Longevity / Muscle Strength Is a Longevity Signal - Full Transcript

Muscle Strength Is a Longevity Signal

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if you are in the strongest third of the population, you are half as likely to die between 40 and 60 as somebody who's in the weakest third of the population. So let's start with a little bit of science if you're okay. So I think most people know that exercise is good for us, but I'm not sure all of us know why that is. So if you wouldn't mind tell us about what what's happening in the body and also in the muscles when we exercise. Yeah, sure. So so there's a couple of really important things. The first thing is that, exercise is not one thing. And that's really important because when people say exercise, a lot of individuals will think, oh, that means I have to run, walk, maybe swim or do something like that. And those are what, what we call our endurance exercises. I call them the rhythmic exercises because what we're doing is we're doing a repeated movement. So we're going to walk. We're going to take a step with the right leg, step with the left leg, and we're going to repeat that over and over 100 times a minute. When we're running, we're going to do that 160 times a minute. As we do that, every time our muscles contract, they push blood back up to the heart. It increases the volume coming back to the heart. So the heart actually is bigger during exercise. And it's what we call a volume overload on the heart. And that actually causes the heart to improve in its functionality. And so that's really important because, you know, 1 in 2 people are going to potentially die from heart disease. And so so that's the first thing that, those rhythmic exercises do. And that means also that we consider dance an exercise. We consider all of these things, anything that has that, that rhythmic repetitive movement. Okay. So that's the first type of exercise. It's kind of lighter weight, longer duration. But you can do it shorter and higher intensity as well. The second type of exercise is when we move against heavy weight.

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Okay. And that doesn't need to be, you know, multiple times our body weight. It can be just holding If we're doing things that are going to challenge our muscles to have lots of tension in them for a shorter period of time. So we can do that by lifting a heavy weight, just picking up a weight or pushing, whatever weight that we do, even if it's during our work, if we're out in the garden and we're lifting, say we're going to plant a tree and we're having to lift that tree if we have to move that around, that's that's resistance-type exercise. The difference there is, as we lift and as we're doing this, our muscles contract really hard for a period of time. And when that happens, they shut down all the blood vessels into those muscles. And so now our pressure that our heart is feeling goes up. And so now instead of getting more blood back to the heart and having this volume effect on the heart, now the heart has to push against the higher pressure. And that's really, really good for the heart because it makes the muscle bigger and stronger. Just like it's going to make our biceps bigger and stronger if we do a lot of, you know, weighted exercise for our bicep. And that means that we're getting two different things for the heart, but our muscles are also getting two different things. When we do those rhythmic exercises, we're going to build things like mitochondria, which are going to allow our muscles to make more energy. So one of the questions I often get from my students is why, you know, exercise makes you tired, but why does it, is it supposed to, over time, give you more energy? Well, it it literally increases your ability to produce energy within some of your tissues. Specifically in your skeletal muscles. They have more of the little machines that are going to allow you to make the energy that you need to go through life. So that's the first thing. And then the second thing is the resistance-type exercise is actually giving us more of those proteins that are going to be the motors within our muscle. So it's giving us

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more muscle protein, and that's making our muscles bigger. But it's also making our muscles stronger. So if we think about these things and we think about why these are important, I said earlier that endurance exercise has this volume overload on the heart. And that's really important because 1 in 2 people die from heart disease. And that's true and that's really important. But what people fail to realise is that the number one predictor of your length of life, not even your just your quality of life, but your length of life for people is your muscle mass and your strength relative to your size. So we know that if we're stronger, we live longer. So there's this axiom only the strong survive. And it's a it's really a literal truism that if you are in the strongest third of the population, you are half as likely to die between 40 and 60 as somebody who's in the weakest third of the population. Fully 30% of the people who die from cancer actually are dying from the muscle weakness that's associated with the cancer. And so if you're in the strongest third of the population, your one quarter as likely to die from cancer. And it's not because you don't get cancer, it’s that we have all these wonderful treatments and these things that are very good about attacking the cancer. But if you're not strong enough to survive those treatments, because even though they are effective, many of them are very, very hard on the rest of our body. If you don't have the strength when you start those treatments, you're not going to come out the other side. So as we think about these things and as we understand a little bit more about the different types of exercise and how they're going to be really important for our body to function, they become even more important than just, oh, you're going to look good, because that's what people think. I don't need to exercise because it's only for the aesthetics. Well, people also don't realise that our neurocognitive function is also related to our, fitness.

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So the best predictor of your brain function is actually your cardiovascular fitness. So if you are fitter your brain works better. So lots of people are worried about Alzheimer's disease or other neurocognitive diseases, or these diseases of learning and memory. One of the best predictors is actually your grip strength, and it's inversely related to the rate at which you're going to get diseases of dementia. So if you are stronger, if you have a really strong grip, if you have a really strong body, not only do you have have a lower chance of dying from cancer, from heart disease, and from other things that are going to kill us, it actually is going to prevent or help us not get these neurocognitive diseases, these problems of our brain that lead to dementia, Alzheimer's disease and other things like that. So I just try and make it really clear that everybody says oh yeah, you should exercise. Well, they always think of why I should exercise as being this aesthetic component. But it's not. It has nothing to do with that. It actually has to do with increasing the longevity and the quality of your life. So in terms of long-term health and longevity, is the benefit coming from the muscles themselves being strengthened, or is it the secondary benefit on the cardiovascular system, or is it a bit of a combination of the two? Yeah, that's a great question. So so really it's a combination of the two. And I always actually use another Scottish doctors famous studies. Maurice was the first one to look at London bus drivers and ticket takers on the double decker busses and, and what he found there in the first study, that was the quite famous study, is that the bus drivers had more cardiovascular disease than the ticket takers who walked up and down the stairs all day. And so the idea there was that, okay, this rhythmic exercise of doing up and down the stairs is going to have this beneficial cardiovascular effect. He then did a follow up study

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where he compared letter carriers to, heavy workers. And the heavy workers were machinists who were picking up heavy things all day. So they had a combination of the the rhythmic exercising and the heavy strength exercise. And what he found for cardiovascular disease, that the heavy strength people actually did better. And so what we think is happening is twofold. The first thing is, yes, we're having this cardiovascular effect that’s going to help our hearts be better whether we do the endurance or the rhythmic exercise or we do the strength-based exercise. The important other component is that we're having a positive effect on the brain. And what that means is that our brains are working better. And that's important not only so that we can think and so that we don't sound like, yeah, we've forgotten everything, like we're a dawdling old man. But it's also important because what it does is when I'm out and I'm walking and I trip on something, my brain is going to function better to get my foot out in front of me so that I can stop myself from falling. And it's going to also prevent the likelihood of me getting that fall and that broken bone. It's going to do other things that are going to be beneficial. As my body is strengthened, my balance improves. So there's all kinds of different levels at which having both the stronger body is going to help you prevent falls, for example. If I'm stronger, my body is actually used to and is much better at getting those balance components. If I do things where I practice lifting, one of the components that we need to practice is we need to practice the actual, what we call the proprioceptors, the little sensors within our muscles and our tendons, which tell us where our body is in space. And as I practice that, by doing these exercises, now when I go out and I'm not doing the exercises, my body actually functions better. It feels where it is better. And so I'm much less

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likely to trip. I'm going to have better balance. I'm going to have all of these things which are also correlated with longevity. So we know that if somebody has better balance, they are going to live longer. We know that if somebody has a traumatic fall and breaks their say, their hip, the life expectancy in an older individual who does that is is less than one year. So if we can prevent those things, not only by having a stronger skeleton from doing that impact loading that we're doing with our exercise, but also having a brain that works better, and better, proprioceptors, better sensors within our body. Now, what our body is doing is just working so much better on so many different levels. And so what you see in people who have or are lifelong exercisers who don't overdo it, and that's another thing, is we don't have to do tons of exercise to get these benefits. We're just active every day. Maybe a couple of times a day. What we find is those individuals, when you look at them, you always think of them as being younger. And it's not because they don't have grey hair or that they have more hair, it's because they actually move like a younger individual. And those types of things are the things that we're building as we build by doing these, these types of exercise. Okay, so sticking on the resistance exercise, specifically, I read that your research has identified something called mTOR, and that's crucial for building muscle. Would you mind giving us a little bit more information on that? Sure. So so that's an interesting protein. And what it is, it's an enzyme within our, with all of our cells. And mTOR is a very important protein. And the people who had originally discovered it kind of out at MIT and other places, they discovered it because what it was involved with was it's involved with the ability of a cell to grow. And the cells that grow the fastest are those like cancer cells. So they had identified it

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as something that is turned on more in cancer cells. They grow faster and they can divide more, and they can increase their size much faster than the rest of the cells in our body. But what our contribution was, what we did was we did an exercise in an animal that would cause lots of load through some muscles, less load through other muscles. And what we could then do is see over six weeks, how much do those muscles grow? And the ones that did the the higher load or went closer to what we call failure, they grew more and they became stronger. The ones that were less taxed, they didn't do as much work. They didn't grow as much. And then we went back and we did a single bout of exercise, and we looked at that protein, mTOR, and how active it became. And what we found was that there was a pretty much a direct correlation between our ability to activate that protein, this enzyme called mTOR, and the ability for that muscle to grow over six weeks of exercise. So that was the first kind of indication that this protein was going to be important in our muscles. The other thing that most of your listeners will know is that they get bombarded by all of this thing, oh you need to eat protein. One of the other things that mTOR does is it senses how much protein we have by looking for one specific amino acid. well, it looks at 2 or 3, but the primary one that it looks at is a amino acid called leucine. And leucine is one of the essential amino acids. And it's one that is, tends to be lower in our environment. So when there's high enough leucine our bodies take that as ‘ oh we have lots of kind of nutrients around us. And what that means is this is a good time if we want to grow.’ And so that's important because evolutionarily we didn't have much food. Muscle is the, one of the most costly tissues

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in your body. So if I don't have much food but I have a lot of muscle, I'm going to go through stress much sooner than somebody who's smaller. So evolutionarily, our muscles were kept kind of small. And what this does is it comes in to our muscles, if we get it to the right muscles, then it’s going to activate mTOR as well. And so one of the things that we helped then establish was that when we do our exercise, our heavy-resistance exercise, if we do that and then we take a source of leucine-rich protein, and there think any animal protein or dairy is a really good leucine-rich source, then what we're going to get is we're going to get a bigger effect of the exercise than if we just exercised alone. And so that one protein, that one enzyme, mTOR in our muscles is sensing how much exercise have you done and how much of the food that we have around us do we have so that we can either grow bigger or do we need to stay small? And so it's really kind of centrally regulating how big your muscles get. And so we all know people who they don't do much and they get really big muscles. And we all know other people who try and do lots and lots of exercise, but their muscles never seem to grow. So a lot of that is because we have differences in our ability to turn that protein on, that mTOR protein on, and we have differences in other regulators of mTOR. So one of the things that, that we know and this is maybe going to be disappointing to your listeners, is that if you were to go to lift weights on a Friday afternoon and then go out and go and hit the pub and drink a number of, pints there, that alcohol actually blocks mTOR. It turns it off. So this is why a lot of athletes will go through periods when they're trying to train where they're going to stay away from alcohol. We know this from studies that we did

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with colleagues in Australia, where they just took the Australian rules football players who used to do their heavy weightlifting on Friday. They just move that weightlifting sessions to Wednesday, and they suddenly got these bigger muscles because they didn't get inhibited by the fact that they went out to the pub that night. So lots of different things are targeting that protein, mTOR, because we know that if we turn it on we’re going to get a bigger, stronger muscle. There are different things that we can do that are going to keep it kind of less active. So that's unfortunate about the alcohol. But anything that we can do to promote mTOR and we know not to do alcohol, but anything we can do positively to activate it. So people will take whey protein, because whey protein is one of the best activators of mTOR. But the best things that we can do if we don't want to take a supplement, and there's no real need to take a supplement, what we want to do is we want to do our heavy exercise, our resistance exercise, just time it before your bigger meals. So what we do is we do that, say 430 in the afternoon, 5: 00 in the afternoon, we're going to go and we're going to lift weights. And then what we'll do is we'll go home, we'll eat our biggest meal of the day, our most protein-rich meal of the day in our dinner. And that's going to give us on average over, over eight weeks, it's going to give us one kilo more muscle mass building. If we add that extra protein in. It doesn't have to be immediately after, because there's this idea of what they call the anabolic window. And this for people who do exercise quite a bit, what they'll do is they'll, they'll have their protein shake with them at the gym and they'll drink it immediately, because there's this idea that you have 30 minutes to get it in. That's not really true in young, healthy people. It's much more true in older people. The reason that we try and time our nutrition together with our resistance exercise

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or our endurance exercise is because what exercise does is it takes our meals and it delivers them to where we want it to go. My friend and colleague Luc Van Loon, has a saying that we are what we eat. And then he also adds to that, that when we exercise, we're more of what we just ate. And what that means is that if we do exercise, it's basically like if you were to write an email but you wouldn't put anybody in the to line. There's no, there's nobody it's going to go to. If you were to send that out there, it wouldn't get anywhere you wanted it to go. And when we exercise, what we're doing is we're addressing that email. And so we're putting an address. And that's exactly where, what we want to send, is going to go. So when I exercise I get lots more blood flow to the muscles that I just exercised. So now when I take something in and I eat something, that blood flow is going to be high to those muscles for at least two hours after the exercise. So now everything I just ate is now going to go to the muscles I just exercised. That's one of the reasons why our swimmers have a big back and no traps, none of the muscles around their neck. It's because they're always pulling and they're pulling. And then when they get out and they eat later in the day, the blood flow to the muscles that they use for pulling are really high. So they're going to get lots of, lots of what they eat is going to go to those muscles in their back. Our cyclists, Chris Hoy has these massive legs. The reason that he's got those legs is because he's going to train really hard, and then he's going to get off and at some point later, he's going to eat a meal. And because he did that training more of the protein that he ate is going to get targeted to his quadricep muscles and his calves. And so he's going to get big, huge legs. When we exercise, what we do is we put the things that we eat to where we want them to go.

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The reason I said it's not a problem in healthy young people is because that's one of the things that insulin does. So when you eat a meal, there's amino acids and sugars there. We're going to get an increase in insulin. And what insulin helps to do is open blood vessels, open blood vessels to our fat and our muscles. Okay. So one of the things that helps to shape us. So I hold my, my fat around my belly. Some people hold it around their hips. One of the reasons I hold my fat around my belly is that the little receptors on the blood vessels that are close to my belly, they open up really easily for insulin. And so now I can target more of what I just ate. If I haven't done any exercise, it gets targeted to my belly. If I don't want it to go to my belly, all I have to do is do what the French call a promenade digestive. So you're going to take a digestive walk. And as I do that walk, now more blood flow is going to go to my legs because I'm walking and now I'm going to get less of what I just ate going to my my belly fat, and more of it is going to go to my muscles of my legs. So in older people they tend to be less sensitive to insulin. And as a result, it helps when you're older, if you exercise closer to your meals because all you're doing there is, you're saying, oh, I've just done an exercise on my legs. That's a signal. There's going to be lots of blood flow. Now when I eat, I don't have to worry about insulin opening up blood vessels. I am going to already have great blood flow to my legs. More of what I just ate is going to go to my legs and become those muscles in my legs. Is there an optimal time for exercising after food? So again, you can exercise either before or after. It becomes more important if your tissue that you're trying to target your nutrients to the blood flow to that tissue isn't as good.

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So a lot of what our work does is we look at both muscle, but we also look at tendons and ligaments. And unlike muscles that have great blood flow, and we know that because we've all eaten a steak, we see it's a dark red steak, and you can see all these little bits in between. All of those things, that's the myoglobin, but there's also little blood vessels all throughout there. If we were to take out if, say, you go to an Asian restaurant and they have chicken feet and you look at it and they take out and they actually serve tendon, it's completely white and it's not white like a piece of pork that still has muscle fibre, it's white and it's hard and it's chewy. There's no blood vessels going into those. And that's part of what a healthy tendon is. It doesn't have blood flow. Part of what you're healthy ligaments don't have blood flow. And the way that they get their nutrients is when we pull on them to say bend our knee or straighten our knee or push off of our foot, it pulls our calf muscle, pulls the achilles, squeezes the water out of the achilles, and then as it relaxes, it's going to suck water in from the environment. So if we're trying to target, say, our tendons, ligaments and other connective tissues like our cartilage, we're going to take what we want to get into those tissues before we exercise about 30 minutes to an hour before. And if I want to target a nutrient to my cartilage, I'll take it in, 30 minutes to an hour later, I'm going to do something where I load that cartilage. And now what I do is every time I squish down that cartilage, the water goes out of the cartilage, that's the absorbing of the energy of the impact, and then as I relax, it's going to suck water in from the environment or fluid from the joint. And that fluid, if I've eaten 30 minutes to an hour before, it's going to have more of the nutrients I want to deliver to that tissue. So if we're talking about connective tissues, there we talk about tendons, ligaments, cartilage and to some degree bone, maybe taking our supplement 30 minutes to an hour before exercise is the best. If we're talking about muscle, and especially in

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older individuals, you can take it up to two hours after. But for most young, healthy people, there's not like a small window. So if my students who are in their 20s, if they lift weights today, tomorrow, the same time they eat a meal, they're going to get much more protein synthesis in their muscles that they exercised yesterday. And that's just as part of the adaptation. It doesn't happen as much in older individuals because the older individuals don't have as much insulin sensitivity to help deliver the meal tomorrow to the tissue I worked today. Okay. So let's dip a little bit back into the endurance exercise if that's okay. You also, identified something called PGC-1, do you mind just giving us a little bit more information on that and why that's relevant to us today? Sure. So so this protein PGC-1, and it's got a very long and complicated name that nobody really needs to know, what it is is it's a cofactor. And what it does is it changes how our genes get transcribed from DNA into RNA. And what it can do is it can turn on everything that we need to make our muscles more endurance-related. And so what we showed was that when we exercise, what happens is we not only make more of PGC-1, but we make it in a smaller form that's actually got more activity. And so we make a different form of it when we exercise. And so that exercise-specific form is only made in our heart and our skeletal muscles. Okay. It's a little bit in certain fat pockets in mostly animals, but it's really only in those two types of muscles. And those two types of muscles are the places where we have lots of mitochondria, lots of enzymes to burn fat,

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lots of blood vessels. And so when we turn on PGC-1, it coordinates this response to endurance exercise so that all I have to do is turn that one protein on and I get more of everything in my muscles as if I were to exercise. And I know that your listeners are like, oh, I want a pill that does that, because then I can sit on my couch and I'll have perfectly endurance-trained muscles and they won't have to run. And you can do that. It's just not great for us because, that's actually what some of the drugs, some of the old diet drugs did. They were called uncouplers. And what the uncouplers did is they just made it so that the mitochondria didn't work effectively. And so it was like you're exercising constantly. They turned on PGC-1, you burned lots of fat. You had lots of good fitness in your muscle. The problem was it caused really bad liver problems. And so those were terminated because they're they're not something that we can take. And so what we do when we exercise is we're trying to turn on that, that PGC-1. And we know that we can do it in in two different ways. We can either go for a long time at a low intensity, or we can go for a short time at a high intensity. When we go at a short time at a high intensity, so when we exercise really hard, say for 30s or two minutes and then we give ourselves a good rest and then we do it again a couple of times. What that's called sprint interval. So between about five and 30s, that's a sprint interval, and then a long or a high-intensity interval is about two minutes to maybe four minutes. And what we're doing there is we're going kind of as fast as we can for say, 30s or like two minutes. Those two things, they'll turn on PGC-1, because that's the transition between two of our different systems for making energy. The way that muscles work

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is that within every single muscle I have what are called small motor units, that means that we have nerves that are very small, and they only can turn on very small numbers of muscle fibres. And those are the ones that we use to say, thread a needle. Okay. So those are our very fine movements. And then we have our really big ones. And those are the ones that we do if we need to punch, or if we need to do something with all of our force. We only use the muscle fibres in our muscles up to the point where we go as fast as we're going. So when we go a long and slow, we're only going to use, say, 40 to 50 to 60% of our muscle fibres. And so when we do that, we're only getting PGC-1 in 40 to 50 to 60% of our muscle fibres. When I do a sprint interval, I actually have to use more of my bigger muscle fibres. And that's going to give me PGC-1 in those muscle fibres as well as those smaller ones. And so it's really good to do some short sprinting work or some high-intensity work where you go for either 30s or for two minutes. And it doesn't have to be, you don't have to be Usain Bolt. You can get out there and just go as fast as you can go for, say, two minutes. And that might just be to go into a jog from your walk. It might be that you're going to maybe try and run a little bit faster. That is going to have a bigger impact than just going for longer, because it's going to get the same signal into more muscle fibres. Okay. And so what we are doing when we do endurance exercise is we are trying to work in these three zones where we go for a long time. That's going to turn on PGC-1 in one way, and we go short and high intensity. The interesting thing is that there was a

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study out of Scandinavia where everybody cycles all the time to commute, and they wanted to know what was the best predictor, was it how long the commute was? So how long were they cycling for, or was it how fast they were going. And so what they did is they looked at their projected improvements in lifespan, and then they looked at to say, okay, if they went for, you know, a less than 15-minute commute, a 15 to 30 minute commute or a greater than 30 minute. There was no difference as far as the duration of the commute. Then what they did is they said, okay, if you just go really slowly, if you go medium speed or if you go fast, what's the effect on lifespan? If you go slowly, there's not really an effect. There's an effect if you go medium and there's an even bigger effect if you go fast. So what this means is when we're doing those repetitive exercises, yeah, it's good to get out and do anything. Anything is going to give you a nice boost. It's going to give you at least 50% of the effect of the exercise. But if I can throw in maybe a few minutes and it doesn't have to be all the time, it shouldn't ever be all the time. It should just be from time to time. We're going to do some things where we're going faster than we feel like we can. We're going faster than we've ever gone recently. And so basically, you know, I have colleagues who say, you know, you go out, you exercise, do a bunch, every once in a while, go and see God. What that means is that you're going and you're going hard and you're like, oh, this is killing me. And you just do that maybe once or twice a week where you go at a really high intensity for you. And that's really, really beneficial because we're getting more motor units, our body has got to work, the brain has to work. You have to do all of these things together. And to do that, to build up to the point where you can do some of those sessions where you can no longer talk when you're doing the exercise. You know, the way that I tell people is

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most of your exercise, you should be able to easily hold a conversation during it. You’re running along. You're having a chat with your friend. Every once in a while, you need to go to the point where it's hard to talk, and then maybe once a week, you should go to a point where you can't talk at all because you're going so hard and you're breathing so hard that you can't even. I can't talk right now. There's no way I can. If you can do those things you'll be in great shape because you'll have every box ticked. Okay. So that feeds in nicely to how can we use this information to make some good sensible choices, for our health and longevity. And that's, that's an important point to make. This is probably a podcast primarily for longevity. Presumably if you have different goals, you'll need to do more. But I'm thinking more from a kind of a minimum amount of exercise perspective, because I think we we struggle a bit with sustainability. I think we're all possibly guilty of going at it a little bit too hard, too quick, and then we find it hard to sustain. Is there such thing as a kind of a minimal amount that would still provide some great long term benefits and would be a great starting point for most people. Absolutely. And that's the key question. And so what people think is they think that, oh, I've got to go out and I've got to do these huge distances to have kind of endurance effects. And what a colleague of mine, Jamie Timmons, is from Glasgow, he was, he actually ran for Scotland as a, as a cross-country runner. He actually did a few studies where he showed that as little as two minutes of exercise a week was enough to get the cardiovascular effects. But those two minutes of exercise would be kind of these sprint exercises where you could do sprint for 20s on a bike usually, go as hard as you can on a bike for 20s and take a few minutes. Just walk around, get on and do that again.

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And if you do that three times today, you do that three times Wednesday, you do that three times Monday. That's going to be enough to get a lot of the cardiovascular and a lot of the health benefits from it. So as little as that much has a huge effect. So what we're trying to understand and what where we go wrong a lot of times is that when I say people should do resistance exercise, people look and they see, oh, there's this big muscly guy in the gym and he spends an hour and a half in the gym, and he does on Mondays he does his back and biceps on Tuesdays. That's not what you have to do. So personally, I lift weights twice a week. I do, each time I lift weights, I do my whole body, and it takes me about 20 minutes to do that. So what we have to understand is that we don't have to do things the way it's written. Most of what is complicated about exercise is intentionally made complicated by people who want to make money. I am a professor. What that means is that I am very bad at making money. And so instead of going out and being able to tell you, if you send me, you know, your large check, I will give you this secret to exercise. Instead, I tell you what the basic principle is. If I want to get a bigger muscle, all I have to do is do anything but keep doing it until I can't do it anymore. It's called going to failure. I tell my students that the gym is the only place on campus where the goal is to fail. Because if you fail in the gym, if you are doing, say, a pressing movement or like a push-up off your desk and you get to the point where that last one, you can't push it up anymore, that's all you have to do. And so all you have to do is say, you know what, the important movements are, for me, are to be able to do a squat. So that means I want to be able to squat down so I can pick things up off the ground. So what you can do is you can go

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and you get like Tesco bags and you fill them up with, say some water bottles or some cans. And now I've got a little bit of weight because it's usually too easy just to squat up and down. And because it's easier to do it as two legs, what I'll do is maybe instead of doing a squat, I'll do a lunge. So I'll put one leg in the front, one leg in the back, I'll have my little Tesco bags and I will just go up and down until I can't go up anymore. And now what I've done is I've done the same incredible exercise for my quad, my quad and my glute on the one side that's forward, that's doing all the work. It doesn't know that I didn't use a $ 10, 000 machine to do that. I have just done everything I need to do for that leg, I don't have to do any more sets. So when I go into the gym, I push until I can't lift it anymore. That's all I'm going to do for that exercise. I'm not going to do another set because that would say that I have to wait. I'm going to rest. I'm going to do another set. Building our muscles is a lot like squeezing water out of a towel. This is an analogy that my colleague Stu Phillips came up with. Basically, you squeeze the water out of the towel, the first time you squeeze the water out of the towel tons of water comes out. The second time you do it, you might be getting a couple of drops, and you have to work a lot harder to get those couple of drops. That's the same thing when we exercise. If I can go to the point where I can't lift the weight anymore because I've been doing push ups against my desk, and if I can do lots of them, then maybe it's not hard enough for me. And maybe I'll use a bench, or I'll use, I'll go down onto the ground on my knees, or you don't have to do a special machine. There doesn't have to be, you just need to do a movement that you think is important. So for us, we want to push. We want to pull. We want to push above our heads, and we want to pull down from above our heads. If we can do anything that does that. Now, we're in really good shape

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and I can use a band, I can use Tesco bags, I can use whatever I have, or I can use a big fancy machine. I'm lucky I have big fancy machines. I understand that, but for everybody else we can just do it, I used to do it with a band, I would pull down just sit on the floor, put the band around the top of the door and I am just going to pull down and I'm going to keep pulling down until the last one I'm trying to pull down. And then I can't pull it down. I've gotten to failure. The reason that failure's important is just like when we are exercising, we only use the bigger muscle fibres when we're going faster. The other time that we use the big muscle fibres is when we get to failure. So when all the smaller muscle fibres have worked, but they got tired, now the big ones have to come in and try and do the movement. When I do that. Now, what happens is that all of the muscles within that, all of the fibres within the muscle have gotten the signal that they need to get bigger and stronger. So for our strength training, we're going to do just one set is fine. Try and go until you can't go any more. That's failure. And if you do that twice a week that's great. Okay? If in between on the other days you want to do something for those muscles. Now what we can do is we can do very lightweight exercises. We can do what are called isometric holds. And these, I've got a video that my university did with me to show people what this looks like. And I can give it to you for the show notes. But what what you do here is you just hold a position and you hold that position for ten to thirty seconds. And we've all done this because we've all had some sort of a sadistic gym teacher who made us to a wall sit where we had to put our back against the wall, and we had to go down until where our knees were at 90 degrees and our hips were at 90 degrees. We had to sit there and hold it for as long as we could. It's always a competition and your legs just start burning.

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And the reason that your legs are burning is because this is great exercise for your tendons, because what happens is, is I hold that position, my tendons starts to relax, my muscle has to keep contracting. That's why they feel like they're working so hard even though they're only doing less than bodyweight. Those are perfect things to do on all those other days, and I do them as what I call a mobility thing. So I'll go and I'll do a lunge where I put one foot in front of the other. I'll put my hands on my head or something and I'll just go down, hold my back knee up just above the ground and I'll hold it there for 30 seconds. And I'll switch to the other side and I'll do a, maybe a squat and I'll hold the squat for 30s. And now in 3 or 4 movements, I've done everything I need to do to give myself that daily load on my legs, that's kind of a resistance load. And so that's 30s per move. And we do maybe four of those. And so that's going to give you about 2 or 3 minutes of activity over say a ten minute period okay. So that's a minimal effective dose, is what we call it, of exercise for the legs. It's easiest to exercise the legs because we're bipedal. And there's all kinds of ways that we can get them. For the upper body, I do like a push against my if I'm going to do, that press. I can just do an isometric press where I can say, grab a little stool, maybe, and I can just hold myself just above the stool and hold it there for 30s. Then if I want, I can get under my desk and I can pull myself up on my desk and just hold it there for 30s, so I can use that band to pull. Now, I've done pretty much everything I need to do. I can do short bursts of high intensity for for the endurance, or I can do what are called exercise snacks. And these are great. And this is just something you incorporate. And all it is, is like a couple of seconds or a minute of exercise. So instead of doing an all out sprint on a bike, what I can do is I can go to my work

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and I can get to the bottom of the stairs, and I can walk up the three flights of stairs or whatever it is. And by the time I got up to the top of the stairs, that's my exercise snack. And then if I, I go through the day, if I do that 3 or 4 times, suddenly I've got that two minutes of exercise. I didn't do it all at once, I’ve spread it out throughout the day. But that's going to be enough to give my system the exercise I need to have a much better outcome. So we get into this Hollywood idea of exercise, largely because the US is very good about publicising all kinds of things and and making movies and all of these things. So we hold up these people who do that. But if we look at longevity, the Europeans live longer than us. people in Asia live much longer than us as well. It is something to do with, you know, universal health care, obviously. But there's also the component of Europeans walk places. Cities are built more for walking in many parts of Europe. And so if you go on to continental Europe, most of the centres, as in Scotland, have pedestrian streets and people will walk to get their groceries, or people will walk to do all of these things. Those little exercise snacks that you do are hugely important. Don't discount those components. The more you're in your car. That's when we get into problems. Oh, you know, now instead of going to the shop around the corner, I'm going to go to the big Tesco that's, I got to get in my car and go. That's when we get into problems. And when you're doing that more, that's when you have to consciously exercise. If you're going to go to the the Sainsbury's local and I'm just going to walk down and it's going to take me about 15 minutes to get there, I'm going to do my shopping, bring it back, I'm going to carry my shopping, I'm going to be carrying my shopping like this. My arms are getting a great resistance training workout for those 15 minutes. It's perfect. Exercise snacks - incorporate them into your day. Then you don't have to consciously get into, I don't know, spandex and do your, right, you don't have to do that. It just has to be something

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that becomes part of your daily life. Just a quick specific about resistance training. Is it better to do fewer reps with a lighter weight until the point of fatigue, or a heavier weight with less reps? Is there a difference? Yeah. So as far as building your muscle mass, there's beautiful work from Stu Phillips where he has people lift 30% of their maximum or 90% of their maximum. Their muscle mass grows exactly the same. What is different is that the strength is a little bit higher in the people who lift the heavy weight, practice lifting the heavy weights. And what that means is if you want to be stronger, that sometimes, from time to time, you need to lift a heavy weight. So what you would do is you would lift, most of the time you would go to failure in a relatively light, lighter weight. But from time to time you would challenge yourself with a heavier weight. And what that would allow you to do is that would allow you to get both the strength adaptation and the muscle size adaptations. So for me, what I tend to do is, I know my progression, I've looked at that. I've got it over two years worth in my, I just have a little sheet that has a line in the middle. I put the weight that I did and the number of repetitions and today's date. So when I go to lift later on today, I just have to take out that sheet. And I know that on my chest press, this is the number that I got last time. A lot of times I just get exactly what I got the last time. Sometimes I get one less, sometimes I get one more. But what I, what happens is the line looks like this. It goes up and down every day, but what the trend is, it's going to end up being higher than it was at the beginning. And that's all we have to do. You just have to be patient with it. You have to, you know, my wife, there's one specific exercise she hates. She hates having to do this big leg press because it takes all of her mental energy to do it. But she knows. She looks at the things she said, okay, that's what I need to do

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now she does it. And at the end of that, she just feels like she's had, it's type-two fun. Type-two fun is the type of fun that's perfect for health and fitness, because what you want is afterwards you think, oh, that was really fun, but during it you're like, oh, this is really hard. That's type-two fun. Type-one fun is the type of fun that we get into, and we hurt ourself because we're like, oh, this is great. I'm going to do more, and what we do is we overdo it. And so really what we're looking for in the gym is that type-two fun. We're going to do something hard. It's going to hurt while we do it. But at the end we're going to feel like, oh my God, we've accomplished something. Okay. So I thought I would just take you back to the nutrition bit. When I go into the supermarket now, there's like sections in the aisles that are all high protein. We seem to be obsessed with protein now. Is that necessary? It was interesting what you were saying about about the protein and the activation. Do we get enough from diet? Is this high-protein food now, and supplementation, is it necessary? Yeah. Again really good. So so the important thing to know about protein is that if you're an omnivore and you eat meat and you eat all, everything basically, then most of what you need you're getting from your diet. If you can have dairy, dairy is a great way to kind of check. So if tonight the dinner is pasta with a red sauce, I know that there's not much protein there. I can just add a glass of milk. Now, what I've done is I've gotten myself a protein that is not part of the meal, but I actually will still have enough protein from from the diet. Or maybe I'll add some. I'll have a dessert with some Greek yogurt or something like that. So what you're trying to do with the protein, and it becomes more important again as we get older, because as we get older, our stomachs become less acidic and we don't digest and absorb as well. And so if I eat a steak

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now, as a 55 year old, that's going to have a different effect than when I was a 20 year old. So what I'm going to do is I'm going to, it's going to be harder for me to get those amino acids from the protein within that steak, because my body doesn't break the steak down as quickly and as well. Luc Van Loon's done these beautiful studies where if you take the steak or you grind it down and you make mince, you actually build more muscle from mince than you do from steak. And the reason is that it's already broken down. So if I'm thinking about this as an omnivore, I'm thinking 1. am I really getting enough protein? And then 2. if I do feel like I have enough protein, either from pulses or from meats or from whatever the source is, then I'm pretty good with it. But as I get older, it becomes a little bit harder to get enough protein because, again the protein is the most expensive nutrient. So that means that, that means that when I'm eating, when I'm going to the supermarket, the meat is costing a lot more. So a lot of people, as they become older, especially as they, as they retire, they're going to take in less meat because it is the most expensive thing that you're getting from the grocery. So now the question is what's that going to do to me? And if I'm older, I already need more protein because I don't digest and absorb as well. But I'm not eating as much of it because it's more expensive, now that's when I might turn to something like a supplement that is, that is a powder that that's relatively easy for me to get something in from. So those are some considerations. if you're somebody who is a vegetarian or vegan, now you have to be really conscientious about this because, to get the same amount of protein, first of all, takes more from plants than it does from animals. And the protein within the plants is harder for our bodies to digest and absorb.

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It's one of the reasons why vegetarians tend to be a little bit smaller, or a little bit smaller in muscle mass. They might still have, have good amounts of fat, but they're not going to have as much muscle mass, because in that situation, even when it says on the side of the the tin that, okay, this is a tofu that's going to have this much protein in it, it's harder for our body to actually get out the protein from the tofu than it would be from, say, dairy or a meat source. And so really we're we're thinking about supplementation when we have somebody who is vegetarian or vegan. And there you can use some of the nice, the proteins that are vegetarian or vegan proteins like pea or like soy. Most people are going for a pea-based protein now. That's a good quality protein. what's happened that's different within the protein powder that you get, that pea protein powder, and why it's important for a vegetarian is that it's hydrolysed. And what that means is it's already pre broken down. It's like the equivalent of taking the steak and make it into the mince. I can now digest and absorb it better. And so for people who are vegetarian / vegan, I would suggest, especially as they get older that they're adding supplemental protein in there, That's best illustrated by a study from Luc van Loon out of Maastricht again, where he actually fed people the exact same number of calories and the exact same amount of protein from an omnivore meal, which was meat, potatoes and applesauce. He is from the Netherlands, so that's kind of the standard meal. Or he gave them the same amount from a vegan source, beans and soy and things like that. And then he took biopsies from the muscle, five hours later to see how much protein synthesis had changed. And what he found was that the people who had the omnivore meal, they all increased their muscle protein synthesis. The people who ate the vegan meal didn't. Again, that's just saying that matched for calories, matched for protein. We don't digest and absorb

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from vegetables and plants as well as we do from, animal sources. It's great for many aspects of health to be vegetarian, because of cardiovascular issues or whatnot. But they then do probably want to think about getting something like a hydrolysed pea protein so that they can actually increase the amount of, of available protein that they have. So that would be the the only kind of area where I would think that supplementation would be good. In young, active people who are lactose tolerant and who drink milk. That's a good source of protein. I use that as a way to kind of say, oh, this meal I'm having is low. I'm going to add some milk. Okay, so I'm going to begin my my exercise routine now. I think I've got some great tips. One thing you always hear about is making sure you warm up and cool down well. What does the science tell us. Like, how much do we need to do? Is it absolutely necessary? What does the science suggest we should do when we exercise. the warming up part is, is we had talked about it a little bit before, that our enzymes within our body work better when our body is warm. And so what that means is that for our body to function at a high level, it helps if our core temperature is a little bit higher. And the other thing that's important when we're doing the rhythmic exercise is that if we want to burn fat from the beginning of exercise, the way that we burn fat is we have to take the little fat molecules and we have to bring them into the mitochondria. And in the process we have to kind of shift them around. And one of the things we do when we warm up is we we make it so that those fat molecules can get into the mitochondria better, and we can make energy from them easier. So basically, there's not a great necessity for warming up. for cooling down. A good rule of thumb is if you're going to go and you're going to go start to to run or you're going to go start to do something, is that you take the first 3 to 5 minutes

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and you just do something at a lower intensity. So if I'm going to go run, I'm going to start by walking for the first 3 to 5 minutes. I can do the walk, and that's going to be enough for me to raise my heart rate, raise my body temperature, and now I can start exercising at whatever level I want from the beginning. And and what the warm up does is it allows me to exercise harder earlier when I start exercising. So if I'm not worried about it, I can use the start of my exercise as my warmup and then it just continues to go in. Just means that I'm going to have to go a little bit slower at the beginning. Okay? So if I'm going to be a swimmer, I'm going to get in the pool and maybe I'm going to do a couple of very light lengths of the pool, that's enough for me to get going. Most of us hit the pool. The pool is a little bit cold and we're all shivering anyways so we go really quickly at the beginning. That's totally good. You don't have to do anything like some prescribed warmup. The difference would be if say I have a shoulder injury with and I'm a swimmer. So now what I want to do is I want to do something that's going to allow me to make sure that my shoulder is healthy. And that's where I would use some some isometric loading beforehand. And all I'm going to do is say, I'm going to grab, say, a band or a belt, and I'm just going to pull. Because I know that this is the movement that hurts myself when I'm swimming. So all I'm going to do is I'm going to do that movement, but I'm going to have resistance and I'm just going to hold it there, and I'm going to slowly activate the muscle. I'm going to increase the tension. So I get tension across it, and all I'm going to do is squeeze those tendons and, and muscles. And that's really good if I have something like a shoulder problem, if I'm a swimmer. If I have an Achilles problem, if I'm a runner or a knee, problem. So I'm just going to do something to put load through those tissues before I just start running. Because the running or the swimming or these repetitive exercises, they have what's called jerk, which is a lot of kind of really rapid, changes of direction of the load

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that's on the tissue, and that's what can cause injury. You can do it as a warm up if you have soreness. I just do it as my, my quote-unquote cool down. And what I do is I do those same types of things that I talked about. The core of what I think is really important for our ability to exercise again tomorrow and the day after is to make sure that we have a good, healthy muscles and tendons that are working properly. And to do that, we're going to do these longer isometric holds, these 30-second holds. And they're after I do a run, for example. What I'm going to do is I'm going to do a lunge where the front leg is 90 degrees, the back leg is backwards. And so I've just taken a big step, and now I'm going to lower myself so that the back knee is hovering like a half inch above the ground. What I'm doing when I'm in that position is I'm getting a good stretch on all the quad tendon and the patellar tendon and the Achilles tendon on both legs. I’m gonna switch it up and do the other one. And then I'm going to do a side lunge to get my knee over my toe to get my Achilles tendon. All it is, is what people would have classically thought of as stretching in the past. We don't necessarily like to stretch because that's not effective for helping the muscle and the tendon. When we put ourselves into a position where we have to hold that position, that's actually much better for the health and safety of the tendons. And again, that's the video that if your listeners want to see it, we've got the video on UCL Davis health website that gives you an example of what we're doing there. What we're trying to do with the cool down is we're trying to make sure that all of the impact, all of the jerk that we've had, which is the change of direction of loading very fast, that is going to potentially injure us over time, that what we're doing is we're trying to decrease the effect of that on our tendons, of our lower body. If I'm a swimmer, I'm going to do the same thing in my upper body. There's four different positions you can have your rotator cuff in. I'm just going to push in those positions and I'm going

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to hold those positions. And that's going to help my shoulder. If I had small injuries during the swim, now my shoulders are going to be healthy and they can be able to swim again tomorrow or in the next day. Okay. So that's all we're trying to do in our cool down, is we're trying to target anything that could have been injured or could have been, made to work less effectively during the exercise that we did. Hopefully we didn't get any problems, but we're just trying to keep it as a preventative. Professor Barr, this has been an absolutely fascinating conversation. Thank you so, so much. Just as a parting kind of message would there be any kind of key take-home points that you would want myself and the listeners to, to take away? Yeah. The biggest thing is that you're not trying to exercise like Rocky, okay? You're not trying to exercise like, what is it, Rocky 2, where you went off and he's lifting logs and all this. That's not what we're trying to do, okay? Exercise is relatively easy. the fact is that people try and hide it to make you think that you need to spend money on a specific program. If we want to get stronger, if we want our heart to get stronger, we need to do some resistance exercise, specifically in our legs. And there, I don't have to do a lot of weight. I can use simple things to to do a squat and hold that squat position. And as I hold that, I'm closing down the blood vessels. My heart has to push harder against the resistance and it's going to get thicker and stronger. When I do my repetitive movements, my endurance exercise, just know that if you get out and you do it in a repeating way, that's going to give you the stimulus that your heart needs to get more blood back to it, to get a stretch on it, so that it's going to get bigger and stronger. And so if you do both of those things together now we've got a bigger volume of our heart. It's a thicker muscle. It's going to work that much better. Our heart's going to be great.

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We're also going to have increased function of our brain. Our learning and memory is going to improve, and we're going to have all of these knock on effects. The biggest thing that stands in the way of most people from doing these things is they get injured. And really, the number one in the US, the number one medical cost for our whole medical system is musculoskeletal injuries. There is more money spent on back pain, neck pain, knee pain, ankle pain, heel pain, than there is on heart disease and diabetes combined. The best thing that we can do to prevent that is these long isometric holds. We don't have to do lots of them. I always tell my students our connective tissues are like my 17 year old daughter. She will listen to me for maybe 5 to 10 minutes, and then she's going to tune me out. If we do 5 to 10 minutes of these kind of longer isometric holds for our tendons, they are going to get the signal they need and they don't need more than that. That's the minimal effect dose is ten minutes, where I'm going to do maybe 1 or 2 loads on the system at that time, but they're going to be these loads that we don't normally do. I'm going to hold it for 30s. If you do those things, that will help you stay healthy, it'll help prevent you from getting those muscle aches and pains that prevent you from doing the things that you love to do. Professor Barr, this has been an absolute pleasure. Thank you so much for joining me today. Absolutely. It's a pleasure.