perhaps anytime you're feeling like you don't want to do one, you could simply do one of these exercise snacks. And of course doing jumping jacks or running to your car or taking the stairs very quickly up and down, or just up and then walking down for instance, and doing a few jumping jacks. Things of that sort of course can take on a near infinite number of different variations. So if you don't like any of the variations that I just presented, you can easily come up with something else. Again, the purpose of these exercise snacks is to get your heart rate up. |
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} | Peter Attia: It takes a while to get people up to dose. So if you're looking at semaglutide, the dose that was studied, so did a one year trial, or maybe it was a little over that maybe 60 weeks, but it took about 16 weeks to get the patients comfortably up to 2.4 milligrams weekly, which was the dose that they ultimately stayed on. In our experience, when we use it, we don't even usually go up to 2.4 milligrams. We can usually get enough benefit between one and two milligrams, and we usually move people along a little bit quicker. But we've definitely had our share of patients who can't tolerate it due to the nausea.
Andrew Huberman: Interesting.
Peter Attia: Which might be part of how it's working, right, is the sort of suppression of appetite which, if taken to an extreme, can produce nausea.
Andrew Huberman: Interesting.
Peter Attia: Yeah. I think most of the effect of semiclutide is central, not peripheral, so I don't know.
Andrew Huberman: I saw one paper that GLP one is acting both on cells in the periphery to cause gut distension in some ways, or sort of make people feel full through promotion of literally mechanical receptors that make people feel as if their stomach is distended even though their stomach is empty. And then perhaps some central hypothalamic effects.
Peter Attia: Is that yeah, I would bet 80% of it's in the hypothalamus. It is also improving insulin sensitivity in the periphery, but I don't think that that's accounting for much of its benefit.
Andrew Huberman: Super interesting.
Peter Attia: And there's next gen versions of these that seem to be more long lasting. So right now, if you look at coming off semaglutide, you're going to see a weight regain. So there's newer versions that seem to preserve the weight loss, even off the drug. So it begs the ultimate question, which is, like, what's the total use case for this going to be? Is this going to be a drug you cycle on and off, or is it going to be a drug that a person has to stay on indefinitely? And if so, will they become tachyphylactic? Will they gain a resistance to it? So it's still super early days on these things.
Andrew Huberman: My hope is that it would be a little bit like the way that you describe testosterone and estrogen therapies, that it would allow people to do more of the behavioral work that's absolutely required for health span and lifespan. |
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} | Andrew Huberman: Speaking of frontiers, I hear a lot nowadays about GLP one and pharmacology, that prescription drugs that mimic or increase GLP one directly, glucagon like peptides. People are talking about this as the blockbuster obesity drug. I haven't heard this much talk about a drug to adjust human body weight favorably since the discussions of fenfen when I was in college. And then of course, fenfen was pulled from the market because people were dying, not left and right, but enough people died that they pulled it from the market.
Peter Attia: Which by the way, is an interesting story. It was the enantomer that they chose to use that was the wrong enantomer and what it resulted in was god, I think it was like some mitral valve. Was it MVP? Yeah, it was something in the mitral valve. Yeah, I think the corte tendin were rupturing in the mitral valve and it was mostly young women I think were getting horrible pulmonary disease as a result of it. Probably pulmonary hypertension or something like that. But there were two enantomers of the drug and had they just used the other one, this issue wouldn't have happened. And there was a stupid reason why they made the choice to use the one they did. And it's one of those things where once you make the mistake, you're never going back. It's not like that company could say, okay, we want to do over but we're going to do it with the right version. So it's a tragic outcome, but you're absolutely right.
Peter Attia: I think the GLP one agonists have more efficacy and for all intensity and for everything we can see, certainly seems safer.
Andrew Huberman: Are you excited about them?
Peter Attia: Yeah, I am. Yeah, I think we're just seeing the kind of tip of the iceberg. They're not miracle drugs, right. They come with problems. Right. Which is they're catabolic across the board. So patients are losing fat, but they're losing muscle as well.
Andrew Huberman: Just sent all the gym jockeys running from semiglutin. That's all you have to say. All you have to say nowadays about something is that it's going to drop testosterone, lower fertility, change someone's skin, hair or nails, and it could extend life to being 250 years old and people are gone. Humans are human. That's a neuroscience and psychology issue, not a biology medicine issue. But I'm pleased to hear that you're excited by them, because I hear a lot of excitement. I haven't heard anything disastrous about them. |
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} | Andrew Huberman: Shifting to a less esoteric and I think probably more important topic overall, metabolomics. Talking about this before we sat down to record what is what are metabolomics? Why should we be thinking about them? I have some idea of what it might be about, but most people, I think, are not thinking about metabolomics at all. And for those that are, I'm sure they could learn more. So tell us about metabolomics and what you'd like to see more of in the world of metabolomics.
Peter Attia: Yeah, so omics is just the term that we use to describe the study of something. So genomics, right, is, like, the broad study of genes and proteomics, the broad study of proteins and things like that. So metabolomics is the study of metabolites. And metabolites, unlike a lot of these other things, they're a relatively finite number of these things, many of which are known, but some of which are not known. So glucose is a metabolite. acetylCoA is a metabolite. Lactate is a metabolite. And so the question is, what do we know about these things and how they work? And more importantly, what do we know about certain physiologic states and the metabolomic profile that results from them? So let's use two extreme examples, like exercise. Everybody understands the data are unambiguously clear. Exercise produces about the most favorable phenotype imaginable. So if you wanted to take a genomics approach to understanding that, you might look at, is there a change in the genome when you exercise? And the answer is probably not. But maybe if you looked at the methylation patterns and epigenome, you could look at epigenomic studies, but you might instead look at kind of the proteomic side of that, like what is gene expression doing? And there you would see a lot of changes.
Peter Attia: Well, what I don't think people are really understanding, although there was a very interesting paper that just came out two weeks ago that looks for novel metabolites that are changing. Is there a huge signal in a metabolomic profile that looks different in the state of exercise versus nonexercise? And could that represent part of how exercise is transmitting its benefit through the body? People always talk about the Holy Grail of metabolomics would be can you find a pill to mimic exercise? And I think the answer to that question is going to be undoubtedly no for a couple of reasons. One, even if you could mimic the longevity sort of lifespan parts of it, you could never mimic the health span parts of it. But what if you could do both, right? What if there were small molecules that can replicate some of the protective benefits of exercise and you could combine those with exercise? What if those could be treatments for other disease states like diabetes, things like that. So that's why I think this field of metabolomics is relatively untapped and I think potentially the next sort of frontier. |
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} | Peter Attia: That was the right patient population to get that. So will we ever get there? I don't know because I don't see what the incentive is, right? You have people who are making money hand over fist doing procedures on the basis of I'm not sure what, what would their motivation or incentive be to sort of see this legitimized. You'd really have to be able to say, well there really needs to be sort of a pharma angle to this. It's sort of one of the wishes I had, right? Like if I was a billionaire, I feel like the way I would probably waste all of my money would be running clinical trials on stuff nobody cared about.
Andrew Huberman: Likewise I would join you because that would be yesterday we recorded a sit down with somebody from Caltech who works on aggression and rage and other things related to that and has identified peptides that are approved. The FDA for other reasons that seem to adjust anxiety, might even adjust aggression, pathologic aggression, and went off onto a long description of why none of these drugs exist on the market for the treatment of psychiatric illness and yet probably would work. And what's missing is a billionaire or a billion dollar company that is willing to invest in something that very likely will work but the market value isn't quite there or it failed in a previous trial and so no one wants to touch it with a ten foot pole. Hopefully someone listening to this will be incentivized to provide this sort of venue for the kind of work that we're talking about. I have to ask, but I want.
Peter Attia: To make one other point, Andrew, which is to me the problem with a lot of these things is it's a crutch. It's sort of like what we talked about with like, hey, just fix my team man and everything's going to be fine. And it's like, no, that's just the beginning. What I worry about when I see people who are clamoring for this stuff is a lot of times they don't realize that whether it's psychologically or otherwise, they sort of say, well now that I've had this thing done, I don't have to do the hard work of the real rehab. I mean, if I've learned anything through my shoulder surgery and I'm now three and a half months out, how does it feel? Amazing. I mean, look, I still can't do a lot of stuff. It's going to be a while. I haven't even been able to shoot a bow yet and it'll probably be a year before I'll go back to long dead hangs and heavy deadlifts. I don't know, maybe nine months, but I'm not there yet. But what I learned through a really amazing prehab and rehab process is you just got to do the work, and it's freaking hard.
Peter Attia: Shoulders are the most tedious, boring thing in the world. I mean, three days a week I am doing four days a week, I am doing 1 hour of just dedicated stuff for this shoulder that is super uncomfortable, super boring, super frustrating. But I have faith in the methodology, right? And I think a lot of people are saying, just shoot the stem cells into me, and I don't have to do any of that stuff. And the reality of it is, I think that's a very dangerous place to be.
Andrew Huberman: Have you ever tried BPC? One five, seven?
Peter Attia: Yeah, we tried it again maybe seven, eight years ago. We had a bunch of patients ask about it. So my view is, okay, I was pretty convinced that there was no safety downside to it, so I was like, Well, I wouldn't prescribe it to a patient unless I tried it myself. So me and another doc in the practice, Ralph, we did it for, I don't know, a couple of months. I didn't notice a single thing.
Andrew Huberman: Interesting. Well, thank you for that. |
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} | Peter Attia: Though it might seem to have some efficacy in some indications. For example, maybe when it comes to early hair loss, maybe when it comes to certain joint issues. But the reality of it is I think we just have to accept the fact that everything we do has an opportunity cost. And that opportunity cost is sometimes financial. But I actually find a lot of times it's in time and effort and energy that goes into something. Now, when I was waiting to get my shoulder surgery, this is an injury that I've had forever, right? This is an injury. This injury was actually probably the greatest source of discomfort I had swimming the Catalina channel the last time in 2009. So that tells you how long I've had this injury. But I sort of knew at some point I'm going to have to have it fixed. And I sort of went down this rabbit hole like, hey, is there anything I can do to avoid having surgery? Would infusing a million stem cells into it work? And in speaking with as many orthopedic surgeons as I could, the answer was kind of unambiguously no. And by the way, it doesn't mean you wouldn't feel better if I injected a bunch of stem cells into your shoulder.
Peter Attia: There are a lot of reasons that might make you feel better, just like there are a bunch of reasons you can feel better if somebody injects saline directly into your joint. The question is, is it going to fix the underlying problem? And if so, will it do so? By what mechanism? So I'm pretty sure that if you took 1000 people with my particular injury and injected them with stem cells it wouldn't do a thing. Because of the nature of my injury, I had a complete laboral tear. Are there some injuries that might benefit from it? Yeah, possible. So the question is, how would you design the trial to narrow down your patient population correctly so that you might see a signal because the other risk of doing a trial is you have too much of a heterogeneous patient population, you don't know what the heck you're really doing and you get meaningless results. You get a null result when in fact there's a small signal but you were underpowered to pick it up because you only had 10% of your patient population. |
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} | Andrew Huberman: The esoteric question relates to something that I think is a little bit niche, but not necessarily so, which is peptides and stem cells in PRP. I don't want to go off on too much of a tangent on rehab, but I know you've done a number of posts on social media recently that I have to tell you are really thoughtful. And I really appreciate that you're willing to share your own tissue rehabilitation experience and point people. That because this is a landscape that a lot of people are in and they don't know how to navigate it. And a mutual friend of ours, not to be named, sent me a text and said I'm going to be talking to Attia. And what do you know about studies on things like BPC one five seven, this, gastric peptides that, anecdotally, again, anecdotally. People report getting injections of this into shoulder, knee, et cetera, and feeling so much better, so much faster. But there really aren't good studies, controlled studies, and you hear all the same sorts of things about plateletrich, plasma, PRP, which if someone tells you there are a lot of stem cells in them, they're lying, there's not a lot of stem cells in them. And you also hear about stem cells which are not FDA approved, at least for most uses in this country, but are certainly people are flying down to Colombia and getting injections. And what is your understanding or experience with things like BPC One five seven?
Andrew Huberman: Specifically, because peptides is a huge landscape, we should probably do a whole episode on peptides, things like PRP, PRP is now approved for, I mean, women are getting injections of this into their ovaries to improve follicle count. We know this. People are getting injections of PRP into every tissue and organ. Hell, men are getting injected in their penis, so I hear, for all sorts of reasons that are unclear to me. What's the deal with PRP, BPC One five seven and stem cells? Do you ever see interesting effects? Are you curious about these compounds? Do you prescribe or direct people towards these, the FDA approved ones?
Peter Attia: Of course. Yeah, so short answer is I'm definitely curious about them and I'd love to see the work done. But I also think this is about as wild, wild west as it gets PRP, less so, but certainly stem cells and peptides. And I just think if you're going to do something without a clinical trial you got to show up with a lot more data, right? So let's use Rapamycin as an example, right? I'm a huge proponent of Rapamycin and you can say, well Peter, how can you take or prescribe Rapamycin for zero protective effects when we do not have a human clinical trial demonstrating that it lengthens life? And the answer is because I have 84 other pieces of data that all point in the same direction across every model organism going back more than a billion years and that's really different from Joey, Sammy and Sally did this thing and I think it works and they just can't be compared. Now I have no idea if stem cells work. I have no idea if BPC one five seven works. I have no idea frankly if PRP even works. |
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} | Andrew Huberman: This sounds so important sounds like the most important conversation because all the hormone stuff and all the stuff about smoking and head injuries and ADHD and all the rest, I mean, is irrelevant if you're dead, right?
Peter Attia: Yeah, it's a great question. I don't think I have a great insight as to why this isn't more front and center. I think the bigger problem is why don't we even understand how to think about it? And there's a whole chapter in my book I'm working on that really gets to this problem of why aren't we looking at atherosclerosis in terms of treating the causative agent. Instead, we look at modifying tenure risk. So that's the fundamental difference between what I call Medicine 2.0 and Medicine 3.0. Medicine 2.0, which is what we're generally practicing today when it comes to asCBD, says, look, we will treat you. We will lower that LDL cholesterol. They still don't talk about ApoB, but that's a very American thing. If you go outside of the United States, everybody's talking about ApoB. It's in the guidelines in Europe and Canada and everywhere else. The United States is very stubborn on this, and it's due to a couple of really weird personalities in the lipid world. But the paradigm is when your ten year risk reaches 5%, when there's a 5% chance that you're going to have a heart attack, estrogen or die in the next ten years, now it's time to treat you.
Peter Attia: Medicine 3.0 says, that's not the way to think about it. You treat the causative agent. If there's a causative agent, you treat it. If blood pressure raises the risk of heart disease, you lower blood pressure. If smoking raises the risk of something, you treat smoking. And the reason that the risk model is so bad when you're looking at ten year risk is age is the biggest driver of risk. I mean, bar none, right? So if you take a 70 year old with perfect lipids and perfect blood pressure and perfect everything, their ten year risk of ASCVD is probably four to five times higher than the most unhealthy 30 year old. It's not even close.
Andrew Huberman: It's a lot like eye disease. There are exceptions, of course, but you always say that the biggest risk factor for going blind from glaucoma is being an older person, frankly.
Peter Attia: So if you could identify what the risk factors are for glaucoma, imagine if the paradigm was we're only going to treat it when your risk of blindness reaches 5%, which isn't triggered until you're old enough anyway. Wouldn't you rather know that when you're 30 and say, wait, if maybe being in the sun without sunglasses or using this type of eyedrop or something like that has a negative impact, I would rather know that sooner. So that's the fundamental difference. It's a philosophical difference with respect to prevention. And I will acknowledge that in one element of prevention, I make no consideration. I am only coming at this through the lens of the individual. I am never coming at this through the lens of society. That makes my life easier and it makes the problem I'm solving easier. I don't have to answer the quality adjusted life year problem. I don't have to ask the question, is it economical to treat people at 30? I don't know the answer to that question. But I also know that when you're trying to solve really complicated problems, the more you can simplify, the better. So I've just acknowledged openly not solving that.
Peter Attia: If you want to criticize me for it, that's fine, let's be transparent. But all I care about is the person I'm sitting across from. And in that situation, it's really their decision if they can justify the cost of treatment.
Andrew Huberman: An esoteric question and then a less esoteric question. |
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} | Andrew Huberman: Okay, so then Monday rolls around and I, like most everyone else out there, I work on Monday, I get right into my emails and preparation for podcasts and running my laboratory, et cetera. However, I make sure that at some point on Monday, and for me that some point is typically and ideally early in the morning, so 7:00 AM or so, I train my legs on Monday, so that includes quadriceps, hamstrings, and calves. Why do I do that workout on Monday? And what is that workout designed to do? Well, that workout is really designed to make sure that I'm either maintaining or building strength in my legs. And this is not simply for aesthetic reasons. This is not simply to grow bigger calves or grow bigger quadriceps and hamstrings, although it can accomplish that as well depending on how you train. We'll talk about details of training. The reason for training legs on Monday is several fold.
Andrew Huberman: First of all, they are the largest muscle groups of the body, and by training your legs on Monday, it sets in motion a large number of metabolic processes that carry you some distance even through the whole week in terms of elevating metabolism, in terms of amplifying certain hormonal events in your body, et cetera, that are really beneficial. In addition to that, I'm of the belief that the legs are the foundation of the body, and provided you can train legs safely, that training legs is vitally important, not just for strength of the legs, but also for strength of your entire body. Again, some of that is through systemic hormonal effects because if you're going to train the large muscle groups of your body under substantial loads, you will get systemic release of hormones, not just testosterone, although certainly testosterone, but also things like growth hormone...
Andrew Huberman: You get increases in all sorts of so-called anabolic hormones that even if you're somebody who's not trying to increase muscle size, because I realize a lot of people are not trying to do that, these are hormones that shift your metabolism and your overall tendon strength and ligament strength and overall musculature into what I would call a strong foundation. So for me, Monday is leg workout. It also just feels good to get the leg workout out of the way earlier in the week, and it accomplishes another goal, which is that I sometimes will take one or two days off of a leg workout because they can be very intense and they are large muscle groups, and I'll explain what I do on the off days, they're not pure off days, they actually include some recovery type training or even some all out training. But by training legs on Monday, I'm able to get what I consider the hardest strength and hypertrophy workout out of the way, and, again, set all those positive physiological effects in motion for the entire week.
Andrew Huberman: The other thing is that no workout exists in isolation. What you do one day is going to be determined by what you did the previous day. And even though the previous day I may have taken a three hour weight vested hike, never are my legs so sore from that long slow endurance work, because it is long and slow, that I'm unable to train legs. Contrast that with a, say, high intensity interval training workout, which comes later in the week, and my legs might be sore. In fact, they might not even be recovered such that I'm able to do a real legwork, I want to say a real workout. I'll describe what that means in a moment. So legs come on Monday, and I think that for those of you that are using or interested in using resistance training, I suggest getting your leg workout done early in the week. And for those of you that have heard the phrase, don't skip leg day, I will go a step further and say, don't skip leg day, in fact, make leg day your first day of strength and hypertrophy training.
Andrew Huberman: Put it on Monday. |
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} | Peter Attia: Exactly. Right. We call it backcasting. So the first step we do is once we've really delineated what the objective function looks like, we then say, okay, how do you break down that into metrics that we can measure? So you describe doing a whole bunch of things. Okay, just to let you know, to do that will require A-V-O two max of 30 oxygen per minute per kilogram. And the person will say, okay, what does that mean? We'll say, well, that's a measure of your maximal uptake of oxygen, and that declines at about 8% to 10% per decade. So if you have to be at 30 and let's just assume you're going to be doing that at 90, so what do you need to be at? 80, 70, 60? Okay, here's what it would need to be at 50. Okay, what are you now? There's a big gap. You're below where you need to be now. So you're obviously higher than 30 now. But if you're only at 42 now and you need to be at 30 and 40 years, you're not going to cut it. You have to be a lot fitter. Okay.
Peter Attia: Now let's do the same exercise around strength and stability. And without exception, most people when they do this exercise will find out they're well below where they need to be. So the gravity of aging is more vicious than people realize, and therefore the height of your glider needs to be much higher than you think it is. When you're our age, if you want to be able to do the things we probably want to be able to do when we're 90.
Andrew Huberman: I absolutely love this approach. I've never done it in terms of my health. I've always thought about what I want to accomplish in the next three to six months or next year or so.
Peter Attia: And by the way, that's a great approach. That's forecasting. Forecasting is fantastic. Forecasting is really good at short term things. It doesn't work for long term things. Long term, you have to do backcasting.
Andrew Huberman: This backcasting approach really appeals to me because in my career, exercise me, I never anticipated I'd be podcasting, but that's what I did. At some point as an undergraduate, I looked professors. That looks like a pretty good life. They seem pretty happy. I talked to a few of them, and then I figured out what I need to do at each stage in order to get to that next rung on the ladder and just kind of figured it out in a back casting kind of way, as you refer to it. I think it's incredibly useful because it puts all the questions about blood work and how often to get blood work and what to measure in a really nice context. That's a highly individualized I've never heard of this before, and I should give.
Peter Attia: A nod to Annie Duke. I used to always refer to this as reverse engineering, but in Annie Duke's book, she wrote about this exact thing and called it backcasting, and I was like, I like the term backcasting better. I think it's more intuitive than reverse engineering.
Andrew Huberman: Yeah, there's a real genius to it because it sets so many things into the appropriate bins and trajectories. |
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} | Peter Attia: It's a very serious exercise, right? Like what? Tell me everything that is going to happen in your marginal decade. I don't know when it's going to be. Andrew. It could be 87 to 97. If we're doing well. Right? It might be 79 to 89. I don't know. But it would really be a very nuanced exploration of that topic. And I think until you do that, all of this other stuff is just abstract and kind of nonsense. Until a person can tell you what it is that they want to be doing in that last decade, you can't design a program to get them there. I mean, think about it. Someone wants to do an iron man. We take it for granted that we know what the objective is. I have to be able to swim two and a half miles. I have to be able to get out, take my wetsuit off, hop on my bike, ride 112 miles, get off my bike, take the bike shoes off, put the run shoes on, run 26.2 miles. We get it. We know what the objective is. And only by knowing that can you train.
Peter Attia: Can you imagine if I said to you, andrew, I'm going to have you do an athletic event in a year, start training. I'm not going to tell you what it is, just do it. It could be playing basketball, it could be swimming to Catalina Island, it could be running 100 miles. You wouldn't be able to do it. So similarly, if we don't know what our marginal decade is meant to be, there's no way to train for it.
Andrew Huberman: Do you think this is a good exercise for anyone and everyone to do on their own, regardless of age? Here I'm hearing this and I'm thinking, I need to think about when my last decade might be and what I want that to look like.
Peter Attia: Absolutely. I mean, when I say we do it with our patients, that's only because that's the population I work with. But there's simply no reason everybody shouldn't be going through this exercise.
Andrew Huberman: And then you sort of backscript from there, figure out what people should be doing given their current health status. |
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} | Andrew Huberman: You mentioned falling and the problems with falling and breaking things and mortality related to that. I wonder whether or not there are also healthspan related effects of just having weak bones that are not just about falling and breaking a bone and dying a year later, even though that's obviously very severe. Because I think when people hear about that, some people might think, well, I'll just be more careful. I just move more slowly. I'll sit in a wheelchair if I need to, even though I might be able to walk if it keeps me from falling. Some people, I think, adopt that mentality. What are some of the benefits of having high bone mineral density for men and women that are perhaps independent of risk of injury?
Peter Attia: Well, I think it's actually the inverse of what you just said. Right? It's sort of like you have to sort of be able to articulate what it is you want in your marginal decade. So we use this thing in our practice called the marginal decade. Marginal decade is the last decade of your life. So everyone will have a marginal decade. That's the only thing I can tell you with absolute certainty. Right.
Andrew Huberman: I believe you.
Peter Attia: There's no immortality. There's no hidden elixir that's going to help us live to be whatever. I mean, we're all going to be in our last decade at some point. And outside of people who die suddenly or through an accident, most of us know when we're in that marginal decade. You might not know the day you enter it, but most people who are old enough, if you tell them, are you in the last decade of your life? They probably have a sense that they are. So I think the exercise that we like to go through with our patients very early on is have them in exquisite detail, more detail than they've ever considered. So we have to prompt them with, like, 50 questions, lay out what their marginal decade should look like.
Andrew Huberman: Wow, that's a serious exercise. |
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} | Andrew Huberman: I highly recommend people check out Dr. Atia's podcast. The drive is excellent, as you can imagine, based on today's conversation, and it's easily available on Apple, Podcast, Spotify, Overcast, and Google. Please also check out Dr. Atia's website. It's Peteratiamd.com. There you can find links to his podcast episodes as well as a sign up for his excellent weekly newsletter. That newsletter provides terrific information related to health that anyone can benefit from. If you're learning from and or enjoying this podcast, please subscribe to our YouTube channel. That's a simple zero cost way to support us. Please also subscribe to the podcast on. Spotify and apple. And on both Spotify and Apple, you have the opportunity to leave us up to a five star review. If you have questions or comments or suggestions about topics you'd like us to cover or guests you'd like us to interview on the Huberman Lab podcast, please put those in the comment section on YouTube.
Andrew Huberman: We do read all those comments, and we do take them to Heart. Please also check out the sponsors mentioned at the beginning of today's podcast, and check out Momentous Supplementation, our new partners in the supplement space. And check out athletic greens. That's the best way to support this podcast. If you're not already following us on social media, please do so. We Huberman Lab on Twitter and we are Huberman Lab on Instagram and both places I cover science and science related tools, some of which overlap with the content of the Huberman Lab podcast, but much of which is unique from the content covered on the Huberman Lab podcast.
Peter Attia: Again.
Andrew Huberman: That's Huberman lab on Instagram. Huberman lab on Twitter. Please also check out our Neural Network monthly newsletter. This is a newsletter that has summaries of podcast episodes. It also includes a lot of actionable protocols. It's very easy to sign up for the newsletter. You go to Huberman Lab, click on the menu, go to newsletter, you supply your email, but we do not share your email with anybody. We have a very clear and rigorous privacy policy, which is we do not share your email with anybody. And the newsletter comes out once a month and it is completely zero cost. Again, just go to Huberman Lab and go to the Neural Network newsletter. I'd also like to point out that Huberman Lab podcast has a clips channel. So these are brief clips anywhere from three to ten minutes that encompass single concepts and actionable protocols related to sleep.
Andrew Huberman: To focus interviews with various guests, we talk about things like caffeine, when to drink, caffeine relative to sleep, alcohol, when and how and if anyone should ingest it relative to sleep, dopamine serotonin, mental health, physical health, and on and on. All the things that relate to the topics most of interest to you. You can find that easily by going to YouTube. Look for Huberman Lab clips in the search area. It will take you there subscribe, and we are constantly updating those with new clips. This is especially useful, I believe, for people that have missed some of the earlier episodes, or you're still working through the back catalog of Huberman Lab podcasts, which admittedly can be rather long. And last, but certainly not least, thank you for your interest in science. |
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} | Peter Attia: Yes. And we've also seen on the flip side of that, you can cheat through semiglutide, right. People who, you know, you can drink a lot of calories and sort of get around the drug. So, for example, we always encourage patients who want to lose weight to really just eliminate alcohol. That's the cheapest, easiest trick to lose weight. And so if you're still drinking a lot of alcohol, which is incredibly caloric and just drinking a lot of caloric stuff, we've seen that that's less this is just anecdotal with our patients, but we've seen that it's easier to get around the benefits of the drug that way.
Andrew Huberman: Interesting. I so appreciate your answers today. First of all, they were incredibly thorough and pointed towards real world application. I also just want to thank you more broadly for the work that you do, because obviously you have this incredible clinical experience and patient population that you work very closely with. But I see you really as one of the few, both clinicians, and I realize you're an MD. Did you do a PhD as well? No. But I consider you a scientist clinician. Clinician scientist is the appropriate wording of that, of course, in the way that you really still drill into studies in detail. I know a lot of clinicians, not all of them do, that for sure. And the fact that you're so hungry for the new incoming knowledge as well as the old literature. So it's an incredibly rich data set in that brain of yours. And I really appreciate you sharing it with us both in your podcast, in the upcoming book, which I think that we'll certainly have you on here again in anticipation of that. But I know I and a ton of other people are really excited for the book and in the way that you approach social media and your podcast and going on podcast.
Andrew Huberman: Thank you so much. I learned a ton. I know everyone learned a ton.
Peter Attia: Thanks, Andrew. Great to be here, man.
Andrew Huberman: Thank you. Thank you for joining me today for my discussion with Dr. Peter Attia all about the things that we can do in order to maximize our lifespan and health span. |
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} | Peter Attia: Again, I think in terms of actual comparing it in a placebo, no effect whatsoever. Right. So does that mean that you put a patient on it, they won't complain of something? No. But if you look at clinical trials, there's no evidence whatsoever that statins impair cognition. There's also no evidence in clinical trials that they accelerate the risk of neurodegenerative disease. In fact, it's the opposite. Now, there's a very nuanced case we make, Andrew, which is we'll look at patients with highly suppressed desmol levels, we will back off. We do want to maintain Desmond above a certain level because of some evidence that is still, I think, very preliminary but enough for us that we say, why take the chance? We have so many other tools to lower cholesterol. Why would we over suppress synthesis in a susceptible individual? So the next tool you look at is a drug that blocks the absorption or the reabsorption of cholesterol. Remember that neiman pixie one like one transporter. So that guy has a drug called Azetamib that just mechanically blocks it. And that's why I mentioned earlier we measure all those sterols in people, so we also measure things called phytosterols and the phytosterols give us an indication of how active that transporter is. So the higher your phytosterols, the more likely you are to respond to zetamide.
Peter Attia: Next class of drugs is a drug that blocks cholesterol synthesis, but only in the liver. So the statin does it globally. This other drug called bempidoic acid does it only in the liver. So it has a very similar mechanism to statins. Different enzyme, not quite as potent, but way fewer side effects. So any patient that's having a response to statins that's adverse will try this.
Andrew Huberman: Other thing, what's it called, one more time?
Peter Attia: Benpidoic acid.
Andrew Huberman: Benpidoic acid. |
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} | Peter Attia: Well, nutritionally, you basically have two big tools, right. And it depends on what's driving up apob. So apob, remember, is the concentration of LDL and VLDL particles. And what do they carry? Cholesterol and triglycerides. So anything that reduces cholesterol and reduces triglycerides is going to reduce apob. Triglycerides are generally driven by carbohydrate intake, so more insulin resistance, more carbohydrate intake, more triglycerides. Clinically, this is readily apparent to anyone who treats patients. If you restrict carbohydrates, you will reduce triglycerides. That just happens all day long. But if you reduce triglycerides by raising fat intake so much, it can still raise apob. So you have to be able to think about it. In an ideal world, it's can. You lower saturated fat, which tends to be the one that is most driving apob while lowering carbohydrate, and then see what you can get. But here's the reality of it.
Peter Attia: Is there's nobody with dietary intervention that's going to get to a level of 30 milligrams per deciliter. I've never seen any pure dietary intervention.
Andrew Huberman: Yeah, so what are the other things?
Peter Attia: It's got to be pharmacologic at this point.
Andrew Huberman: Statin type intervention.
Peter Attia: Well, now you have multiple classes of drugs, so the tried and true is the statin. So statins work by inhibiting cholesterol synthesis, and the net effect of that. Is that? So the liver is really sensitive to cholesterol levels. It doesn't want too much, it doesn't want too little. When you inhibit cholesterol synthesis, the liver says, I want more cholesterol. So it puts more LDL receptors on its surface and it pulls the LDL out of circulation. That's what lowers the LDL in the circulation. So again, nine statins in use today, we typically use four of them. The side effect profile, contrary to kind of all the sort of statin hating propaganda out there, very benign. Right. 5% of people experience muscle soreness which reverses upon cessation.
Andrew Huberman: Cognitive effects. |
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} | Andrew Huberman: I see. So for somebody who, let's say their total cholesterol is let's just stay with 200 for simplicity, what do you like to see in terms of the HDL LDL ratio?
Peter Attia: Couldn't care less. I only care about apob. I only care about apob. I care about the causative agent of atherosclerosis. Apob is the thing that drives atherosclerosis.
Andrew Huberman: And what levels are attractive or repulsive for you? When you see levels of apob that are blank, you get really concerned.
Peter Attia: It depends on the person's objectives. So, again, we take a very different view.
Andrew Huberman: I mean, we have vitality now, live to and I want to live to be 100.
Peter Attia: Yeah. Assuming some tape, if you tell me you want to live to be 100, you're going to need to keep your apob below 30 milligrams per deciliter.
Andrew Huberman: Let's say I want to live to be 100. Well, how about I don't care how long I live, but I want to feel great while I live?
Peter Attia: Again, it depends, right. Like anybody who's had a heart attack is going to be compromised in their ability to feel well after. Right.
Andrew Huberman: I guess I may say it that way, because if you're going to tell me that in order to achieve that live to 100 level, I'm going to have to give up my personal life and my no and my brain functioning, then I'm not really interested.
Peter Attia: Sure. But to get LDL levels, and really, again, people think of it as LDL, it's really apob. Right. Apob is this total concentration of LDL and VLDL, and that's what matters. Those are the big atherogenic particles. LDL also includes the LP Little A, although the concentration of LP little A is, relatively speaking, so small that it doesn't generally show up as much in the apob. So we treat apob, and basically what it comes down to is you want APO B to be as close to the level as it was when you were born. So we start developing heart disease when we're born. That's just the way it is. The autopsy studies make this abundantly clear when you look at autopsies of young people who are dying in their twenty s, and this was first done in the 1970s, it was again repeated again, it's always done after we have a war. Right. So in the 1970s, it was done on people who died in Vietnam. In the early 2000s, it was done on mostly young men, but some young women who were dying in Iraq and Afghanistan. And we saw without any ambiguity that cardiovascular disease is already taking hold in people who are 18 1920 years old.
Peter Attia: Wow. And to be clear, they aren't going to die of atherosclerosis at that age. They're still 40, 50 years away from it. But this is a lifelong disease, and we also know that the disease can't really develop until apob reaches a certain threshold. And that's the threshold that most of us get to by the time we're sort of in our teens. So it's this really young APO B level of kind of 20 to 30 milligrams per deciliter that makes it impossible to get atherosclerosis. So apob is necessary, but not sufficient to develop as CBD. Now that go ahead.
Andrew Huberman: I'm sorry, I was just going to ask what are some of the top behavioral nutritional supplementation, if any, based and prescription drug based ways to target apob? |
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} | Andrew Huberman: And while I think most people are familiar with the number of different variables associated with the resistance training, sets, reps, rest intervals, cadence, et cetera, there are also a tremendous number of very important variables for endurance in any kind of cardiovascular training. And there are a lot of excellent resources out there about that. I think the most important one, in fact I will go on record saying what I believe to be the most important variable for any endurance or cardiovascular training is that because it's a repetitive movement, that you are able to complete the movement safely, meaning you're not putting your body into range of motion or into positions that can damage joints or put you in any kind of compromised state. And some people might think, well, that seems kind of silly. But if you've ever set the, for instance, the seat too high on a stationary bike and then done Airdyne or assault bike type interval training sprints, if it's set too high and you're over-striding, as it were, the next day, you can really pay the price in terms of some back pain or sciatica. And sometimes that pain can extend for quite a while. So of course you don't want to approach any exercise with so much caution that it's neurotic and preventive and yet you don't want to approach any exercise in any way that's so cavalier, forgive the pun, Jeff, that you're also going to compromise the integrity of your joints and musculature and connective tissue. |
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} | Andrew Huberman: Welcome to the Huberman Lab guest series, where I and an expert guest discuss science and science based tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today marks the second episode in the six episode series with Dr. Andy Galpin, a professor of kinesiology at Cal State University Fullerton, and one of the foremost world's experts on the science. Andy app applications of methods to increase strength, hypertrophy, and endurance. Today's episode is all about how to increase strength, speed, and hypertrophy of muscles. Professor Dr. Andy Galpin. Great to be back. Last episode, you told us about the nine specific adaptations that exercise can induce, everything from strength and hypertrophy to endurance, muscular endurance, so on and so forth. And you gave us this incredible toolkit of fit tests for each of those adaptations so that people can assess them for themselves and then, of course, improve on each andy every one of them if they choose.
Andrew Huberman: By the way, people can access that information simply by going to the first episode in this series with you. And it's all there Andy timestamped. And I highly recommend people do that. Today we're talking about strength and hypertrophy, Andy. So right out the gate, I just want to ask you, why should people think about Andy train for strength and hypertrophy? And that question is, of course, directed towards those that are trying to get stronger and grow bigger muscles. But I know that many people out there perhaps have not thought about the benefits of strength and hypertrophy training and how beneficial it can be, not just for people that want to get bigger biceps, et cetera, but that have other goals, longevity goals and health goals unrelated to what most people associate with hypertrophy. So what are the benefits of training for strength and hypertrophy, for the everyday person, for the athlete, for the recreational exerciser and so on? |
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} | Andrew Huberman: I should just mention that catalog of supplements is constantly being updated. As mentioned at the beginning of today's episode, the Huberman Lab podcast has now launched a premium channel. That premium channel will feature monthly AMAs or ask me anythings where I answer your questions in depth as well as other premium resources. If you'd like to subscribe to the premium channel, you can simply go to hubermanlab.com/premium. I should mentioned that the proceeds from the premium channel go to support the standard Huberman Lab podcast, which will continue to be released every Monday per usual, as well as supporting various research projects done on humans to create the sorts of tools for mental health, physical health and performance that you hear about on the Huberman Lab podcast. Again, it's hubermanlab.com/premium to subscribe, it's $10 a month or $100 per year. If you haven't already subscribed to our zero cost newsletter, we have what is called the Neural Network Newsletter.
Andrew Huberman: You can subscribe by going to hubermanlab.com, go to the menu and click on newsletter. Those newsletters include summaries of podcast episodes, lists of tools from the Huberman Lab podcast. And if you'd like to see previous newsletters we've released, you can also just go to hubermanlab.com, click on newsletter in the menu, and you'll see various downloadable PDFs. If you want to sign up for the newsletter, we just ask for your email. We do not share your email with anybody. And again, it's completely zero cost. If you're not already following me on social media, it's hubermanlab on Twitter, on Facebook, and on Instagram. And at all three of those places, I cover topics and subject matter that are sometimes overlapping with the information covered on the Huberman Lab podcast, but that's often distinct from information on the Huberman Lab podcast. Again, it's hubermanlab on all social media channels. So thank you for joining me today for our discussion about building your optimal toolkit for fitness. And last but certainly not least, thank you for your interest in science. |
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} | Andrew Huberman: So thank you for joining me for this discussion of what I'm calling a foundational, or yes, we could even get bold and call it an optimal fitness protocol. Although the word optimal is a tricky one. There's no real optimal fitness protocol. And today what I've really tried to focus on is this foundational protocol because it does allow you to check off most, if not all the boxes related to strength, endurance, hypertrophy, speed, power, flexibility. It will also teach you how to regulate your nervous system up and down. That is to ramp up and focus, mind muscle link, et cetera, and then quickly calm down, physiological sighs, three to five minute decompress breathing at the end of training, et cetera.
Andrew Huberman: Really, even though I talked about the protocol that I follow, and again, that we will provide as a newsletter at hubermanlab.com if you want to look at it in more detail, even though we talked about it in the context of what I do, again, I really want to emphasize that this protocol and the description of this protocol and all its variables is really for you and for you to tailor to your specific needs. So please, take the protocol into consideration, but do not treat it as holy, treat it as a starting point from which you can adapt it to your specific fitness needs. If you're learning from and or enjoying the Huberman Lab podcast, please subscribe to our YouTube channel. That's a terrific zero cost way to support us. In addition, please subscribe to the Huberman Lab podcast on Spotify and Apple. And on both Spotify and Apple, you also have the opportunity to leave us up to a five star review.
Andrew Huberman: If you have questions for us or comments about the information we've covered or suggestions about future guests, please put those in the comments section on YouTube. We do read all the comments. Please also check out the sponsors mentioned at the beginning of today's episode. That's the best way to support the Huberman Lab podcast. Not so much today, but in many previous episodes of the Huberman Lab podcast, we talk about supplements. While supplements aren't necessary for everybody, many people derive tremendous benefit from them for things like enhancing sleep and focus and hormone optimization. The Huberman Lab podcast has partnered with Momentous Supplements. If you like to see the supplements of the Huberman Lab podcast has partnered with Momentous on, you can go to livemomentous, spelled O-U-S, so livemomentous.com/huberman. And there you'll see a number of the supplements that we talk about regularly on the podcast. |
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} | Andrew Huberman: Before we wrap up, I do want to emphasize one tool. It's a very easy, in fact, zero cost, very low time commitment tool. And this was one that was provided, again, by Dr. Andy Galpin when he was on the Huberman Lab podcast. And it's a tool that there is excellent research to support the effectiveness of, and that I do believe should come at the end of every training session. And that's to do three to five minutes of deliberately slowed breathing. It sounds so simple, three to five minutes of deliberately slowed breathing. So this could be while you're in the shower or when you arrive at your car, you might sit in your car quietly and do that if you have time or maybe even while you're driving back to, or onto your next destination, just to really slow down your breathing, to really look at the recovery period that has to follow each training session. And of course, during which the adaptations, the changes that make you more fit than you were going into the exercise occur. And that three to five minutes of deliberately slowed breathing has been shown in Andy's group and in related experiments, not exactly the same, but related experiments in our laboratory, in other laboratories, to really so-called downshift the nervous system and really set you up for maximal recovery, rapid recovery, and allow you to lean into the next training session with full intensity when that training session eventually arrives. So it's a very simple tool, but a very potent tool for your overall fitness. |
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} | Andrew Huberman: Earlier we talked about whether or not to train if you're sleep deprived and how to recover from what I would say is moderate sleep deprivation by doing NSDR as opposed to total sleep deprivation like being up all night or having a truly miserable night, which case, I think you should just skip training the next day and slide it forward. Now, a similar issue comes up from time to time where people wonder whether or not they should train or not if they're sick. And here there's all sorts of crazy gym lore and sport specific lore. For instance, I used to hear this, when I ran cross country, there was this adage that if the symptoms were from the neck up, you could still train. That is if you were really congested and you had a headache, you could still run. Whereas if it was in your chest and in your lungs you couldn't run. I don't think there's any data whatsoever to support whether or not that's true or whether it's not true.
Andrew Huberman: For myself, and because my general goal is to be training and fit over time, but also to include general health in the fitness equation, that is to not be sick or chronically sick and certainly not to get other people sick. If I have a little tiny sniffle, like I think I might be getting sick, even then, I'm a little cautious in the sense that I'm not going to do my typical workout. I might stop at about 15 minutes earlier. And I would do that not by neglecting any body parts or anything of that sort. If it's a weight training workout, by simply reducing the total number of sets, I probably wouldn't do any sets to failure, if I did, I might reduce the total number or percentage of sets to failure from about 30% of sets to maybe closer to 10% of sets, something like that. And if it was endurance work, I might throttle back by 10 or 20%. And I will shorten the total duration of the workout. And I often find that because of the known, yes, peer reviewed known immune system enhancing effects of exercise, sometimes that alone will allow me to avoid getting sick. But of course I'm also careful to get home, take a hot shower, not stress myself out, if I can avoid getting myself stressed out and focus on sleep, NSDR, other forms of recovery, good nutrition, et cetera.
Andrew Huberman: If however, I have a real sniffle, a cold, I'm not feeling well or I think I might be coming down with a flu, I absolutely do not train and I don't get back into training of any kind until I'm completely recovered. So what I'm basically saying is that, no, I don't believe you should train if you're sick. And perhaps equally importantly, when you come back from a layoff of any kind, whether or not because of illness or for whatever reason, I do believe that because your body is a bit untrained, it's not ideal to jump right back into maximal training and to take one, maybe two weeks of ramping up to the full duration and intensity of workouts that then I would continue on going for however many cycles I can complete before I hit another sickness or I hit another gap in my schedule due to family obligations or other obligations, et cetera. So we've covered a lot of tools and protocols and variables related to fitness, but we have by no means covered all the available tools and protocols and variables. |
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} | Andrew Huberman: Now the relax into the stretch is something has been talked about in martial arts circles and Pavel Tsatsouline has an excellent book on stretching, we can provide a link to that, talks about this, has a lot to do with relaxation of the nervous system and the way that the nerves innervate muscles and allow for stretch, if you will. Also, the way that the tendons and ligaments are innervated by nerves. The converse is also true. And here, again, this is a principle that Pavel has put forth, I believe he calls it irradiation, meaning irradiating out or emanating out from a source, which is that while exhaling and relaxing the torso, the midsection, some people call it the core, although some people don't like that term, can facilitate relaxation and stretching through a larger range of motion. So too can contracting the core, the midsection, or gripping very tightly with the fist can facilitate muscular contraction because of the way that the nervous system heavily, we can even say over-represents the fists in the brain. And so how would you apply this to your overall foundational fitness protocol?
Andrew Huberman: Well, it turns out that, let's say, you're doing a movement that involves one limb moving and then the other, let's say it's bicep curls, just for sake of example, turns out that you will actually be stronger in moving that dumbbell with the arm that happens to be moving if you grip the handle very tightly, but also grip the handle of the opposite dumbbell very tightly. Now that said, in between sets, I encourage you to do the opposite. To try and completely relax in between sets, combine that with the physiological sigh, and then when the set, the next set commences, employ that very strong grip, both, again, of the weight that's moving and the weight that at that moment might be stationary or in isometric position. So the nervous system, of course, is what controls muscles and that operates in both directions. If you want to relax, try and use long exhales, maybe even physiological sighs and really concentrate on mentally and physically relaxing, in particular your core and your fists. And if you want to generate force, right, you want to move a heavy barbell or dumbbell, you want to do a chin up with the maximal force, that's when you can employ the opposite, which would be to grip the bar or dumbbell, et cetera, very tightly. And you want to contract your core or even fill your body with air as a, say, plug all the leaks, et cetera. So this gets into kind of form and movement, which is an extensive near infinite landscape of discussion, again, that we don't have time to go into.
Andrew Huberman: I just want to mention those two nervous system related tips because I suppose as a neuroscientist, they appeal to me because they're grounded in fundamental principles of how the nervous system innervates muscle. And I know that they will benefit you the first time you use them and every time. |
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} | Andrew Huberman: We haven't talked so much about flexibility yet, but we did an entire episode of the Huberman Lab podcast on flexibility and I encourage you to check out that episode if you're interested in increasing your flexibility. But the basic takeaway from that episode is that if you look at what I like to call the center of mass of the research, that is most of the studies and what the conclusions of most of the quality studies point to, so not the exceptions, but the kind of general rules that have been gleaned over time from multiple labs over multiple decades, et cetera. What you find is that static stretching, that is, holding a stretch and in fact exhaling and relaxing the midsection and torso and relaxing into the stretch as opposed to staying full of air and tense, but mentally and physically relaxing into the stretch, but not stretching maximally, that is not extending as far as you possibly can go, but more like 60% or even less. And then holding those static stretches for anywhere from 30 to 60 seconds and then repeating, doing that two or three times throughout the week for multiple muscle groups, so it could be for your quadriceps, could be for hamstrings, for your lats.
Andrew Huberman: There are protocols out there. In fact, we have a newsletter that is focused entirely on protocols for flexibility and stretching. You can find that again by going hubermanlab.com. You don't even need to sign up for the newsletter, although we invite you to if you like, but you can simply go there, scroll down to the flexibility newsletter and all the protocols are there for each of the muscle groups, et cetera. But what I typically try and do is some stretching in the evening, because I train in the morning, as I'm perhaps getting ready for bed or if the TV is on, which in our house doesn't typically go on because we don't have a TV, but of course there are computers and people are on their computers, et cetera. Well, I'll try and do some stretching while I do that.
Andrew Huberman: I also have a standing desk, so during the day at work, regardless of whether or not I train that morning or not, or I'm going to train in the afternoon, I'll try and do some static stretching for my hamstrings, my quads, my lats, my shoulders, my back, really doesn't take much time and I really try to space that out throughout the week, which, if you look at the peer reviewed research, matches well to what's known to be most effective, which are going to be short, repeated sessions ideally every day. But truth told, I fail. I categorically fail. I was about to think of whether or not I ever stretch every day. I fail to do it every day, but I get about three or so stretching sessions in per week. And again, it's just static hold, trying to really relax into the stretch. |
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} | Andrew Huberman: And then I don't have to skip a workout entirely just because I didn't get a good night's sleep. A lot of people ask whether or not you should train fasted or fed, and this is a very controversial area. I personally prefer to do my cardiovascular work not having eaten anything in the previous 3 to 10 hours. And typically that's because I wake up and I'll do the cardiovascular training within about an hour of waking up, sometimes later, because my first meal generally falls, generally, not always, falls around 11:00 AM. I don't do any kind of formal intermittent fasting, but typically my meal schedule somewhere between 11:00 a.m. and my last bite of food is around 8:00 p.m. but I'm not super strict about that. I might eat in as late as 9:00 p.m. and I might eat something at 10:00 a.m. if I wake up really hungry, I might have something before 11:00 a.m., I'm not neurotic about it. But in terms of training, I like to train fasted and that includes the resistance training workouts and those come early in the day for me. And typically if I'm going to train legs on Monday, for instance, which is when I train legs, I'll make sure that the night before I'm ingesting some starch, some carbohydrate, like rice or pasta or something of that sort to make sure that when I do that morning leg workout, I have enough glycogen in the muscles, et cetera. Again, nutrition is a somewhat controversial area.
Andrew Huberman: In fact, it can evoke very strong feelings 'cause I know we've got vegans and we've got omnivores and we've got carnivores and people who are keto. This isn't really the format for us to get into all of that. I think the rule to follow is figure out what optimizes your training for your particular training goals. For me, that most often means training fasted and then eating pretty soon after I train. And if it's a high intensity resistance training workout, and frankly, all of my resistance training workouts are pretty high intensity, I'm not going to failure on every set, but at least, say, about 30% of those sets I'm going to failure. And the other sets I'm working very hard nonetheless, well then I eat some starches after I train and I also ingest some protein in the form of a protein drink or a meal that includes some protein food. But I don't like to eat before I do resistance training or at least not within the hour or two before I do resistance training.
Andrew Huberman: There are exceptions to that, and I should say that the same basically applies to endurance work. If I'm going to head out for a run, typically I don't want my belly full of food or any food at all, but there are times where I wake up hungry and I very much need to eat something or I have something scheduled socially like a breakfast and I'll have that breakfast and then an hour or 90 minutes later I'll do my workout because I want to make sure that I finish the workout. I, again, am not neurotically attached to training fasted or fed. For me, fasted is preferred, but if I have to train fed, better to train than to not train at all. |
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} | Andrew Huberman: Let's talk about some real world practical variables. For instance, let's say you get a poor to terrible night's sleep. Should you train the next day or not? Well, that really depends. I can honestly say I've had some of the best training sessions, resistance training or endurance training sessions after a really poor night's sleep. But that's the rare event. More often than not, if I'm not sleeping well, I've had a terrible night's sleep, the next day I will just skip training that day. I know that will shock a number of you out there, or perhaps you're already calling me names, weak, et cetera. But I find that if I've slept really poorly or I've had a very stressful event the day before and I don't sleep well, training the next day sets me up for getting ill and getting ill sets me up for not being able to train for multiple days. So it is my preference in that case to skip a day and really focus on recovery. And then, as I mentioned earlier, slide that workout to the next day and rarely double that workout up with another workout, but then just slide the schedule forward by a day. But I really try and strive, that is, I really try to double up at least some workouts later in the week in that case, so that I can get back on schedule of starting the seven day protocol again on the same day.
Andrew Huberman: I don't want to be excessively vague there. What I'm trying to say is I try and adhere to the same schedule, but if I get a poor night's sleep, I'll just simply skip the workout the next day, slide the workout forward. There is one exception to that, and it's an important exception, which is there are times when I've not slept well or I've had some particularly stressful event the day before and haven't slept well, but I'm able to do so-called NSDR, non-sleep deep rest the next day. So there have been times when I've only got three or four hours of sleep the night before and I'm feeling really behind the ball the next morning, but I really want to get my workout in. So instead what I will do is a 10, but ideally in that case a 30 or even 60 minute non-sleep deep rest. And there's a 10 minute non-sleep deep breath protocol read by me. But it is a non-spiritual, non-mystical, science-supported non-sleep deep breath protocol available on YouTube.
Andrew Huberman: You can simply put my name, Huberman, put NSDR, and Virtusan, V-I-R-T-U-S-A-N, into YouTube and you'll find that script. There are other NSDR scripts that you can find now on Spotify and on YouTube. And if you fall asleep during those non-sleep deep rest scripts, that's great. And if you don't, you will also find that it will restore your ability to perform mental and physical work. So there are times when I haven't gotten as much sleep as I would like, or I'm feeling a bit more stressed for whatever reason, and I'll do NSDR, and then I will go train. And that often works fabulously well for me. |
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} | Andy Galpin: You cannot get that through any other form of exercise besides heavy overload strength training. And we can walk through in detail what that is, but that is reason number one. In general, human movement is a function of number one, some sort of neuromuscular activation. So nerves have to turn on. The second part is muscles have to contract. And the third part is those muscles have to move a bone. All right? If you want to be alive and you want to live by yourself, you have to be able to engage in human movement. If you have any dysfunction in the neuromuscular system there, then you're not going to be able to do that. And again, as I mentioned, the only way to preserve that or fight that loss of aging is to strength training. So people will tend to hear numbers like you lose about 1% of muscle size per year after age about 40. And that's true. However, what they don't realize is you lose about two to 4% of your strength per year. So the loss of strength is almost double that.
Andy Galpin: The loss of muscle mass. With aging, muscle power is more like eight to 10% per year. And so we can very clearly see the problem you're going to have with aging is not going to be preservation of muscle, although that is incredibly important. It's going to be very specifically preservation of muscle power and strength. And why that really matters is your ability to, again, stand up and move, your ability to catch yourself from a fall, your ability to feel confident doing a movement that is a function of muscle power more than it is muscle size. Andy so functionality is really what we want to be, right? You want to be able to do whatever you want to do physically and feel confident in doing that as you age. That's going to only be obtained through strength training.
Andrew Huberman: So is it appropriate to say that training for strength and hypertrophy is also a way to keep your nervous system healthy and young?
Andy Galpin: Yeah, absolutely. It is the only exercise route we have for that. If you look at just basic numbers like motor units, you're going to see that older individuals have like a 30% to 40% reduction in total motor units.
Andrew Huberman: So when you say older, approximately what ages are you referring to? Because I know many people out there, such as myself, are 40 and older, but I know many of our listeners are in their 20s, maybe even in their teens. Andy I can imagine that people that start doing strength andy hypertrophy training younger will afford themselves an advantage over time, but that everybody should be doing strength and hypertrophy training for as much of their lifespan as possible. That's really the message that I'm getting. So if somebody is, for instance, 45, would that fall into the bin of older? |
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} | Andrew Huberman: Now that said, I do realize that some people might be hyper focused on things like strength and hypertrophy and the aesthetics that come with it. A key point about strength hypertrophy and weight training, and this is something that has been covered on multiple podcasts, certainly the one with Jeff Cavaliere and with Dr. Andy Galpin and the one that I did on building muscle strength and hypertrophy, the solo episode. And that is the following, it is the rare individual who has perfectly balanced musculature, right? Most people can be a bit quad dominant or hamstring dominant, or they have trouble activating their glutes or somebody has a terrible time trying to activate their chest muscles, but they're very strong in the back, et cetera. It's very clear that we can know that not just based on aesthetics, right, but based on deliberate contractibility of those muscles. So I don't want to get into this in too much detail for sake of time, but this is something that has peer reviewed research to support it and was also discussed extensively with Jeff Cavaliere when he was a guest. And that actually he's really popularized this notion and it's absolutely true, which is that if you can contract a muscle very hard to the point where it almost feels like it's cramping, if you can do that even when there's no weight in your hand or there's no resistance against it, so you're just using your mind muscle connection to contract that muscle hard and isolate it, chances are you'll be able to generate hypertrophy and strength gains pretty easily in that muscle compared to muscles that you have a harder time activating. So during all resistance training, that mind muscle link is really important, so much so that some people will even try and emphasize contraction of the muscles in between sets, et cetera.
Andrew Huberman: I personally, because I'm not somebody who likes a mirror when I work out, and I'm not somebody who wants to spend time in between sets flexing muscles and et cetera for whatever reason, I want to actually rest between sets, and I'm more concerned with performance during those sets and really putting my mind into the muscle during the set, I really try and emphasize deep relaxation between sets. And so here's a tool that again is built out of science and I should say peer reviewed studies, some of which are being done in my lab, but other labs as well, which is that in between sets what I really strive to do is to bring my heart rate down as much as possible, calm myself down as much as possible, and I'll do the so-called physiological sigh in order to do that. That's two inhales through the nose, back to back, and then long full exhale through the mouth. I just did it partially there for the sake of time, again. So a big deep inhale through the nose and then sneak in a little bit more on a second inhale to maximally inflate the lungs and the alveoli in the lungs, and then a full exhale of all your air via the mouth to empty your lungs.
Andrew Huberman: That's the fastest way that we are aware of to calm your nervous system down. And really, in between sets you can use that to calm yourself down and conserve energy. But then as you move into the weight training set, you really want to ratchet up your focus and attention to the muscles that you're going to be using. Now, I'd like to acknowledge that there's a huge range of parameters in terms of how to actually perform during the set. You can focus on a particular muscle and try and really isolate from the beginning of the movement. Some people will really try and isolate it only during the peak contraction. Some people accentuate the negative. There's speed and cadence. There are, again, remember, concepts are few, methods are many. And if you're interested in the various methods of eccentrics and concentrics and all the different ways of changing up cadence and so forth during sets, there's an enormous amount of quality information out there, far too much for us to get into detail now. But what I describe the general principles of how to set your mind, if you will, during the set, you should be focused on the muscles that you're using and or moving the weight.
Andrew Huberman: If movement of the weight is more important, you can either focus on moving the weight or challenging muscles, right? You can either try and isolate muscles and make specific muscles do the work or simply moving the weight. Moving the weight is going to be more geared towards strength improvements, but focusing on the muscle, so called mind muscle link is going to shift that very same set more toward hypertrophy. I realize I'm painting with a broad brush here, but nonetheless this is grounded in the way that the nervous system governs muscular contraction. |
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} | Andrew Huberman: So we've completed the total arc across the week and we can summarize it as saying Sunday is, let's just say long endurance, Monday is leg resistance training, Tuesday, heat cold contrast, Wednesday, torso training plus neck, Thursday, I would call it moderate intensity cardiovascular exercise, so that 35 minute moderate intensity cardiovascular exercise, Friday, high intensity interval training of sprinting or some variation thereof and Saturday, arms, calves, neck and torso, indirect work. That's the total structure. But I want to emphasize again, you do not need to start this on Sunday. That is, you could make the long endurance work start on Tuesday and then just fill in the rest as described before. It's really up to you. There's another important point I want to make, which is that neither I nor anyone is going to be successful in doing the exact workouts on the exact same days of every week because of travel, work, illness, other demands, et cetera.
Andrew Huberman: The thing about the schedule that I like so much that I do believe that will benefit you as well is that you have some flexibility there. What's the flexibility? Well, let's say you train your typical Sunday workout of endurance, then you train legs on Monday and then you don't manage to do your heat cold contrast on Tuesday for whatever reason. Well, you can put it on Wednesday. Just make sure that if you're going to do the cold stimulus, that you don't do it too close, not within four, ideally eight hours after the training of torso, but you could do it before or you could do it just heat and skip the cold that particular week, right? Not ideal, but better than not doing anything. Let's say, for instance, the leg workout was particularly brutal, you don't sleep that well on Monday night or Tuesday night. Well then should you do the torso workout on Wednesday?
Andrew Huberman: Well, I would say, why not move the heat cold contrast to Wednesday and then push that torso workout to Thursday and maybe also try and do that 35 minute run on Thursday every once in a while rather than lose the total control of the program and let everything shuffle forward. Here's the basic principle. I do believe that any one of these workouts, whether it's for endurance or resistance training, can be shifted either one day forward or one day back, right? You could delay it by a day or you could accelerate it by a day in order to make sure that you get everything done across the week.
Andrew Huberman: In fact, I would say the best way to think about this foundational fitness program is not from the details up, but from the top down, from the big picture down to the details, and say to yourself, once a week you're going to get some long endurance in, another day during the week, you're going to make sure that you get a kind of moderate faster endurance workout in, and then one other day during the week, you're going to get an all out sprint, high intensity cardiovascular exercise workout in. You're going to get those three workouts in somehow. And then in addition to that, you will also do resistance training for every muscle group in your body. And that means doing your legs hard at least once a week, your torso hard at least once a week and your arms hard at least once a week. And of course you are also paying attention to training your calves. And I do, for reasons I described before, believe that you want to train your neck at least to keep it strong.
Andrew Huberman: You may not want to generate hypertrophy there. People vary in terms of how quickly their neck grows. Some people grows very, very fast. Other people, for the life of them, they can't get much hypertrophy in their neck. But keeping that neck strong, at least through some very light work to moderate weight work, very, very important, for reasons I stated earlier. If you set out those goals, then the specific days that you do each workout isn't as critical, but the specific spacing is. So for instance, you're not going to want to do your high intensity interval training the day after you train your legs, because if you're doing that high intensity interval training correctly, you're going to be taxing your legs and eating into their recovery. And so you want to space them out by two or three days. So I think you'll notice that the point is really to optimize everything on the whole rather than any one specific aspect of training or adaptation. |
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} | Andrew Huberman: So we've covered Sunday through Friday, and then Saturday rolls around and Saturday is when you train arms, calves, and neck. So this may sound as if you're training a bunch of small muscle groups, biceps, triceps, necks and calves, and that's true, but I should mention that you are also training your torso a second time and you're doing it indirectly, or sometimes not indirectly. Why do I say this? Well, keep in mind, again, that for strength and hypertrophy, you're going for that once about every 48 to 72 hours, you want to stimulate that, on Wednesday is when you train your torso, right? Chest, shoulders, back and neck. You've had Thursday to rest, Friday to rest. I know a lot of people are going to want to emphasize those body parts and they're going to think, oh, you have to train it twice a week. But if you have modest recovery ability or low recovery ability, such as I do, and you're doing these other cardiovascular training sessions, et cetera, well then, on Saturday is when you will train arms, calves and neck directly. But included in that, remember, two exercises per muscle group, one with a peak contraction, one with somewhat of a stretch in there.
Andrew Huberman: Included in that, I suggest doing some sort of dip movement, which I think it was Pavel Tsatsouline said the dip is synonymous with or at least similar to an upper body squat. Excuse me, Pavel if I got that wrong. Maybe it wasn't you that said that, but big admirer of his work, and certainly the dip is a great exercise to hit multiple muscle groups, chest, shoulders, and triceps, maybe even some back to some extent depending on how you do it. So doing some dipping movement will indirectly stimulate strength hypertrophy, et cetera, in the chest and shoulders and including some sort of pulling movement for the bicep, like a chin up or palms facing movement, pulling up from to the bar, especially if it's a close grip type movement. But even if it's a wide grip type movement, will of course trigger strength and hypertrophy, maintenance or improvements in the biceps, but will also trigger strength hypertrophy in the lats in the back.
Andrew Huberman: Okay, so Saturday is this arm workout that I'll just give an example of a potential workout where you might do a few more exercises and maybe not just two, but maybe three to make sure you get the torso indirect stimulation. So what would this look like? Well, this might be your sort of classic dumbbell curls for the bicep and maybe incline curl for the bicep because it has more of a stretch on an incline bench, and then you might finish with two sets of chin ups. So palms facing you, chin ups, or three sets of chin-ups depending on whether or not you're in a heavier load month or a more moderate weight month. Again, activating the biceps muscles 'cause arms day, but also activating strength and hypertrophy in the lats or at least maintaining it so that, because you're not training those torso muscles again until Wednesday, you're not allowing the hypertrophy and strength gains that you generated on Wednesday to atrophy, to disappear.
Andrew Huberman: Then, thinking about triceps, it might be some sort of triceps isolation or peak contraction movement. So that could be tricep kickback or some overhead extension would be more of a stretch type movement than a kickback. But then also doing regular old dips. You might even start with dips, which again, are going to activate those torso muscles and the triceps. And then calf work in the same way that you did on Monday. And neck work... Again, I am a believer in training neck multiple times per week. And if you are able to finish all of that in 45 or 50 minutes, great. Most people will find when you're doing a lot of small muscle groups, it actually takes longer because you have to go around to more exercises. But again, just adhere to the same principles we talked about before, about 50, five zero, to 60 minutes of real work after a warmup with an asterisk next to that, that if someone's on the equipment or you can't find the dumbbells you need, et cetera, then maybe 75 minutes max. But really trying to not extend that workout too long, making sure that you activate the arms directly, but also activating the torso muscles indirectly, and again, I won't repeat it this time, again, but following the same weight and repetition and rest interval scheme that we talked about earlier, a bit heavier, lower reps, more sets and longer rest for about a month. And then alternating to more repetitions yet fewer sets, right?
Andrew Huberman: Shorter rest intervals and do that for about a month. This carries through for all the resistance training workouts regardless of the day of the week. |
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} | Andrew Huberman: That's simply not the case. But you're going to trigger strength and hypertrophy and other types of adaptations in those muscle groups. So this for me also represents the second leg workout of the week where I'm not touching any weights. One important point that I don't think I've heard mentioned anywhere else, but that I hope to have Dr. Kelly Starrett on the podcast to discuss and that I've discussed with him one on one, which is be careful with all out sprints or all out anything cardiovascular exercise, you can get injured doing those. So for instance, if you go out and you just sprint across a field, all out, 20 or 30 seconds and then walk back and can do it again and again, don't be surprised if the next day you have some sciatica or even some pelvic floor pain. I don't recommend going all out on any movement that you can't perform with perfect form. Okay? So for me, I really try and stay away from all out sprints.
Andrew Huberman: I'll sprint it about 95% of what I can do because I find if I go all out sprint, I don't know what the reason is, but it might be an over extension of a limb or something like that, I'm not a sprinter, I'm not a sprinting coach. I do hope to get Stu McMillan on here or Dan Pfaff, who are excellent sprinting coaches, at some point they were world class sprinting coaches, but I'm not a pro sprinter, I'm not even a amateur sprinter, I'm a fitness sprinter. So the Airdyne or assault bike or the rower is really a safer option for me. And if I'm running or I'm doing some sort of movement where I'm unconstrained, really, in terms of how far my stride is, I mean I'm obviously constrained by the musculature, I'm really careful to not overextend or do something like that. And the only way to do that is to not go all out. So again, the goal for this Friday workout is to really get the heart rate high, do high intensity interval training... A number of different ways you could do that.
Andrew Huberman: You can look up HIIT, HIIT workouts online, find the one that's best for you and really pick something that's safe that you can do consistently, and I believe that ideally will also trigger a bit of either strength and hypertrophy and speed power maintenance or even give you a little bit of a stimulus so that by the time you roll around to that leg workout on, again, on Monday, you've got a little bit of an additional boost to your leg strength, hypertrophy, speed and power. |
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} | Andrew Huberman: Now what is your maximum heart rate? Do you need a heart rate monitor? No. If you like using that sort of thing, great. But again, Andy Galpin beautifully supplied us with the information. He said if you take the number 220 and you subtract your age, that for most people, most, is going to be your maximum heart rate. Although for certain people who are very fit or certain ages, that's not going to apply. So it's a little bit too crude to measure, but it's a good starting place and you can look up other information or see that podcast episode, we provide the link to it in the show note captions if you want to get more details on that. I don't use a heart rate monitor. What I'm trying to do is get to that point where I quote unquote feel like I want to die. Now I don't want to die, and please don't die, right? If you're not in good cardiovascular health, do not just jump right into this fitness protocol. But I want to get to the point where I really feel like I could not pedal any faster or pull any faster on the assault bike, the Airdyne bike, or if I'm doing this workout in a place or at a time or because I choose to not use a bike or a rower, 'cause you could also use a rower, I will simply do sprint jog intervals.
Andrew Huberman: I will sprint for 20 or 30 seconds, then jog for 10 seconds, sprint for 20 or 30 seconds, and then jog for 10 seconds and just repeat. I used to have a big field next to my laboratory, my old laboratory, and I used to bring my bulldog Costello out there. He was really good at the first sprint part and then he would just lie down and watch. he didn't even do the jog part. I would just go back and forth, back and forth, back and forth, panting like a bulldog nonstop, barely able to recover before sprinting again. And the basis of this workout again is several fold. First of all, it's to get the heart rate really high, up towards maximum heart rate at least once a week. So you accomplish that this Friday. Also, if you are sprinting and then jogging or you are really pushing hard on an assault bike or an Airdyne bike, or using a, for instance, a skier or a skier machine or any number of different cardiovascular training tools, you are going to get activation of the legs, of course not to the same degree as you would with squats or dead lifts or leg extensions or leg curls. |
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} | Andrew Huberman: Okay, so with that Thursday cardiovascular, let's call it endurance, but cardiovascular training workout done, around roles Friday and on Friday I'm going to do another cardiovascular training session, and I alluded to this earlier, but this cardiovascular training session is also designed to tap into some of the ability of hard, I should say high intensity interval training, to tap into strength and hypertrophy increases for the legs. 'Cause remember, we train legs on Monday and what the science tells us is that protein synthesis in a muscle group can be stimulated about every 42 to 72 hours. And so we've had Tuesday off, Wednesday off and Thursday off and you don't want to lose progress that you made from that terrific Monday leg workout. But in order to make sure that you can do the other things that follow in this program and pick back up on Monday with another leg workout, at least for me with my recovery abilities and my work schedule, I'm not going to do an entire other leg workout because it's going to set the whole thing out of whack.
Andrew Huberman: That is, I won't be able to consistently do the same workouts on the same days of each week. Now with that said, a little bit later I'll explain what happens if you have to miss a workout and how you can combine days, et cetera. But I really strive to get certain workouts done on certain days consistently at least as best I can. So Friday is high intensity interval training, and that can take a variety of different forms. For me, the ideal thing to do, for me, again, you could do something completely different. Exercise choice, again, should be governed by what you can do safely so you don't injure yourself and that you can perform effectively and that gets you or provides you the stimulus that you want. And what I'm trying to do on Friday is get my heart rate way, way up. Talked about this in the episode with Dr. Andy Galpin.
Andrew Huberman: In addition to the benefits of getting 180-200 minutes of zone two cardio per week, minimum, it's a really good idea to get up to that max or near max heart rate at least once a week. And you're not going to do that for very long periods of time. You're not going to do that for 30 minutes. You can't sprint all out for 30 minutes unless you're Steve Prefontaine. If you haven't seen the movies "Without Limits" or "Prefontaine," you should absolutely see those. He was able to go out and run 12 laps, what seemed to be an all out sprint or close to it. Incredible. But most people are not going to do that or going be carried away on a stretcher if they try. These high intensity interval training for me ideally would be on so-called assault bike or Airdyne bikes. So these bikes that have the fan, which might seem like, oh, just cools you off, but actually there's a lot of resistance there. So what I will typically do is a 20 to 30 second all out sprint using arms and legs and then 10 seconds rest and then repeat all out sprint for 20 to 30 seconds, 10 seconds rest, repeat. And I'll do that for anywhere from 8 to 12 rounds, which, trust me, even if you start out a little bit less, or I should say not all out intensity or effort, by the time you hit the fifth or sixth one, you will be certainly headed into if not near your maximum heart rate. |
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} | Andrew Huberman: I also sometimes will travel with a jump rope. I always try and travel with a jump rope and skip rope, much to the dismay of the people who are housed below me in the hotel room. Skipping rope, I should mention, can be a very effective way of getting cardiovascular training while you're on the road. But in all seriousness, if you're in a hotel room or an apartment and you can't really jump high and you're very good at jumping rope, what you'll find is it's not going to get you into that higher elevated heart rate zone. Okay? It can be great for zone two type training, but if you're really good at skipping rope, and I wouldn't say I'm really good at it, but I've done enough skipping rope that I can just kind of cruise and talk and it, it's more zone twoish, even feels like walking at times. Now you can do double unders where you're really jumping and putting the rope under you twice each time or crossovers, et cetera, depending on your skill level. But again, if you're in an apartment or you're in a hotel, that's going to be harder to do. And because there's some skill involved, sometimes you're stopping more often than you're continuing.
Andrew Huberman: By the way, and I just have to mention this, a really terrific Instagram channel is @anna.skips. This is a teacher, a science teacher, or I believe it's a math, maths as they say in the UK 'cause she's in the UK, maths teacher. I don't know Anna, but I know she skips 'cause she has this amazing Instagram channel called Anna Skips. And what's really cool about her Instagram is she shows you her progression from not being able to skip rope at all to the absolutely incredible types of rope skipping that she's doing each morning while getting sunlight, which of course is essential health protocol. So check out Anna Skips on Instagram, really inspiring and made me want to get better at skipping rope. I'm still working at it. |
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} | Andrew Huberman: First of all, it really gets my heart rate up and it improves multiple aspects of endurance, because as you recall earlier, the different bins of endurance that include muscular endurance, anaerobic, that 3 to 12 minute range and then 30 minutes or longer, none of them really precisely match what's accomplished in this 35 minute or so cardiovascular session where I'm pushing hard but not all out. But that's exactly the reason to do it, which is that it taps into multiple fuel systems for the muscle and multiple aspects of the heart and capillaries and arteries and veins that are involved in generating that movement. So it really cuts a broad swath into multiple categories of endurance. And also just keep in mind what this foundational or optimal fitness protocol is really designed to do. In my mind, a foundational fitness protocol is one that leaves you or has you in a state where if you need to walk really far and carry a bunch of weight, you can do it.
Andrew Huberman: If you need to lift a heavy object with your legs, you can do it. If you need to run really fast for two minutes, you can do it. And if you need to run a little bit further, like maybe in 10 minutes for whatever reason, you can do that. So it's a really kind of all around fitness program and that 35 minute run, again, could be swapped with a 35 minute erg row. Or sometimes if you only have access to a stationary bike, you could do that. I suppose if you didn't have access to any equipment and running is not your thing, one thing that I have done, especially if I've been stuck in a hotel 'cause I arrived late someplace and I really want to get this workout in, you could do the dreaded burpee. I know there are a lot of opinions out there, some people think burpees are downright dangerous, other people love burpees. You could do that. Or you could do really fast but full jumping jacks. I know that's a little PE class, right? Physical education class-ish. But sometimes if I need to get the workout in, what I'll do in a hotel if I've arrived late in particular day of travel is I will find the stairwell, the fire stairwell, I'll make sure by the way that I can get back into the building 'cause I've been locked in those stairwells before. And I will simply walk really fast up the stairwell as many flights of stairs as there are, or maybe even jog it, not quite sprint, but a run up those stairs over and over and over again in order to get that 35 minutes of 75% to 80% of max output cardiovascular work done. And if I'm really just restricted to my hotel room, I'll just do jumping jacks for 30, 35 minutes, sometimes while watching something on TV. And believe me, if you're doing full jumping jacks, like really extending your legs, really getting arms overhead and really doing the full movement, by the time you hit five or six minutes you are going to be sweating and your heart rate is really going to be up. |
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} | Andrew Huberman: I'd like to take a brief break and acknowledge our sponsor, Athletic Greens. Athletic Greens is a vitamin, mineral, probiotic and adaptogen drink designed to help you meet all of your foundational nutritional needs. I've been taking Athletic Greens daily since 2000. Andy twelve. So I'm delighted that they're a sponsor of this podcast. The reason I started taking Athletic Greens, and the reason I still take Athletic Greens once or twice a day, is that it helps me meet all of my foundational nutritional needs. That is, it covers my vitamins, my minerals. Andy the probiotics are especially important to me. Athletic Greens also contains adaptogens, which are critical for recovering from stress, from exercise, from work, or just general life. If you'd like to try Athletic Greens, you can go to Athleticgreens.com Huberman to claim a special offer. They'll give you five free travel packs and they'll give you a year supply of vitamin D. Three K, two. Again, if you'd like to try Athletic Greens, go to Athleticgreens.com Huberman to claim the special offer. |
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} | Andrew Huberman: You hear this all the time that doing these big, heavy compound movements or resistance training increases androgens things like testosterone, Dht, Dhea and so forth. Does anyone know how that actually happens? What is it about engaging motor neurons under heavy loads? Sends a signal to the endocrine system, hey, release testosterone? I've never actually been able to find that in a textbook.
Duncan French: Yeah, well, I mean and how can.
Andrew Huberman: I do more of that?
Duncan French: As much as I know. And again, I'm digging out into the annals of Duncan French's kind of brain now. But yeah, I mean, I think it's the stress response, right? It's mechanical stress and it's metabolic stress. And the downstream regulation of testosterone release at the Gonads comes from many different areas. My work primarily looked at catecholamines and sympathetic arousal.
Andrew Huberman: So things like epinephrine adrenaline, correct?
Duncan French: Yeah, epinephrine adrenaline. Noradrenaline how they were signaling cascade using the Hpa axis, releasing cortisol, and then looking at how that also influenced the adrenal medulla to release androgens and then signaling that at the gonads.
Andrew Huberman: That raises an interesting question. So, presumably, weight training in women, people who don't have testes, also, it increases testosterone. And is that purely through the Adrenals, when women lift weights, their adrenal glands release testosterone? Absolutely.
Duncan French: I mean, that is the only area of testosterone release for females. And yes, it's the same downstream cascade. Obviously, the extent to which it happens is significantly less in females. But that's how you there's good data out there that shows females can increase their anabolic environment, their internal anabolic milieu, using resistance training as a stressor, and then they get the consequent muscle tissue growth, whether it's tendon, ligament adaptations, the beneficial consequences of resistance training, which is driven by anabolic stimuli.
Andrew Huberman: Yeah, I have two questions about that. The first one is something that you mentioned, which is that the androgens the testosterone comes from the Adrenals under resistance loads in women. Is the same true in men? I mean, we hear that the testes produce testosterone when we weight train for men that have testes. But do we know whether or not it's the Adrenals or the testes in men that are increasing testosterone more? Both a little bit from each.
Duncan French: The field is divided presently in as much as understanding the acute Adrenergic response in terms of anabolic response to exercise in an acute phase and the exposure to a stimulus that is stress driven, which might be partly from the adrenal glands partly from the Gonads versus a longitudinal exposure to anabolic environments, which is primarily driven by, obviously, the Gonads and the release, the endocrine environment from testosterone release at the Gonads. So the field is split in terms of how exercise is promoting hypertrophy muscle tissue growth and whether that is very much an adrenal stimuli or if that's significant enough in these acute responses versus the longitudinal exposure. Just elevated basal levels of anabolic testosterone habitual level.
Andrew Huberman: So it sounds like in most case, like with most things, it's probably both. It's probably the adrenaline and the gonads. Yeah. And then you mentioned that testosterone can have enhancing effects, growth effects on tendon and ligament also that you don't often hear about that. People always think testosterone muscle, but testosterone has a lot of effects on other tissues that are important for performance, it sounds like.
Duncan French: Absolutely. I think the testosterone hormone listen there's androgen receptors on neural tissue, on neural.
Andrew Huberman: Axons pretty much everywhere.
Duncan French: Exactly. So the binding capacity of testosterone and influencing different tissues within the body I touched on muscle tissue, but the ligaments, the tendons, even bone, to some extent, testosterone is potential to influence that in terms of removing osteopenic kind of characteristics, et cetera. So, yeah, it's a magic hormone, let's say, with many end impacts in terms of adaptation.
Andrew Huberman: I definitely want to get back to your trajectory. |
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} | Duncan French: Basically, imagine a 20 foot by 20 foot square of turf with a small raise in the middle. I e the crown so it slopes to the edges. And then you throw out a white jack, a smaller ball, and then you roll out larger balls to try and get closest to the jack. It's a very European thing, let's say. Yeah. Sports Performance at Crown Green. Bowling. There you go.
Andrew Huberman: All right. Wow. And then to mixed martial arts.
Duncan French: Absolutely.
Andrew Huberman: And everything in between. So along those lines, could you give us a little bit about your background? Where did you start out? Where are you from originally?
Duncan French: Yeah, I'm from the northeast of England. So I'm from a town called Harrogate, which is in Yorkshire, which is a northern kind of area of the nice.
Andrew Huberman: Sunny weather all year long.
Duncan French: Yeah, you can imagine with the two weeks of summer that we get. But, yeah, I mean, I did my undergraduate studies there in sports science. I did teacher training to be a physical education teacher. After that, like most people, I then worked as a high school physical education teacher. Great experience working with kids, developing athletic qualities. But something in the back of my mind always, I wanted more. I wanted to be at the higher end of elite sport. I was a failed athlete. Like many people, I represented my country in different sports and things, but I never made it professionally. So that little seed was sown in as much as I then started to reach out to different areas to do a PhD, whether it was in the UK or also Chanced, my arm took a punt, see if I could get over to the States. All my buddies were going on gap years after the Finnish University or whatever and going to Bali and hanging out or whatever, traveling through Thailand. And I figured, Well, I've always loved the States and can I go and kill two birds with 1 st and do something academic, continue my studies, but also do it in a different environment and get some life experience? And many, many rejections, as I'm sure you're kind of aware from different professors, whether it's Roger or William Craven.
Andrew Huberman: You just wrote to these folks.
Duncan French: I just cold called and sent out information and saying, yeah, so have you got any opportunities? Pushed back from more, but dogged and kept asking and, yeah. Dr. William Kramer, who was at Ball State University in Indiana at the time, a muscle neuroendocrinologist and researcher in muscle physiology using resistance training. He basically said, Listen, I can guarantee you funding for the first year of your studies, but not the next three.
Andrew Huberman: Sounds like a typical academic response. I can take care of you, but not that well, necessarily. Right.
Duncan French: So, spoke to my parents and said, hey, can we take a punt? And they were great in supporting me. And, yeah, long story short, came out to begin my PhD at Ball State. After a year, Dr. Kramer transferred to Yukon, Connecticut, in stores in the Northeast there, and I transferred to him with him. And yeah, four great years with my PhD and getting my PhD with a really prolific research group that looked at neuroendocrinology hormonal work, but using resistance training primarily as an exercise, stressor as the major mechanism, and then looking at all the different physiologies off the back of resistance training.
Andrew Huberman: Yeah, you guys were enormously productive. I found dozens of papers on how weight training impacts hormones, and your name is on all of them, and it's remarkable. I have a question about this. I'll just inject a question about weight training and hormones. |
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} | Andy Galpin: That's going to help you identify where you need to go. So if you can do all those things you're going to be in a good spot to balance specificity and variation. All right? So if you want to make sure you grow your biceps, you better make sure your biceps are working. Having said that, if you over rely on specificity you're going to increase the likelihood of overuse injuries which is going to come back. Andy actually hamper consistency over time. All right, so this is when hedging towards specificity is important. But too much can cause a problem if you go the other direction and you go too much variation. So imagine you're just sort of doing all kinds of different exercises every time you work out. That's actually not enough stimuli directly on the muscle or muscle groups or movement pattern if you're wanting to learn a new movement to get you very far. And so this is a classic problem of I'm doing a lot of work but I don't have a very clear direction. I lack specificity. So I'm working, but I'm not seeing a lot of improvements. And this is like in the business world, et cetera.
Andy Galpin: This is like doing a whole bunch of different things means you get nothing really done. So that's the game we're going to play here, right? How do we overload this stuff? How do we make sure we're balancing specificity and variation? How do we make sure I want to do this? And then how do I individualize it for my needs and circumstances andy movement restrictions, andy of time availability, andy my calendar and desires and all these things. So those are the concepts we absolutely have to hit. The methods that we choose run across a handful of variables. And we call these things modifiable variables because as you modify them or you make different choices within these variables, you get different outcomes or adaptations. This is exactly what determines the nine adaptations that we've been talking about. So the way that I like to say this is exercises do not determine adaptation. So you can't simply go, I want to get stronger, therefore I'm going to choose these exercises. That's not how it works.
Andy Galpin: What determines adaptation is the execution of the exercises. So deadlift is my favorite example. A deadlift is a common example that people think of when they want to choose a lower body strength exercise. But a deadlift will not increase your strength unless you're executing it in the proper fashion. I'm not only talking about technique here. I'm talking about these modifiable variables. The same thing for power exercise science commonly see mistakes of doing activities like a box jump, which is great. People think, oh, I'm going to improve my power. Which we know is extremely highly correlated to activities of daily living and particularly living unassisted as you age, right, is reduction in power. So they'll do an activity like a box jump. What they're failing to realize is unless you do it powerfully, you won't actually increase power. If you don't move fast, you won't get faster. So the way that we manipulate these variables is everything to determining the adaptation you get or again, don't get. So with that foundation, I think we can kind of run right into these things and we can start off with perhaps speed and power. And what I would like to do is walk you through all those modifiable variables, what to do with them, and then hit you with as many different methodologies as we really have time for. And then we'll move on to strength and hypertrophy and kind of round the entire thing out. And then maybe at the end we can talk some other variables, like what happens if I have a training protocol and I'm halfway through it and I can't finish my workout?
Andy Galpin: What should I do? Reduce my weight or reduce my duration or things like that? So there's lots of what if scenarios that we can go through that potentially a lot of people listening have questions about. So sound like a plan?
Andrew Huberman: Sounds like a plan. |
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} | Andrew Huberman: Training and skill learning is incredibly mentally fatiguing. I've often wondered why when one works out hard, whether or not it's with run or with the weights, why it's hard to think later in the day, right? Yeah. There really does seem to be something to it. And I've wondered, is it depletion of adrenaline? Dopamine? I sometimes think it might be dopamine. And here I'm totally speculating. I don't have any data to support this, but if you hit a really hard workout or run early in the day, oftentimes the brain just doesn't want to do hard mental work, which gives me great admiration for these athletes that are drilling their mind and body all day, every day with breaks. So what are your thoughts? What leads to the mental fatigue after physical performance?
Duncan French: Well, again, I don't want to talk out. I'm talking to the man here.
Andrew Huberman: Well, we're just two scientists speculating on this point. Up until now, you've been giving us concrete, peer reviewed, study based feedback on my questions. But if we were to speculate, I think this is a common occurrence. People think if I get that really good workout in in the morning, I feel better all day. That's true. Unless that workout is is really intense or really long.
Duncan French: Yeah.
Andrew Huberman: And then you just the mind just somehow won't latch on to mental work quite as well.
Duncan French: Just philosophically, I think there's coming back to this kind of stress consideration like a public speaking or taking an exam. If you have an amazing coach who is setting up training in a particular way, it's challenging. There's a strain related to it. I'm not talking physical strain. I'm talking figuring things out, figuring out the skill. And I think that can be stressful. Like the learning process can be stressful. So we've touched on stress. I also think if they hit the right technique, that reward center in the brain, that dopamine shot is going to fly up there. And there's only so many times that we can get that before that becomes dampened. And I think there's an energetic piece to it. There's the fueling of the brain. There's the carbohydrate fueling exercise. That actually the strategy around how you fuel for learning and fuel for physical training is actually pretty similar.
Andrew Huberman: Glucose.
Duncan French: Yeah, it's glucose. It's sugar at the end of the day. Right. So are you fueling accordingly around your training sessions be that very physical because everyone thinks, okay, I'm going to jump on a treadmill and I'm going to bang out 15 sprints max effort, and I'm going to be dropping off and lying on the floor at the end of it. I need to refuel. Well, what about the refueling of the brain in a very demanding exercise or drilling session where you're looking at technique that you're trying to figure out that's very challenging for your mind to figure out the complexity of it that still needs to be fueled or refueled afterwards. And I think that obviously might be an area where athletes do themselves a disservice by not appropriate fueling from what might be considered to be a lower intensity session. But the cognitive challenge has been significantly high.
Andrew Huberman: So they're doing skill work or drill work, and it's taxing the brain, and they're thinking, oh, I wasn't pushing hard lifts or doing sprints, and so I can just go off the rest of my day. But then their mind is drifting.
Duncan French: I speculate.
Andrew Huberman: Yeah, that seems very reasonable. I mean, I know that here and presumably with the other athletes you've worked with, nutrition is a huge aspect of that. And I think the general public can learn a lot from athletic nutrition because at the end of the day, the general public is trying to attend to their kids, attend to their work, whether or not they're lawyers or whatever they need to focus. Nutrition is a barbed wire topic. |
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} | Duncan French: Absolutely. Yeah. You have to be strategic about when you use some of these interventions. And the time when you're preparing for a competition is not the appropriate time excuse me, is the appropriate time when you want to drive recovery and make sure that your body is optimized? When you're far away from a competition date or out of season or whatever it may be, and you're really trying to just tear up the body a little bit to allow it to its natural healing and adaptation processes to take place? Well, you don't want to negate that. You want the body to optimize its internal recovery, and that's how muscle growth is going to happen. So, interesting, there's a time kind of consideration that you need to make with these interventions, for sure.
Andrew Huberman: At the UFC Performance Center, are the fighters periodizing their cold exposure, or are they just doing cold at will?
Duncan French: Well, it's not just the UFC. And again, I talk about my personal experiences with different sports, I think just education around where science is at and our understanding of concepts like the use of cold exposure for recovery. Ice bath. Everyone wants to jump in an ice bath. But I think as we've stepped back and scientists have started to figure out and look at some of the data, we're now more intuitive about, well, actually, that might not be the best or the most optimal approach. And I think that's any given sport. So, yes, certainly here at the UFC, we're trying to educate our athletes around appropriate timing. And it's the same with nutrition. It's the same with an ice bath intervention. It's the same with lifting weights. It's the same with going for a run or working out on the bike. There's tactics to when you do things and when you don't do things. And I think stress and cold exposure, we have to have a consideration around that as well. But it's not just MMA fighters that's any athlete and I think the best professionals, the most successful professionals do that really well.
Duncan French: They listen. Number one, they educate themselves, and then they build structure. And I think at the most elite level, we always talk about it here at the UFC, but the most elite level, you're not necessarily training harder than anybody else. Everybody in the UFC trains hard. Like, everyone is training super hard. But the best athletes, the true elite levels, are the ones that can do it again and again and again on a daily basis and sustain a technical output for skill development. Therefore, their skills can improve, or physical development, their physical attributes can improve. So that ability to reproduce on a day to day basis falls into a recovery conversation. Now, when is the right time to use something like an ice bath? And when isn't is part of the the high performance conversation, for sure.
Andrew Huberman: So really, they're scientists. They're building structure. They're figuring out variables. But it sounds like the ability to do more quality work over time is one of the key variables.
Duncan French: I mean, it's fundamental. I mean, garbage in, garbage out, quality in, quality out. But in our sport, I talk about mixedmartial arts. Arts. It's truly a decathlon of combat. So there's so many different attributes, whether it's a grappling, whether it's a wrestling, whether it's a transition work, whether it's a stand up striking. So the different facets of a training program in this sport are significantly large compared to something like a wide receiver. In football. That's no disrespect for wide receivers, but they run routes. They're going to run a passing tree, and that's all they need to do. These guys have to be on the ground. They got to be great on the ground. They got to be great standing up. They've got to be great with the back against the fence. There's so many different kind of facets to our sport. So managing the distribution of all the training components is one of the biggest challenges of mixed martial arts. And the best guys get that right.
Duncan French: They allow their body to optimize the training. And remember, why are we doing training? We're doing training for technical and tactical improvement. Now, if your body is fatigued or you just can't expose yourself to more tactical development or technical development, then you're essentially doing yourself a disservice. You're going to be behind the curve with respect to those guys that can reproduce that day in, day out. |
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} | Andy Galpin: Yeah, momentum or movement. Right. So this is like think about this in old gym class. It's like your high knees andy, your butt kickers and just different things like that where you're moving in different planes, you're moving joints through tons of range of motion. You're getting a lot of movement there. So you're getting the local warm up. You're also getting the total systemic activation. Everything else is going on there. So that is what we consider to be a general warm up. Five minutes is a very sufficient number, perhaps ten if you're a slow goer achy and some things like that. And you really got to get the ankle warmed up. If you're doing lower body stuff, really make sure that that's moving correctly. The hips and knees will follow. Upper body stuff really good. The shoulder blades andy the neck, like making sure you're going there and the elbows will follow after that. So five to seven minutes of a general warm up.
Andy Galpin: A lot of the times, like classic exercise science, it will even just put you on a bike cycling for five minutes. I don't like that personally. Dynamic movement is more preferred. If you really just move for five to seven minutes, you'll be fine there. Now specificity within each movement, it's very important that your first exercise of the day is generally the thing you prioritize. That's oftentimes the most important you're going to do for it. It oftentimes is also the most complex and the most moving parts. So it tends to be multi joint. Therefore you need to have movement precision and skills dialed right. You don't typically start your workouts off with a forearm curl. You don't need a tremendous amount of warm up to get going on that. You're going to start off with medicine ball throws or a snatch or some agility work. You need to have the whole system going because multiple joints are moving. Position matters, technique, there's just a lot of skill requirement, et cetera. So the individualized workout or the specific workout for the specific movement for that very first one, my general rule of thumb is like whatever it takes to move perfect in that first exercise.
Andy Galpin: Past that, you don't necessarily need to do individualized warm ups for your next movements, unless it is a movement you're trying to learn or just even get a little bit better at. Like drop the load a little bit, work on some accruing, some practice reps. Fantastic. Or it's another dissimilar complex movement. So let's say your first exercise was a front squat and you got loaded for that. Andy now you're going to move into a pull up, but your mechanics aren't the best there. And so you really need to change and do some maybe more specific activation warm ups for that or something else or it's running or something totally different. So yeah, you don't need to re warm up for every single exercise as you go. Generally, once you're good to go, the same muscles that you're going to use in the next exercise are warm, same joints, then you're good to go. |
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} | Andrew Huberman: So what are the essential components of an effective strength and hypertrophy protocol?
Andy Galpin: Okay, so what I would like to actually do is walk you through both of those because as we mentioned before, they overlap. But the training needs to be differentiated so that you can optimize either strength, hypertrophy or if you actually want, you can get a combination of both. This allows you to then get the adaptation you want, avoid ones you don't want and then get it even a combination if that's the preference. So a lot of people will talk about I want to get a little stronger. I want to add some muscle. That's a different answer than someone who wants to truly maximize muscle which is a different answer from somebody who wants to maximize strength which is a different answer from somebody who wants to maximize strength but not actually gain muscle. So we have all these combinations. What's important to understand before we get into the details is a couple of things. Number one, we've been teasing this concept so far of the concepts are few but the methods are many. And so I want to hit those concepts right now.
Andy Galpin: These are as you as you say, these are the non negotiables that have to happen in any training program and I'm referring to these in the strength and hypertrophy conversation. But these are true of power development, speed development, muscular endurance, endurance, any other thing. These are things that just have to happen for any training program to work. I mentioned one a little bit earlier, which was adherence. Andy so my frequent collaborator Dan Garner will constantly say consistency beats intensity. Again, in fact, the literature will show you very clearly adherence is the number one predictor of physical fitness outcomes. So we want to do something that you will engage in, you'll put effort into and you'll be able to repeat consistently over time. So that's number one. The second one is and this is a major reason that people don't hit their fitness goals. In fact, I would argue outside of not doing it, the number one mistake they make is progressive overload. So I'm going to walk you through exactly how much you should be creatine your sets and reps and weight, et cetera per week, per month later. But that's the biggest thing. |
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} | Andrew Huberman: What are a few of the major changes that occur in muscle, nerve, et cetera, when we experience hypertrophy? I've heard of protein synthesis changes. I'm assuming that's true. Maybe you can tell us a bit more about that. Changes in blood flow, perhaps. Changes in neural innervation. Who knows? Maybe even changes in fascia. I'm not aware of any specifically, but I have to imagine that they're somehow involved.
Andy Galpin: Sure. So when we talk about hypertrophy, a lot of the adaptations are going to be similar because the mode of training is close enough, so your nerves probably aren't smart enough to differentiate between a set of five reps or a set of eight repetitions. They're smart enough to differentiate anything, like they know everything that's going on, but it's going to be a huge overlap. The primary difference with hypertrophy is a couple of things. So if you think about the muscle microstructure, I have a whole series of videos on YouTube, if you want to see the visuals behind this. In fact, in there, I include the specific diameter, size of muscle fibers that I was failed to give you a few minutes ago.
Andrew Huberman: We will provide an active link to this.
Andy Galpin: So what happens is this when we talk about and you hear this classic buzz phrase of muscle protein synthesis, generally what we're talking about there is contractile units. And so when we say contractile units, we're talking about the myosin and actin. And so what we're really trying to do is say, okay, there's some amount of protein turnover where we're coming in and we're trying to add more proteins to the equation. And so what has to happen there is a series of steps. So step number one is there has to be some sort of signal from the external world. This could actually oftentimes it's things like stretching of the cell wall, which is what happens with exercise. Right. So you're contracting Andy shortening get this big stretch of the cell wall. It can come from as simple things like an amino acid infusion this is just creatine protein. This is why protein ingestion alone is anabolic. Right. It will help you grow muscle independent.
Andrew Huberman: Of even moving, just eating protein will grow your muscles.
Andy Galpin: Yeah, certainly, Andy, those data are very clear. Of course, like anything, there's a saturation point in terms of total amount you need to get to and things like that. But, yeah, if you were to walk into a laboratory fasted overnight and I gave you 30 grams of protein, we would see a very measurable increase in protein synthesis quite clearly for several hours, probably four to five plus hours. We could maybe bring in some people that would know those data better.
Andrew Huberman: But many hours with no weight training.
Andy Galpin: Correct.
Andrew Huberman: I am betting that most people are not aware of that fact.
Andy Galpin: You know, what's actually interesting about it is if you do the exact same study again and you just did strength training, you would also see an improvement in protein synthesis. Right. But those factors are independent and the mechanisms are independent, such that if you do them both together, they stack on top of each other, which is really wonderful. And if you were to add carbohydrate into that mix, now you're actually adding fuel for the entire muscle protein synthesis process. And now you're going to see even additive benefits. And this is why for so many years, this is what bore the whole post exercise anabolic window thing, which is like you got to get carbs and protein in post exercise to maximize muscle protein. Now, that turned out to be not totally true in terms of the window.
Andrew Huberman: Window not be as strict as people initially asserted, as I recall. But still, I think that's super interesting. These are parallel pathways for protein synthesis. Simply eating protein or training each independently increases protein synthesis. |
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} | Andrew Huberman: So Wednesday is torso and neck and then comes Thursday and that means another cardiovascular exercise session, although it's a brief one. Unlike the endurance training on Sunday, the cardiovascular session on Thursday, and again, for me it falls on Thursday, but for it could fall on a different day depending on when you started this protocol, is going to be about, again, about 35 minutes of, for me, running, although it could be rowing or it could be cycling, it could be something of that sort. The goal of this workout is what's important. The goal of this workout is to tap into, remember that long list that we talked about earlier where you've got skill and speed and power and strength and hypertrophy, et cetera, different forms of endurance, is to get into that range of endurance where your heart rate is elevated quite a bit more than zone two, but that you're not really going all out sprint. So what that means for me is warming up for about 5 to 10 minutes.
Andrew Huberman: That could be jogging, a little bit of light calisthenics, might even be hopping on a stationary bike, although to be honest I loathe the stationary bike, and then setting a timer and doing about 30, but ideally 35 minutes of what I call 75% to 80% of all out. Okay, now I realize this spits in the face of all you heart rate monitor wearing super techy exercise types. But when I think of all out sprint, I think of 100%. And what is that? In my mind that's somebody is chasing me with a needle full of poison and I am sprinting away at maximal speed. That for me is 100%. So after a brief warm up, what I'm going to do is go out, typically outside, although sometimes it has to be on a treadmill if I'm traveling, and move, run for about 30 to 35 minutes at about 75% or 80% of that all out. What that means is that I'm striving to keep a steady pace, but in reality I don't.
Andrew Huberman: I sometimes have to stop at a stoplight, there are cars, please don't run into traffic just to maintain that speed and that timing, that would be terribly antagonistic to fitness, in particular, lifespan. That running tends to be running in which I'm breathing hard so I'm not able to restrict myself to purely nasal breathing. And I should have mentioned earlier, on the Sunday long ruck or weighted hike or jog, if I'm alone, I try and do pure nasal breathing. If I'm with other people or I'm talking, obviously I'm not going to do pure nasal breathing because I'm talking, although I'm sure that sometimes they wish I was doing pure nasal breathing. That Thursday workout accomplishes a number of things. |
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} | Andy Galpin: Like we've just had new things come out in this last couple of years where that detraining effect we thought was a reason of well, what happens is, if you had the muscle before and you brought in these nuclei and they differentiated and turned into a nuclei and then the muscle got small again, you preserve those nuclei. And that's why when you go to train again, they were already around. So the muscle grows faster the second time than it did the first time. Well, now it looks like that's actually not the case. In fact, it's actually probably what's happening is it's an epigenetic change in the nuclei's ability to access the DNA needed to grow muscle. It's effectively the analogy we used. The nuclei are remembering how to ride a bike. So it's quite funny that you said that, because it's not really necessarily that they're being preserved over time, they have learned the sequence it takes to grow the protein there, and it happens faster the second time. And we've also learned that there are specific nuclei.
Andy Galpin: We've known this for actually a while. We found this in our lab. We didn't discover it. We saw this in our sum of our hybrids. But there are different shapes. The nuclei, some are more oval, some are more elongated. And the shape determines a lot of the function. Some of them are hanging out more towards the periphery, and some of them are hanging out right around the nucleus. Well, it looks like there's actually probably different types of nuclei, a lot of them that are specific to the mitochondria. In fact, you can see on some of the imaging we have, they're just packed around the mitochondria. And there are some that are probably specific to injury repair. And so this is probably explaining a lot of the individual variation. I mean, I know you've said previously you're very slow at recovery. There's a lot of things that go into that. And I would love to walk through sort of all the buckets, maybe later into recovery. But one of the inherent genetic variations is, could be simply that you maybe have more or less of the nuclei responsible for tissue repair.
Andy Galpin: That's something that's been happening in the last handful of months that's been coming out. We'll see if that holds up as true or not. So, as we're learning more and more almost every day about muscle physiology, what's super fun and interesting, and I think the most exciting what to do in terms of how to train and how to eat and how to do everything else to get these adaptations, has been pretty well established for a long, long, long time. We're just figuring out what's happening in the muscle now, but we know what to do. So, from a practical standpoint, putting together protocols for any outcome that you want or don't want for any modality. You don't have a gym, you have weights, you have dumbbells. Only you only have kettlebells. You don't want to, you only use body weight. You only have three days a week. You have seven days a week. You want to maximize muscle growth, you want to get a little bit stronger. Any of these variables you want to throw at me.
Andy Galpin: We have a large evidence base for exactly how to get those adaptations and not others. So while we have a lot to learn about the mechanisms and the physiology, we have pretty good legs to stand in terms of what to do to get whatever adaptations you want. |
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} | Andrew Huberman: Well, when people talk about muscle memory, like the ability to ride a bicycle after so many years of not having tried to ride one that's actually largely independent of the muscle has something to do with the muscle. It's basically a nervous system phenomenon.
Andy Galpin: 100%.
Andrew Huberman: So muscle memory has been co opted by different communities to mean different things on our side.
Andy Galpin: Muscle memory is going to mean that ability to remember that muscle size, right, that hypertrophy. Because, as you explained, the motor control thing is it's a totally a nerve thing. I'll give you this one. The nerve. People can have this one.
Andrew Huberman: Well, it seems to me that there are a tremendous number of parallels between strength and hypertrophy changes and neuroplasticity. This is coming up again and again in this conversation because we know, for instance, that if you are exposed to a couple of different languages early on in life, you will learn any number of different languages far more easily later in life, of course. And that's because there's some crossover between different languages, especially latin based languages, that allows for that. There's a substrate for it. It's similar to the ability to hop on a bicycle again phenomenon or play an instrument phenomenon, but it's broader than that. And again, I think this speaks to the huge number of different adaptive changes that are occurring in the cells and in the nerves that innervate these cells when one experiences increases in strength and hypertrophy.
Andy Galpin: So to round that out, Andy, to go back to what I was saying there, what we're actually learning now is that nucleation thing. And by the way, this entire trajectory story is probably over the last like, eight years, this is how fast we've changed our understanding of how muscle grows. The sarcoplasm reticulum thing five years ago was bro science. Now it's pretty well established. The myronucleation thing was eight to ten years ago. It's changing every week. This paper we just submitted this week showed actually why we had generally thought a few years ago. And in fact, you can find me on podcasts and probably in some of my videos talking about this. And I'm going to tell you right now those things are wrong. |
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} | Andy Galpin: Correct. And the beauty of this whole thing is, while we don't yet know the mechanisms specifically, and there's a lot of confusion and there's a lot of changes that happen, we actually just submitted a paper a few days ago myself, Jimmy Bagley at San Francisco, and Kevin Muric has a wonderful muscle physiology lab at Arkansas. And this is a very lay article, actually. It's incredibly easy to read. We describe the role of myonucleation in muscle hypertrophy, and this is actually a lot of interesting stuff we get into there, but we're learning more and more about it. As a quick example, so skeletal muscle is unique in the fact that it is so large in diameter. It's also unique in the fact that it's multinucleated. What that means is, typically in biology, you see, like, a cell has one nucleus. That's the place that houses and holds the DNA, and it's a control center. It tells it to grow, shrink, die, repair, that whole thing.
Andy Galpin: Well, skeletal muscle in human is awesome because it has thousands, if not more, this nuclei, which gives it that plasticity. And so a normal cell has one place it has to go to for any time it wants to upregulate, down, regulate, do whatever. The thing is, your muscle fibers have these little control centers all throughout them. And for years we were like, okay, great. The amount of hypertrophy that you can experience is probably limited by the amount of nuclei you have because you're not going to exceed a certain size of muscle fiber if that's going to mean you lose control. And so we're like, okay, great. We found and identified a limiting factor to what will determine how much a muscle can actually grow. And then the next question was, then where are these things coming from? And this is where satellite cells come in. And so it was very clear, a satellite cell that's lying dormant sort of on the outside, the periphery of the fiber, will then go in into the fiber.
Andy Galpin: It will turn into my nuclei, and then it can actually increase your diameter like that. Andy so then actually, it was like, hey, you're actually limited by the amount of these satellite cells you can get in and turn into nuclei. And then the evidence came out that showed, hey, what if you detrain? So what if I used to lift weights like a long time ago, andy, I got big, but now I've lost a lot of my muscle. If I train again, you actually get that muscle back faster than it took you the very first time to build it. That's what we call muscle memory, like an art field. Now, on your side of the equation, muscle memory is something different, right? It's a nerve. |
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} | Andrew Huberman: Let's talk about strength and hypertrophy. If you would, please remind us what strength and hypertrophy are in terms of the specific adaptation they represent. What I mean by that is, when somebody is training for strength, what are they really training for? Obviously, it means the ability to move more weight, but I know that it includes a number of other things as well. And when one is training for hypertrophy, for the growth of muscle fibers, what does that represent? Because I think if people understand that, they will far better understand the methods and protocols that are going to be best for strength and hypertrophy at its core.
Andy Galpin: You've basically described it. When we talk about strength, we're talking about an actual function. So can you create more force across a muscle or muscle groups or total movement? When we talk about hypertrophy now, we're specifically referring to just an increase in size. There's no actual mention of function. So a muscle can grow larger without actually technically being stronger. For a number of reasons. However, there is a strong relationship between strength and hypertrophy. So a lot of the times in the general public, in the lay conversations, we sort of lump those two things in as the same thing. Andy so we have to recognize people who are new to training or people even are intermediately trained. There is a huge overlap between strength and hypertrophy. Once you get past that, though, they become disentangled. And a good example of it is this if you look at the strongest people in the world, this would be people who compete in the sport of powerlifting.
Andy Galpin: That's a true test of maximal strength. So it is a deadlift, a bench press and a back squat, and you're going to do a one repetition max in all three of those. And so whoever wins is the person who lifted the most amount of weight one time. That's it. It's not like World Strongest Man where it is how many reps can you do in a row? Or your time right is a true maximal strength test. Andy you compare those to, say, bodybuilders. Now, both of those individuals are strong, and both of those individuals have a lot of muscle. However, it is extremely clear the power lifters will be significantly stronger than the bodybuilders on average, right? There are individual exceptions, but we're just talking collective averages, and the bodybuilders will have more muscle than the other ones. In addition, whether you look at Olympic weightlifting or power lifting or World's Strongest Man for that matter, there are weight classes. And the reason is, as you go up in weight classes, you will always see the world records go higher and higher and higher. So you can clearly get stronger without adding any muscle. |
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} | Andrew Huberman: What are some of the other things that strength Andy hypertrophy training can provide? I know a lot of people use strength and hypertrophy training for changing their aesthetics. What is your sense about its potency for changing aesthetics as compared to, say, cardiovascular exercise.
Andy Galpin: Yeah. The mantra I always like is the reason you want to exercise is threefold. Right? You want to look good, feel good, play good. That comes from sport, comes from football specifically. We always say that. And what that means, really, is you want to look good. People want to look the way they want to look, whatever that means to them. And there are any versions of what you feel to be aesthetically pleasing, and that's totally irrelevant. But people want to look the way they want to look. Number two, you want to be able to feel good. What's that mean? You want to be injury free. You want to have energy throughout the day. You want to be able to ex cute anything you want to. So whether you want to go surf in the morning, you want to play racquetball or you want to hike or you want to do all three of those in one day, you should have the ability to do that. And then you want to play good, which means you should be able to execute Andy Galpin activities that you want to execute, whatever that means.
Andy Galpin: All right, so backing all up. What's that got to do with your question? One of the major benefits of strength training is the responses tend to happen extremely fast. So you can see noticeable changes in muscle size, certainly within a month, absolutely within six weeks. And so we have this wonderful feedback loop that sort of tells you, am I doing this incorrectly? Oh, my gosh, yes, I am. Also, it's very addicting. The feedback, the response, the physical changes, whether this is actually 0.2 or three, look good or feel good, play good, or it's even just part one, you're starting to see that when you compare that to things like fat loss, that journey tends to be longer. It's more difficult. It's more reliant upon other factors like nutrition, et cetera. Strength training is really about, like there's some very minimal nutrition requirements. Outside of that, it comes down to the training, and the feedback is immediate.
Andy Galpin: That's powerful because if you look across the literature on exercise adherence, you'll see that that is, in fact, the number one predictor of effectiveness of any training program. So what that means is if you were to put Andy variable possible and figure out what is going to determine whether or not this program works, this is what we typically call the methods are many and the concepts are few. So the methods of exercise, the methods of strength training, the methods of hypertrophy training, which we'll talk about, are infinite. However, there are only a handful of key concepts that you have to achieve in order for that program to work. Adherence is one of them, and again, is often the top one. So you need to do something. You need to do something consistently when you are getting that feedback and you're seeing results in your appearance immediately. And you see that every single day.
Andy Galpin: Every time you take off your shirt or every time you look in the mirror, you see that result that tendons to drive adherence really powerfully. So it's important to give people wins, especially people who are not maybe like you and I, who are like, I'm going to lift weights and I'm going to exercise no matter what the rest of my life, because I just love it. Not everyone's like that. And so giving them a little bit of carrot of success, and if you can achieve that in, say, three to four to five weeks already, it's very powerful tool. |
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} | Andy Galpin: There's a wonderful saying. I think it was Bill Bauerman, one of the founders of Nike, and he always said, if you have a body, you're an athlete. And I think that's very important for people to understand because one of the major disservices we've done in this field is convince people that things like strength training are for athletes or for growing bigger muscles, and cardiovascular training are for things like fat loss, andy heart health. And that is a tendons disservice because it puts a lot of unnecessary barriers and leads to a lot of false assumptions and then therefore, poor actions. Classic examples of this are people who are resistant to strength training because they don't want to put on too much muscle, people who only perform one type of exercise because they want, say, fat loss, or they're in it for longevity and health and they're not worried about being an athlete. And so right out the gates, we can actually draw back a little bit to what we were our previous conversation when I walked you through the history of exercise science. And the reason I did that is to help you understand these are the railroads that you're running down and you don't even realize it in terms of everyone thinks of strength training and they immediately default to our principles to optimize muscle growth. Andy that's not the only adaptation one should be after with strength training.
Andy Galpin: When we think of endurance training, we immediately default to things like, again, cardiovascular health or fat loss or things like that. What I really want to do across this entire series and conversations is to just break that immediately. Talk about all the other things that you can do with your training andy. So that people can be comfortable andy. Confident in doing an optimal training program for whatever goal they have, whether that be specific, like growing muscle or nonspecific, like just feeling better, having more energy, being more prepared for life and longevity. Andy so to directly answer your question, we could do 100 episodes on the benefits of exercise and we could run all the way from mood and focus cognitive tasks to a better immune function. You'll get less colds, you'll fight them off more effectively to mortality, right? So some of the strongest predictors of how long and how well you will live or exercise however, there are independent benefits that come from just endurance training and there are independent benefits that come from strength training. And so to just give you one categorically, the way that you want to think about this is resistance exercise. And strength training is the number one tool to combat neuromuscular aging. |
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} | Andrew Huberman: Welcome to the Huberman Lab Podcast, where we discuss science and sciencebased tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today I have the pleasure of introducing Dr. Duncan French as my guest on the Huberman Lab podcast. Dr. French is the Vice President of Performance at the UFC Performance in Institute, and he has over 20 years of experience working with elite professional and Olympic athletes. Prior to joining the UFC, french was the Director of Performance Science at the University of Notre Dame, and he has many, many quality, peer reviewed studies to his name, exploring, for instance, how the particular order of exercise, whether or not one performs endurance exercise prior to resistance training or vice versa.
Andrew Huberman: How that impacts performance of various movements and endurance training protocols as well as the impact on hormones such as testosterone, estrogen and some of the stress hormones such as cortisol. He's also done fascinating work exploring how neurotransmitters things like dopamine and epinephrine, also called adrenaline, can impact hormones and how hormones can impact neurotransmitter release. What's particularly unique about Dr. French's work is that he's figured out specific training protocols that can maximize, for instance, testosterone output or reduce stress hormone output in order to maximize the effects of training in the short term and in the long term. So today you're going to learn a lot of protocols whether or not you're into resistance training or endurance training. You will learn, for instance, how to regulate the duration of your training and the type of training that you do in order to get the maximum benefit from that training over time. So whether or not you are somebody who just exercises recreationally for your health, whether or not you're an amateur or professional athlete, or whether or not you're just trying to maximize your health through the use of endurance and or resistance training, today's discussion will have a wealth of takeaways for you.
Andrew Huberman: There are only a handful of people working at the intersection of elite performance mechanistic science and that can do so in a way that leads to direct, immediately applicable protocols that anybody can benefit from. Dr. French also provides some incredibly important insights about the direction that sport and exercise are taking in the world today and their applications towards performance and health. |
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} | Andy Galpin: You're going to start seeing decrements past again around the age of 40 or so. Now, there's a lot of genetic variation there and a lot of other things go into that equation, like your sleep and your nutrition, but that's a fair number to sort of think about. One actually response is it's actually sort of counterintuitive. The wonderful thing about strength training is you don't actually have to start at a young age. In fact, I was reading a paper this morning because of our previous conversation, it was in over age 90. So these are folks 90 plus, and they saw improvements like 30% to 170% in things like muscle size and hypertrophy over a very short period of time. I think it was twelve weeks. So you don't actually have to start. There are some adaptations that you're going to need for health that you god, you really need to start in your twenty s.
Andy Galpin: The reason I like to mention that is because if you are listening and you are 50 and you're like, oh shit, I haven't been strength training, you're not toast. You should absolutely start now, but you're going to be able to get to a fantastic spot very quickly. Similarly, though, if you are 20 or 25 and 30 and you aren't lifting, there are still many reasons why you should do that. Now, I'd like to point that out because a lot of folks will be like, oh, my gosh, they said I have to do it when I'm 20 or 25 or I'll be sort of screwed. And that's not the case at all. There's really no age limit on this. In fact, there's actually interesting data that just came out showing this reduction in muscle strength. Andy hypertrophy that I sort of talked about is basically ameliorated with a preservation of activity. In other words, you don't lose these functionalities because of aging.
Andy Galpin: You'd lose these because of a loss of training to state that, again, you don't lose these because of some innate physiological thing that happens with genes become less sensitive or you lose functionality. You pretty much can describe the loss of function of strength and muscle in aging as exclusively because of a loss of training and nutrition and anabolic resistance and some other things. So you can do a lot more than you think when it comes to maintaining high quality muscle. And that's really important to point out.
Andrew Huberman: I'm reminded of the words of the great Sherington. He won the Nobel Prize. Physiologist. I guess the neuroscientists try and claim him as a neuroscientist because he worked on the nervous system. The physiologist claim as a physiologist, he.
Andy Galpin: Is 100% a physiologist.
Andrew Huberman: I would call him a neuroscientist. Maybe we can argue about this later. We will. But I think one of the key things that Sherington pointed out was that and I believe the quote was that movement is the final common path. And what he was referring to was the fact that a significant fraction of the brain itself is devoted to our ability to move and our ability to engage in resistance type movements. And that resistance type movements and the continuation of movement throughout the lifespan is what keeps the brain young and healthy and vital. And there are so much data now to support that. But I'm so grateful that you brought up early this fact that there's a neuromuscular link, because I think a lot of people think about musculoskeletal. They forget that the nervous system is really in charge of the strength of the muscle contractions and the types of muscle contractions that occur. I'm certain we're going to get into that in a lot of depth today.
Andy Galpin: You're close there. We're not totally right, but we're close.
Andrew Huberman: Okay, well, I look forward to being corrected and to achieving the precision that you're known for around that discussion. So if we are to step back and say strength training and hypertrophy training is critical for people of all ages for developing and maintaining the neuromuscular system and for our ability to function in the world not just offset injury but the ability to pick things up and move, et cetera. |
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} | Peter Attia: Yeah, actually an interesting aside that I always tell my female patients who get a kick out of this, when you look at a woman's labs, you'll see her estrogen, her progesterone, her fsh, her LH, her testosterone, her sex hormone binding global and all these things. But based on the units they're reported in, it's a very distorting picture of what the most common androgen is in her body. If you actually convert them to the same units, she has much more testosterone in her body than estrogen.
Andrew Huberman: Interesting. Yeah, I did not know that. Then again, I've never been a woman getting my hormone profile.
Peter Attia: So even though a woman's testosterone is much less than a man than a man's level, it's still more than she has estrogen in her body.
Andrew Huberman: Wow.
Peter Attia: So phenotypically, right? Estrogen is the hormone that's dominating. She has much higher estrogen than a man and much lower testosterone than a man, but in absolute amounts, she has more testosterone than estrogen. Just worth pointing that out. Incredible what's happening to a woman from the age she starts menstruating until she goes through menopause, outside of pregnancy and birth control and stuff like that, is she has this cycle roughly every 28 days, but it can vary where at the beginning of her period, we call that day zero. Her estrogen and progesterone are very low. You can't measure them. And then what happens is the estrogen level starts to rise and it rises in response to a hormone called follicle stimulating hormone. Follicle stimulating hormone fsh that is getting her ready to ovulate and she ovulates at about the midpoint of her cycle. So if we're just going to make the math easy, on day 14, she's going to release a follicle from one of her ovaries, and the estrogen level is sort of rising, rising, rising.
Peter Attia: We love to measure hormones on day five because I want to have a standardized way in which I measure her hormones. So our women know if we're in the business of trying to understand her hormones, the day her period starts, even if it's just a day of spotting, that becomes our benchmark. And then day five, I want to see every hormone on that day. And if everything is going well, I know what her fsh LH estradiol and progesterone should be on that day. So the estrogen rises, starts to come down a little bit as she ovulates, and then the luteinizing hormone kicks on because it's now going to prepare her uterus for the lining to accommodate a pregnancy. So now you start to see estradiol go back. But now for the first time, progesterone goes up. So progesterone has been doing nothing for 14 days, and now it starts to rise. And actually progesterone is the hormone that's dominating the second half, which is called her luteal cycle. So the first 14 days is the follicular cycle, second is the luteal cycle. So once you get to about the halfway point of that, which is now just to do the math, 21 days in the body has figured out if she's pregnant or not. And again, most of the time she's not going to be pregnant. So the body says, oh, I don't need this lining that I've been preparing.
Peter Attia: I'm going to shed it. So now progesterone and estrogen start crashing, and the lining is what is being shed, and that is the menses, by the way. It's that last seven days of that cycle that in a susceptible woman is what creates those PMS symptoms. Actually, this is something that you would probably have a Peter understanding of than me. There is something about this in a susceptible woman where the enormous reduction of progesterone so quickly is probably impacting something in her brain. So I think this is a legitimate thing, right? It's not like, oh, she's crazy because she's having all these PMS symptoms. No, we know that that's the case because if you put women on progesterone for those seven days, those symptoms go away. So if you can stabilize their progesterone during the last half of their luteal phase, and sometimes we would just do it for the entire luteal phase, just put them on a low dose of progesterone, all PMS symptoms vanish.
Andrew Huberman: Very interesting. I'll have to look up where the progesterone receptors are located in the brain. The Allen Brain Institute now has beautiful data of NCTU hybridization, which for folks that don't understand looking at RNA and where genes and proteins ought to be expressed in the human brain by using actual human brain tissue sections as opposed to just mice. So I'll take a look, I think, some insight into what that progesterone emotionality link might be and where it might exist neural circuit wise.
Peter Attia: So then when the estrogen and progesterone reach their nader again, that starts the cycle. So that cycle is happening over and over and over again. Okay, so it became well known in the 50s that, okay, a woman's going to stop menstruating at some point, her estrogen goes down. |
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} | Andrew Huberman: Let's talk about fitness and let's talk about how you can develop the optimal fitness protocols for you. So that includes what to do each day of the week and your fitness protocol across the week, and indeed across the month and the year and even year to year. When we had Dr. Andy Galpin on the podcast, he said something very important that we want to keep in mind today, which is concepts are few, methods are many, that is there are an infinite number of different programs and exercises and set and rep schemes and different runs and burpees and pushups, et cetera, et cetera that one can follow. However, there are really just a few basic concepts or principles of muscle physiology, of cardiovascular function, of connective tissue function that provide or set the basis for the adaptations that we call fitness or that lead to fitness. So I'm going to list those off now. We can talk about a fitness protocol that's really aimed mainly toward developing skill. That's one. Or speed. That's another. Or power, which is speed times strength, or specifically strength, or hypertrophy, growth of muscles, or endurance such as muscular endurance.
Andrew Huberman: Muscular endurance is, for instance, your ability to stay in a plank position or to do a wall sit, to sit on an invisible chair against a wall, or other forms of endurance like near pure anaerobic endurance. So a one minute sprint or less or a one minute all out cycling on stationary bike, this sort of thing, or endurance that occurs in the kind of 3 to 12 minute total duration range. So that might be sprints or high intensity interval type training. It could be an all out swim, it could be all out row. That's another form of endurance, taps into different fuel systems, different aspects of muscle physiology, et cetera. And then endurance that lasts 30 minutes or more, which is typically what people think about when they think about endurance. But of course, the other forms of endurance matter. So we've got skill, speed, power, strength, hypertrophy, muscular endurance, anaerobic endurance, what I would call 3 to 12 minute endurance, although it goes by other names as well, and 30 minutes or more endurance type exercise and adaptations. |
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} | Andrew Huberman: In fact, most of the time I can't even remember that they're on my face, they're so lightweight. However, they also can be worn anywhere, to work, to dinner, et cetera. They have a terrific aesthetics. Unlike a lot of other performance eyeglasses out there that you can only find in designs that really make people look like a cyborg. ROKA makes the cyborg versions, some people like those, but they also make versions of their eyeglasses and sunglasses with frames that you can wear out to dinner, to work, et cetera. If you'd like to try ROKA eyeglasses or sunglasses, go to roka.com. That's R-O-K-A .com and enter the code Huberman to save 20% off your first order. Again, that's roka.com and enter the code Huberman at checkout. Today's episode is also brought to us by Helix Sleep. Helix Sleep makes mattresses and pillows that are customized to your unique sleep needs. Now, sleep is the fundamental layer that is the most important aspect of mental health, physical health and performance.
Andrew Huberman: I've said that before on this podcast, and I'm going to be saying it over and over again. If you're sleeping well, everything else is better, and if you're not sleeping well, everything else gets far worse. So sleep is vital, and sleeping on the correct mattress is absolutely vital. Helix understands this, and they have a brief quiz that you can take. So you simply go to their website, you take this quiz, ask you questions such as you tend to run hot or cold during the night, you tend to sleep on your back, your side or your stomach, or maybe you don't know, and they match you to a mattress that's ideal for your particular sleep needs. For me, that was the Dusk mattress, D-U-S-K. I've been sleeping on a Dusk mattress for well over a year now, and it's the best sleep I've ever had. If you like to try Helix Mattress, you can go to helixsleep.com/huberman. Take that brief two minute sleep quiz and they'll match you to a customized mattress for your sleep needs.
Andrew Huberman: You'll get up to $200 off all mattress orders and two free pillows. Again, if you're interested, you go to helixsleep.com/huberman for up to $200 off and two free pillows. The Huberman Lab podcast is now partnered with Momentous Supplements. To find the supplements we discuss on the Huberman Lab podcast, you can go to live Momentous spelled O-U-S, livemomentous.com/huberman, and I should just mention that the library of those supplements is constantly expanding. Again, that's livemomentous.com/huberman. |
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} | Andrew Huberman: Before we begin, I'd like to emphasize that this podcast is separate from my teaching and research roles at Stanford. It is however, part of my desire and effort to bring zero cost to consumer information about science and science related tools to the general public. In keeping with that theme, I'd like to thank the sponsors of today's podcast. Our first sponsor is InsideTracker. InsideTracker is a personalized nutrition platform that analyzes data from your blood and DNA to help you better understand your body and help you meet your health goals. Now, I've long been a believer in getting regular blood work done for the simple reason that many of the factors that impact your immediate and long-term health can only be analyzed from a quality blood test. One issue with a lot of blood tests and DNA tests out there, however, is that you get information back about hormones, blood lipids, et cetera, but you don't know what to do with that information.
Andrew Huberman: InsideTracker makes understanding all of that very easy and even better points to specific directives, that is things you can do in terms of your lifestyle, your nutrition, supplementation, et cetera, in order to bring those numbers related to metabolic factors, lipids, hormones, et cetera, into the ranges that are optimal for you, your immediate and long-term health. If you'd like to try InsideTracker, you can go to insidetracker.com/huberman to get 20% off any of InsideTracker plans. That's insidetracker.com/huberman to get 20% off. Today's episode is also brought to us by ROKA. ROKA makes eyeglasses and sunglasses that are the absolute highest quality. The company was founded by two all-American swimmers from Stanford and everything about ROKA eyeglasses and sunglasses were designed with performance in mind.
Andrew Huberman: I've spent a lifetime working on the visual system, and I can tell you that your visual system has to contend with an enormous number of challenges in order for you to be able to see clearly. ROKA understands this and has designed their sunglasses and eyeglasses to be worn in any number of different conditions and for you to still be able to see with crystal clarity. Now, I wear eyeglasses at night, when I work or when I drive, and I wear sunglasses during the day. I don't wear sunglasses when I get my morning sunlight viewing, a practice that I'm absolutely religious about every single morning, but throughout the day, I'll wear sunglasses when I drive or if I'm heading into bright sunlight to protect my eyes. ROKA eyeglasses and sunglasses are terrific because they were designed for performance, so they were designed for things like cycling and running, so they won't slip off your face if they get sweaty. They're extremely lightweight. |
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} | Andrew Huberman: What they saw was a large magnitude, for example, 52% less postprandial, that's after a meal, glucose excursion, So 52% less increase in blood glucose and 60%, six zero less hyper insulinemia, so reduced levels of insulin. They also, miraculously, observed that despite this being, again, a small muscle, 1% of the total muscle mass, so very small oxidative use, they saw big improvements in systemic metabolic regulation. So this is interesting and I think something that we should at least know about. I'm not aware that anyone's replicated this study yet. I know there's a ton of excitement about this study in the popular press, and if the data turn out to hold up, which I like to imagine they will, I can understand why there's so much excitement. What this means is that if you're somebody who cares about blood glucose regulation, you want to keep your metabolism running, please don't stop exercising, the other ways that you exercise. But if you're somebody who wants to maximize your health, doing these soleus pushups fairly continuously while seated is going to be beneficial. And in addition to that, I know that there are going to be people out there who, for instance, might be injured or you're traveling and you're stuck on a plane or you're in the classroom and you're forced to study all day or take notes all day.
Andrew Huberman: You're just not getting enough opportunity to get those steps that you want to take, whether or that's 10,000 or fewer or more, getting enough steps or movement. Maybe you don't have time to get out and do your run, or maybe you're also running, weightlifting and doing yoga classes and things of that sort, but you want to further improve your fitness, at least in terms of your metabolic health. This seems like a terrific, very low investment way to do it. Certainly zero cost. It does take a little bit of attention, so you have to divert your attention from other things you're doing to make sure that you're still doing these soleus pushups. I'm sure that many of you are going to have a lot of detailed questions such as how high did they lift the heel and did they contract the muscle very hard or not? Couple of things about that, they did not have subjects really contract the muscle hard.
Andrew Huberman: They did measure the angle of heel raise and it was anywhere from 10 to 15 degrees so they didn't have to go way, way up on their tippy toes or things of that sort. In any event, 270 minutes, four and a half hours of doing these soleus pushups is a lot, but by my read of the data and the rather significant, or I should say very significant effects that they observed on blood glucose regulation and metabolism, et cetera, seems to me that doing less would still be beneficial and that you don't necessarily have to do the full 270 minutes in order to get the benefits that they observed. More about the study includes the fact that the benefits they observed were very long lasting, as long as two hours after a meal, they could still see this improved blood glucose utilization. I don't know because I wasn't able to find it in the methods whether or not they were doing the soleus pushups while they were consuming blood sugar in this study.
Andrew Huberman: The point being that if you're somebody who cares about their fitness, this study is interesting, because what it means is that, again, if you are forced to be immobile or sitting longer than you would like, if you're stuck in a meeting or Zooms or class or on a plane, et cetera, or if you're simply trying to add a bit more fitness and metabolic health to your overall regimen, soleus pushups, at least to me, seem like a very low investment, simple, zero cost tool to improve your metabolic health. For those of you that want to peruse the study in more detail, we will provide a link to this paper published in iScience in the show note caption. |
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} | Andrew Huberman: This study had people continuously do soleus pushups and they looked at things like blood glucose utilization, they looked at metabolism and so on. Now, a couple of important things about this study before I tell you what they discovered, which was frankly pretty miraculous, almost hard to believe, and yet I believe the data looked to be collected quite well, and there are a lot of statistics and the study looks to be quite thorough. First of all, they used an equal number of male and female subjects. There were a wide range of body mass indices, okay? So this wasn't just super fit people or people that were purely sedentary and not fit. They used a wide variety of ages, time of day, people who tended to walk a lot or not walk a lot. They measured changes in metabolism and blood glucose utilization and people that had done these soleus pushups while seated in the laboratory, and I must say, they had them do these soleus pushups for quite a long while, continuously. So they had them do it for as long as 270 minutes total throughout the day. So if you divide that, that's four and a half hours, you might say, well, four and a half hours of lifting the heel and putting the heel down, lifting the heel, putting the heel down, that's a lot. But they didn't always do it continuously.
Andrew Huberman: They had some breaks in there. So this is the sort of thing that you could imagine you or other people could do while seated, while doing Zooms or while on calls or maybe even while eating, doing that sort of thing. Although I'm not suggesting that you constantly be focusing on soleus pushups throughout your life. The point is that people who did these soleus pushups experienced dramatic improvements in blood sugar regulation and in metabolism despite the fact that the soleus is just 1% of the total musculature. So here I'm going to read from the abstract about what they found, people who did these soleus pushups, despite being a tiny muscle and using very little local energy... In fact, they measured muscle glycogen, the burn or essentially the utilization of fuel within the muscle, and there was very little utilization of fuel within the soleus itself, and that's because the soleus has this unique property of needing to basically keep you going all day, walking all day or moving all day. |
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} | Andrew Huberman: Hyperinsulinemia is something associated with blood glucose that's too high because insulin goes up to essentially match the level of blood glucose. You don't also don't want to be hypoglycemic, you don't want to have blood sugar that's too low, and insulin is involved in both regulating peaks and troughs in blood sugar, blood glucose. So we can basically say, and this is very simple, but we can basically say that you don't want blood glucose to be elevated too much or for too long. That's not good. In fact, people who have diabetes because they don't make insulin, people who have type 1 diabetes do not make insulin at all, their blood glucose is so high that they actually have to take insulin in order to regulate otherwise their blood glucose can go so high that it can damage cells and damage organs. It can even kill people. People who have type 2 diabetes are so called insulin insensitive.
Andrew Huberman: They make insulin, but the receptors to insulin are not sensitive to it, and so they make more insulin than normally would be made and blood glucose isn't regulated properly, et cetera, et cetera. The take home message about blood glucose is that you want your blood glucose levels to go up when you eat, but not too high and you don't want them to stay elevated for too long. This study looked at how people who are largely sedentary or at least sitting can increase the utilization, the clearance of glucose from the bloodstream after eating, and they also looked at overall metabolism. For people, get this, that were using just that 1% of muscle, the soleus, by doing what they call a soleus pushup. So the soleus pushup can be described very simply as if you're sitting down with your knee bent at approximately right angle, like a square corner, and pushing up, or I should say lifting your heel while pushing down on your toe and contracting the calf muscle as it were, and then lowering the heel and then in lifting that heel again, lowering the heel, lifting the heel again, each one of those is what they call a soleus pushup. |
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} | Andrew Huberman: Before we dive into today's content about fitness and fitness protocols, I want to tell you about a brand new study that is very exciting and frankly very unusual. This is a study that was published out of the University of Houston, examining what I would call a micro exercise or a micro movement. It's a very small movement of a very small portion of your body, in fact, just 1% of your musculature, that when it's performed continuously while seated has, at least what they report, are very dramatic positive changes in terms of blood sugar utilization and metabolism. So the title of this study is "A potent physiological method to magnify and sustain soleus oxidative metabolism improves glucose and lipid regulation." This study was published in iScience, and as I mentioned earlier, it is getting a lot of attention and it's very unusual. Without going into all the details of this study, let me just briefly give you a little bit of the background.
Andrew Huberman: First of all, you have a muscle called the soleus. The soleus muscle is a more or less wide flat muscle that sits beneath what most people think of as their calf, although it's part of the calf muscle. The other portion of the calf is called the gastrocnemius. The soleus sits below that. Now, the soleus muscle is a unique muscle because it's largely slow twitch muscle fibers. It's designed to be used continuously over and over again for stabilizing your body when you're standing upright, for walking. This is a muscle that's designed to contract over and over and over again. In fact, you could walk all day on this muscle and most likely it would not get sore. You probably done that and it did not get sore. In contrast, a muscle like your bicep or your tricep, if I were to have you perform hundreds or thousands of repetitions, even with a very lightweight one pound weight or a two pound weight, eventually it would fatigue. You would feel a sort of a burn there.
Andrew Huberman: It's a very unusual set of muscles to use repeatedly. But the soleus is an unusual muscle in that it really is designed to be used continuously. Now, this study was focused on how people who sit a lot of the day and don't have the opportunity for a lot of physical movement or maybe who don't even exercise at all can improve their metabolism and glucose utilization. Without going into a deep dive about glucose utilization, because we've done the deep dive on this podcast, episodes such as metabolism, et cetera, you can look those up at hubermanlab.com. They're all timestamped and available there. Anytime you eat, your blood sugar goes up to some extent. So your blood glucose, as it's called, goes up to some extent. And then insulin is a hormone that's used to essentially chaperone and sequester and use that blood glucose or it's basically the idea is you don't want blood glucose to go too high. |
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} | Andrew Huberman: Welcome to the Huberman Lab podcast where we discuss science and science-based tools for everyday life. I'm Andrew Huberman and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today we are discussing fitness. Fitness, of course, is vitally important for cardiovascular health, for strength, for endurance, for lifespan, for healthspan. I can't think of anyone out there that wouldn't want to have healthy hormonal function, healthy cardiovascular function, to live a long time and to feel vital, that is to have a long healthspan as well as a long lifespan. Fitness and fitness protocols are tremendously powerful for developing all of that. However, despite there being an enormous amount of information out there on the internet and in books and elsewhere, it can be a bit overwhelming. So today's episode is really designed to synthesize science based tools that we've covered on the podcast, some with expert guests like Dr. Andy Galpin or Dr. Peter Attia, or world renowned Movement specialist Ido Portal, or physiotherapist and strength and conditioning coach, Jeff Cavaliere.
Andrew Huberman: We've had all of them as guests on the podcast, and each and every one of them provided a wealth of knowledge in terms of the various things that you can do to optimize very specific or multiple aspects of fitness. Today, we're going to do something a little bit different than usual. Typically on the Huberman Lab podcast, I offer mechanism upfront or first, and then we talk about protocols that you can use that really lean on those science and science based mechanisms. Today I'm going to describe a specific protocol that serves as a general template that anyone, in fact, everyone can use in order to maximize all aspects of fitness. So that includes endurance, strength, flexibility, hypertrophy, aesthetic changes, et cetera. However, this general framework can also be modified, that is customized to your particular needs. So if you're somebody who really wants to build more strength or bigger muscles, you can change the protocol and the overall program according to that. And I'll talk about very specific ways to do that. Or if you're somebody who really just wants to maintain strength, but you want to build endurance, we'll talk about that. And of course, we will cover real life issues, such as should you train if you are sleep deprived, what about food?
Andrew Huberman: When should you eat? What if you haven't eaten and you're hungry? Should you still train? Et cetera, et cetera. We're going to cover all of that, again, in the context of this, what I would call foundational template of fitness. Now, this foundational template of fitness is something that I personally use. In fact, I've used it for over three decades, hard to believe that I'm that old, but I just recently turned 47, and I still use this basic protocol or template across the week and modify it according to what my particular goals are that year, that month, even that day, because I, like you, live in the real world and sometimes I've been traveling or I miss a workout, yes, it does happen, or life isn't organized in exactly the way that I need to in order to have everything go according to the protocol that's on paper. So we're going to discuss real world issues and how to work with the real world issues in order to get the most out of your fitness program. And again, by the end of today's program, I can assure you, you will have a template protocol that you can build up from, build out, change and modify, and that will really serve your fitness goals according to the science and what peer-reviewed studies and the experts that appeared on this podcast and other podcasts really tell us is best and optimal for our fitness.
Andrew Huberman: I'm pleased to announce that the Huberman Lab podcast has now launched a premium channel. I want to be very clear that the Huberman Lab podcast will continue to be released every Monday at zero cost to consumer, and there will be no change in the format of these podcasts. |
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} | Andrew Huberman: Each and every one of these requires different principles, different concepts in order to improve, say your muscular strength or your hypertrophy or both. However, there's a general theme that sits beneath all adaptations leading to fitness, and that's what we're really going to set down as the base layer, the foundation of everything we talk about today. And that's that we need to think about what are the modifiable variables? Again, I'm borrowing directly from the episode with Dr. Andy Galpin. He was the one that said, modifiable variables are the key thing to think about. What are you going to modify? What are you going to change in order to increase one or some of the various things I listed off before, skill, speed, power, strength, hypertrophy, endurance, et cetera, et cetera. And some of the key concepts that emerge from that discussion are that we need to think about progressive overload.
Andrew Huberman: Normally when people hear about progressive overload, they think about adding more weight to a bar or picking up heavier dumbbells, but that could also be progressive overload in the context of running up a hill of steeper incline or running a little bit faster or a little bit further and so on and so forth. Now, as I promised earlier, today we are not going to drill into each and every one of the mechanisms that underlie the different adaptations that are going to develop speed and strength and endurance, et cetera, because that was covered in the podcast with Dr. Andy Galpin and the other podcast with experts that I mentioned earlier. And we again, will provide links to those podcasts if you want to drill into those mechanisms.
Andrew Huberman: Instead, what we are going to do is we're going to start with a program that essentially is designed for you to maximize all aspects of fitness to the extent that you can simultaneously maximize all aspects of fitness, but then to change or modify that protocol so that if you want to build up more, for instance, strength and you want to just hold onto the endurance you have, you don't want to build endurance, at least not in that week or that month, you can do that. Or if you want to improve your endurance while maintaining your strength, you can do that. And so on and so forth. Most people, I do believe, would like a combination of strength and endurance and flexibility and maybe even hypertrophy, particularly for certain muscle groups that maybe are not as well developed as other muscle groups.
Andrew Huberman: They want to bring balance to their physique, both for sake of aesthetics and for sake of health and for sake of general functioning, to maybe even to eliminate pain, the protocol that I'm going to describe really works as a foundational template for that as well. |
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} | Peter Attia: Yeah, if you look at the literature on this, it's going to tell you it's going to differentiate power lifting from weightlifting. In other words. Yeah, you do need to be kind of moving against a very heavy load. Now, again, that can look very different depending on your level of experience. Like, I really like deadlifting. Now. I can count the number of days left in my life when I'm going to want to do sets over £400, but I'll pick and choose the days that I do. But I grew up doing those things. I'm comfortable with those movements. If I had a 60 year old woman who's never lifted weights in her life, who we now have to get lifting, I mean, we could get her to Deadlift, but I think I wouldn't make perfect the enemy of good. I'd be happy to put her on a leg press machine and just get her doing that. It's not as pure a movement as a deadlift, but who cares, right? We can still put her at a heavy load for her and do so safely.
Peter Attia: Now, that said, there was a study that was done in Australia and hopefully we can find a link to it. There's a video on YouTube that actually kind of has the pi sort of walking through the results. I could send it to you.
Andrew Huberman: Okay. Yeah.
Peter Attia: And it's just amazing. They took a group of older women, they look like they're in their 60s or 70s, who had never lifted weights in their life, who had osteopenia, and some probably already had osteoporosis, and they basically just put them on a strength training protocol. And it is remarkable to watch these women. They're doing good mornings, they're doing deadlifts, they're picking heavy things up off the ground. I think one woman was picking up god, I want to say she was like, picking like 50, 60 kilos up off the ground. I mean, just staggering sums of weight for these women who have never done anything. And their bone health is improving at this age. So the goal, frankly, is to just never get to the point where you have to do this for the first time. Strength training is such an essential part of our existence that it's never too late to start, but you should peter, stop. |
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} | Andrew Huberman: In terms of frequency of blood testing, if somebody feels pretty good and is taking a number of steps exercise, nutrition, et cetera, to try and extend lifespan and improve healthspan, is once a year frequent enough? And should a 20 year old start getting blood work done just to get a window into what's going on? Assuming that they can afford it or their insurance can cover it?
Peter Attia: Yeah, I mean, look, I certainly think everybody should be screened early in life because if you look at what's the single most prevalent genetic driver of atherosclerosis is, LP little A. So unfortunately, most physicians don't know what LP little A is. And yet somewhere between eight and 12% of the population has a high enough and depending on who you I had a recent guest on my podcast who suggested it could be as high as 20% have a high enough LP Little A that it is contributing to atherosclerosis. So to not want to know that when it's genetically determined, right? This is something that you're born with this, and you only need to really check it once. Why we wouldn't want to know that in a 20 year old when it can contribute to a lot of the early atherosclerosis we see in people, it's leaving money on the table, in my opinion. The frequency with which you need to test really comes down to the state of interventions.
Peter Attia: I don't think it makes sense to just do blood tests for the sake of doing blood tests. There has to be kind of a reason. Is something changing? A blood test is, for the most part, a static intervention. It's a look at a window in time, and there's benefit in having a few of those over the course of a year if you're unsure about a level. So if something comes back and it doesn't look great, yeah, it might make sense just to recheck it without reacting to it. But typically in patients, we might check blood two to four times a year, but we're also probably doing things in there to now check, like, hey, we gave this drug. Did it have the desired outcome? You put on £3 of muscle and lost £3 of fat. Did it have the desired outcome? |
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"chunkTitle": "Momentous Supplements",
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} | Andrew Huberman: We partnered with Momentous for several important reasons. First of all, they ship internationally because we know that many of you are located outside of the United Statins. Second of all, and perhaps most important, the quality of their supplements is second to none, both in terms of purity and precision of the amounts of the ingredients. Third, we've really emphasized supplements that are single ingredient supplements and that are supplied in dosages that allow you to build a supplementation protocol that's optimized for cost, that's optimized for effectiveness, and that you can add things and remove things from your protocol in a way that's really systematic and scientific. If you'd like to see the supplements that we partner with Momentous on, you can go to Livemomentous.com Huberman. There you'll see those supplements. And just keep in mind that we are constantly expanding the library of supplementation available through Momentous on a regular basis. Again. That's livemomentous.com.
Andrew Huberman: Huberman. |
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"chunkTitle": "Health Optimization",
"episodeTitle": "Dr. Peter Attia: Exercise, Nutrition, Hormones for Vitality & Longevity | Huberman Lab Podcast #85",
"imgUrl": "https://img.youtube.com/vi/DTCmprPCDqc/maxresdefault.jpg",
"published": "2022-08-15T00:00:00+00:00",
"url": "https://dexa.ai/huberman/episodes/doc_2065?sectionSid=sec_29159&chunkSid=chunk_57967"
} | Andrew Huberman: Welcome to the Huberman Lab podcast, where. We discuss science and sciencebased tools for everyday life. I'm Andrew Huberman, and I'm a professor of neurobiology and ophthalmology at Stanford School of Medicine. Today. My guest is Dr. Peter Attia. Dr. Attia is a physician who's focused on nutritional supplementation based behavioral prescription drug and other inter ventures that promote health span and lifespan. His expertise spans from exercise physiology to sleep physiology, emotional and mental health, and pharmacology. Today we talk about all those areas of health, starting with the very basics such as how to evaluate one's own health status and how to define one's health trajectory. We also talk about the various sorts of interventions that one can take in order to optimize vitality while also extending longevity, that is, lifespan. Dr.
Andrew Huberman: Artilla is uniquely qualified to focus on the complete depth and breadth of topics that we cover, and indeed these are the same topics that he works with his patients on in his clinic every day. Dr. Attia earned his Bachelor of Science in Mechanical Engineering and Applied Mathematics and his MD Stanford University School of Medicine Medicine. He then went on to train at Johns Hopkins Hospital in General Surgery, one of the premier hospitals in the world, where he was the recipient of several prestigious awards, including Resident of the Year. He's been an author on comprehensive reuse of general surgery. He spent two years at the National Institutes of Health as a Surgical Oncology Fellow at the National Cancer Institute, where his work focused on immune based therapies for melanoma in the fields of science and medicine. It is well understood that we are much the product of our mentors and the mentoring we receive. Dr.
Andrew Huberman: Attia has trained with some of the best and most innovative lipidologists, endocrinologists, gynecologists, sleep, physiologists and longevity scientists in the United States and Canada. So the expertise that funnels through him and that he shares with us today is really harnessed from the best of the best and his extensive training and expertise. By the end of today's episode, you will have answers to important basic questions such as should you have blood work? How often should you do blood work? What specific things should you be looking for on that blood work that are either counterintuitive or not often discussed and yet that immediately and in the long term influence your lifespan and health span? We talk about hormone health and hormone therapies for both men and women. We talk about drug therapies that can influence the mind as well as the body. And of course, we talk about supplementation, nutrition, exercise, and predictors of lifespan and healthspan.
Andrew Huberman: It is an episode rich with information. For some of you. You may want to get out a. Pen and paper in order to take notes. For others of you that learn Peter simply by listening, I just want to remind you that we have timestamped all this information so that you can go back to the specific topics most of interest to you, I'm pleased to announce that the Huberman Lab podcast is now partnered with Momentous Supplements. |
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"chunkTitle": "Mental Resilience",
"episodeTitle": "Dr. Duncan French: How to Exercise for Strength Gains & Hormone Optimization | Huberman Lab #45",
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"published": "2021-11-08T00:00:00+00:00",
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} | Andrew Huberman: You have circuit in your brain, right?
Duncan French: You just plan like, you know where all the targets are going to be here. It's a moving target because you might be just hanging out, doing some general prep work, and then you might get a short notice fight. They give you a quick call and it's in six weeks or five weeks, and, okay, I've got to ramp everything up really quickly. So that's a real challenge in terms of just managing all these different components of mixed martial arts alone. To come back to your question, the other thing which is truly fascinating about these individuals is just their mental resilience. And again, we've touched on it in the talk. But the ability to do what they do on a daily basis, to look at all the different skill sets that they have to try and engage in and bring into their training to do that and embrace the grind, embrace the process of just learning the physical side of our sport is unprecedented. But the mental side, we have a funny saying.
Duncan French: We always say it's 90% mental apart from the 60%, that's physical. So it's just more and more and more. And these guys ability to just do that on a daily basis is very impressive. Like their resilience, their internal drive, and their resilience is really impressive to see.
Andrew Huberman: All the fires I've met here have been really terrific. It's interesting, every time I meet a fighter, how often I shouldn't be surprising, where they're often very soft spoken, right? Always extremely polite. And fighting is such a it comes from a very primitive portion of the brain, right? But a large portion of the brain nonetheless.
Duncan French: But I think that's another skill is that switch, and again, that's the recoverability piece, right. You cannot be type A or you cannot be like, supercharged 24 hours a day because you're going to just fry your system, right? And I think that's something else where we're really trying to manage this whole process, be it through nutritional interventions, be it through education, around sleep, be it through training, program management, be it through psychological interventions. You could look at fighters and say these guys are go like they're red alert and they'll run through a brick wall. But actually, again, their ability to turn it on and off means that they can do what they do. They can bring it down and be very normal, very polite, very accommodating, maybe.
Andrew Huberman: Even better than most people. |
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"chunkTitle": "Muscle Growth Insights",
"episodeTitle": "Dr. Duncan French: How to Exercise for Strength Gains & Hormone Optimization | Huberman Lab #45",
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} | Andrew Huberman: Interesting, you mentioned lactate. So it seems still a bit controversial as to what actually triggers hypertrophy. You hear about lactate build up or people, the common language is the muscle gets thorne and then repairs. But I don't know, does the muscle actually tear?
Duncan French: I mean, microtrain, okay, microtrauma disruption within the muscle tissue for sure.
Andrew Huberman: Interesting. And we're talking now about non drug assisted people. Let's just say, let's define our terms here, whose testosterone levels are within the range of somewhere between 300 and 1500 or whatever 1200. Because it does seem that athletes who take high levels of exogenous androgens can do more work and just get protein synthesis from just doing work. I've seen these guys in the gym, the whole tail signs are not that hard to spot, where they're just doing a ton of volume, not necessarily moving that much weight, they're just bringing blood into the tissue and then they're eating a ton of protein, presumably because they're basically in puberty part 15, right. They got on their 15th round of puberty, where during puberty, you are a protein synthesis machine. To me, that's pretty clear about puberty. Interesting, because I know the audience likes to try protocols. So you described a protocol very nicely. What about day to day recovery?
Andrew Huberman: I mean, can the workout that you described as intense but short, how many days a week can the typical person do that and sustain progress?
Duncan French: Yeah, I mean, I think that comes back to your training age and your training history. Obviously, there's a resilience and a robustness with an incremental training age. So that's not a protocol that I would advise anyone to go out and start tomorrow.
Andrew Huberman: They'll be mopping them off the gym.
Duncan French: Floor, but at the same time, it's also relative. Right. So 80% of your maximum at a young training age is still 80% versus been training ten years, it's still 80%. But, yes, the mechanical load is going to be significant, it's just more tonnage. Right. But yeah, I think a protocol like that we would look at two times a week, something that's pretty intensive like that. Because again, it comes back to the point you make, is that you really need to be, for want a better term, suffering a little bit through that type of protocol, both in terms of the challenge of the load, but also being able to tolerate the the metabolic stress that you're exposed to. It's it's, it's, you know, a bit of a sicko feeling right. Because of the lactate that you're driving up. So I wouldn't promote an athlete doing that type of modality multiple, multiple times, unless you are from the realms of bodybuilding and then that's the sole purpose of what you're trying to achieve.
Duncan French: Most athletes in most sports have diverse requirements in terms of outcomes that they're trying to achieve. They're not just targeting muscle growth. Muscle growth is a conduit to increase strength, increased power, increased speed, obviously. So, yes, trying to get bigger cross sectional area of a muscle means that we can produce more force into the ground or wherever it may be if we're a locomotive athlete. But usually sports, men and women are not just purely seeking muscle growth, they look for different facets of muscle endurance or maximal muscle power, muscle strength. So then you've got to be very creative in how you build the workout. If it's a bodybuilder. Absolutely. They're chasing muscle growth and they're going to do so with these types of protocols, which sees high intensities and high volumes of workload on a pretty regular. Basis.
Duncan French: If it's just somebody, a weekend warrior that wants to keep in shape and look good, I would say two times a week for a really challenging workout like that, and then flex the other types of workouts within the week to have more of a volume emphasis where you reduce the intensity. And you might just look at larger rep ranges from twelve to 15 to 20. Another workout where you're looking at reducing the volume but increasing the intensity and really trying to drive a different stimulus to give you more endpoints of success.
Andrew Huberman: Great. No, that's really informative along the lines of androgens and intensity. |
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