The Anabolic Garage Door for Protein Intake - Dr. Stuart Phillips

[Music] Hello and welcome to the CSAT podcast brought to you by the Canadian Society for Exercise Physiology. This podcast is designed to provide our listeners with the gold standard of information in exercise science and personal training. In our host Abby, as she discusses important topics with industry leaders and provides you with insights to help your interests, education and career. [Music] Hello everyone, this is Tyler from CSAT Member Services and I'll be taking over hosting today as Abby is away this week. Today's episode features a leading voice in skeletal muscle research, Dr. Stewart Phillips. Dr. Phillips is a CSAT academic member, a professor in the Department of Kinesiology at McMaster University and a tier one candidate research chair in skeletal muscle health. With over 400 scientific publications and more than 31,000 career citations, Dr. Phillips has made a profound impact on how we understand the role of nutrition and exercise in shaping human skeletal muscle. His research explores how diet and physical activity influence body composition, muscle health and overall wellbeing. A passionate advocate for accessible movement, Dr. Phillips emphasizes that even small amounts of exercise can make a meaningful difference, especially for older adults. In this episode we'll dive into the science of muscle health, protein intake, aging and how to translate research into real and a practice. Okay, welcome to the show, Steve, where do we happen to have you? Thanks for having me, Tyler. Pleasure to be here. Pleasure's ours. So, yeah, before we launch into our main topics, we'd really love to learn where your passion from the field comes from. Would you mind sharing some moments or big events in your career that have kind of helped you get to this point? Yeah, I think, honestly, my passion for this work probably started the same way most people does. It's through your own life. I grew up playing all kinds of sports. Predominantly, the sport, if you said what's number one would have been rugby. So I was constantly curious about what I was eating and how I could improve my performance and training. And I think that curiosity sort of never really went away. And I did most of my undergrad and master's work here at McMaster and then had some excellent mentors and people like Mark Tornipolsky, who I'm sure a lot of the people listening will who will know. And people like Mark and Duncan McDougall, Stephanie Ackinson really galvanized in me and then how he green at the University of Waterloo, you know, a real curiosity around physiology and human performance and that sort of thing. So I think that it's been an evolution particularly when I did a post-op with a guy named Bob Wolff down in Texas to understand protein. That was another sort of one of these epiphany moments. And Mark instilled in me, of course, that muscle was the most important tissue. So, and getting a chance to, if you like, peek under the hood about how muscle actually works. But more recently, I think it's just been an evolution. I've been doing this. I've been with Master in Alpha for 28 years. The real fuel has been the trainees that I've had the privilege of working with generations of students, post-docs. You know, I've gone on to do spectacular science. So watching them ask better questions than I ever did is kept me sharp. And, you know, more recently working with older adults through our physical activity, center of excellence at McMaster. It's just reminded me of why a lot of this matters. And so it's not that I'm not interested in performance and everything anymore, but a little bit more interested in, you know, what can we do to help someone in their 70s or their 80s get up off the floor without thinking about it. And I think that's worth a lot more than a lot of citations, for sure. Yeah, that's awesome. And I think it really speaks to, I guess, the progression of motivation through a career path where, you know, it starts with a lot of people get into this because they play sports, they like to be active. And then, like you said, the mentors are the people that you had along the way. It kind of transitions into, okay, that's a big motivator in learning from them. Now that being in that position yourself, you're still equally motivated, but maybe it's changed to motivated by the people that you're working with and the people who are now learning from you. So that's just, I think that speaks to a pretty full career path. Yeah, absolutely. I guess getting into the main topic of protein here. So obviously a lot of people are aware of how important protein is, but it still is often under-consumed. Just from a very basic level, why do we need to consume an adequate amount of protein and then what is the role of exercise in making this consumption effective? Yeah, you know, I'd say it's probably fair to say that protein is having a moment right now. You know, I've been doing protein metabolism for quite some time and I don't think that it's being as popular as it is right now, but the point I make to people to distinguish protein from carbohydrates and fats, it's the only macronutrient that we can't store. We have capacity to store carbohydrates as glycogen and both our fat or, excuse me, in our liver and our muscle. Fat obviously goes into adipose tissue, but protein gets constantly turned over. And I like to invoke the concept of a brick wall and that bricks are constantly being put into the wall. That's obviously amino acids, but they're constantly being pulled out as well. So you're breaking down somewhere in the order of about 250 to 300 grams of protein in your body and rebuilding the same, approximately the same amount. So the dietary protein you eat isn't an optional extra. It's actually the raw material. It's the building blocks for that turnover. If you under consume protein and then your body's going to find somewhere and usually that somewhere that it pulls the extra protein from is muscle. That's the label label, label reservoir and exercise a resistance exercise in particular is the other half of the equation. So a boat of resistance exercise sensitizes your muscle to amino acids for between probably 24 to 48 hours. So that post exercise, anabolic window that everybody talks about is more like an anabolic garage door to quote a good friend of mine, Sean Aaron, to coined that phrase. So what that means practically is that the same serving of protein that you ate if you were sedentary for a day builds more muscle when it lands on top of a training stimulus. And you can think of protein as they said is the bricks and exercises if you like the, I guess the mason that tries the brick layers. Bricks without a mason just sit there and a mason with no bricks is out of work. So you need both. Absolutely. That makes sense. And yeah, I think that it's whether it's protein or other big supplements that are on the rise right now. Obviously, pretty nothing. It's made macronutrient, but things like creatine and other forms of supplementation there. A lot of people think that, okay, I take it and then that's kind of it. It does its job and really, yeah, exercises that kind of key piece that makes what you're doing effective. Absolutely. I think that there can definitely be some confusion when people are just looking at recommended daily amounts. There's some places where it's cited as 0.8 grams per kilogram of body weight, but I've seen just in a lot of what you've put out that you are that the amount should be higher. So can you just dive in a bit to what the, what your view is the recommended daily amount. And if this varies based on age, sex activity level, things like that. Yeah, so to be clear, the 0.8 grams of protein per kilogram of body weight is the recommended diet here at Lounce or RDA. It's probably a little bit misunderstood. To be clear, it was derived from nitrogen balance studies, which, you know, myself and several other people have been critical of as a fairly crude technique. And it was really designed to offset deficiency with a margin of error in that, but it treated all protein and all of the amino acids as being equivalent. And you know, not recognizing that there might be rules for certain amino acids as part of protein in optimizing some of the outcomes that are supported by protein ingestion and I'll sort of explain what that means. But you know, with the brick and wall analogy, I guess the idea is that, you know, that I mean and to be clear, we're not just talking about muscle, we're talking about all kinds of different protein requiring processes. But the idea is that above the recommended diet here at Lounce, so my practical recommendation would sit somewhere between. between 1.2 to 1.6 grams of protein per kilo per day for healthy folks. And if you were training, you could maybe push it as high as say 2.2 grams. But I do think that once you hit 1.6, it becomes pretty difficult to see any benefits beyond that. That said, the idea is what are the benefits that you would see? And of course, for athletes, the idea is that if you're consuming more, that you could get a better adaptation in muscle. And from that standpoint, are you going to gain more muscle if you're lifting weights or are you able to make more mitochondria if you're aerobically active, for example? And those have been, to some degree, shown by various labs ourselves included, but good colleagues around the world. We're pretty sure now that you get this blunted response to protein with aging. And so protein needs in our minds again, for an optimization of the process would be higher or so closer to that, at least 1.2 and maybe as high as 1.6. Sex differences largely when you express the data per kilogram of lean mass. And so you can argue that's maybe the functional unit that's going to use the protein. Then men and women actually have requirements that are very similar. And they respond very similarly to protein. But in fairness, women have been understudied, I think in exercise physiology or in physiology in general, it's full stop. But the signal that we have says the per kilogram protein recommendations are broadly the same. It may matter, obviously, if a woman is pregnant or lactating, and where the demand is going to go up. But if I'm talking to men and women and I'm looking at per kilogram body weight, we're more accurate if everybody knew their lean mass and everybody wants a per kilogram lean mass estimate. And I'm like, well, not too many people know their lean mass accurately. So we use per kg body weight. And the advice would be the same for males and females until you get older. So probably somewhere in your 60s, I would say. - Okay, yeah, that makes a lot of sense. And I guess just kind of building off of that. In terms of the protein that we are consuming throughout the day, there is what does your take on the idea out there that not all protein is created equal? Is it more important enough or the quote unquote right protein? - Yeah, yeah, that's a good question. And I think both are true, right? And one is probably much more important in the real world. Protein quality differences are real. They're now quantified using a method called the diast, or the digestible and dispensable amino acid score. They have a mouthful. And it's basically just a reflection of how digestible the protein is and the indispensable amino acids or essential amino acids are scored as if they are compared to an ideal or a theoretical protein. So animal source proteins like dairy, so the components of which will be weigh in casing, eggs, meats, fish, chicken, that sort of thing, score higher than plant proteins. And that's a fact, it's not an opinion. Soy would be the exception on the plant-based side and that largely comes down to, it's pretty digestible and it's amino acid score is fairly high. But my understanding now of, you know, the US stew 20 years ago, I'd have been like, oh yeah, like those digestibility, it's absolutely animal source proteins or bacteria. And then the evolution work that we've done, a lot of it has been done by my good friend and colleague, Luke Fanlune and people in Islam, show us that actually the difference between animal source and plant source proteins becomes quite a bit smaller than we would have thought. In other words, if you're going to pick one thing to fix in an average person's diet, it would be the total daily protein and not the source should be, you know, let's say if they're hitting 1.4 grams per kilo per day from a mixed, you know, plant-based diet, it's better than somebody hitting 0.8 grams per kilo from an entirely, you know, chicken breast diet, for example. So that quality gap between animal and plant is real, but the effects it has physiologically or relatively modest. And so you can close it in two ways by eating a bit more total protein, by varying the sources, of course, if you're an omnibor, no problem, so that the amino acid profile is complete. And, you know, I think people who are vegan, as an example, have figured out, you know, everywhere around the world, people have figured this out that a grain and a leg used, so rice and beans or, you know, black beans and corn, this sort of thing. And they've been doing that math, whether they knew it or not, for, you know, for thousands of years. So interesting that everybody's got that figured out at some point. Oh, absolutely. It is good to know that, I mean, there are going to be different diets out there, especially the listeners who are working with people who have different dietary restrictions, just being able to make that recommendation. I guess it's good to not just be, okay, you're dealt with a vegan client and suddenly you have to be, hey, really no, eat meat is going to be very, yeah, just, just, just, just not needed. But, yeah, no, you're being able to set that as a goal, I think is very important. So yeah, going back to, I guess, the garage door analogy that you used at the start, I really liked that. Credit to Sean Aaron for that one, I gotta give him a shout out. Yeah, it's his, his words. It's a good one, though. You can get the idea of Crock, not a window garage door. Absolutely. I think that's just whether it's, yeah, meal timing or just that view, or the way that people have communicated for so long of being that anabolic window. Can you speak at all to the effectiveness of different strategies for timing and ways to take protein or, you know, is there a benefit to smaller meals throughout the day? But does that really matter at the end of the day? Yeah, and again, this is a question that I think our understanding of which has been shaped by some pretty recent work. And I know that we have some work coming out of our group. The two fantastic students took a long time to do. So I don't want to steal their thunder too much. But I would say that, you know, total daily protein intake, the 1.2 to 1.6, does the majority of the lifting with respect to, you know, stimulating particularly muscle protein and ablysm, so muscle protein synthesis. And then, you know, so in order of priorities, it would be, you know, first be as active as you can, get to the gym, et cetera, or go, you know, for a walk and all this sort of stuff. But after that, it's emphasized the daily protein intake. And the per meal recommendations that a lot of people have spent some time sort of engineering and talking about myself included, I'm beginning to think, matter maybe a little bit less than we once thought. At the same time, I do think in the one meal that people almost chronically under consume, if that's the right way of saying it protein is the first meal of the day. So at breakfast, whenever that meal happens to occur, I do think that that meal should be a little bit higher in protein than people habitually make it. Most people eat breakfast usually in the morning, that's particularly carbohydrate rich. And it is the first meal after you've been in an overnight fast. And so it's the meal that, to my mind, it kind of patterns that protein synthetic response for the rest of the day. But if it's only got a small amount of protein, which for most people it does, then you're missing out on an opportunity to really get the whole process of protein remodeling started. So that being said, I still think that it's probably the overall daily intake that's most important. Now that definitely makes sense. When we're looking at populations, specifically, I guess I'm thinking athletes, just for those listeners who are working in the high performance space, when you're able to get into the nitty-gritty a little bit more in the performance space, do you find that it matters a little bit more when timing it around exercise or around sleep for that sort of 12 hour fast that you're mentioning? - Yeah, I mean, I think variation in dose rather than timing. So athletes in particular, those doing sort of high volume training, trying to gain or tolerate and benefit from higher, I would call them per meal doses. So the usual spread we talk about is if you're eating three meals a day, then at minimum it's 0.4 times three gives you 1.2 or it's closer to somewhere around 0.5 grams per kilo times three gives you closer to the 1.6 type intakes. So I mean the scenarios are sort of like combat sport athletes making weight or endurance athletes and heavy blocks. Also probably need more than the general recommendation to protect their lean mass and their muscle mass. And older adults are another group and where per meal dose might matter a little bit more because of a phenomenon known as anabolic resistance, which is something akin to insulin resistance but basically framed around aging and protein metabolism. So when you get older, your normally robust animal response to protein begins to get sort of dialed down. So the practical issue then is that older people would need to consume more protein or more of the essential amino acids and try and eat it in maybe a slightly more balanced fashion than the skewed fashion where you need a small amount of breakfast a little bit bigger at lunch and the biggest amount at your dinner time meal. So try and emphasize a little bit more protein at the breakfast and lunch time meals. And evening up that distribution for some folks is the kind of low hanging fruit. Still comes down to total daily intake though. I think that that begins to trump just about everything when it comes right down to it. - Now that's good to know. I think yeah, if there's a theme for the episode, it will likely be just hit your total daily intake and you can fix the majority of any of your problems or get most of the way towards your goals. So now that's good to keep in mind. - Yeah. - And it's just, on the idea of just what to keep in mind, I think we've kind of talked a lot about getting to the facts surrounding protein. But I do think just with the popularity of, I guess fitness culture on social media and everything like that, there's a ton of myths out there. - Yeah. - So I guess just, yeah. What are some of the main sort of recurring myths that you've been seeing and just would like to, you know, put an end to? - Uh-huh. (laughs) Yeah, well, if you're gonna do social media myths or, well, even protein myths, I guess we always do a whole episode on that, if you want, but I'll kind of, I'll give you a, I think the, I'll call them the greatest hits, if you like. So the first myth and we may have unwittingly contributed to this, but the idea is that you can only absorb 20 or 30 grams of protein at a time and the rest is, you know, in quotation marks is wasted. So that's wrong. Absorption is not the same as usualization. So we had a study several years ago that was done by former PhD student of mine, Dan Moore. He's now a professor at the University of Toronto, in which we sort of showed that around 20 grams of protein maximize the anabolic response and everybody goes, well, that's all you need and I'm like, that's fine, but that doesn't mean you can absorb more. Now what you can use in a single dose, beyond I would say, probably about 40 grams doesn't, doesn't dial up muscle protein synthesis much more, but it gets used by other tissues and like say the gut, so the body's not throwing food away. Myth number two, probably would be high protein damages kidneys and, you know, in people with healthy kidneys, there's actually no evidence of that. And everybody goes, well, absence of evidence is an evident, you know, I'm like, yeah, fair enough, but that's a 60 year old, they're coming a little bit more. Now hypothesis, which came from extrapolating findings in, you know, predominantly rodents, or in people with pre-existing kidney disease, which isn't particularly good science. And so 60 years following that runner hypothesis, we're still searching for evidence. And, you know, at what point does a hypothesis become just that, right? It was a great idea, but we haven't found evidence for it, so time to move on. Myth number three, I think is, you know, plant protein is useless for building muscle. It's not useless. I think it would be fair to say it's a little less efficient per gram of protein, and that begins to close the more you eat. And so if you vary your sources, if you're a lacto-ovogetarian, so you drink milk, you consume dairy, you eat eggs, no problem at all, if you're an omnivore, obviously, no problem. If you are vegan, you just have to be a bit more judicious about how you pick your foods. And I think that that's sort of we kind of address that before, but people are like, well, protein that you derive from plants, quote, "in quotation marks" doesn't count. And there's no reason for that. I think the last myth is that that post-workout window is, you know, we just seem to bury that one. (laughs) It's still coming back to the idea that, you know, you have to walk around with a shaker of protein in the gym in fairness, I usually see young men doing that. So just not needed. - Yeah, and I think that a big sort of trend behind any of these myths be with protein or just kind of anything that we're seeing out there is that I think the, especially with the advent of social media, it's like those binary sort of rules or big titles are the ones that get the whites and get the traction. So it's like, yeah, that protein is useless, is going to be a much bigger headline that a lot of people are clicking on as opposed to it. - And this is a function of social media, right? Social media rewards algorithms that have decorative statements that people interact with, whether it's interaction to say, absolutely, I agree, or interaction to say, that's total garbage, then the algorithm goes, oh, look, people are interacting with this post, it pushes it up higher and it gets a lot more attention. So I can understand about being controversial and putting something out there that is kind of in your face because you get more engagement, you get more likes and more likes drives, more followers and more, you know, and you can see how it goes. So absolutely. - Yeah, and I think just kind of, to maybe think of, I guess, maybe more of a two-pronged question here. So four are CSAT members and people who kind of exist in either a research space or even just an area where they're bringing a higher level of knowledge to their clients, the general public, whatever it may be. What, through your career, have been some effective knowledge translation strategies for being able to promote facts, promote your research and just make sure it's easily accessible to the highest number of people possible. - Yeah, I think the funerary answer is, you know, to try and meet people where they are. I think the evolution of my sort of why I do social media because I have lots of colleagues that are like, you know, why do you bother? But one of the main reasons, you know, I used to teach your first year class in nutrition and metabolism for Kinesia algae students. And the assignment to, you know, to put an perspective when I first started teaching was to cut an article out of the newspaper, and I know who handles newsprint, but people used to. And then find the corresponding journal article that it was referring to and see how good a job the article in the newspaper did actually translating the science. And, you know, over years of teaching that class, I noticed that, you know, nobody was handling newsprint anymore. People wanted to print something off the internet that they had seen. And I was like, yeah, sure, that's, that's fine. And then it became, you know, people were listening to podcasts, people were listening to people, you know, comment on things. And, and now I don't teach that class anymore, but I do parachute into a first year class that a lot of faculty members in our department go to. And I ask students, you know, where are they getting their information and they're almost exclusively, it's coming from social media. So, you know, I think that that's, you know, that's the population that I'm interested in influencing, right? I mean, it's what drives everybody here at university. And so, you know, I do podcasts like this one. I do short videos. I am on social media. I write for lay audiences and I try quite hard to speak and engage people with, you know, in plain language, without, I'll call it, you know, in quotation marks, dumbing down the science so much. And I think it, It's a different environment in which we are living right now where a mistake that a lot of academics make. I think as an assuming that if you publish the paper, the world will come and find it. And the short answer is it won't. And so you have to go to the world. So for practitioners in the public without a research background, three things. First, be suspicious of anyone who speaks in absolutes because most scientists like me, and I say this to my students, I'm like the answer to the most interesting question is always, it depends. You know, science never works in absolutes. Second, look for convergence. So if the top of the pinnacle of evidence, and I have to say evidence based something coming from a master. So systematic reviews and meta analyses and good journals, you know, tend to agree with it. Kind of practical recommendations, professional bodies. You're probably on solid ground. And then third, sort of be wary of anybody selling you the answer, which is. Is hired on social media these days because you know, a hidden agenda to somebody's. Substacks subscription or or Patreon subscription or whatever is that you get access then to their inner circle that recommends products that then, you know, they're endorsing and everything else like that. So yeah, I don't know how to put it any planer, but I'd say that that would be the way to do things. Yeah, no, I think that's that is really important. I think yeah, kind of tying us back to the earlier myth question, but that speaking in absolutes is usually a sign of like, okay, something's missing here. Well, it becomes dogmatic, right? And that's like what we were saying earlier, just as soon as you take a dogmatic stance and people engage with you, whether they agree or disagree. It, yeah, it, you know, it's much more popular on and on all the algorithms, you know, because people, the engagement is what drives everything. So yeah, you can see how why people will gravitate towards that for sure. Now that makes a lot of sense. Switching back a little bit here to pro. I guess this question just comes from a talk that I had watched you give a little while ago here. And specifically regarding the, I guess we've kind of touched on the amino acids and just the role of Lucine in synthesizing protein. I know that there's a really interesting example that you gave on, I believe it was 25 grams of protein without Lucine and five to six width and just kind of the effects that we're seeing there. Yeah, yeah. Yeah, I mean, of all of the amino acids, the one that is key, it's an essential amino acid called Lucine. And it's one of the three branch chain amino acids, but it's essentially the amino acid that sort of, I don't know if it flips the switch, but it turns on the light and kind of a dimmer switch fashion that is dose responsive. And did activates a protein called mTOR or mTOR C1, which is the mammalian target of rapamysin complex one, you know, who said biochemist don't have a sense of humor, but there you go. And it's kind of the master regulator for muscle protein synthesis. So if you, if you, you know, give a little bit of Lucine, you get a little bit of response, you get a little bit more. And it's like turning that dimmer switch. And so the threshold where you kind of got to get up to, and this is a bit speculative because nobody really knows where it is, but is at least two to three grams of Lucine per meal for most adults to get the full, you know, you've turned on the dimmer switch and the lights are on as bright as they're going to get. Now you could go higher than that, but you can't turn the lights on any any any brighter, if you like. So, you know, dairy proteins in in particular way protein is such a favorite in our field because it's rapidly digested. It's Lucine rich. So you hit that threshold quickly and quite decisively. You know, that said, Lucine is, it's necessary, but it's, it's not sufficient. So you also need the full compliments of all of the other essential amino acids, not enough to just turn the lights on because you begin to use essential amino acids, you need the other building blocks as well to. So you're, you know, if you just took Lucine for a certain period of time, you'd be fine, but you'd be using up the bricks that are sitting there in the pile as opposed to the ones that you're going to get from what you eat. So, Lucine is definitely the trigger if you like amino acid for sure. Okay, that's, that's good to keep in mind because I do think that there are going back to kind of what we've seen out there. There is, I guess a trend really pushing, oh, just take this one amino acid, whether it's. Yeah, Lucine, blue to mean things like that. So obviously it's, it's important to know the role of these and, you know, what you're taking, but I do think that, you know, obviously it's important, but then being able to introduce that nuance of just enough protein enough exercise and yeah, I think that's again just going to keep echoing that's that is going to be the theme of today's episode. Yeah, for sure. I guess just on that topic of exercise and specifically resistance training in terms of our ability to create and retain muscle, but an area that I know that you've spent a lot of time and and something that I think often gets forgotten just being that this is a population that maybe more a verse to exercising. I guess can we just kind of discuss the importance of resistance training in older populations and then some of the adjustments or considerations you might make for a practitioner working with that demographic. Yeah, I mean, I, I'm fond of saying I have very good colleague in my department, it's named Dr. Marty Gabala, a lot of people on the podcast with no who he is and, you know, it sort of seems like we've kind of made fun of each other. We were hired on the same day, so that's important context to put in there. So, you know, our careers of running parallel and Marty's been this sort of a Robic training and now high intensity interval training. And I'm like the resistance training guy, right? So Marty would say, you know, via to peak, via to peak and it's really important. Of course it is. And I think that being a robically fit, that's the thing that keeps you out of the, you know, the doctor's office until you get a little bit older. And I'm fond of saying that probably this single most important exercise intervention for aging well is resistance training. So, you know, once you stayed out of the doctor, that's awesome. You've got there and now, and then, you know, that's a pretty strong claim. So I got a defendant. So the point I would make is starting somewhere probably in your late 30s, early 40s. I know that will depress some people. You lose about 1% of your muscle mass per year and strengthen power to climb even faster, generally in the range of about 2 to 3% per year. And so by the time you get into your 60s, you can begin to demonstratably have lost some capacity of muscle function. So that's the, you know, the base tissue that, you know, lets them get out of a chair or climb stairs, you know, catch yourself if you're going to fall or trip. And resistance training is the only thing that reliably reverses or, or doesn't reverse it as much. It definitely slows the trajectory of downward decline. You know, I think what has to change for people and it's a little bit of playing catch up to aerobic exercise because it has so much data on aerobic exercise and, you know, V02 peak is, you know, arguably 5th vital sign is the image of what resistance training looks like. So for an older adult, you know, we don't, you don't need a, if you don't want a commercial gym, you don't need barbells on day one, you don't need anybody pushing reps to, to failure. But you need progressive loading. So that's, I think, appropriate for the person right in front of you that might start with, you know, with a chair stand with resistance bands with light, light tour dumbbells with body weight. And it moves towards heavier loads that are challenging and progress over time. So heavier loads when they're done, I think safely is a lot of times sort of where the quote unquote the magic happens. And the power training or training to move fast means essentially focusing on the what we call the concentric phase or essentially the shortening phase of a muscle contraction and just having even the intent to do it with, with good velocity. And it's basically force times velocity. So the velocity component begins to matter and that's what prevents or is a part of preventing. falls as people get older. So I think what needs to change is the assumption that older people are fragile. They're not the research in octogenarians, non-engineer. People in their 80s and 90s lifting heavy things is unambiguous. They respond. They adapt, they get stronger, that their quality of life improves. What they need is a coach, C-E-P-C-P-T, who believes in them and who programs intelligently. So two sessions a week covers off a lot of bases. Seven to eight exercises, maybe up to 10, covering the major muscle groups, progression over time. That's the prescription. And everything that we have data wise would suggest that that really does play a big role in successful aging and maintaining mobility as we get older. - No, and I think that's really important. Going back to the initial part of your answer there, the piece about being able to combat that idea of frailty is gonna be really important. I think that that does start with the coach or the trainer. I think if you are approaching that with the big rubber gloves, it's not gonna be the population that you're working with might already consider themselves that way. And so it's not gonna really do that many favors if they're not being provided the adequate amount of resistance or the proper exercises that might need. - Yeah, I mean, I think that there's some pragmatism, right? There are older people who are frail or frail or right. And so we're not gonna get them under the bar and do a max squat on day one, right? So things are scaled obviously to ability and if there are any limitations, but as you say, it's appreciating that the capacity of physical systems even at advanced age have the ability to adapt. And so trainers with, and it's a blend with trainers, right? That I think the nice part when I talk to people about CCEP, trained CEPs and CPTs is basically, they've got the science underpinning everything that they talk about. But there's also experience, right? Trainers get a feel for what people can tolerate. And that's the art of the science that the practitioners, the people at the call face have harnessed. So the ability to motivate people, sometimes realizing that the socialization aspect of what a person has to work out for older people is maybe as important as the functional exercise part of things as well. - Yeah, absolutely. I think one thing I took away from this was both endurance or aerobic training kind of keeps you out of the doctor's office that resistance training. It's the key piece for both injury prevention as far as falls go, but also just that quality of life. So you're getting that social piece and also maybe you're retaining the strength to play with your grandkids or to do the things that you're learning. - Absolutely. - Yeah, the lift isn't always a max bench in the gym, as you'd say, sometimes it's a very life oriented lift and talk to a lot of older people and playing with their grandkids is, it's high on the list, right? - That's great. - For CCEP members collecting professional development credits for today's episode, today's code word is garage door. Please enter this code word in the PDC track or located in your CCEP store account. - Sort of switching gears here a bit, but I do still want to keep it on the idea of exercise or recommendations for specific populations. So there was a host that you had kind of around the time of the Super Bowl regarding the inclusion of ads for GLP ones. - Oh, yeah. - And just, I think the kind of pieces of that post was just they are clearly here to stay with being promoted on that stage. And so it's don't really need to get into pros and cons or anything like that, but I do want to touch on the piece of what should exercise professionals keep in mind when working with people who are currently taking GLP ones. - Yeah, yeah. Well, thanks for the reminder about the ad. I mean, I might have made a mistake in posting that. Like my genuine fascination was because the ad came from Serena Williams, which, you know, she's an athlete that I admire greatly. And I thought that's pretty bold of her to get up there and, you know, basically admit that she'd been using these drugs and to put it on the Super Bowl. I mean, there's no more prime time than a Super Bowl ad. I don't think so. I was like, wow, this is pretty interesting. And I think, yeah, well, let's just leave it alone and say that, you know, my point was to make the message clear that you said, you know, GLP ones are here and they're not going anywhere. The expectation is, of course, with patents here in Canada running out on Summit Lou Tide. So would Gov. It was epic. You're going to see generic soon. And, you know, once we have generics, then more people are going to be using them. Eli Lilly is rolling out another version of a drug. Like it's just, they're not going away. This is just the beginning. So, you know, to be clear, to me, GLP ones, they're a genuine breakthrough. And we need to acknowledge right up front that that's the case. They work. People are losing significant weight. And for a lot of folks, they are the cardio metabolic, you know, I don't know, silver bullet is the right thing. It's, you know, it's unequivocal. The concern isn't whether they work. It's the kind of weight that people are losing. And I don't, I stop short of where a lot of people go, which is to press the absolute all out. We need a panic button. And I'll just tell you where that comes from, is that. So the data we have, and it's definitely still accumulating, suggests that somewhere between 25% to 40% of the weight that people lose on these drugs is lean tissue. Now, if it's 25%, that's the sort of normal amount of lean tissue that you would expect losing weight, the, you know, quote unquote, old-fashioned way. So just restricting dietary energy. But lean tissue includes muscle and includes bone. And if it's as high as 40%, which is disproportionately high. And I don't think that's a drug effect. That's just the effectiveness. Oh, well, it is a drug effect, but it's not the drug that's doing it. It's the drug is so effective at suppressing appetite and then food intake. You know, 40 is a big number. So if you're 100, I'm going to make them atheazies. So if you're 100 kilo person who drops 20 kilos, right, which is amazing, you've potentially lost five to eight kilos of lean mass, depending on your starting point, that depending on how much of that is muscle, but the usual off the risk calculation is it's about half. That is, it looks great on a scale, but that's concerning in an older adult. So, you know, in a woman, for example, entering midlife with lower muscle reserves and anybody who plans to come off the drug, because fat regain without regaining the lean mass is, you know, it's a bad setup. And so, are you actually functionally in a worse place than you were when you when you started? So, you know, in those scenarios, I think the practitioner has to do probably four things. So first, resistance train. So if there's ever a population that needed two to three quality lifting sessions a week, it is this one. Second prioritize protein because appetite is suppressed, food intake drops, I'd be aiming for, you know, definitely in that one point two to one point six range, based on probably, you know, the body weight where you're aiming to be if you like, goal body weight. So that's a protein first approach. And weight on a scale is great, but you should, if you can, and have the means, be tracking body composition. So not just scale weight. So get a dexa or a bio-impedance analysis. And the last thing, you know, if you're a trainer is to be the voice that says losing weight fast is great, but it's not the goal. What you want to do is to keep function come out stronger on the other side. So, you know, the drugs are awesome. They work really, really well, but we've got some concerns. Muscle is one bone is another that I can't speak as well to, but pretty big deal for sure. Yeah, I think that's really important, especially with the example that you gave of, you know, the woman entering midlife, like there are certain populations that at the same time might be more drawn to the drug and also at maybe higher risk of the adverse effects, if not properly mitigated. Absolutely. Okay, so where are you? switch over in terms of segments here to our rapid fire questions. So again, these are the goal is to try not to think too much, you know, just answer an essence or two. And yeah, I guess first question being, what motivates you? Well, what motivates curiosity and and trainees? So I still I'm still the kid that took the radio apart and, you know, unfortunately couldn't put it back together. But I want to know how this stuff works. I still get a kick out of watching students now figure that out and and that I didn't teach them, right? They like they they just go at things. Yeah. So those are probably top of the list. That's awesome. What's a quote there is something that doesn't. Yeah. Well, so there was one, and I you read so many good ones on social media, like, yeah, I love that quote. Yeah, that's good. But the best time to plan a tree was 20 years ago. The second best time is now and I say a version of that to everybody or anybody who tells me their tool to start lifting weights. I think that's really important. I think it can almost feel like, oh, you know, haven't done it yet. So what's the point? But yeah, yeah. Yeah. What is the best piece of advice you received? Oh, there's a lot of them. I think from a science perspective, my mentor for my postdoc was a guy named Bob Wolf. And he always was he would harp on me. He's like, you got to follow the data. Not the story you want the data to tell. And I try to remember that every time I'm looking at the data that I would say my own results quote unquote, but it's the results that my students have generated. And then I find myself, you know, telling them that. And yeah, I do feel like a bit of an imposter because I think it's Bob's words that I'm saying, but it, but it's true. They want to, you know, they want to tell the story. But I'm like, well, what does the data say? Like, let the data speak first. So that's something I've carried with me for some time. It's a good thing to use in mind. What do you do to maintain balance in your life outside of work? Yeah, you know, look, I mean, it probably knows surprised to anybody. Like I train almost every day. I try and spend time, you know, decompressing the Hamilton and, well, Canadian weather. That didn't always allow you to do that. But I have a great group of friends. We enjoy hiking. And ideally something involving, you know, a good meal at the end of it is my idea of a great time. And, you know, I've got an amazing wife, three boys who keep me grounded and remind me what, in the end, is really important. That's a good thing to keep at the center. I think a lot of people in this industry can definitely get kind of go, go, go. And it's important to have that strong base to come back to. Our final segment here is ask our guests to leave a question for a future guest. So the fun thing is, is that we don't know in this episode who you'll be asking this question to. Oh, okay. So you can ask whatever you want. And we will take from our pool of questions for our for a few extra episodes. Yeah, yeah, yeah, yeah. Yeah. If you could get every Canadian to change one health behavior tomorrow and the new that they would actually do it, what would you ask them to do and why? I really like that. I guess it's a great question off the top of your head. Do you have an answer for that question? Oh, wow. For me, it would be, yeah, everybody should be lifting weights twice a week or, you know, doing something to keep themselves strong. I think that would be incredibly effective. We could get that across Canada. Yeah. But we on the segment can ask a question from a previous episode. This one comes from our episode with Jeff Osanic at the Canadian Sports Institute, Alberta. Right now. Looking back, say, 15, 20 years, is there something that with the knowledge that you have today that you would do differently? Uh, differently. That's hard to say. I mean, I, I think, yeah, like the one thing that I would do differently, I would try and embrace a few things that I should have taken a chance on maybe 15 to 20 years ago that I didn't. And I was just worried that they wouldn't work out or it was mainly ideas around science that I now think I'm a little boulder and sort of going after the things that I think are important. 15 to 20 years ago, I just didn't have the same level of confidence. And so, you know, like, have a take a chance and have a run at something that, you know, you, like, you might fail, right? And how's the phrase go? You either, you either fail or, or you either win or you learn, right? So, you know, failure is tough sometimes, but sometimes you learn a lot through it. So, yeah, take a chance is the biggest thing, I think. That's a great thing to leave our listeners. Thank you. So yeah, I just want to say thank you so much for joining us. And yeah, we're really appreciative for what you've shared and happy to bear excited to see what's coming up next. Before you go, could you build a little list of listeners know where they can keep up with your work? Yeah, for sure. Well, you know, thanks for having me. It's definitely been a pleasure. The easiest place to find me is on social media. I'm active on Instagram. And not as much as Mackin Proff, that's M-A-C-K-A-N-P-R-O-F. Our lab website at McMaster has links to publications, et cetera, et cetera. If you want to know nonsense version of what, you know, we've been publishing those two spots will get you there. There's a little bit of saltiness every now and again, I apologize, but that's who I am in real life too. So. I'm sure there's a lot of people who are going to enjoy that. Yeah. Again, yeah, Stu, thank you so much for joining us. My pleasure. Thank you for listening to this episode of the CSEP podcast brought to you by the Canadian Society for Access Physiology. As always, our members are encouraged to enter the code word of today's episode into the PDC tracker in their CSEP store account. We would like to invite our listeners to leave a review on Spotify, Apple podcasts, and wherever you stream your podcasts. Our social media is linked in the episode description and more information about our organization, including how to join can be found at CSEP.ca. [BLANK_AUDIO]