Transcription
Hello Dr. Phillips, you are a professor of chinology at McMaster University where you research among other topics exercise physiology and gerontology. So welcome to Modern Healthspan and thank you so much for joining us today.
It's my pleasure to be here Richard. Thanks for having me.
Thank you. So Dr. Phillips, your two specializations, kind of exercise and gerontology, uh, fit so well with what we want to talk about and and and the channel in general. So, it's great to have you on today. So, awesome.
During the during today's talk, I I'd like to keep in mind a couple of personas that I kind of see from my comments and and would probably fit with people that I've I've kind of talked to. So, one of them is is like a semi-serious older adult and maybe they're retired, but they they're spending most of the they spend a reasonable amount of time exercising. So, how can they make the most of that?
Yeah. And then I think another kind of group of people would be someone who has not so much experience. They may not have that much time and what they're really looking for is minimum effective dose. But both of these are older. So, so we're talking about older adults, but yeah, minimum effective drug. What is it that I can do to ex to make my to get an optimal health span? Um, I'm not looking to run marathons or anything, but right. Yeah, that's kind of okay. Yeah.
So, I I think there are some truisms with those types of personas. I mean um there are some people out there that use the case of mast's athletes as an example. Most of them masters runners or or cyclists or something that you know seem to age particularly well as you know these are the people to who we should compare ourselves and um you know they're the optimal aers. Um, they might not actually be the best aers. They're pretty good. Um, but the person who is sort of serious about exercise I mean I think that the message back is first of all in my opinion anyway you've dialed in what I think is the key activity to uh healthy successful aging and and good health span. Um, I'm fond of saying that, you know, cardiorespiratory fitness, so heart lung fitness, um, will keep you out of the the doctor's office. And, you know, that's where we know all these chronic conditions that lower our quality of life, uh, are going to come from. And so, you know, the more that you do with that, the the better off you are. I think the more recent revelation has been the importance of muscle and strength. Uh, and I know we're going to talk about muscle power as well. Um, as what I call not just adding years to your life, but adding life to your years. So, you know, there aren't too many masters lifters. Um, mostly because if you lift it early in life and you keep keep lifting, uh, you're probably not doing it later in life. But people who, uh, discover that being a little bit stronger in life is, um, you know, uh, better as you get older.
The folks I call the mere mortals, you're you're time pressured, uh I'm not really sure about exercise, uh probably need to hear the message that, you know, for most people first, it's never too late to start. And I think that, you know, it sounds trit, but it's completely true. And that the biggest reduction in risk we get from every and any chronic health condition is when we take someone who's not exercising to starting to exercise. That's the really big reduction in risk or the really sharp rise in benefits. And so even doing something as little as you know 20 minutes a day of walking where you didn't before um has some pretty profound benefits in terms of not just physical health but also mental health we're beginning to realize as well. So you know everybody wins. Um, it's just a question of where you are on the curve and uh, you know, somebody who likes to exercise just about every day I'd say I'm probably more on the serious end. But you know, I have lots of friends who are uh, you know, tell me about this exercise. What's the least amount I can do? And um we know that benefits begin to happen well before the 150 minutes a week, which people think, you know, how am I ever going to do that? And and and the answer is you don't have to, but just realize that that's probably a sweet spot. Yes.
So yeah the 8020 rule and and you can so if we thought about so why do you do exercises? So and so what metric should we aim for? So how do we measure how we progress? I mean I could measure like how big my bicep was but that wouldn't be such a a useful metric. So what are the metrics that we know are correlated with mortal with or cause mortality or not correlated in fact and um which are the most important ones?
Yeah, I mean I think that they're you know from the cardiovascular or cardiorespiratory side there's one that sort of you know is top of the heap and that's your peak V2 or your peak oxygen uptake. Um and there's a little bit of maybe misunderstanding about you know what that metric is but in my view and the way I sort of deconstruct it for people and the reason why I tell people that it's so you know it's so ridiculously good and well correlated with you know morbidity so all kinds of disease symptoms and severity but mortality as well is it's the it's the functioning of your brain being able to transmit signals through your nerves to coordinate the actions of your muscles to exert themselves to their maximum capacity. And so your muscles need to be in good shape, but so does your brain and your nerves. And then it requires the coordination of your heart to pump blood and your lungs to breathe. And you take them to their ceiling. So it's, if you like the sports car analogy, it's really, you know, taking the car up to top gear and seeing where the red line is. And that's always where, you know, that's a true stress test. And you know that's what we call you know cardoppulmonary exercise testing for our cardiac re rehab patients. And the clinic is two two floors down from where I am right now. And you know that's a stress test. And so when we stress the system we have a good sense of where its ceiling is. And the ceiling is going to come down like aging wins. And I'd love to come on here and tell you we we know how to turn the clock back. All we know how to do is to you know do it well or or or not well. Um, so V2 peak or maximum oxygen uptake is essentially like riding up a hill or running up a hill or whatever you want to say to the point where you're like, I'm done. Like I can't do it anymore. Um, that's a number not a lot of people would know and I would freely admit that. But there are variety of tests that are out there on the internet where you can go and for free you can essentially put yourself through a sort of a pseudo V2 max test and get an idea of where your ceiling is and the higher your ceiling the better off you are. Uh and the way to preserve your ceiling is occasionally to do some exercise that pushes that outer envelope.
The strength end of things is a little different and we could talk about lots of sort of functional tests. I don't know that there's one that's uh, you know, the best that's out there. I mean, we you know hand grip strength is the one most people point to. Um, I think it's good because we have a lot of data and so we've got a lot of data points and we can look at associations but muscle power uh is probably a little bit better and we don't have a standard metric for that. But, you know, let me put it to you in sort of a test most people would understand that at some point in your life, uh, the biggest test that you're going to do is to be able to get up out of a chair. And I'm not talking about using your hands to push on, but actually just stand up and use your leg power. And that's strength compressed into a short period of time. And when you can't do that, um, you're probably in full-time institutionalized care or you're reliant on somebody else for a number of other things. So, you know, if you can do those things and do them well, uh, those are the metrics that we scientists would point to to say you're in good shape. Um, getting across an intersection, doing it relatively rapidly is another one to be able to avoid the, you know, the the cars. Um, but those are the sort of key metrics that are out there.
So the the sitto stand test, could you do that to estimate your your power?
Yeah, we I mean there's a standard sitto stand test where we get people to st sit in a chair. They cross their arms across their chest and they just push themselves up out of a chair. Now you can imagine some older people or even some well younger people with certain uh diseases or conditions or maybe who have been on a a period of bed rest or muscle disuse for whatever reason uh actually wouldn't be able to do one sitto stand test. We do it five times and we time how long it takes people to do it. Uh the idea is for it not to be a race but essentially just a standard push up and out of the chair. Uh, and it really relies on your quadriceps and sort of the four muscles across the top of the front of your thighs. Uh, and everybody goes, "Oh, it's a it's a measure of strength." And I'm like, "Actually, it's a measure of power." And your time to do five sitto stand tests is um a very good predictor of a lot of things that could happen uh or could not happen later in life.
So, how about body composition? So, do I want to work for like lean tissue or strength?
Yeah. Uh both or or the answer, you know, as most scientists, you know, frustratingly like to give to uh interesting questions or it depends. Um I mean, I think that, you know, if I had one to pick that if you know, and a lot of people uh reach out to me on social media and say like, I'm really worried about my muscle. I've got a, you know, a scale that I stand on or I've got a test that I do at a gym and I just can't put on muscle mass. And my answer back is always, well, how's your function? Like, what what can you do in your daily life? Is there anything in your daily life that you know you can't do that you wish you could? Um, and most they go, "Oh, no, no, I'm I'm fine." And I'm like, "Well, that's really the test that I think is most important." We we use what what we call three tenses of movement when we talk to people. We ask them to self-evaluate what their activity level is. We bring them into the lab and we test them or we give them, you know, a Fitbit or or an Aura ring or something and we see how much they can do. When you sort of compound all of those things, what it really means is, you know, what are you doing in your daily life? And if there are no limitations to it, uh, then you're in good shape. Now clearly you know in your 40s and 50s that hopefully there's no limitations but you know as you get older uh in life these are the sorts of things you begin to realize you I can't I can't do that anymore and if that's something that's a key and critical or core part of your day uh then it's time to work on your strength and power. I could care less whether your lean mass change and I know I'll probably lose some friends in saying that but uh, you know, I think the you know, the the enemy of uh of good is perfection right? and you don't need to have both but function is the key part I mean that's the metric uh that I would hope that everybody would have later in life for sure.
So one other question in this area so is V2 max and strength and power are they independent? Are they additive? Has anyone tested?
Yeah. So, they tend to be, you know, it's the old adage that you get good at what you do, right? So, practice a lot of tests that take you to the top gear. And so, you know, riding, running, walking, whatever it is, up a really steep hill, you're going to get better at doing that. So, you'll improve your V2 max or your your maximum oxygen uptake. So that's the brain muscle heart lung uh capacity issue. Uh and then at the same time if I uh practice lifting weights and I practice moving weights relatively rapidly to develop power that's what I get better at doing. And so the two tend to sort of uh move independently. And of course the guidelines when you look at the WH or anywhere in the world probably about the same 150 minutes of moderate to vigorous aerobic the sort of subnote of a lot of the guidelines the part that most people aren't familiar with is two days a week of strengthening work. Um and that's not necessarily going to the gym and lifting weights although if it is great for you. Uh but something that makes you stronger. Um and and from that standpoint, they do tend to sort of they're not necessarily related, but for older people that we find who come into our research lab, volunteer for studies, and we find these people uh in their mid70s, sometimes their 80s, they don't take any medication. Uh they're ridiculously good shape. They sort of look metabolically like they're in their 30s and 40s. So, this is where everybody's looking for, right? That's that's true health span. Um, and we give them a p a pedometer or we ask them what they do and they're generally very physically active. Never have we found somebody like that that isn't doing something that you go, "Oh, okay. There's a reason for these things." So, um, you know, that's that's somebody who does probably all of those things. They swim, they bike, they run, they walk. Uh, they've got five dogs or something like that. So, they're, you know, they're taking the dogs for a walk twice twice a day. and something like that.
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Okay, so we we want to build muscle. So, so there are these different elements to what we what it is we want to achieve, but I think I want to talk about muscle building today. I mean, V2 max is kind of another thing and we could spend hours on that. We could we that could be a whole podcast and and and yeah, you could still probably debate and rage about it for sure. Yes.
Okay. So, we're looking at resistance training. Um, and so we want to do so, yeah, what should our resistance training look like in terms of like how often per week, how many Yeah. like how many reps, how much one RM Yeah. Yeah.
It it's complicated, right? And and and I'm fond of saying is, you know, I have a colleague and good friend two doors down uh named Dr. from Martin Gavala and he's a big advocate of highintensity interval training as a way time efficient you know improve and maintain your V2 max um and he and I actually created a um it's an online open course I'll mention it because it costs zero money to take it so it's called hacking exercise for health um where we and it's it's hosted on the Corsera platform where we sort of jokingly take the whole idea it's like Marty's the cardio you're a respiratory fitness guy and I'm the muscle guy and you know which is better and so we both take our own journeys and then eventually come back and obviously say well you you need both. Um but the tough part about resistance training is that um most people believe you have to go to a gym and you don't. Um most people believe it needs to be uh heavy weights and you know heavy is always relative but you know my point is is we've demonstrated now time and time again that actually lighter weights as long as they're lifted to the point where you get a fairly good sort of I'll call it uh sense of effort about doing what the work that you do um are just as effective as as heavy weights. So, uh, you know, the message is first, it doesn't have to be something you do in a gym. Body weight work is just as effective. Uh, it could be lighter weights, uh, that you have around the house that are easy for everybody to obtain. Uh, or even resistance bands. You know, these, uh, used to be the bands that people had to hold with the grip. Those were challenging for some people, but now there are sets of bands that have grips that come on the end. probably cost you around uh $50 um to to buy a good set that you could use and you're just exerting yourself to the point where the resistance is essentially becoming challenging to your muscle and you you know the reps that you do uh I think anywhere between 8 to about 20 um is a range where at the end of the eight or the end of the 20 you should feel like that's tough. So if I'm looking at a scale um it's about an eight or a nine out of 10. I don't need everybody to go to failure or you know the idea, you know, you're pushing a bar and you're like, I can't get this off my chest. I need a spotter. Not everybody needs to be there, but something where you exert yourself twice a week. The guidelines probably have it about right is is the type of dose that we're looking to um, you know, for people to do. And it's not all upper body stuff, although that's what I'm demonstrating, but clearly lower body stuff. If I point out to people that 60% of their muscle is always below their belt. And so it's your it's your thighs, it's your hamstrings, it's your glutes, and those are actually the muscles that you want to hang on to as you get older to be honest with you. Not that grip strength isn't awesome, but it's a proxy marker for everything else that we have. It's just so easy to test. you know, in a doctor's office, you know, everybody can do a grip strength test, but not everybody can do, you know, an instantaneous power test, which which we can do in the lab, for example.
If I'm doing HIT, just out of interest, so if I'm doing HIT, right, I'm I'm doing my sprint like a 4x4, like my legs are tired. Yes. Does that help me build muscle?
Uh, yeah. No, it doesn't actually, but it helps you hang on to muscle. So, it's an interesting sort of difference, right? I think as the uh stimulus goes it certainly uh if you looked at people who are sprinters their muscle mass would sort of decline with age normally but the difference would be is that their curve would be like this and somebody who doesn't sprint their curve would be a little steeper. Um but somebody who lifted weights the curve would be even flatter still. And so, uh, it it does help, but it's certainly not as effective as some resistive stimulus or a loading stimulus if you were to do, you know, a leg press on a machine or free weights or something like that. So, it helps and it's great for cardiovascular exercise. And remember that HIT is, you know, that's the sprinting end of things and a lot of people choose not to do that, which is fine. Um, but walking or even sort of slower jogging or running uh similarly would be you know somewhere on the curve where it would change the trajectory from somebody who's sedentary but less effective than something that's a loading exercise or something where you fatigue relatively quickly due to load. But but HIT hit works for sure.
How much so you you kind of mentioned that it it may not help you build muscle but it would right stop. So how much harder is it to build compared to maintain to increase your muscle it because my understanding is like muscle is constantly turning over right some is getting but it still seems like it has a set point and like making it go above that set point is harder. Is that right?
Uh yeah, I mean I think it's like a lot of things you know um I'm fond of pointing out to people that you know drug companies and pharma have known for you know decades um that you you give somebody a drug to lower blood pressure. There are people who get a great effect you know systolic and diastolic drop by 20 millimeters and you know it's like awesome. And then some people get a moderate effect they get 10 and 10. Some people blood pressure doesn't change and some people bizarrely their blood pressure might go up a little bit. You know not too many of those people but this what we call response variability to drugs is you know it's really well established and that's just a genetic phenomenon that humans are you know what we call an outbred species. We tend to you know go in different directions and have different partners and so our gene pool is sort of getting more and more dilute. Um but it's the same in response to exercise. So nobody should be surprised that there are some people who are good sprinters and not everybody will be a good sprinter just like there are some people who will be what we call you know easy gainers or or you know big gainers and and people that are hard gainers and just don't gain muscle. Everybody though when they practice resistance exercise will get stronger. But as you say, some people experience lots of benefit, some people they don't really budge the needle. Um, but everybody gets stronger. And so, you know, hence my message that it's the strength and then the associated power that goes along with that that's more important than muscle.
But it seems to me that uh based on data that we have that's sort of cross-sectional, people can build muscle probably into their 70s, even even their 80s for a short period of time, but eventually age is going to win. So the, you know, the the big question is when does muscle loss begin in earnest? Uh, you know, for most people it probably starts in their 30s. And I and I know that's not a great message, but for a lot of people um it's not measurable until their 50s and so you can put it off and delay it. I think at some point the curve does begin to tip and it's just you know this is this is normal aging. Um the difference and we like to make this point is that the small difference in trajectory of that curve of even one or two degrees at an early time in life has a big effect because the two curves diverge later in life and you hit a muscle mass or a strength or a power or a V2 peak as the case may be that's going to limit you and the difference was later in life could be as many as you know it could a decade and if that decade is you know between 75 and 85 or 85 and 95 that's a massive difference in quality of life and you know disease risk and lots of other things. So to the health span point uh that's that's really the crux of what we're talking about.
But some people are good at gaining muscle uh and they tend to gravitate towards those activities earlier in life. Other people can run long distances and never get tired. other people are just fast and that's it. You know, you remember those kids in school, everybody had a race and then you were like, "How is that kid?" You know, why are they always fast? And you know, the next thing it's like they're at the top of the heap in terms of crosscountry runners. They're being developed for this, that, and the other. And so, it shouldn't surprise anybody that, you know, the mere mortals uh who aren't quite at the top have a response variability that would be okay. You know, we're we're good at this, we're good at that. But the big message back is everybody still benefits on some dimension. Um, and hopefully that's the one that you're trying to maximize. It doesn't always happen though, I'll be honest.
So you we we talked about metrics and and we said power was an important metric. Yeah. So how do I do power training and how do I do it safely, especially as I'm getting older?
Yeah. Yeah, this is a great question. Uh, and I mentioned to you before the before we started here, you know, uh, myself and, uh, a woman named Ashley Glowski, who's a researcher in the UK, just authored an editorial for the American College of Sports Medicine on muscle power for older people with the recognition that, you know, for a long time and myself included, uh, we focused a lot on strength and we said that was important. The reality is is that the better it appears predictor of morbidity and even mortality is muscle power. And so the ability to generate force and to do it quickly. Um, you know, so everybody I talk about muscle power then people go, oh, you you should never power train older people. Um, and we now have actually probably about two or three decades worth of data showing that actually power training in older people is very safe. What people where people I think get a bit confused is they they look at an Olympic lifter throwing a big heavy weight over their head or pushing it up to here and I'm like, that's that's very that's power lifting for sure, but it's not the type of of exercise that we're talking about. So where power is most effectively developed is to take loads that are actually quite a bit lighter than those individuals would try to move, you know, and and you know, anybody who's out there and does Olympic lifting and like power to you, you know, pardon the pun. Um, but you know, for most people, uh, it's a lighter weight and it's just about moving fast. And so we take, you know, small medicine balls, for example, and we have people push them off their off their chest and throw them to each other, for example. Um, and and and nobody who's done that with the weight of the medicine balls that we have like we start with something that's just a rubber ball and it's about getting the velocity component. Uh, and it's the same thing, you know, with with leg stuff. So it's it's the standing action instead of, you know, sort of loading up and trying this. It's about sort of trying to lean forward and move quickly out of a a a sitting um maneuver. So all of these things don't require heavy weights at all and it's about generating the velocity more than it is about generating it with the load on top. I would say that being stronger first. So doing some typical resistance training where you're using, you know, heavier weights and maybe not focusing on the velocity is a key foundational piece before we would put anybody through a power program. But there are plenty of studies out there that have done uh power training in older adults um with without incident. I mean it's it's not something that I think people can do right away but it is something that can be trained and you like everything you you get better at doing what you practice. So, uh, it does it it it does pay dividends. And, uh, the exact reason for why that's better for you or more predictive, I'm not sure I could put my finger on it, but if you think about daily tasks that become important and just because of the mobility issue in later life, it's it's power that's going to limit you. You know, if you want to go up a flight of stairs and do it safely, that that's a power maneuver. It's not I mean you could do it relatively slowly one step at a time but most people when they're moving up stairs like that choose to take uh the elevator or the lift. Um, so once you but if you can still do it and you still rise through those stairs with each step those are power maneuvers. It's strength in a short period of time to snap off that you know stair rise uh maneuver.
Could you no how would you combine the power and the strength? I mean they have to be done on different days. We said twice per week. So you'd have like two strengths and one power or how would that work?
Yeah. Yeah. It's a great question. I mean this is this is the this is where the uh the art and the science of balancing this for people really comes in. I don't know that there's an exact formula. I do tend to get people uh when we train people in our facility downstairs, we train them in strength work first and that's the foundational piece and then we begin to practice power uh type maneuvers. Uh in that sense uh we generally say if you're into the facility twice a week, one day is a strength piece uh and then the other day is a power focus piece. And just realize is that sometimes one sort of steals from the other. So you might find, oh, I'm getting stronger, and then you back off of this, and then you get more powerful, but maybe your strength goes down a little bit. And everybody gets a little bit worried about that. And I'm, you know, I try to point out to most people, I'm like, look, you're doing something that's so good for you, uh, that not a lot of other people are doing is that these sorts of, you know, relative differences and, you know, squeezing the last piece, the last drop out of the cloth to your 8020 rule, which I love. I love that you said that because you don't know how many students have sat in my office here and I've explained that principle to them and they sort of I think they're quite young. They kind of glaze over and I'm and then later they get back to me and they say you remember that 8020 thing you talked about that's that's so true and I'm like there you go. Uh, you know, the and again the the enemy of good is perfection right? You don't need to be the person that that that squeezes the last drop out, but just realize is that, you know, sometimes working strength and power and doing them independently. We do them on different days is the short answer, but um some coaches like to work, you know, power and strength work. Some people like strength over and and there's all kinds of ways of doing it. There's no wrong way unless it's something that's aggravating an injury that you have or creating pain. uh and you know pain uh as much as we hate it, it's a signal that something's being overstressed and so time to to back off and take a rest.
So one thing I think we don't talk about much is recovery. So yeah, especially when we get old uh right so it's it's harder to build muscle. Older older I always say older never older never older. Yes. uh what is the what are the things we need to do to optimize our recovery?
Yeah. Yeah, you know recovery is like the forgotten variable uh in programming right it's almost you like a lot of coaches focus on you know this is the program this is the design and the point I make to you know athletes when I talk to some of the younger folks and then obviously older people is all the all the good stuff actually happens once you stop exercising and and you recover. Uh, and you pointed out earlier and you're spot on about the remodeling of muscle. It's constantly being turned over. So, we're we're making it, but we're breaking it down. And it's that turnover that I mean, that's great, right? It's it's actually putting new bricks into the wall and taking old bad bricks out and the wall stays in great shape. Um, but the recovery aspect and and I generally like to simplify things and when I talk to athletes, uh, I I use the same message. The first is there are three Rs in recovery. rehydration. So, if you sweat, uh, and you know, our climate is is we're experiencing a hot summer right now. I'm in the northern hemisphere. Um, but I mean, uh, you know, in in hot weather, you've got to rehydrate. You'll feel, you know, adverse events if you don't uh refuel, uh, and the fueling of muscle for it to do work is generally carbohydrate-based and repair. And the repair part is is protein. Um, so you know, then it then you climb into a big part of my world, which is talking about protein recommendations. Um, but you know, trying to get those things on board as quickly and as soon as possible afterwards without stressing too much because there was a great emphasis on the timing of those nutrients for a long period of time. And what we realize now actually is the window for getting all of that nutrition with the exception of the hydration uh is open for a very long time. So even for a day but it's regular food. It doesn't need to be supplements. But those are the aspects of recovery as well as obviously rest and so you know it could be relative rest. So if you did something with your upper body on Monday and something with your lower body on Tuesday on Tuesday your upper body is recovering because you're not using it. Um, but if you're if you're walking every day, uh, or running every day or cycling every day or or lifting three or four days a week, then you need to pay closer attention to because your recovery periods are much shorter, the type of nutrition that you follow and the types of regimes that you have to really cover those those three Rs. And then there are other things that we could add on top. We could talk about creatin. We could talk about lots of different supplements that might enhance recovery. Um, if people are interested in those, I I think it gets a little bit more nuanced. And to me, and I like to deal more in sort of broadstrokes, big picture stuff. It It's really about carbohydrates and protein and recovery and worrying about supplements. I'm like, to me, that's a little bit of the the squeezing the the cloth a little bit, but they're out there.
Do you think do do you see just very briefly do you see something like red light, sauna, cold therapy? Do any of these help? Do or do you use any of them?
Yeah. So, so I'm pragmatic about about talking about, you know, red light therapy, cold water immersion, and lots of other things. I mean, I think that um, you know, I've been at McMaster now for 28 years and I've seen a lot of things come and go. Uh, more things come and go than come and stay. Um, I think, you know, if I had money to bet uh that five years from now, we won't be talking about cold water immersion as some savior or something that's going to delay aging or or enhance recovery. If anything actually it may even delay recovery because of the effect that it has in constricting um small blood vessels that that are necessary to bring blood for repair and and remodeling. Um, a lot of those things I I I see as fadish. Um, lots of people will then tell me I this stuff I do it I feel great it works for me. And my answer is always like, you know, drink up. Like if it if it works for you, then by all means do it. Um, but for most people, I don't think that those are are big deals. So the big picture broadstroke uh is do the activity, recover to the extent that's possible that you're not sustaining an injury or developing pain in the long term. Sleep is great. I'm not a great sleeper. Um, but I've I've learned through my my wife's work actually who's a cardiovascular physiologist, the effects that that um, you know, shortened sleep and restricted sleep have on cardiovascular health. And I think there's now a revolution in understanding about how important sleep is. Um, and that's another aspect of recovery. And then it's nutrition. and nutrition. You can blow that topic up and um, you can get really deep into it, but it really is broadstroke stuffs around, you know, uh, foods that have good carbohydrate content, high quality proteins, um, and nourish you in other ways as well.
Yeah. So, let's let's talk about nutrition. Sure. So, yeah, protein. How much protein for as as we get older? Yeah. Um, and you say high quality. Does it matter animal or plant? Yeah.
Um, so let's do the the quantity one first. I mean, everywhere you go, sort of just about anywhere in the world, there's uh in North America, we call it the recommended dietary allowance or the RDA, the recommended nutrient intake. It has various sort of definitions around the world, but it generally hovers around 08 grams of protein per kilogram of body weight. And that's per kilogram of body weight. It's not ideal body weight. It's not lean mass. It's just body weight. Um, I think that's too low. Um, myself and another group of scientists, we've been advocating particularly as people get older uh that they should be increasing their protein intake mainly to support muscle mass um as they get older. And so it probably could be as high as double that. So about 1.6 grams per kilogram per day. And you know, for anybody that deals in pounds, that's about.7 grams per pound. Um, I think beyond 1.6, it's really hard for somebody to justify, particularly with evidence, uh, why they would advocate for protein intakes that are higher than that level. Lots of people do. Um, they kind of cook up stories and they talk about all kinds of, you know, I think, you know, not particularly valid reasons, but we think up to about 1.6 six is an intake that people should should aim for. Most older people uh hit the 08, no problems, but they don't hit the 1.6. So, it requires a little bit of a shift in focus to sort of emphasize proteinbased foods.
And traditionally on the animal-based side, those are, you know, it's eggs, it's dairy, uh, it's meat, chicken, fish, that sort of thing. the increasing knowledge around the environmental impact that animal-based proteins might have that health effects of plant-based proteins may be better than animal-based proteins. People are asking about plant-based proteins and it's something that I've had to change my um opinion and not just opinion but based on evidence um around. So when I first started it was very clear plant-based proteins were and I you know use inferior and inverted commas um to animal-based proteins and by inferior meaning that they had a different quality score and the quality score is comprised of their digestibility. They're less digestible uh plant-based proteins and their what we call amino acid score. So, they're essential amino acids. The building blocks of protein were lower in plant-based proteins. And I was like, 20 years ago, I was like, "Yep, uh, animal-based proteins, higher quality. Those are the ones you should emphasize." And everything. Time marches on. 10 years ago, I'm like, "I don't know." Beginning to see some some work comparing plant to animal-based proteins. And I'm like, "It's not as big a difference as I thought it would be." Um, and then we've conducted some of our work and I have you know good friends and colleagues around the world who have done this work and actually I think the differences are much closer than we first thought. So let me just say that um I don't think it's as big an issue plant-based versus animal-based as I once said it was. I know that upsets people because they're like, "Oh, you changed your mind." And I'm like, "Well, science is a is a changing process." And you know, what kind of scientist would I be to ignore my own data? Um, but we find that they're um they're they're they're far closer than they are different. You know, from that standpoint, uh I think you do have to be a little bit more judicious about how you pick plant proteins versus animal proteins. Um, so you know, uh, just be aware of what the sources are, how much you're eating. Complimentation, although some people would say it doesn't matter. I think it does. And the complimentation means the grain and the legume pairing. Um, that I think should be in the same meal to be optimal. Um, and a few things like that that are quite nuanced, but that most people who are plant-based or plant focused, and there's lots of definitions, people are flexitarian now, so they choose plants more often, which I think is a great choice, no problem. um and from that standpoint and and I won't comment as much on the chronic health issues because I think that story is evolving but there is some evidence to suggest that more plantfocused diets could be better for you from a cardiovascular disease type 2 diabetes standpoint. Uh, I'm a fond uh user of the saying that exercise is the forgiver of many sins. And so maybe some of the more animal focused issues uh aren't as big an issue when you account for physical activity.
So I mean it sounds as long as you're getting a whole food whole food diet, you don't really you don't really need to care about the amino acid mix or go into that kind of detail.
I I think it matters less than I once thought. Um, I think with Whole Foods and when I try to teach um younger people and athlete groups how to shop, it's generally like grocery I my one of my favorite activities when I travel is actually to visit a grocery store and say what does it look like in you know name the country where I am and they seem to be this general pattern that around the outside of the grocery store is where you know the fruit and produce and the fruit and veg is down one aisle and then the sort of meat and dairy and then that there's the the grains down another aisle and all the foods that tend to typically be not so good for you are are in the middle. Um, and so I say, you know, shop around the outside of the store, uh, and Whole Foods, as you say, and you you generally tend to you you do fairly well. And, you know, and everybody goes, "Well, but there's coffee in the middle." And I'm like, "Okay, well, never skip the coffee aisle for sure." Um, but the point in the end is is yeah, whole foods are are really the way to do it. And it's it's not tricky. uh there's no um you know message but if there's a common enemy in the nutrition world I do think that it's ultrarocessed foods and we should cut down our consumption at those things and they tend to be in the middle of the grocery store for sure.
Does the other macro matter too much right where you get your calories from?
Yeah. Uh, that's a good question. Uh, I have days where I think it matters and other days where I think it don't, where it doesn't. Excuse me. Um, I think you can probably find some people that
Are I'll call them more sensitive to carbs, uh, and the insulin effect. And maybe they should be consuming less carbohydrate.
Um, I don't do as much exercise or activity as I used to when I was younger. Uh, and so I tend to eat less carbohydrate. Um, but I tend to eat less period.
Uh, you know that having being said I think you know really sort of glazing over and sort of trying to take a big step back and say big picture I think it matters a whole lot less around the balance of those nutrients and it is a little bit around you know what tends to work for the individual because you know surely the h the hallmark of human evolution the the fact that we're still here uh you know for as long as we have been is is our ability to adapt And I think that there's a broad range of macronutrient intakes which are probably generally you know good for you quote unquote uh that you can do well on.
Um, and the specifics around you know low carb, highfat or you know uh combinations thereof are probably in my mind a little less important than the quality of the foods that comprise those ratios. And still again I layer over top the fact that you know the more physically active you are either through occupation as well but you know recreational or chosen physical activity or exercise um a lot of it begins to matter a whole lot less and I know that that really grates against the nutritiononly people.
Um, I have I have a foot in both worlds. I I do nutrition work and and and I do physical activity work. And I do think that the combination of those two things is the the best of all of them. And so, you know, people say it's hard to outrun a a bad diet. And my trit reply back is it's it's hard to out nutrition being sedentary.
So, uh and people go, well, from a weight loss standpoint, and I'm like, that's a myopic look at what nutrition is. It's not always just weight and energy balance. It's it's providing your body with the nutrients it needs. And I tend to say to people, you know what, um, be physically active, as physically active as you can, exercise, and, you know, to the extent that you, you know, can and enjoy and don't hurt yourself, eat well.
Um, but hopefully enjoy some food, right? I I mean I don't know what you think but I think we tend to be focused on nutrients and nutrition and we've forgotten a little aspect of sitting back and what it means to have good food uh enjoy prep preparing good food and sitting down with friends and enjoying a good meal because you know that surely that's the other part of life that to me uh you know if successful aging isn't sitting around with your friends and having a good time I'm not sure what is. So um I I think that's a big part of it. It absolutely is. Yes. Yeah. Yeah.
Um, when you exercise, right, you burn glycogen in your muscle? Yeah. Does eating carbs replace that more quickly than doing it with fat? Do we know that? Yeah, absolutely. I mean, carbs are the easily replaceable substrate. Fat actually doesn't replace carbohydrate at all. I mean fat just puts fat back into atapost stores for the most part or in muscle if that's where it needs to be stored.
Uh I think the you know the the message inside the low carb highfat sort of mantra is that uh carbohydrates release insulin and insulin traps fat inside fat cells. Um some people subscribe to that hypothesis and I think that there are grains of truth around it. I don't think however it's the thing on which you know the size of a fat cell and how much fat you have in your in your body as an example really hinges but some people find you know great effects in terms of you know lower carb higher fat in terms of their macronutrient intake and I'm always fond of saying you know if that is how you want to run your life and how you like to eat and it works for you quote unquote then then so be it.
Um, but again coming back to this human evolutionary message. Surely at some point in human evolution uh that was a diet that we survived on because of food scarcity. But food scarcity isn't an issue. Uh well that's not true. Food scarcity for most developed countries is not an issue anymore. Now it's the decision around you know what you buy with your your disposable food income dollar. And most people choose to buy uh ultrarocessed foods that are consumed within generally 5 minutes of buying them. So that's either fast food or something that you you know you compress on a microwave and generally higher sodium uh higher saturated fat contrived foods that have been you know that don't exist in nature. They're just sort of stuck to glom together. And you know, uh, fat and and and sugar are cheap, so they're easy to put into those foods. And I think that that's the conundrum as opposed to, you know, should I eat a, you know, relatively highfat uh diet versus a relatively high carbohydrate diet. There are nuances in there that are very important.
So, one question on supplements. Actually I don't want to but yeah so I saw that you looked at uralithna yes in terms of I guess protecting muscle when it was not moving um right yeah so would it help with sarcopenia uraliththna yeah the the the organization that markets uralithna under the timeline brand um is is banking on that is the the core outcome of one of the supplements, right? Is that part of aging is a decline uh in an intracellular organel uh the mitochondria uh uriththin promotes the what we call mphagy. So actually sort of turning over of mitochondria and promoting then obviously that their their message is mitochondrial health.
Um, I think it it could help. Uh, I think that there are some papers with the those folks have produced that are impressive in terms of the outcome. Uh, I think it's lacking the big trial, the long-term clinical that we would like to see that would make me sort of say broadly, yeah, I'd endorse this as a supplement. Um, I I've got some inside knowledge, as you said, on on the supplement that I I can't quite share at the at the current time, but uh there's something there that's going on. Um, it's not quite on my supplement shelf yet, but it could be.
Cool. So, I had like three questions. Um, kind of quickfire questions. Yeah, go for it. Go for Um so in my exercise stick to the same protocol all the time so that it's safe and I'm I'm doing the same I'm exercise you know it's I'm doing the same exercises and I can measure how I'm doing or or should I change it how frequently?
Yeah, I I'm an advocate for change only because you know hallmark of uh you know exercises is that if you keep doing the same thing you just sort of you know you get better and better and better at it then the effects of doing the same thing begin to diminish uh in terms of benefits. So you should change it. You should challenge yourself. There should be something that's sort of progressive and you either do heavier uh or more um but to only to a certain point and you know how much time do you have? how much recovery do you have and everything. So, I'm a fan of changing things. I don't think it needs to change every week, maybe even every month, but it should change. And part of what I enjoy about, you know, my exercise or physical activity routine is doing something that's a little different just to keep myself mentally fresh uh as opposed to doing the same thing. But I have I have friends and colleagues who, you know, this is their exercise routine and they enjoy the routine of routine. So, you know, I don't want to say, you know, thou shalt not do this, but uh I enjoy change. I think change for most people is generally good, but it's not necessarily required. Just remember most people do nothing, right? So, if you're doing something, something is so much better than nothing.
And then, you know, the what of the something is that's the sort of, you know, the the small maneuvering inside the box. Free weights or machines. either doesn't matter. Your body doesn't know whether you're lifting a free weight or a machine, whatever is your preference or you have access to.
Well, so this kind of comes into my last question as well. Sure. Which is the importance of mimicking real life motions when you're training. But for me, that's why I prefer free weights because they're giving the the side, you know, like the balancing muscles, right? And yeah, I mean, you know, there was a big push in the US NIH around what they call functional training. And so by their definition of functional, it was activities that fit into things that made, you know, activities in your daily life better or easier. And I have no problem with with doing that. But I do think that we have to realize is that any sort of generic strength training will have a spillover effect into function in lots of different areas. the free weights and and I use free weights, you know, just confession, um, work great and I think that they are something that, you know, have a little bit better translation into daily activities. So, if you want to push something over your head, you can still use a machine, but if it's a piece of equipment, then you, you know, free weights mimic the piece or the suitcase or whatever it is better than does a machine. So, I have no issues really. I think the differences in some of those things are subtle. Unless there's a specific daily activity that you have that is like I and for the benefit of our Scandinavian friends, I cross-country ski, then by all means, you know, you should practice that because that's a pretty unique maneuver. Um, but yeah, I I agree for for the most part.
Okay. Yeah, I think about you Dr. Peter and his uh was it um centinarian Olympics. It's like what is it you want to do when you get old? Yeah. You know, and it it's day-to-day things and like lifting Absolutely. lifting things into cupboards and stuff like that. Yep. Absolutely.
Okay, Dr. Phillips, thank you so much for joining us. So, where can people follow your work and see more of what you're working on? Yeah, I'm um I'm MC K I N P R O F MK Kinprofiology Professor uh on uh X Instagram. I am on Tik Tok. I'm really on there just to upset my uh my my 23-year-old son who says old people shouldn't be on Tik Tok. Um and I'm on Facebook as well as LinkedIn. So you can find me. I'm easy to find in my affiliation with McMaster University as well. So give me a follow.
Excellent. I will link to those in the description. And uh yeah, thank you so much for joining us. That was really interesting. You're very welcome, Richard. My pleasure. [Music] [Music]