PHW Podcast 001: Movement with Dr. Jay Weimar
Episode Date: February 23, 2024
Guest: Dr. Jay Weimar, Neurosurgeon
Episode Description
In the debut episode of the PHW Podcast, Dr. Jeffrey Davis sits down with Dr. Jay Weimar, a neurosurgeon in Wichita, KS, to explore the significance of Movement in health and wellness. Dr. Weimar discusses his passion for preventing patients from needing surgical intervention while emphasizing the importance of physical fitness.
The episode focuses on Movement as one of PHW's 5 Pillars of Health and stresses the importance of building muscle and the neurologic connection for overall well-being. Dr. Davis and Dr. Weimar introduce Transform Training, a unique gym initiative that emphasizes individualized training paired with specific nutrition plans.
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Key Topics Discussed
- The importance of posterior chain development for spinal health
- Why "just because we can operate doesn't mean we should operate"
- Functional medicine approach vs traditional Western medicine
- The journey from 5x5 training to N1 certification methodology
- Transform Training: individualized training with nutrition integration
- Protein requirements and the misconception about "eating too much protein"
- Why muscle is the "organ of longevity" (Gabrielle Lyon)
- Sarcopenia: the hidden epidemic of being "under-muscled"
- Addressing women's fears about weight training
Notable Quotes
"Just because we can operate doesn't mean we should operate." — Dr. Jay Weimar
"It'll take you about 5 years to really learn how to prescribe medicine properly and about 15 years to learn not to prescribe medicine." — Dr. Jeffrey Davis
"Muscle is the organ of longevity." — Gabrielle Lyon (quoted)
Episode Transcript
Auto-generated from the episode audio — may contain minor transcription errors.
When we do hit those roadblocks, we've got that expertise next door, in most cases, to be able to help that patient find that. And I think the trainers also begin to be more, uh, adept at understanding who needs that referral, who needs to go back. And I don't know, I don't know that you would get that in another gym where you didn't have that close, you know, sharing lunch with those people every day. Oh, absolutely, I mean, I'm not — I think, um, I mean, there may be another model for this somewhere in the country, but certainly not another model for this in Wichita, or even the region, that I'm aware of.
All right, so this is the first episode of the Prairie Health and Wellness podcast, or the PHW podcast, as we're going to call it, and I am super excited that our first guest is Dr. Jay Weimar. Um, Dr. Weimar and I have been friends for a long time, um, he's been an important, um, I'd say ally to our clinic, uh, I rely on his expertise in his field, uh, which is the field of neurosurgery. Um, as a family doc, um, I'm often having to refer out to specialists, and I'm often getting feedback from my patients about their experience with that, and I can say that, um, Dr. Weimar's feedback from my patients has been overwhelmingly positive, over and over and over again.
And I think one of the things that I — you probably don't remember this — but early on I would send you a patient, and I think you at that time knew that I was more functionally minded and wasn't jumping, you know, right to a pill for a problem for most of my patients, and you would call and say, hey, I'm really sorry, but I think I need to take this person to the OR, and so you would apologize when you would have to do your job as a surgeon, and I think I really appreciated that, because I knew that, number one, you were similarly minded as me, and that we — the probably the most important thing we have to do is identify when we shouldn't be doing something.
You know, I think I remember hearing, um, you know, during my medical training, a doctor said, it'll take you about 5 years to really learn how to prescribe medicine properly, and about 15 years how to learn not to prescribe medicine, and that has really resonated with me, I feel like you've said some of the same things. So give us some background on — what brought you to that style of medicine, where you really are thinking more of the root cause of what's going on with the patient, or looking for alternatives to surgery, talk a little bit about your medical training and what brought you to where you are today, and how you practice medicine the way you do.
So um, you know, it's interesting you mention that, because I had one of my mentors in residency, um, used to always say during conferences, and M&M, and whatnot, when we were reviewing cases, you know, just because we can operate doesn't mean we should operate. So, you know, can we do this case, well, yeah, we can do this case, but should we do this case, in this particular patient, you know, that's another question. Um, so my wife often jokes that, um, you know, if there were such a thing as a functional neurosurgeon, that's what I would be — of course, when you say functional nerve surgery, or functional, you know, nerve surgery, to a neurosurgeon, they think, like, someone who's practicing deep brain stimulation, or spinal cord stimulation, or something, but um, she's talking about it in light of actual integrative, or more naturopathic, medicine.
Um, and so I probably really credit her with my journey into more functionally minded, or naturopathic focused, medicine, um, during residency, actually. So, I was, um, you know, a classic, um, Western trained allopath, you know, a physician who went to an allopathic medical school, and uh, just believed what I was told, um, until my eyes were opened, and realized that, you know, a lot of what we are taught in medical school, and a lot of our training, um, is really, you know, falls short of taking care of the patient as a whole, and doesn't get to the root cause of, you know, why they may be presenting to you in clinic and whatnot.
And so um, towards the end of my residency, uh, she really became interested in functional medicine, and that sparked my interest, and I really began to ask those questions of, you know, why is this patient coming to see me, what's their history, you know, all these things that a lot of surgeons don't take into account, um, don't look at the medications they're on, don't look at their past medical history. And I think you might be the only neurosurgeon who checks people's vitamin D levels, that I know about. Um, that's true, uh, unfortunately, and sadly, every single person that I check a vitamin D on, I mean, literally nine times out of 10, it's not just low, it's subnormal, um, and so, uh, which is below 30, uh, I think nanograms per deciliter, but most people, some it's even in the single digits.
So what was your understanding of functional medicine? I think that's a term that a lot of people hear and they don't understand what it means, what was your understanding as your wife got interested in functional medicine, what was your early understanding of that? Well, so of course initially, and well initially, because of my, you know, how I'd been trained, um, I definitely looked at it with an eye of skepticism, I thought, well, that's quackery, and that's, uh, snake oil, and um, unproven, unproven, there's no research, that's not FDA approved.
Um, of course, that's a subject for another day, but that phrase FDA-approved doesn't hold quite the gravitas that it did years and years ago, I think. Exactly, not anymore. Um, for sure, for sure, after the past, you know, several years, I think most people have come to that realization. Um, so yeah, so yeah, I, uh, it really was — um, I mean, the audience probably doesn't care to know this, but we had a child at the time that was diagnosed with a condition that, um, the physicians said would be chronic, and he would have to be on chronic steroids the rest of his life, and um, there really was no good treatment, there was no cure for it, and my wife, to her credit, uh, you know, didn't accept that as an answer, and really began to delve into, you know, alternative treatments.
And so, um, like I said, that really kind of got me interested in exploring, um, you know, alternative treatments other than just, you know, a pill for every ill, or you know, a surgery for every patient that comes through the door. I don't know if that answers your question. Yeah, it does, I mean, I think the idea behind functional medicine, like you said, it's getting to the root cause, and you know, for me we joke that it's solving problems you didn't know you had in ways you don't understand.
I mean, there really are, I think, a lot of complexities about the human body — that you and I were talking, before this, that they don't lend themselves easily to studying in a randomized double-blind controlled trial, you know, those trials are where you're flipping one bit and then trying to measure an outcome, and seeing if there's a statistical deviation in the signal that will tell you, did flipping that bit produce this change, when oftentimes we're coming into a patient's world, and you know, looking at their diet, looking at their sleep patterns, looking at their levels of stress, and all those things, and it's, you know, almost impossible to then turn around and say, well, we're just going to do something in a very randomized and controlled way to affect that.
So for me, I think it was exciting, learning about functional medicine, it really felt like it went back to our roots, of when we were in med school, you know, those first two years in medical school, when you're studying the basic science, what I feel like is you're studying the miracle of what the human body really is. I mean, going back to that verse in the Bible, that we're wonderfully and fearfully made, that verse keeps coming back to me over and over again, every time I learn something about the human body that I didn't know before, I think, this is this amazing machine that we have, um, so I think that's — I look at functional medicine as being something that really gives us a bigger toolbox when we're dealing with patient problems.
Yeah, absolutely, and um, and I think you — you know, initially, going to med school, um, you know, you're bright-eyed and bushy-tailed, and you think, um, you don't really have an appreciation for the fact that this is much more art than it is science, and I thought everything has been figured out, and of course we know why everything works the way it does, and we have an answer for everything, and um, and then specifically, as far as the brain and the nervous system goes, um, you know, much like the gut, you start to realize that we really have — we're just scratching the surface.
I mean, absolutely, even the most — what I figured the most basic thing was that was established, was that this whole serotonin hypothesis, that emotions and depression and anxiety are all driven by serotonin, was completely upended, with a very large, you know, meta-analysis, saying there's really no data to support that serotonin is the reason we're depressed. And so, you know, again, those pillars, or what I would call foundations, of science, um, they move, right, they change over time, our understanding changes over time, um, again thinking — I think it was the same professor in med school who said, 50% of what you learn here will be already out of date by the time you graduate, right, and your challenge is to try to figure out which 50% of what you're learning is no longer relevant.
Right, and I would say really the rest of my career really has been that — is trying to figure out what part of medicine is not going to change for another 150 years, and what part of medicine are we going to think about differently even tomorrow. Um, so I think research has its place, and obviously has advanced our understanding, but I think there's a lot of mysteries out there that we have to really hone our art, right, and understand that that art of practicing medicine sometimes comes down to trying something with an individual, and um, being more N of one in our — which will bring up something we talk about later — but treating the patient as an individual rather than looking at them as a population.
Absolutely, and I think, to further answer your question, that's what really, um, began to open my eyes, in terms of a functional medicine approach to medicine, or to treating my patients — was, and the more I read, and the more I learned, you know, outside of reading, you know, neurosurgical journals, and um, and what was specific to my profession — and that's another thing I think physicians, um, become very focused on, you know, their area of medicine, unless, you know, maybe you're a family physician, or you're an internal medicine doctor, uh, you become very, you know — the old expression, if you have a hammer, everything is a nail — and so um, you don't think about, or ask, those questions of root cause, and looking at the patient as an individual, just like you said.
And I think — and that's one thing I really appreciate about functional medicine — is it's more inclined, uh, to think of, you know, individuals as an N of one, meaning that, you know, they may not fit neatly into this population of a thousand patients that this study showed, you know, X, Y, or Z. Yeah, and everybody's genetics is different, um, everybody's, you know, epigenetics act in a different fashion, and um, and then, you know, our genetics — and we might be getting off track here — but our genetics, um, you know, I think, load the gun, and I didn't coin this phrase, but I love this phrase, uh, our genetics load the gun, but they don't pull the trigger, so environment, you know, nutrition, uh, your lifestyle, exercise, etc, all play a part in what's going on, I think, you know, underneath the surface.
Yeah, I would totally agree, and I think that's, you know, one of the things we've really tried to do at PHW, is we've started, um, identifying what those large categories are in lifestyle, so you've seen our pillars, the Five Pillars, we have, you know, the three central pillars I usually talk about are going to be, um, sleep being the central pillar, and then nutrition and movement, and then we also have a pillar of stress, because stress can be both a good thing and a bad thing, right, and then we have the pillar of detoxification, which in our practice isn't really so much about helping people detoxify as it is about trying to identify where toxins exist, and keeping them out of their life, first of all.
So I think the pillar that we really want to talk about most today is that movement pillar, um, and that's where I — the more I, uh, came to understand your style of practice, and your approach to surgical problems, um, I think could best be defined as — diagnosing, uh, patients, you made a comment that everybody that gets to your table, when you turn them over, it's amazing how there's no posterior chain development, and your term for that was FAS, which is flat butt syndrome, um, and of course I immediately looked in the mirror and I thought, I think I've got it.
Um, but I think, you know, that was a key turning point in my mind, to think that, okay, these patients that have chronic back pain, um, it's not always due to an injury, it's oftentimes due to the fact that they do not have the necessary neuromuscular development in that posterior chain. Can you talk a little bit about that, like, how does that pertain — you know, in the past I was told, okay, if you have back pain, don't lift heavy things, and then you told me no, if you have back pain, you need to learn how to lift heavy things, and so that seeming paradox — I think you do a much better job of explaining that — so talk to our patients about why posterior chain is so important, or, more, neuromuscular development in general is so important when it comes to back pain.
So um, you know, that's very true, I, you know, this is another area of medicine where I think we don't really completely understand what leads to, uh, degenerative spinal disorders, I mean, so, I'm not saying we don't have any understanding, but I don't think we completely understand why some people develop terrible degenerative spine disease and others don't, um, and it's not just age related, it's not — you know, smoking plays a factor, but it's not the only factor, um, and there's a lot of people that believe that, uh, at least an acquired scoliosis, or degenerative adult scoliosis, is actually a result of a muscle imbalance, um, not really a problem with the spine.
Um, and so, uh, you know, a lot of people end up in my clinic complaining of back pain, um, and you know, a lot of people have degenerative disc disease, but many studies have shown that, um, you know, if you study a population, um, of people, and you do random imaging on those people, um, some who are complaining of back pain and some who aren't, you'll see about half the people who don't complain of back pain don't have any finding, or have horrible findings on their MRI but aren't, you know, in pain. And so I — I think you're saying, in that imaging, almost — you would say you would look at their image and think, like, let's say you were looking at that image before you walked in the room, you would walk in and be like, oh man, this person's probably in terrible pain, and then you walk in and that person goes, I don't have any back pain.
Oh, it happens all the time, I mean, uh, you know, we kind of have a joke in neurosurgery, that, you know, show me the MRI, and I'll tell you what the patient's complaint of, or what the patient's complaint is, before you even walk into the room. And so, you know, I'll usually look at the imaging, uh, before I go in, just so I have an idea of what's going on, um, so in my mind I can start formulating my discussion with the patient. And you're right, it happens all the time, I'll look at an MRI, and be planning my surgical talk, you know, to the patient, the risks and the benefits, and you go in, start talking to them, and they're really not hurting, you know, or they're — they're not — their complaint doesn't fit with their imaging.
Um, and so, uh, yeah, it really began to dawn on me how important, um, you know, back to your original question, how important, um, paraspinal musculature is, how important the core is, how important, um, the glute region is for spinal stabilization, particularly in the lower lumbar spine, and the sacrum, and the pelvis. And so I think, um, kind of back to your earlier question, um, I see so many patients who have atrophied and completely underdeveloped, um, posterior chain, um, paraspinal musculature, they have no core, um, or you know, they're overweight, and sometimes I describe it as, I tell patients, you're carrying around, like, a 15 pound sack of potatoes, you know, just above your belt line, of course your back hurts, and they don't understand why my back hurts.
Yeah, um, yeah, I have similar — you know, people will come in and say, I'm just tired all the time, I'm like, well, you're 50 lbs overweight, if I gave you a 50 lb sack of corn to carry around with you all day long, how would you feel at the end of the day, like, yeah, I'd be really tired too, right. Um, so so how do you approach, in your own life — I know for you, uh, training, uh, and I don't even want to call it weightlifting, because I think what you do goes beyond just lifting weights, I mean, you have — more than anybody I think — when you dive into something, you go so deep on that topic, um, that you end up finding things that I've never heard of, and part of that, I think, happens with your training, right, your desire to improve your own musculature, hopefully probably to avoid a lot of what you're seeing in your OR, has led you to a different way of training.
So talk to me about your experience, where you identified that in your own life, and how did you correct that. So um, I guess to start at the beginning, real quick, I had always been interested, um, in sports, played sports as a kid — when we were talking about this the other day — um, and uh, grew up playing basketball, football, soccer, and uh, just was very active from an athletic standpoint, worked out, uh, in the gym for football, and got to college, and uh, didn't work out quite as much in the weight room, became more interested in, um, running, and by the end of my college career had become really interested in the sport of triathlon.
Um, when I went to grad school, I really dove deep into triathlon, and um, you know, was biking, uh, hundreds of miles a week, and swimming and running, and I was in great cardiovascular shape, and I got to med school, and um, didn't have as much time to train, but I was still running, and still swimming to some degree, and still cycling on the weekends, and towards the end of my residency training, um, had lost a significant amount of weight, was down to, like, 135 lbs, which for my frame was too light, and I looked like, oh, he's in great shape, you know, he's skinny, he's thin.
Um, and one day I went to, uh, do some pull-ups, and I could do one pull-up, which was embarrassing for me, so at that point in time, I think the light bulb went off, um, in my head, that I got — I got to do something, this is ridiculous, yeah, and I was skinny fat, um, right, so I really — you know, I looked like, oh, he's in good shape, but I really had no muscle mass on my frame, and had no strength. Um, and so, started just working out lightly with some dumbbells, and doing some, um, I don't know if you remember the program P90X, but — oh yeah — started, uh, some P90X training, and then that just kind of — we never finished one P90X workout, we'd get about 75 minutes in, cause they're not — they're an hour and a half workouts, right, and uh, I remember my wife and I had the whole DVD set, and we — I think we did the first, second, and third, and by the fourth night I was like, we got to do something different.
So I looked ahead, and I saw that there was the yoga one, cause one of the DVDs was yoga — oh god, let's do the yoga, that's going to be so much easier — kicked my butt, and so, yeah, that whole workout was depressing. So, uh, yeah, they just kind of evolved into, um, adding a little bit more equipment, I think I got a squat rack, or, I got a power rack which I could squat in, um, and uh, shortly after that I got into a program called, um, 5x5, which I know you're familiar with, um, and then kind of plateaued with that, and um, so to make a long story short, just began to accumulate some more equipment in a home gym, and um, began to see some positive results, and gain some muscle mass, and, uh, felt stronger, and um, felt better — at my nutrition, I really, that was another deep dive for me into the nutrition world, and really made significant changes for me — in residency, you know, eating healthy was — I chose the baked Lay's instead of, you know, the regular Lay's.
So, uh, what were the potato chips that were made with the, um, the fat substitute, the Olean, remember those? Oh man, the Olean was great as a colonoscopy prep, that's all I remember, just massive diarrhea in people who ate too many of those, right. And I remember, uh, yeah, me in college, that sugar-free — remember how everything was sugar-free? Yeah, Entenmann's Bakery, remember that, and all the girls were so excited cause, uh, fat free, but the carbs were just insane, yeah, absolutely, that they had in there.
So anyway, that's how my, um, that's a kind of short version of my journey, and how I really got, uh, to where today I'm more vested, and a believer, in strength training for everyone, no matter what your age is, um, and uh, I think, you know, we hear a lot — you're hearing more and more, I think, at least in the functional medicine, naturopathic medicine world, about how important muscle is, and yeah, um, I don't know if, uh, you're familiar with Gabrielle Lyon — right, I love her work — I don't know if she coined this phrase or not, I'll give her — I borrow it, I'll borrow it from her, I don't know where it came from — but you know, she says muscle is the organ of longevity, um, and uh, you know, it may not be — or it may not be the, um, organ of longevity, or the key to longevity, but I definitely believe it's an important one.
It's a huge one, yeah. So I mean, I think that brought you and I talking, um, about how we could collaborate more, um, with the goal of hopefully helping our patient population more, and so, you know, you and I, um, sat down, and talked about, what would it look like if we opened up a training facility that really took these principles and helped people on an individual basis, and so that began Transform Training, which we opened almost a year ago, uh, and you know, we're now to the point where we have, uh, two trainers, and a third one on their way.
Talk a little bit about where you see — what we're trying to do in Transform Training, how that differs from, you know, uh, a typical YMCA, where someone's, you know — because patients will ask, like, okay, I know I need to work out, I need to lift weights, but what does that look like, right, and you know, I'd say I gave a lot of people the 5x5 program, and it is a fantastic starting place for someone who's never lifted weights, 5x5, I saw fantastic results with people — oh, agree, totally — but my own experience with 5x5 is that I would get to the point where, you know, 5x5 is all about lifting — it's the same five exercises, so you got squat, deadlift, overhead press, bent over row, and bench, and you're doing, you know, squat every other day, so it's a very squat-heavy program.
You're — if you finish the last rep of the last set, which is five sets, five reps, then you're going to add five pounds to that exercise the next time you do it, which is great, because initially you have a really nice linear path for your strength, but then you get to the point where most of your workouts you're just failing, right, because you haven't — um, you know, and I didn't understand why, but I got to the point where I was literally dreading going down in the basement, because I'm going to go down there, I'm going to do my warm-up sets, I'm going to load the squat bar with all this weight, and I'm going to do one rep, and I'm going to fail, because I'm just at the point where I cannot move the weight anymore, and it got to be the point where it was just psychologically really tough.
Um, and in the program it says, you know, you're going to fail three times in a row, and then you deload, and then you try to move past that, which oftentimes you can, but those deloads and moving progressing get more and more difficult, and I think that's when I kind of realized that strength in that program is really focused on one thing, how much weight can you lift. And so talk about how the training that we're trying to do with Transform, how it differs from that 5x5 type program. So um, yeah, being familiar with that program, I can identify with everything you just talked about, and felt like I kind of had reached the ceiling, and um, and wasn't, you know — I'll get to this in a second — but the nutrition wasn't married with the workout, um, and not everything has to be — so I've learned not everything has to be taken to failure for you to grow and to see results.
Um, yes, there's a time where taking things to failure is important, um, depending upon what phase workout you may be in, um, but I think, uh, you know, you walk into the Y — and I'm not saying that there's not good trainers at the Y, and this is not, uh, this is not a knock on the Y at all, in fact in Wichita I think we have, you know, some great YMCA network, um, but it could be any gym, in general — and you walk in, and someone's in a shirt that says trainer, uh, or is wearing a t-shirt that says trainer, and you really don't know anything about their background, you know, do they really know what they're talking about, do they not, did they just put that t-shirt on yesterday and begin training people, and I feel like a lot of times that's the case, and that's one reason, um, I think people in general get frustrated with programs like that, or going into a facility like that, where they spin their wheels for a period of time, and then not really see the results they want.
Because — correct me if I'm wrong — the typical certification path for a trainer at the YMCA, maybe a weekend, or two-weekend, course? Correct, to where they then get to where they're the trainer, or even a day — I mean, some of them are a day, one day. Yeah, so I mean, you know, and I think we see this in our own field, right, I mean, there are physicians who, when they leave med school, they become lifelong learners, and so certainly someone could build off of that weekend training, and go on and consume material, and read studies, and build the practice themselves, and you know, it's kind of like physicians, you know, we always joke, what do you call the person in med school who finishes last, MD, MD, you call — doctor.
Um, so I think, what — how is the training different for the trainers at Transform, what's different about their training? So uh, to back up, um, in my personal journey, when I kind of felt like I'd exhausted 5x5, I wasn't sure — I was trying to do workouts on my own after that, and trying to do my own nutrition, and um, you know, I'm — as much as I have read on the subject, and tried to educate myself, I'm still not a, you know, a personal trainer myself, um, not a nutrition expert by any means, and so I kind of went looking — I was like, it's time for me to get a trainer, and take it to the next level, and started looking for, um, somebody out there, and came across, uh, a guy, um, by the name of Cassim Hansen, who at the time was at a gym in Tampa, Florida, called MI40, uh, but has since, um, launched kind of his own, not gym, but his own training program and philosophy, which interestingly enough is called N1.
I love it — and of course the N1 for him stands for just what we were talking about, that everyone's an individual, and we have to look at everyone as an N of one, and um, for people that — your audience probably knows this — but for people in your audience that may not know, that N typically refers to how many people were in the study, so you know, we looked at the study of a thousand people, so there was an N of a thousand, well, this is all about looking at a study of one, you know, or study of an individual. And so, um, the more I learned about his philosophy, um, and his mindset — and he, by the way, is a, um, a protégé of, um, Poliquin, and I think — I could be wrong, is probably not listening to this podcast, and never will listen to this podcast, so I can probably say whatever I want to — but um, I think he went as far as you could possibly go in all the certifications with Poliquin.
And Charles Poliquin, for people who don't know, because I don't know — his name is really known well — how would you describe Charles? He was, um, a real — I'd say visionary, um, if not — I well, I mean, he's a giant in the world of physical fitness, and um, and when I say bodybuilding, I don't mean, you know, necessarily like he only applies to people like Arnold Schwarzenegger, or, right, or Christopher Bumstead, for your — I don't know if your audience knows who CBum is or not, but uh, you know, you don't have to — I mean, Poliquin wasn't working with people who were stepping on stage and competing in bodybuilding shows, but he — I think really was one of the first to really understand the importance of anatomy, and how it applies to growing muscle, how it applies to particular exercises, and um, how, when you apply force to a muscle in a certain, you know, direction, exactly what that muscle is doing.
And um, and then also the importance of nutrition, and the importance of supplementation with that as well. Um, so anyway, back to — he uh, I think went as far as he felt like he could go with this guy, Charles Poliquin, and has kind of even further developed his own methods, and now has his own certification, um, which is very extensive and exhaustive, and so all of our trainers go to N1, um, and go through the N1 training to become N1 certified, and that is — it's not just a day, or um, a weekend, it's uh, months, it's months of training, I think, um, you know, it can be done, uh, online through, um, working through various, uh, videos and whatnot, but uh, it does also require an in-person practical, where you go for four days, and you have to, um, essentially — you essentially train with the trainers at N1, and really learn how to put people through these particular exercises.
And yeah, well, and so I came from 5x5, and started working with my N1 trainer almost a year ago, and I think what's amazing about, um, the periodization that you touched on, you know, that there are times when you're trying to build hypertrophy, there's times when you're working on that neuromuscular control, there's times when you're working on hypertrophy of the sarcoplasm — which I don't think I fully understand that — but but the — my training days look so different from when I was doing 5x5, like, 5x5, you really have — you have three things you can do, you can change the weight, the number of the reps, or the number of sets. With an N1 trainer, you're changing, um, you're changing the — the rep in reserve, so uh, you know, I know you know this, but um, I don't — I don't lift to get a goal at a certain pound, I'm lifting to produce a certain effect, I mean, I want to be able to fail, I want to get to my third set and have only one rep in reserve, right, and that changes based on what period I'm in.
Or I might be changing my tempo, so with 5x5, there's nothing about tempo, it's just get the weight down and pop it back up as fast as you can, whereas with my N1 trainer, he's always saying to me, slow it down, slow it down, which makes it a lot harder, but it's also exercising a different part of that muscle, and then failure is different, I mean, even the way I fail is different for different periods, so sometimes he doesn't count it as a failure until I've failed at the very top of the movement, and then I'm done, other days, like today, it was like, you're not failing until you can't get out of that starting position, so whether the muscle's in its lengthened position or the shortened position.
So it's amazing to me, how similar — functional medicine has this really large toolbox, I feel like an N1 trainer has a gigantic toolbox for how to challenge the muscle to produce that adaptive change, which is ultimately what we're trying to do, is trying to get the organism to adapt and lay down more muscle, right. Yeah, and until I was introduced to N1, I'd never even heard of this concept, that a muscle — I mean, of course I fundamentally understood it, but from my anatomy and my background as a physician, the terms made sense to me, but how that applied to training, lifting weights, that you could work a muscle in the shortened phase versus the lengthened phase — and as I began to train myself, learned that on certain movements I might be very strong in the short phase, or my, you know, my quads might be — and this is true of me actually, really is true of me, my quads are much stronger in the shortened position than they are in the lengthened position, so if I'm doing a leg extension, where I'm working in the short — or really stressing, working that muscle in the short position — I'm stronger than if I'm doing a squat, or something, or a — a barbell squat, or a hack squat.
Wonder if your triathlon training changed some of that, you, cause bikers, it's a different — your force curve is probably a lot different when — yeah, I think you're in the short position a lot, yeah, you're pedal — you're squeezing that shortened position to get that pedal to go to the next rotation. Um, yeah, and then nutrition, again, in 5x5, there's no mention of, how much protein do I need, how much protein do I need in this phase of my training, um, how do I utilize carbs effectively, you know, I've gone through periods of time where I've done zero carbs, I've gone through periods of time when I've tried to do higher amounts of carbs, and so, you know, the nutrition component that you talked about I think is huge, because if you're doing all this training but you're not giving yourself an adequate amount of protein intake, you're really taking three steps forward and three steps back.
Yeah, absolutely, and um, and to carry that even further, I've learned how important it is that your nutrition match whatever particular phase you're in, um, so you know, if you're in a particular phase of training, you may need more carbs, um, and less fat, um, and if you're in a hypertrophy phase, you may need more carbs than fat, and it's an individual response too, because you probably respond very differently to carbohydrates than I do. Absolutely, so, on what's known in the horse world as being an easy keeper, don't have to give me too many oats and I'll put on a nice thick layer, winter fat, but um, yeah, so it — and it became very, um, or I realized, how important it was that your nutrition was — just like you said — to your training, and that it's almost, I think, impossible to really grow and achieve your goals if the two aren't, you know, married together.
Well, I mean, I think some of the things we struggle with, with patients, um, is that they want to use diet to lose weight, and I think that can help, but you had a phrase — again you've got some great phrases that continue to stick with me, or haunt me, I'm not sure which — um, you said one day, we're like, well, you can't outrun your mouth, you know, and I've thought about that, like, well, these people that are doing tons of cardio, you know, that — and you know this, as a triathlon — when you start first triathlon training, early in your season, you're putting in a lot of volume, and after, you know, riding 30, 40 miles, you're pretty tired, but then the more you do that 30, 40 mile ride, you end and you're not as tired, your body has adapted to become more efficient, so you're technically burning fewer calories on that 40 mile ride three months into your training than you were burning your first month of training.
And so if you're trying to — if you're trying to simply burn calories, the more you exercise in that cardiovascular state, the more efficient you get, so you either have to add more miles or go faster, it becomes very difficult to adapt to that. Yeah, absolutely. So why is weight training different, how does weight training help people lose weight? Um, so, and this is another fallacy — even I think among my, um, just to elaborate on what you said — among our fellow physicians is — and this is what I've learned in med school — is calories in equals calories out, and I know you know this, that it's not that simple, it's much more complex than that, um, well, hormones play a huge role in how those calories are utilized, the quality of calor — I think matters a lot, and I hear from my patients all the time, um, well, I'm really not eating that much, and early in my career, um, before I've gotten to where I am today, I thought, well, that can't be true, because calories in equal calories out, you're not telling me the truth, and now I realize they probably are telling me the truth, they really aren't eating much, um, in fact they're probably undereating, but yet they continue to gain weight, because I think what's happening is their body is transforming into, you know, less muscle and more fat.
Yeah, so and probably that's a good point to put that finer point on, patients and clients, to where they say, I want to lose weight, we need to specify, are you trying to lose bone mass, muscle mass, or fat mass, and obviously most of our patients will say, well, I want to lose fat. Right, um, but I find that challenging, I have — especially with my female clients — that they will look at the scale, and say, well, the scale is not moving, and I'll look at their DEXA scan, which is a — it's a highly accurate way of assessing their body composition — I'll say, well, you've lost five pounds of fat and gained seven pounds of muscle, so the scale moved up, but you're less fat than you were before, and I think sometimes that's — I find that most difficult for my female patients to accept, maybe because they're focusing just on the scale weight.
Yeah, absolutely, and so to kind of answer your original question, I think, um, you know, those biometrics are important, um, and yes, weight is one thing we look at, but like you said, it's not really indicative of what may or may not truly be happening. What I think you should really be interested in — well, I mean, and this is what I think makes us unique too — is, it depends on what's your goal, what are your goals, you know, and so we sit down with every client, um, and do an intake session, that's one of the things we discuss, is what are your goals, you know, do you want to lose weight, and what does that mean, you know, to you, to lose weight, are you wanting to gain muscle, are you wanting to become more cut, are you wanting to, uh, increase, you know, your — are you wanting to become stronger, um, or you, uh, are you wanting to kind of — you're trying to change your look in the mirror, and we talk about body recomp, which I think is really more important than what your weight is on the scale, like you were just saying.
And so that's why I think building muscle, number one, um, I just think it's important to be strong, and I do think that having, um, extra muscle mass is maybe not necessarily going to increase longevity, but at least increase your quality of life. Um, yeah, touch a little bit on — I think, you know, so Gabrielle Lyon talks a lot about this — is that, um, she feels that what we really have is a, uh, an epidemic of sarcopenia, and I think that term sarcopenia, even some physicians may not be familiar with, because it's not — I'm not even sure if it's an official ICD-10 code, that we can diagnose somebody with — it's certainly not something that we're measuring, you know, we may — we could be measuring someone's weight, their weight could not change, and they could be sarcopenic and getting worse over time, with that scale weight staying the same.
Yeah, and so, um, for the benefit of your audience, what that means is, you're not over-fat, you're under-muscled, um, and so, uh, we know, you know, muscle actually takes — it takes, you know, more fuel to grow muscle, and so, to maintain it, and to maintain it, and so um, you know, kind of, thinking about it very simply, muscle burns more calories than, you know, than fat does, um, and so really, if you want to — your goal shouldn't be to lose weight, but really should be, I think, to gain muscle. Yeah, yeah, um, we see that — I hear this a lot from my own patients, they'll say, um, I have not changed what I've eaten, and I believe them, they'll say, I haven't changed anything I've eaten for 15, 20 years, they're very habitual in their eating habits, and yet they say, but yet I'm getting bigger.
Mhm, and you know, I think that's — for me the realization was that, you know, I would always look at, okay, well, it's got to be what you're eating, um, or it's got to be your hormones, so we'd measure their thyroid, thyroid looks okay, I mean, it might be a little bit better, but it's not terrible, um, you'd measure their sex hormones, well, they've gone down a little bit, but not — they're not super deficient. So I think for me it was a big aha moment, to see that it's the muscle mass, that if they are eating the same thing they've been eating, but they're losing that muscle mass, like you were saying it takes calories to maintain, what they're losing is metabolism, their resting metabolic rate is going down, so while their calorie input for the day might be the same, it's always been — now that they have an engine that's not burning as hot, they're actually now in a calorie excess in some way, and where is the body going to store that.
Well, one thing our bodies are amazing at doing is storing fat, I mean, fat as a tissue is pretty awesome, I mean, the fact that once you store it there, it costs zero calories to keep it, um, and it really for us is a survival advantage, which we don't need much nowadays, I mean, we've got grocery stores in every gas station practically, um, so so how — but yet I think the brain still, you know, back to your earlier point about stress, um, sometimes being a good thing, sometimes being a bad thing, I think we live in an environment now, in a world where, um, the vast majority of us live in a — in a constant, um, flight state, you know, and so our bodies are so stressed out, we live in a stressful environment, and so of course it's going to store fat.
Yeah, I often can say, like, the inside of our body, it's all it sees is this blinking red trouble light, and so the internal adaptation is, okay, well, let's pump up cortisol, cortisol is a catabolic hormone, it's going to break muscle down, it's going to pump up the ability to store fat, so again, I think that's, you know, again, we focus on sleep, and you know, my trainer actually has me tracking, like, how many hours of sleep are you getting, um, because that's important, right, if I'm only getting six hours of sleep, uh, that's a stress signal to my body, that's not going to help me in adaptation, or certainly not help me towards that goal of increasing my muscle mass over time.
Right, and I was going to make this point a second ago, I think, um, I mean, to my knowledge — correct me if I'm wrong — I think we're probably just starting to see some studies that relate muscle mass, or sarcopenia, to clinical outcomes in patients, right, I mean, I don't know, are there a lot of studies that exist that have looked at health and longevity, or quality of life, and you know, I'd say, I think this is where I think there's the biggest, um, deficit, is in the realm of nutrition science, and we've — I mean, you know, highlighted by studies that get shared online, like this latest one saying that Oreos were more effective than a statin at lowering cholesterol, well, that's the headline, but then when you dive down and you figure out what happened in the study, it was studying something completely different.
And so I think we're in a phase where nutrition study, it's, first of all, the body of nutrition study out there is just not high quality, in my opinion, and I think we even have less studies on muscle mass. The one study that I was really excited about, it wasn't directly related to muscle, but it was related to strength training, was in, um, postmenopausal women with osteoporosis, you know, we've got a lot of drugs that we can give for that, and some of those drugs — I don't know if you know this — but some of these drugs that you give for increasing bone density, they have a half-life of 10 years, so think about it, it takes what, five half-lives to get something out of your body, so a single dose of this drug is sitting around your body for 50 years, right.
And what's interesting is, when these drugs first came out, they did make denser bones, but the fracture rates didn't change, and in fact we started to see these really strange spiral fractures which we hadn't seen before, so you know, this study went back and said, okay, well, how do we build bone, well, we build bone by stressing it, and then there's these cells that line up along those lines of stress and build the bone into a more functional way. So they took these women who are postmenopausal, all had osteoporosis, which is when the bone is brittle enough that you're at risk for a fracture, and they put them into — it's similar to a 5x5 program, I think they just did three exercises, it was overhead press, uh, deadlift, and squat, and I saw videos of the researchers and their subjects, and even their form just looked terrible, like, you're watching it, you're going, oh my gosh, that's a terrible squat, a terrible deadlift, but even with terrible form, and what I would consider is not great proper training, their increase in their bone density was better than if they had been put on a drug to increase that.
And I would argue, probably — and this would take a long time to tease out — probably their fracture rates were lower, right, which is really the thing we worry about, I mean, does it matter if I make your bone density better, and I haven't overall improved your ability to not break your hip when you fall. And so I think, going back, when you ask, like, well, how is building muscle — how is that the anti-aging organ, right, or the organ of longevity — I think a lot of it is that muscle is there to protect us, protect our joints, and we move better, right, I mean, your ability to squat, I mean, how many patients do you see who couldn't squat, who couldn't do an air squat, that come into your office. Yeah, many, many, and yet — and you know why is that, well, because, you know, we all come out of the womb, and through our normal neural development, you know, every toddler can do a perfect squat, you've seen these kids sitting on the floor, and they've got their elbows between their knees, and they're playing with something, and they can do it for really long periods of time.
Then we take that toddler, and they go to kindergarten, what do we do in kindergarten, sit them in a chair, and then that's it, they're sitting in a chair for the rest of their life, and so we kind of destroy that ability, but so I think some of the training is actually going back to what we're supposed to have, those neural patterns that we're supposed to have as we developed as humans, we've lost a lot of that, and I think certainly doing a proper squat, having a proper hip hinge, means that you're going to be more protective in a lot of ways, but I think also it speaks to metabolic flexibility, you know, I see my patients have a higher — my patients with a higher muscle mass have a lower metabolic rate risk — they're less likely to be insulin resistant, and I think insulin resistance is one of these diseases we're just not tracking enough of, you know, we're not watching, um, someone's fasting insulin rising over time, and even though their glucose may be staying steady, and their A1C isn't moving, we'd say, oh, everything looks to be fine, and all of a sudden they're diabetic the next year, right, like, what happened.
Well, if you'd been following their insulin all along, you'd see their insulin went from six to 9 to 16 to 40, you know, their pancreas is just at the point where it's redlining, they can't keep up with that anymore. So that increase in muscle mass — what's amazing about muscle for me is that it can pull that glucose out of the bloodstream, and it's insulin agnostic, doesn't care if insulin is there or not, in fact you can take a type 1 diabetic, who, by definition, produce no insulin, and if they have a very high glucose, but have no insulin available to them in that moment — let's say they're not near their supplies — they could go for a run, use their muscles, and their muscles will actually just absorb that glucose right out of the bloodstream, and you can watch their blood — their blood monitors — go right down.
So I think muscle, as an organ, is just — I mean, it's just overlooked, and its value is way beyond just being able to lift up something heavy. Yeah, I agree, um, talk a little bit about — going back to the phases of training — talk a little bit about what the neuromuscular — you know, from your standpoint as a neurosurgeon, and understanding how the brain is teaching the body to move — what do you feel like that training is doing for the individual, that neuromuscular training, which is not necessarily about strength. Um, so you know, I think you're developing, I mean, simply, that connection between the nervous system and muscle, and that muscle movement, and so by putting that, uh, muscle through certain movements, you're developing those pathways, those neural connections, and enhancing those, um, so for someone who — and this is where, I think — and a lot of people have, um, you know, issues with that that they don't even realize, and this is where I feel like, um, a lot of people would benefit with an evaluation by a MAT specialist, like you have at PHW, um, a muscle activation technique specialist, where, um, they can reconnect the nervous system with that muscle, so that muscle may not even be firing, um, and so whether that be the paraspinous musculature, like we talked about earlier, or the glutes, um, I think it's — certain movements, certain exercises can retrain the nervous system to fire that muscle again.
Yeah, that brings up a really interesting thing, I — so I had a session with our muscle activation technique specialist, and um, I thought what I was having was a problem with my quad, and in the evaluation he identified that my hamstring wasn't really firing, and — you've had muscle activation techniques before, that it's a somewhat painful process to go through, but it's a brief pain, and it's really, I think, stimulating that muscle and its attachment and its insertion, and sort of waking that muscle up, but when he was doing that to me, I felt a pain that I hadn't remembered, but when I was 16 I was on my bike, and I was hit by a truck from behind, so I don't remember ever seeing this truck, I just woke up in the ER, and you know, that had this terrible road rash, which is where you've got, you know, road tar and grit all stuck in your skin, I had a nurse who's scrubbing with this terry cloth towel, but all I remember was the towel was just blood red, so it was pretty — a very traumatic thing for both me, and probably very traumatic for my parents.
But from that injury, I recovered fine, but I had this small hematoma in the muscle that was causing pain for years, I mean, anytime I'd sit down on a bench, I'd have to adjust to not get pressure on that hematoma, and then I just had forgotten about it, and it wasn't until he was pressing on that muscle that I was like, that is exactly the pain I remember having when I was 16 years old, and he said, you know, your body has protected you from using that muscle for so long, it just turned that function off. Mhm, and so I think, again, amazing what our bodies do to protect us, but it was the very next day that I went into the gym to do squats, and I felt that muscle contracting in a way I'd never felt it contract before, it was really pretty amazing.
So again, that's, I think, that's building that neuromuscular connection that you're talking about, right. Yeah, it's fascinating, I mean, again, I think there's so many things in medicine, and in science, I think we think we totally understand, and then when we peel back a layer, we realize, oh my gosh, this is a deep topic, and I feel like we could talk about this for a long time. What are some of the challenges you see, um, specifically in training, as you see it, for your female patients, what are some of the things that they maybe worry about, or what are some hesitations they have, for not going into doing weightlifting in particular, because I think they're the ones who want to — they always say, I want to tone, right, we hear that term a lot, and I want to lose weight, so they want to look skinnier, I guess.
So what are you hearing their — the female client especially — consistently say, that keeps them from lifting heavy weights? Uh, well, of course the number one hesitation, uh, complaint, or fear, among our female clients is that, well, I don't want to work out, because I don't want to look big, or I don't want to look huge, or I don't want to look jacked, or I'm going to look like a man if I work out with weights, um, they're worried about being too bulky, right. And so — I would love that problem — yeah, me too, I'd love to have that issue, um, and of course we know that's not the case, um, the other thing is, I think this notion that you're not eating enough, and you need — it more, um, so for someone, um, and I'm not necessarily picking on the females, but since you asked the question, I think it tends to affect the psyche of females probably more than males, who are thinking, I got to do more cardio, and I got to eat less to lose weight and to look the way I want to.
Um, and a lot of times the reality is, no, you're not eating enough actually, and you need to eat more, and you know, a lot of times, if you're not eating — you know, we talk a lot about being in a surplus or being in a deficit — and to, um, if you're talking about not so much function, but you got a look you want to achieve, you know, to achieve that look, you might have to actually eat more, because you're on so few calories now, you — there's — we can't put you in a deficit, you know, it's like your body's already in a survival mode. Right, hanging on to that fat storage probably as much as possible. Exactly, yeah, like we talked about, it's in a stress-induced state, and it's kind of in that fight-or-flight mode, and um, so that'd be the second thing.
I think, so just to be clear, you've never seen a female who went and started lifting weights accidentally just puff up. I haven't seen that, if someone has seen it, I would — I just want to make sure we haven't seen any outliers yet. Um, no, I would agree, I do hear that a lot from my female patients, and I tell them, if that happens, it's easy to fix, but I've never seen it happen, and what I have seen is, uh, females, um, you know, before and after transformation pictures, body recomp, you know, pictures, who weighed one particular weight on the scale at the beginning of the transformation, and either weighed the same or more at the end of the transformation, yet looked better, and actually liked their look better.
So, and I think that's another thing, in Transform Training, the ability to get that body composition scan on everybody, um, and being able to sit down with our clients, and show them, you know, that gaining of five pounds of muscle and losing five pounds of fat, you know, fat's going to take up about three times the amount of space that muscle will, so muscle being denser, their body does shrink, even while that scale weight goes up, and I know psychologically for women that's probably the hardest thing to do, is step on the scale and not see the scale moving, and so I find that DEXA scan to be an indispensable tool, and it's not — I don't want to say that it's always perfectly accurate, cause you and I have talked about, you know, there are probably margins of error in measuring that, but I think it is a fundamentally important tool for being able to show that client that you've truly recomposed this body that you have.
Right, absolutely, and um, I think, to dovetail on that, you know, to further kind of expound upon what we believe makes Transform different, is — so you're not only working with trainers who — I don't think there's anyone else in town who has the training that our trainers have, of course you may say I'm biased, but I think if you look at the exhaustive amount of training and work they have to go to, um, to become N1 certified, I don't think you'll find that anywhere else in town, uh, you're working individually with an individual trainer, uh, we don't really, you know, if you're looking for group classes, um, for weight training, I'm speaking about, I know you guys offer some group classes for other things at Prairie Health and Wellness, but if you're looking for a group, you know, um, workout session, you're not going to find it at Transform, you're working — so kind of like your, um, CrossFit box gym, where you walk in, and on the chalkboard it's like, here's the workout for today, and you're doing that workout with eight or nine people.
Yeah, absolutely, yeah, and a lot of gyms have gone to that because, um, I mean, just speaking honestly, it's more economical for them, um, it's more financially profitable. Yeah, but we feel like that's not really our goal, our goal is to see true transformation, you know, in our patients, um, and for them to achieve their goals, and to achieve optimal, you know, fitness, an optimal look, um, and also I think what makes Transform unique is that we are working, um, very closely, at least for the Prairie Health and Wellness members, um, with providers at Prairie Health and Wellness, who, uh, are tracking, uh, labs and hormones, and you mentioned earlier, especially with females, um, I think, you know, with males it's a little bit different, um, I think you and I joked about, males are more like a '57 Chevy, where you just add gas and oil, you just put a little testosterone in the tank and they're good — good — and women are more like a, um, you know, a two, three hundred thousand dollar Ferrari, they require a little more nuance, tweaking, and so um, that's another thing, I think, that makes us unique, again, at least for the Prairie Health and Wellness members who are working out at Transform, is that there's a lot of cross talk between your trainer, your provider, and you know, we've hit a roadblock, okay, let's look at some labs, let me talk to your provider, you know, what might be some things that are challenging you that I'm not aware of.
Um, well, and I know we even had one client who just didn't really seem to be hitting — stumbling and stumbling — and so for that client we said, you need to go back and see physical therapy first, so we've got, um, you know, a partnership with Phoenix, and we've got, um, PT in our Movement Center now, and then with Movement we also have chiropractors, who, I think our chiropractors — I would also say are the most unique chiropractors in Wichita as well, have a very different approach that they do with their chiropractic medicine, and of course you got muscle activation, so there's a really amazing suite that dovetails with what we're trying to do with training, that when we do hit those roadblocks, we've got that expertise next door, in most cases, to be able to help that patient find that.
And I think the trainers also begin to be more, uh, adept at understanding who needs that referral, who needs to go back, and I don't know, I don't know that you would get that in another gym where you didn't have that close, you know, sharing lunch with those people every day. Oh, absolutely, I mean, I'm not — I think, um, I mean, there may be another model for this somewhere in the country, but certainly not another model for this in Wichita, or even the region.
I'm — one other thing I hear, um, patients concerned about, is when I talk about their protein intake, you know, I will do their DEXA scan, and oftentimes I'm primarily looking to see what the muscle mass is, so I can find out, are you getting enough protein in your day, because I think just like you're seeing a lot of vitamin D deficiency, I think we're seeing a lot of protein deficiency, and there's this misconception that, well, the USDA sets protein — I believe it's one, uh, gram of protein per kilogram of lean body mass — which I think is about 50% of what you need to be optimal. So this idea of, you know, in functional medicine, we talk about, well, a normal lab result isn't always an optimal lab result, right, like vitamin D, the normal is 32 to 100, and you're measuring people who are, you know, they may be 30.1, and a typical doctor would go, well, that's normal, but we know, well, 60 to 80 is where optimal function is, you know, so we try to push people out — so where do you see protein — how has your opinion about protein changed over time, those patients who wonder, who say, I think I might be getting too much protein, similar to getting too bulky, what do you say to people who say that?
Yeah, so for whatever reason, in the mainstream media, um, lately there's just this, um, huge attack narrative, almost — yeah, the narrative — it's a nasty narrative, um, against protein, I don't know, I'm sure there's some ulterior motive behind it, um, but well, we've had the war on fat, we've had the war on sugar, or on salt, and we're now having the war on protein, we're not having the war on probably what we need to be having it on, which is the highly refined carbohydrates and massive amounts of sugar that people are eating. Right, absolutely, and so protein's become vilified now in the mainstream media, and I do think it's important, you know, that you're eating, um, a high quality protein, um, and I realize, you know, maybe not everyone can eat, you know, grass-fed beef, but we're not talking about protein like in a McDonald's hamburger, we're talking about a high quality, um, protein, and I think red meat has always been vilified, um, seems like ever since — even I was in med school.
Yeah, and we know that people will come in and confess to me, they'll say, well, I've been eating a lot of red meat lately, and I'm like, great, right, where's your meat come from, because I think, you know, we've often said, well, you are what you eat, I've changed that a little bit to say, you are what your food ate, you know, what was that cow eating that you ate, and so going back to grass-fed, you know, I think you were the one that kind of told me, that hey, I found out grass-fed doesn't always mean grass-fed all the way, right — right — you all of a sudden you start diving into this, and you find out, well, technically every cow in the United States is grass-fed at some point, and the way the labeling laws work, it's like, you can stamp — and grass-fed, people don't know any better, right.
But yeah, so red meat's not going to kill us, no, absolutely not, um, in fact everyone should probably be eating more red meat, um, so you know, I realized that I was undereating protein, um, when I, you know, began to become more serious about my weight training and working out, and — all I know, all my patients are undereating protein, and so, yeah, a lot of — you hear it, I hear it from men and women, but particularly the women — I can't, I can't eat that much protein, um, but I think you can, um, I do think there's some trainability, um, I think the gut has trainability, um, in terms of, uh, learning to eat more, and learning to eat more protein, um, and I think you just have to be maybe more cognizant of it, and schedule it, and be mindful of, you know, making sure you're getting protein at every meal, um, you know, back to Gabrielle Lyon, I know she's a big proponent of — I can't — I think she says 35 or 40 grams of protein per meal, every meal.
Yeah, for women at least, I think she, uh, is a proponent of at least maybe 0.8, to, um, or I think she says, um — how much protein does she recommend? I think she's at the point where it's, um, one gram of protein per pound of lean body mass, I couldn't remember if it was 0.8 or one gram, um, but which, you know, comes out close to that, um, one kilo — you can do one kilogram per pound of ideal body weight, so again, ideal body weight is what you want to get to, lean body mass is how much of you is muscle, bone, and tendon, um, in our clinic we use the one gram per pound of lean body mass, which for most women is going to be 90 grams of protein a day, and I'll ask them how much protein, and they're like, I'm probably not even half that.
Um, you know, sometimes they'll say, well, I don't know how much protein is in food, I'm like, well, one egg is six grams of protein, and their eyes are like, oh my gosh, that's a lot of eggs to eat, right, you know, so, yeah, but if you're eating, you know, beef, chicken, pork, I mean, there's a lot of ways to get that protein, but yeah, I think that — I don't understand this whole, like, well, won't that hurt my kidneys, and I'm like, no, you know what hurts your kidneys, diabetes, that's the number one cause of kidney failure, it's not eating too much protein. So I don't know, I don't know where that's coming from, but I do hear that narrative a lot, and that irrational fear is what I call it.
Um, so any other common misconceptions that you feel like need to be addressed with training in general, I know we've kind of talked about how we feel, you know, that the mix of cardio and weight training — would you, if you had to weigh those two, and let's be more specific, if we had to say, well, for a person who's in their late 40s or 50s or above, that are not trying to, um, you know, be a triathlete, they're not, uh, trying to, you know, run an ultramarathon, what would you say is the proper balance for them in scheduling their week, how much time should be spent muscle training versus how much time should be spent in cardio, uh, or is cardio even necessary?
I mean, if you're training, I know in certain periodizations at Transform, I feel like I'm getting plenty of cardio just lifting weights, right, um, and I feel the same way about my workouts, where a lot of it depends upon what period of training I'm in, just like you referenced, my workout may be very, uh, you know, cardiogenic in nature, I may be getting quite a bit of cardio just with my workout itself, and a lot of that can depend on, you know, how much rest you're taking in between sets, and your tempo, like you mentioned earlier. So and then I think it depends on your goals, you know, do you need cardio, well, I think — what are your goals, and what phase are you in right now, and um, if you're in a hypertrophy phase, and you're trying to build muscle, um, maybe you don't need as much cardio, if you're, yeah, um, in a phase where you're in a deficit, and you're trying to maybe burn some fat, um, and you can — um, there's this misconception that you can't build muscle in a deficit too, I think you can gain muscle in a deficit, it just has to be done the right way.
Yeah, and uh, so you know, another plug I would say for Transform is — and one thing that I also, I think we didn't touch on this, but might keep women away from the gym or from wanting to work out — is this fear of, um, you know, I'm going to be in this big gym with all these people watching, and with all these meatheads, and uh, Transform is not like that at all, it's a very individualized experience, and our trainers, you know, teach you how to do the exercises, um, you know, a lot of women say, well, I don't even know how to — and I'm not, again, I'm not picking on women, it sounds like I am, but um, a lot of our female clients would say, I don't even know how to pick up a dumbbell, I don't know how to work out, so I'm so self-conscious, I'm just not even going to start, because I don't know where to begin.
But well, I think some of that is — and I see this on social media — that the gym can be somewhat toxic, you know, um, you know, people, you know, if there's an etiquette in a large gym, like, you know, don't use the squat rack for anything other than squats, well, if you've never worked out in a gym, and understood that, you might walk into the squat rack and sit, because there's a mirror there, and you might be doing a workout with the dumbbell, well, man, if you do that at Gold's Gym, uh, you're going to find a medicine ball being thrown your way, and so I think there's a culture there that — I don't know that they're trying to be toxic, but you're new in that environment, you may not know that squat rack is just for squats, don't do anything else in there.
Um, but yeah, I think that's a huge benefit, I think, of having that personalized one-on-one training. Another misconception would be, oh, I'm going to get hurt, because I don't know what I'm doing, and I think, um, at Transform that's not going to be the case, again, our trainers are working with you one-on-one, um, they're going to teach you how to safely do the movements, and so one of the things we've started to do now is, we do that functional movement score, mhm, which we've actually incorporated into our — for our membership, you know, as you well know, we do an annual lab panel for everybody, it's just included in the membership, we don't want it to be a pinch point for people to decide whether they're going to do labs or not do labs, and so we've incorporated now, everyone's going to get a functional movement score, just part of their membership, and it's been a fantastic thing, because it gives them an objective measurement of their ability to do several — what I would call archetypal movements — you know, the ability to lift your leg up and step over an obstacle, and be able to do that with balance, to be able to pull your leg back, um, you know, and you and I have said a lot of times, what you're not measuring, you're not managing, and so that functional movement score, I think, has been a really key component to being able to show people that, hey, your functional movement score is improving as you're increasing your strength, because you've got more neuromuscular control, because you've got a better strength that goes through that full range of motion, and these are all things that we didn't get trained on any of this stuff in medical school.
No, absolutely not. Yeah, where do you see, for you, where do you see this partnership between Prairie Health and Wellness and Transform Training going forward, what excites you about it going forward? Well, um, so some of — I've already touched on the cross talk, I think is, uh, is just hugely beneficial for our clients, um, or our patients, and uh, I see us only learning how to better facilitate that, how to streamline that, where, uh, patients who need physical therapy are getting the physical therapy they need, um, and like you mentioned earlier, maybe they're not ready to lift weights, or lift heavy weights, uh, because they, you know, have a deficit, or they've got an injury, and so they need to rehab that with physical therapy, not that you can't rehab an injury and still work out with weights too, I'm not suggesting that, um, and then uh, working with, with Ian, the muscle activation, uh, technique, uh, guru, I think identifying areas where muscles aren't firing, I think that's only going to continue — I think we're going to continue to get better at communicating with one another, and enhance the experience for our clients, or our patients.
Um, I, uh, I would love to see us grow, you know, we're, um, we're in a great space now, it's very unique, and it — um, but I'd love to see us grow bigger, and to be able to handle more clients. Yeah, yeah, I think that's the thing that I'm excited about, is that it's hard — it's hard for me to find a patient in our clinic that wouldn't benefit from personalized training, like, I think it really is one of those things that's just fundamental, um, for people to learn how to do those movements, and make that exercise just a daily part of their lives, um, to kind of protect them, um, it's one of the things that we're working on at Transform, that I think is also really exciting, is this app we've got coming, because I think, you know, again, some of the training that you do with the trainer, you're doing one-on-one, but there are — you need to go home, or to your home gym maybe, and do, uh, some sessions yourself, so you know, that app — what I love about it is that there's the details of how to do the exercise properly, like, we're going to have a video for every single move, and even for me, I mean, having done this for a year, I still have to go back to the training library, and look, and go, okay, am I doing the right angle of this movement, am I working out — is the muscle shortened properly before I load it — and so um, it's going to be really exciting to be able to move from where we are now, with the spreadsheet that we're sharing in a Google Drive, to be able to have that app, so I think that's something that I'm personally looking forward to.
Um, yes, we're very excited about the app, um, yeah, and I think it'll allow, uh, almost like a one stop, for, you know, our clients, where they can book sessions in the app, they can see their workout in the app, they can communicate with their trainer in the app, they can see their nutrition plan for the week, um, and see what their macros, you know, how much protein, fat, and carbs, um, they're supposed to be eating this particular day, or this particular week, or what have you, um, and uh, I think, uh, hopefully booking through the app, sessions, um, and back to — you're right — we like to see clients not just working out when they come in for a training session, but that they are taking that with them, and working out at home, or maybe in whatever gym, uh, they may belong to.
Um, yeah, and I'd love to see us grow to the point where we did have space, so that clients — we still haven't — we still have — we're still able to provide a unique and individualized, and kind of boutique experience for, yeah, our clients, but yet have space where you could come and work out on your own during the week. Um, yeah, I think that'd be great, because one thing we haven't talked about, um, and maybe you were headed there, I don't know, but um, is I feel like another thing makes this unique is our equipment, I think we have world-class, um, very specialized and unique equipment, some of which you won't find anywhere else in town, if even in Kansas.
Um, well, I know it certainly took a long time to get it — true — when I heard our dumbbells were coming from the UK, I thought, why in the world would we wait for dumbbells from the UK, and then the first time you pick them up, you go, oh yeah, this is why we got dumbbells from the UK, they're amazing. And one thing that's unique about a lot of our equipment is, you know, we were talking about working a muscle in the short, middle, or lengthened position, um, and for your audience, our, um, a lot of our equipment comes from a company called Prime, which is in Pennsylvania, and uh, they have a very unique set of equipment, that, um, in a very broad range, uh, of pieces that allow you to work just about anything you could possibly imagine, but um, most of their equipment is set up to work particular muscle groups in the shortened, the mid-range, or the lengthened position.
Yeah, our leg extension machine, I've never seen a machine that works quite like that, where you've got this cam that you can set, and it's amazing, a weight that feels fairly simple to do, you change the cam position, and now you're working the beginning range of that muscle, completely changes the dynamics of that lift, right, um, it's fascinating to sit down and play with that, and feel the difference that that creates in your training response. Um, yeah, and I think, you know, I know a lot of our audience is going to be our patients and clients initially, but I'm hoping that, you know, uh, we're at the point now where we're opening to the public, uh, and that's been one of my visions long term, is creating, um, more of a campus feel to what we do, to where our clinic is really partnering with some of these sister companies, and Transform being one of them, um, and that even if someone's not a member of Prairie Health and Wellness, not a patient in our clinic, I want them to be able to engage, and hopefully they see a little bit about what goes on, and how that — that interlocking of the disciplines — could maybe help them in ways they didn't know.
So absolutely, well, this is great, I think we worried that we wouldn't have anything to talk about, and I think we've been going now for a little over an hour and a half, so at least we didn't stare at each other for 15 minutes, right. Well, I appreciate you more than you probably know, appreciate your friendship, and thank you for being the first guest on our PHW podcast. Well, I'm very thankful for you having me, I'm very honored, uh, for you to have me on today, and especially honored to be the first guest on the PHW podcast, and um, hopefully you'll have me back at some point, this won't be my only visit.
Many more, many more to come.