Dr Gabrielle Lyon is a functional medicine physician and Founder of the Institute of Muscle-Centric Medicine.
Most health advice focuses on shedding excess weight. But what if your longevity, healthspan, resilience and quality of life was more determined by gaining muscle than losing fat? This isn't a bodybuilder's coping strategy, it's new science backed by mountains of data.
Expect to learn why the quality of your life is a direct correlation to your muscle health, whether it's more dangerous to be over-fat or under-muscled, whether exercise is more important than nutrition, Gabrielle's favourite hacks for getting more protein in every day, whether protein timing matters, if it's possible to achieve this with a plant-based diet and much more...
The Importance of Skeletal Muscle for Longevity and Health
- The quality of your life is directly correlated with your muscle health, as muscle is the organ of longevity and determines your capacity to perform daily tasks.
- Building physical strength also cultivates mental strength, fortitude, and resiliency.
- Health span is tangibly linked to the plasticity of skeletal muscle, which is far more than just "broscience".
- Skeletal muscle is the primary site for glucose disposal. Many leading causes of death, such as cardiovascular disease, cancer, diabetes, and Alzheimer's, originate from issues within skeletal muscle health. Obesity and lack of skeletal muscle are often overlooked contributors to mortality.
- Skeletal muscle acts as your "body armour" during "catabolic crises" like illness or injury, protecting you during rapid declines in health. Your ability to recover and return to a youthful baseline after such events (e.g., a broken hip in an elderly person) relies on healthy skeletal muscle, a capacity that must be trained for.
- Skeletal muscle functions as an endocrine organ system, releasing myokines (hormones like interleukin 6 and 15), glutamine, BDNF, and irisin. These interact with the brain for neurogenesis and with the immune system to blunt inflammation and fuel white blood cells. This allows for conscious control over your immune and inflammatory responses.
Understanding and Addressing the "Under-Muscled" Problem
- Many diseases, including those related to obesity and Alzheimer's, are rooted in unhealthy skeletal muscle decades before symptoms become apparent. The focus on the "obesity epidemic" has often missed the underlying issue of being "undermuscled," not just overfat.
- The health of skeletal muscle is determined by its activity. Obese individuals may have more muscle mass, but it can be infiltrated with fat, indicating poor tissue quality, which requires consistent flux and stimulation beyond just walking.
- Current methods for measuring body composition, such as DEXA scans, primarily assess bone and fat, often estimating rather than directly measuring skeletal muscle mass. This lack of direct measurement has led to a misdiagnosis of the core problem.
- There is an obsession with BMI and weight loss, often driven by a fear of death, which prioritises what people have to lose rather than what they can gain.
Optimising Nutrition for Muscle Health
- You must track your food intake if you have specific body composition goals, similar to how you would track finances or speed. Tools like Chronometer are recommended for this.
- Aim for 0.7 grams of protein per pound of body weight (or ideal body weight) daily, with the option to go higher. Protein is the only macronutrient whose needs significantly change with age or during catabolic crises.
- Prioritise protein distribution throughout the day, aiming for approximately 40-50 grams of protein per meal. Consume your first protein-rich meal within 1-2 hours of waking when muscles are primed for stimulation, and stop eating earlier in the evening to improve metabolic retraining and sleep quality.
- Protein intake below 20 grams per meal may be less efficient for muscle protein synthesis, as it might not meet the essential leucine threshold (optimal is 2-3 grams per meal).
- The post-exercise protein window is not as critical as once believed; total daily protein intake is more important than immediate post-workout consumption.
- Focus on nutrient-dense, whole foods. Key "superfoods" for protein and overall nutrition include liver (rich in iron, Vitamin A), lean beef (creatine, taurine, zinc), eggs, whey protein concentrate (immunoglobulins), and salmon (omega-3s, but monitor for heavy metals).
- Be critical of plant-based diets for aging individuals, as they can contribute to osteoporosis and sarcopenia due to challenges in obtaining all essential amino acids and vital nutrients like B12 and iron from a food matrix.
Effective Training Strategies
- Exercise is arguably more important than nutrition for overall health due to its profound impact on every organ system and homeostatic mechanism.
- For individuals who are both overfat and undermuscled, the primary focus should be on building muscle (what you have to gain) rather than solely on losing fat (what you have to lose). Prioritising muscle gain leads to long-term health benefits and can be motivating through visible "gains".
- Incorporate exercises that translate to real-life functionality and mobility ("training for life"). Recommended exercises include:
- Squats (e.g., barbell back squat with a low bar and wide stance).
- Deadlifts (e.g., Sumo deadlift).
- Overhead Carries for overhead strength and stability.
- Push-ups to develop upper body strength and the ability to get off the floor.
- Pull-ups (suggested for scapular attraction and back strength).
- While VO2 Max is a strong predictor of longevity, the literature on the relative importance of muscle size versus strength is evolving. Direct measurement of muscle mass (e.g., using D3 creatine) may shift current understandings.
- The traditional "repetition continuum" (strength, hypertrophy, endurance) may be overly simplistic. Lighter weights with more repetitions can still effectively stimulate hypertrophy, especially in older individuals. Focus on time under tension and tempo to achieve physiological adaptation.
- Track your workouts (e.g., sets, reps, weights lifted) to ensure progressive improvement. Apps like "Heavy Set" can facilitate this.
Lifestyle Factors Supporting Muscle and Longevity
- Sleep deprivation significantly impairs muscle protein synthesis, potentially suppressing it by 18% after just one night. It also negatively impacts willpower, leading to cravings for unhealthy foods and increased irritability.
- A lack of sleep creates a "glass ceiling" for muscle-building potential that cannot be overcome by other practices like breathwork or meditation.
- Use a sleep tracker (e.g., Whoop, Oura Ring) to accurately assess your sleep patterns, as most people overestimate their sleep duration and quality.
- Sleep is vital for brain health, as it allows the brain to "clean itself," and chronic sleep deprivation is a risk factor for Alzheimer's. Avoid having your phone in the bedroom to improve sleep quality.
- Women need to train and maintain physical activity during pregnancy, as a healthier and fitter mother contributes to better offspring health through epigenetic changes. Being fit before and during pregnancy can also aid in the physical demands of childbirth.
- For men, a healthy diet rich in zinc and proteins, along with good body composition and resistance training, can improve fertility and sperm health.
The Broader Impact of Muscle-Centric Medicine
- "Muscle-centric medicine" posits that skeletal muscle is the pinnacle of health and well-being, shifting the paradigm from solely focusing on weight loss to building and maintaining this vital tissue.
- This approach provides both immediate gratification (aesthetic improvements) and long-term health impacts, making it an "easy sell" for sustained commitment to fitness ("come for the gains, stay for the longevity").
Psychological Aspects of Health and Fitness
- Individuals must overcome a "self-worth threshold" to achieve their fitness goals. They will only allow themselves to become as fit, lean, or muscular as they feel they deserve.
- Your current habits are highly predictive of your future success and health outcomes.
- Be aware of your personal weaknesses and predictable patterns of failure to mitigate them. Planning for vulnerable moments (e.g., after stressful events) can prevent falling off your nutrition or training plan.
- It is crucial to close the gap between your desired future self and your current actions, as time is limited.
- A key motivator is the understanding that "if you think you don't have time for fitness, how are you going to have time for sickness?".