The InForm Fitness Podcast

Adam & Mike welcome one of the top high-intensity training experts in the world, Dr. Doug McGuff. Together, they will try to help you find The REAL Fountain of Youth.

Show Notes

This is one of our most important episodes.  A must listen!

Dr. Doug McGuff and I met back in 1995 at an exercise conference and we have stayed in touch ever since. He is such a brilliant thinker and teacher. I cannot emphasize enough how important Dr. McGuff has been to our understanding of the mechanisms and benefits of high intensity exercise  Dr McGuff  is a full-time emergency room physician and owns, Ultimate Exercise, a high intensity, personal training facility in South Carolina. 

In 2008, Doug released the ground-breaking book, Body By Science, and is considered one of the top high-intensity training experts in the world.  I highly recommend that you follow Doug for his incredible insights and findings via  DrMcGuff.com and his YouTube channel.

We kick off this episode discussing that the measurement of an individual’s muscle mass should be included as an important vital sign, similar to one’s blood pressure and hemoglobin A1-c.  Strength, we are learning, is a great indicator of overall health; including being a good predictor of system inflammation and physiologic reserves.

Doug does a fantastic job explaining the concept of S-O-R (Stimulus – Organism – Response), helping us to understand the relationship between exercise, genetics and our expected (and unexpected) results.  

Did you know that muscle is the most powerful endocrine organ in the body? High intensity exercise and healthy muscle mass dictates and signals for: 
  • the reversal of the aging process
  • how energy is utilized in the body
  • the conversion of white fat to brown fat (a good thing). 
  • the partitioning of nutrients
  • how glucose is regulated
It will be practically impossible for you to listen to this episode and not feel compelled to hit the weight room ASAP.     Enjoy!

Adam Zickerman – Power of 10: The Once-A-Week Slow Motion Fitness Revolution:
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Inform_McGuff 1_August 9 Transcript
 
Arlene [00:00:01] The Inform fitness podcast with Adam Zickerman and co-host Mike Rogers is a presentation of Inform fitness studios a small family of personal training facility specializing in safe efficient high intensity strength training. On our bi monthly podcast Adam and Mike discuss the latest findings in the areas of exercise nutrition and recovery with leading experts and scientists. We aim to debunk the popular misconceptions and the urban myths that are so prevalent in the fields of health and fitness. And to replace those sacred cows with scientific based up to the minute information on a variety of subjects. We will cover exercise protocols and techniques nutrition sleep recovery the role of genetics in the response to exercise and much more. On this episode Adam and Mike welcome Dr. Doug McGuff, one of today's leading high intensity experts. This is a must listen as they discuss that there's a lot more than meets the eye when it comes to all the benefits we reap from high intensity training. If you're still looking for some more motivation to stick to your exercise program well this episode is for you. 
 
Doug [00:01:21] If you want everything bad that can happen to a human to happen immobilize them and overfeed them. Movement is life. And I believe that movement against resistance is life elevated. 
 
Adam [00:01:36] Hello. Welcome to the show. Adam and Mike here I have known today's guest Dr. Doug McGuff now for over 20 years. We both caught the weight training bug as young men in our teens, we are about the same age. And we've been geeking out on it ever since. He's a doctor he's a practicing E.R. doctor in South Carolina and Doug is one of those few doctors who actually happens to run his own gym. It's called Ultimate exercise and it's in Seneca South Carolina. In 2008 Doug co-wrote the groundbreaking book Body by science along with John Little and let me tell you it is required reading for all my staff and even many of our clients. Why. Well honestly it was and really is a really important book because it comes from a theoretical understanding of basic physiology and for the first time properly applies it to high intensity exercise. I can't emphasize enough what his book has done to our industry and bringing high intensity exercise to the mainstream. So anyway it's my great pleasure to introduce a guy who I really consider a mentor. Welcome to show Doug. 
 
Doug [00:02:45] Yeah Adam it's my pleasure. I've been looking forward to it. 
 
Adam [00:02:47] I just saw you recently at the conference, what was it... a resistance exercise conference in Minnesota. 
 
Doug [00:02:53] Yeah. 
 
Adam [00:02:54] And your keynote speech was fantastic by the way. 
 
Doug [00:02:57] Thanks. Appreciate it. 
 
Doug [00:02:59] You said something I really rang true in me because we come from similar backgrounds experiences and the timing because we're similar ages and we got introduced to high intensity training the nautilus principles relatively around the same times. We we go back a few years with this high intensity training at this point and you end you said that for the last 20 30 years that we've been lifting weights primarily to get big and strong, swoll as they say you know maybe to give us an edge in sports and if we were on an unusually perceptive day we might have actually also thought that it might protect us from injury but really is about getting big and strong. Now we're finding out so much more that we were getting from these workouts than we ever thought. You know the health benefits of exercise that go beyond just getting strong which quite honestly if you told me that just getting strong is all we got from strength training I'd be happy with that. 
 
Doug [00:03:53] That would be awesome. Yeah. 
 
Adam [00:03:54] I mean that's why we were doing we didn't think we were getting anything more from it. But, so Doug this is what I want to speak to you about the health benefits of strength training beyond just getting really strong. So Doug the paper you brought up was titled muscle should be the new vital sign. Something like that right. 
 
Doug [00:04:11] Yeah. Yeah I think that that's probably accurate. I mean at least it should be you know not on a visit by visit vital sign but in terms of someone's health history I think that ought to be recorded as a health parameter body mass index is being used a lot now. But that's not truly accurate. But I think if there was some sort of measure of muscle mass or strength that could be included as a vital sign it would provide a lot of useful health information. And it's simply because skeletal muscle speaks to everything else in our body. And it's a good indicator of what your overall health passionate situation is going to be is going to be an indicator of what degree of systemic inflammation might be going on. It's a great indicator of your physiologic reserve should you become ill if you get an infection you end up with sepsis end up in an intensive care unit the degree of muscle mass that you're trending down from basically gives you the clot that you're racing against to get better. So it really is a pertinent vital sign. And I would agree with the premise of that article. 
 
Adam [00:05:22] You mentioned that recovery in ICU use have been shown people that have higher muscle mass recovered better in ICU units. 
 
Doug [00:05:29] Yeah absolutely. How long you have before you have to go on total parental nutrition in the ICU is very much related to your skeletal muscle mass which again directly correlates with your overall Organ Mass. That kind of starts the countdown clock because your body is going to tap in to the reservoir of your skeletal muscle not just in terms of stored glycogen for energy usage but also the amino acid pool that's within your skeletal muscle for synthesizing enzymes nutrients generating antibodies. All that is used as a storehouse for raw materials that you'll need in your fight for survival and when you've kind of tap that out then you have to go on to kind of. Into intravenous total parental nutrition which is very challenging for ICU specialists. 
 
Adam [00:06:26] You don't want to be there at that point. 
 
Doug [00:06:28] It's just so easy to screw up you know. 
 
Adam [00:06:31] The health benefits. I want to start talking about some of these real physiological changes that occur as a result of high intensity exercise but before we go right into that which is really where I want to spend most of our time I want to do a review of s o r. Stimulus organism response if you can in very succinct way talk about that and when we talk about exercise we talk about the stimulus what type of exercise the protocol that we do. I want to start getting into more of the responses down the road. 
 
Doug [00:07:01] OK sure. So you know everyone just needs to take a bout of Arthur Jones can I explain it to everyone for the very first time that your natural inclination and orientation towards exercise that is directly doing something that benefits you. The Ab roller will firm and tighten your abs, right no no. That's not how it works. I mean that exercise is some sort of formatting or threat stimulus to the body the body receives that. And then if it has appropriate resources and time it will synthesize an adaptive response but that exercise itself is just a stimulus your body generates the adaptive response and that adaptive response. Preconditions for it to occur. And the adaptive response is really not just one thing it's a myriad of things. We're coming to discover and we've always intuited that you know you and I both know I mean you remember going into a big box gym back in the 80s and you could walk through there and you had all your anemic sickly looking people on treadmills and then you had all the robust healthy looking people that you would like to look like over in the weight section and you kind of wondered if that was just a selection bias or if there was really something to it. And as it turns out our instincts about that were correct. That really is something to it. There's something almost magical about exercising against meaningful resistance. 
 
Adam [00:08:33] Yeah it was probably the best selection bias too because I think I think when you have one when the organism that's prone to build muscle you tend to gravitate there. 
 
Doug [00:08:41] Sure yeah. 
 
Adam [00:08:43] And as the organism part talk about like the organism for a second where because and expectations. 
 
Doug [00:08:51] Sure. And this kind of gets into my whole Pandora's box discussion that came up with the resistance exercise conference and you know when you look in Greek mythology the story of Pandora's box they put hope at the very bottom of the box. And that was so that you would take everything else that was in the box and release it out into the world in the process of going after Hope and in the resistance training realm. The hope is actually big muscles. That's kind of what got us all into this to begin with. Because the outcome of resistance training in the correct individual and the correct organism produces dramatic physical response in terms of muscle hypertrophy and that's what everyone is after was what was visible. And that was the hope at the bottom of pandora's box. And that's what got a lot of people hooked and kept them in it for the long term but in the process of going and going after what was at the bottom of the box we were unknowingly reaping all these other benefits that only over time did we start to have some sense that there is a lot more to this than just getting big. There seem to be more benefits and there seem to be more impact in terms of. Body composition and health. And that became more and more evident over the years from the 1980s forward. A general populace the wheels were just starting to fall off everyone was getting metabolic syndrome everyone was getting fatter and fatter. Those hidden benefits of strength training started to manifest themselves because the body composition changes that we were seeing could not simply be explained by caloric account. It could not just be that the amount of activity you were doing relative to the amount you were eating something else was going on. And that's all of those other things that were inside Pandora's box that we were bringing out through the process of trying to get bigger and a lot of people. How big you're going to get in terms of muscle mass is really dependent upon the organism that specific organisms genotype and genetic expression is going to determine the ceiling of how big they can get. And there are so many young men and nowadays young women that are pursuing a degree of muscle mass that they've seen in magazines or on Instagram or the Internet that they're never going to achieve. But they keep going after it but in the process of doing so they're reaping all these other benefits that they may not even be aware of or that they become aware of in the process of doing it. 
 
Adam [00:11:39] But also we should think that because of these other benefits that we're getting as opposed to just getting big and strong for a lot of my clients anyway and this realization has been very useful is to tell people listen just because you're not getting as big as you like it and you're not looking like somebody that you idolize that's doesn't matter. The high intensity exercise is doing so much more for you than just this idea of getting really big or reaches a certain level hypertrophy and as are we as we also heard from the rec conference that size and strength aren't necessary completely literally correlated so we're getting very strong on this we're getting big and again the act of high intensity exercise has all these huge other health benefits. 
 
Doug [00:12:24] Right. And the ironic thing is is the people that get really really strong are the people that tend to not get very big and the people that get very very big are the people that get very modest strength improvements. 
 
Adam [00:12:39] I know, it's annoying. 
 
Doug [00:12:41] There's different mechanisms. 
 
Adam [00:12:46] Cause I may get strong, but I don't get big I think I'd rather give a little bit of that up. 
 
Doug [00:12:48] And the size increase is an improvement of last resort which is kind of funny because it's the one thing that got us hooked into the whole process. But in terms of all the adaptive responses that are available from high intensity training. It's only muscle size that is heavily negatively regulated. So the only thing that really has a hard hard ceiling put on it in terms of response over time the most pleasurable clients to train, turn out to be the ones that don't give a rat's ass about the hypertrophy issue. 
 
Adam [00:13:24] I agree. 
 
Doug [00:13:26] There are in particular if you have older clients they are so appreciative of the benefits and the myriad of benefits that come from high intensity strength training because they can appreciate them because you don't really realize those things are there until they go away. I don't know if you've ever had numbing drops put into your eye but you never realize how much sensation there is around your eye and blinking and all of it until it's taken away. 
 
Adam [00:13:55] Yes I've had that happen. It's crazy. 
 
Doug [00:13:56] And then when it comes back to you you're just so amazed. It's like a fish and water it's like this is water is like what's water. All of a sudden you get back to these people all of these you know functional health benefits that have gone away and they can feel it. And the thing is is if you have a client is training high intensive you know muscle mass aside just let's say we have a you know an older client that's training in your facility Adam, if you pluck that client out and drop them into the middle of a gate at the airport with 150 200 people and you and I stand together. And you asked me Doug which one of the people stand around here is my client. I guarantee you I coul d point them out. 
 
Adam [00:14:42] Mm hmm. 
 
Doug [00:14:43] They have a different appearance all together the way that her body orients itself against gravity the color of their skin. They go. They don't stand out for any muscle mass reason. There is a signaling of health that's unmistakable when when you look at them and I guarantee you I could plug your client out of 150 people at the airport gate. 
 
Adam [00:15:10] You know you just used the word signaling. That's a great entree into what I want to talk about with muscle. I don't think people realize that muscle is a signaling organ like the pancreas. And so let's talk about muscle as a signaling organ and that's what leads all these health benefits that we're talking about what high intensity exercise promotes what it stimulates muscle to do.    And there are some things that I just want to throw out there like you know let's. I want to talk about myokynes, myokynes. I want to talk about the energy and protein metabolism characteristics of muscle when I talk about glucose uptake. I want to talk about the Simon Melov research. They've shown that exercise can actually reverse aging and human skeletal muscle. These are the things we're talking about here. 
 
Doug [00:15:51] Yeah. And the whole myokyne issues probably less than 10 years old can't remember where she's from. Some Scandinavian country Bente K. Pedersen is the one that kind of coined the term and first discovered the notion of myokynes is basically their cytokines chemical messengers that are released by exercising skeletal muscle that it turns out that they operate in a signaling fashion both within the muscle working that's autocrine to nearby muscles that's paracrine and then to other organs and tissues throughout the body and that is endocrine. So it turns out that skeletal muscle is the largest and most powerful enduring organ in the body. Guys like us we always had a sense of that that that was the whole the benefits in terms of body composition seemed so disproportionate to anything that could be accounted for simply by caloric energy balance or accounting issues it was much greater than than the sum. And I know you remember the discussion of Ken Hutchins had about indiscriminate weight loss and you're talking about your body as a corporation that had a board of directors and you're in a calorie deficit and in one scenario you lose all tissues in your body at a calorie deficit but if you add high intensity strength training. It will all be shunted towards discriminate. Fat loss because you can't get rid of skeletal muscle because you got a stimulus for more. You can't get rid of nervous tissue because the skeletal muscle that you're adding needs to be innovated. You can't get rid of bony tissue because the skeletal muscle you're adding has to be attached to that bone and you have more added on. And he made this case for how when you have a caloric deficit in the face of high intensity strength training it which should shunt everything towards fat loss. And that was sort of beating around the bush of this whole myokyne issue group. Is that hard work with skeletal muscle is doing so much to dictate how energy is utilized in the body to dictate nutrient partitioning to dictate enhanced glucose uptake and disposal out of the out of the skeletal muscle to increase lipolysis and fatty acid breakdown to stimulate the change of adipose tissue from white energy storing inflammatory hormone releasing tissue into brown adipose tissue which uncoupling itself from the mitochondria and releases heat and contributes to improvements in body composition and loss of inflammatory fat. There's just so many things that are triggered when you do hard work. 
 
Adam [00:18:45] And is it necessary for to be intense work as opposed to let's say just. 
 
Doug [00:18:50] No not entirely. I mean there there are myokynes that are released by lower levels of activity and this is the difficult part with myokyne research is when we are going to measure them we don't know about the amplitude of their release and the time course of their release and whether certain myokynes are triggered best by certain types of activities. So it may be that there are certain myokynes that are released but lower intensity exercise is carried out for longer periods of time. Certain types of exercise may cause a spike in a myokyne release immediately after the exercise. In other cases that spike may not occur for many hours later we don't know whether we're sampling at the right slice of time relative to each different myokyne. Perfect example of this is one of the first myokynes that was discovered was interleukin 6 and under normal circumstances interleukin 6 is released fairly steadily from the body and particularly from the adipose tissue and it is known as a bad player. It is a very inflammatory cytokine and chronically elevated levels of interleukin 6 can actually lead to the development of cancers. So when we first started recognizing that cytokine release occurred with exercise we are finding that interleukin 6 after high intensity exercise would spike like a thousand fold. Immediately after a high intensity exercise bout and the immediate response was like oh no this can't be good. This is a bad player we're spiking it a thousand fold. We're going to make everyone sick. Have heart attacks and inflamed their blood vessels giving them cancer fill in the blank. But what we came to find out was that those acute spikes in interleukin 6 ended up down regulating the receptors for interleukin 6. So you have a lot fewer of the receptors and over the longer span of time your sustained serum interleukin 6 levels fell. It was like lowering your serum insulin levels when you had those acute spikes, you ended up creating a circumstance where over the longer span of time interleukin 6 levels and systemic inflammation was greatly blunted. So there's a lot of things that seemed counter intuitive that actually turned out to be beneficial. By this whole myokyne concept. 
 
Adam [00:21:35] So your gut feeling however is that myokynes are good. 
 
Doug [00:21:41] Yeah I think it's is simple is this. And I kind of concluded the talk. So humans fall under. And you mentioned this in your email the whole classification of living organisms wonder King Philip came over for good sex as the mnemonic that I learned and you had a one that was less offensive. 
 
Adam [00:22:06] Soup probably want. I went for the sex. 
 
Doug [00:22:10] One of the distinguishing characteristics of animals is movement. That is the key distinguishing feature of that kingdom and movement is so important to us because for animals without movement you can't get food. You can't keep from becoming food. It's as simple as that. And at the conclusion of the talk I thought movement is life. That's basically all there is to it. If you want everything bad that can happen to a human to happen immobilize them and over feed them. Movement is life and I believe strongly based on the experience that you and I have had in this field that movement against resistance is life elevated it takes it to another level. That is just much much better and I think it is really as simple as that and I do for that reason think that the discovery of myokynes has been an amazing thing and that I believe that this chemical messaging is nature's way of saying movement is good movement against resistance is even better. 
 
Adam [00:23:23] Yeah well amen. Let's talk about Simon Melov's work a little bit because it isn't hyperbole to say that high intensity strength training can actually reverse aging. Is that hyperbole? 
 
Doug [00:23:36] No, and he proved it and I was that research is at least 10 years old now and I like you I know you do just kind of everyone so I'll sit down with the laptop or get on a computer and just kind of plow through Pub Med and see what's out there. I just stumbled across the article and I love that article that gives you the answer in the title of the article and it's saying that resistance training reverses aging in skeletal muscle, that's the name of the article online. Well damn I'm a click on that one. It was truly astounding. They used a statistical technique called the false discovery rate to discover gene expression that was markedly different in advanced age than it was in youth. And they identified. I can't remember as close to 200 different genes as candidates and then they apply to 16 week strength training protocol to elderly subjects. And measure their gene expression before and after. And what they found is that the conclusion of the study of the gene expression had reverted to the same type of gene expression that you saw in twenty five year olds in 16 weeks. And when you actually dig into the methods section of the paper and you look at the quality of strength training that was done compared to what you and I are used to saying it was pretty darn mediocre. Yet you had these results that were just completely astounding. You know this was in mitochondrial DNA where they were looking at these genes which is very well preserved DNA. And it's also DNA that is integral to the cellular functioning of everything and the organisms. It's not just the icing it's the sprinkles on top of icing in terms of genetic expression. My immediate thought was wow this changes everything. I mean our most ancient literature is about seeking the fountain of youth. And there it was. And you and I both know that what happened afterwards was nothing. 
 
Adam [00:25:46] Unbelievable. 
 
Doug [00:25:46] I thought Man I'm going to. We couldn't build facilities fast enough to train clients and... 
 
Adam [00:25:53] No if there was a pill that would do that. 
 
Doug [00:25:56] You remember how resveratrol flew off the shelves when that research came out and junk like a 16 percent lifespan increase in flap worms. And people were like spin and big bucks buying it off the shelf. But we're talking about bona fide age reversal at the molecular cellular level in humans. And nothing happened because what was required was to get off your ass and do hard work. And that was the difference. I mean the kind of person that's willing to get up go out pay good money for someone to make them work really hard and be uncomfortable. To reap the benefits. That's just a different kind of person and that's you know I'm I'm okay with that being a minority population. I wish it would be more but it's a special kind of person and that's why I love training clients you know. 
 
Adam [00:26:57] And you see it day and as an emergency room physician you must see the problem associated with the loss of strength. 
 
Doug [00:27:07] Me & my wife was talking about this today before the podcast and because we went to a Starbucks today we had to run some errands and we went to a Starbucks. She always gets this white peach tea it's unsweetened she likes it. So I went to order it today and lo and behold it comes to the door and it's sweetened. So we're like tap on the window at the drive through us like we said I'm sweet and you go sweet like oh we're sorry. Starbucks has changed the formulation. It only comes sweet now it's brewed into the bag and that's the way it is. And we believe in you know we've got an alternative. We're leaving on the schedule so plenty. I really do think it almost borders on conspiracy theory that every big empty out there seems determined to force feed us the shit that's gonna make us sick. It's gonna make us fat and with metabolic syndrome and cancer and diseases because I really do think there's just so much profit in people being sick that that's what we're getting. The fact that we had corn and grain subsidies back in the Great Depression and we couldn't just unwind those now it's a requirement that we have 10 percent ethanol in our gasoline so that we can continue to propagate those grain subsidies and the fact that we have to have 10 percent gasoline in our gas tanks is probably a major driving reason why the vast majority of population in this country has been turned into human brain disposal machinery. Oh well yeah we're just sicker than hell and I mean when I go to work. I mean I can't even begin to describe to you how sick and deconditioned people are. It is rare for me to pick up a patient that has less than 30 medications. 
 
Adam [00:28:53] Jesus. 
 
Doug [00:28:53] It is rare for me to pick up a patient that has not been at the E.R. or in the hospital within the past two weeks is just a revolving door. I went from especially where I could like you know make major turnaround on people a major saves. And now it's just a revolving door of trying to put the wheels back on and they fall back off and come back really really slid on our overall health status. 
 
Mike [00:29:24] This reminds me of when my dad was in the hospital he had heart failure a few years ago and we've covered this on a previous podcast but when he was there he was diabetic and this special Diabetic Menu had all sorts of incredibly high levels of carbohydrates on a special diabetic menu, there was pasta even bread like the like. And I asked to see the nutrition said. I said what's. He just ordered two grilled cheese sandwiches and she goes What do you do have a problem with the cheese? I said no I get that this is the clinical dietitian at the hospital and I was like Oh my God I printed it out. I took a picture of it. I was like Oh my God I can't believe this is the special Diabetic Menu at a hospital for someone who is recovering from a fem pop a bypass surgery. 
 
Doug [00:30:14] It is mind blowing know I operate on the two ends of the spectrum my whole life was a barbell including my interaction with humans. It's a barbell strategy where on one end I got the sickest of the sick and on the other end I got my clients and the. The disparity between the two is just so astounding that you know the cognitive dissonance every day when I go to work and do what I do is just unbelievable sometimes. 
 
Adam [00:30:41] Yeah well you and when we were talking in person at the conference you and I were talking about exactly this. 
 
Doug [00:30:46] And your wife works in an ICU. Does she not? 
 
Adam [00:30:49] She did she. She did work in ICU. Yes and she has experience similar things and now she's working in oncology. Speaking of what Mike just talked about being fed grilled cheese from a diabetic menu it also amazes me how little the cancer doctors are talking about nutrition to their oncology patients. It's pretty much nonexistent and this is like a high end Oncology Group. Those those conversations frustrate me to no end. 
 
Doug [00:31:16] And I got a weird story. This is not science. This is purely anecdote. I had a client my place been open for more than 20 years now had a client that had you know just out of blue who had a seizure. Part of the workup got a C.T. scan is actually one of my partners diagnosed her with an astrocytoma of the brain highly malignant brain tumor. And this was probably early 2000. Just when the whole low carb ketogenic thing was kind of taken off but I knew there were some literature on ketogenic diets in relation to brain cancer and seizure disorders and things like that just made the suggestion she latched onto it and over the course of a year or 18 months the tumor shrunk and then became undetectable. But they went ahead. They recommended that she still go through some chemo and radiation therapy had a lot of radiation therapy actually develop some mild dementia as a consequence of the radiation. She had a fall and had a laceration about a week ago and I ended up seeing her in the E.R. but still alive. Still no return of tumor. This just gets to the whole oncology discussion that we're not talking about you know ketogenic diet carbohydrate restriction. The things that might be driving cancer metabolism and the other thing is is using diet and high intensity exercise as adjuvant therapy to chemotherapy and more traditional treatments I think should start to become a standard of care. I mean they can show that Interleukin 15 which is one of the major myokynes release that inhibits myostatin promotes muscle growth but also has been shown in vitro and in vivo. That means in the test tube and in the animal to actively arrest growth and kill breast cancer cells. So I mean there's a strong argument to be made for high intensity exercise as adjunct therapy to chemotherapy. I do have an oncologist that will occasionally send me clients PRE Chemo just to kind of build up their muscle mass in their strength to give them a higher ceiling to start from when they start doing chemo. But there's not really been any discussion yet of the potential anti neo plastic effects of this myokyne release and what it could mean. 
 
Adam [00:33:48] Myokyne release through high intensity exercise which doesn't take a lot of time to do it and think about it. And some good nutrition does carbohydrate restriction movement. This stuff is in our control. 
 
Doug [00:33:58] Right. 
 
Adam [00:33:58] It's so within our control. We don't have. 
 
Doug [00:34:02] Really in terms of moving the needle on doing anything beneficial. The things that are within our control move the needle a hell of a lot more than the medication regiment. I mean if they could get the kind of percentage benefit that's documented by those sort of interventions in a pill drug manufacturer would just like go completely bonkers over something of that efficacy. 
 
Adam [00:34:28] I agree. Well we've got to wrap it up now but let's end on that. That says it all. I mean if you're not motivated to go based on all this stuff that we're finding out it is start doing some high intensity exercise get moving and maybe pay attention to your nutrition then then I don't know I don't know. 
 
Doug [00:34:45] The time commitment or maybe one thing but the time commitment is just so minimal and the reward relative to the time is hugely disproportionate. It's just a win win you know. 
 
[00:34:56] Big bang for your buck. 
 
Mike [00:34:57] Doug. He's happy to be a part of the minority though. 
 
Adam [00:35:00] Yeah. Well thank you so much Doug I really appreciate it. 
 
Doug [00:35:04] My pleasure, it's been a fun talk. 
 
Arlene [00:35:08] This has been the Inform fitness podcast with Adam Zickerman. For over 20 years Inform fitness has been providing clients of all ages with customized personal training designed to build strength fast. Visit inform fitness dot com for testimonials blogs and videos on the three pillars exercise nutrition and recovery. 
 


What is The InForm Fitness Podcast?

Now listened to in 100 countries, The InForm Fitness Podcast with Adam Zickerman is a presentation of InForm Fitness Studios, specializing in safe, efficient, High Intensity strength training.
Adam discusses the latest findings in the areas of exercise, nutrition and recovery with leading experts and scientists. We aim to debunk the popular misconceptions and urban myths that are so prevalent in the fields of health and fitness and to replace those sacred cows with scientific-based, up-to-the-minute information on a variety of subjects. The topics covered include exercise protocols and techniques, nutrition, sleep, recovery, the role of genetics in the response to exercise, and much more.

Inform_McGuff 1_August 9.mp3

Arlene [00:00:01] The Inform fitness podcast with Adam Zickerman and co-host Mike Rogers is a presentation of Inform fitness studios a small family of personal training facility specializing in safe efficient high intensity strength training. On our bi monthly podcast Adam and Mike discuss the latest findings in the areas of exercise nutrition and recovery with leading experts and scientists. We aim to debunk the popular misconceptions and the urban myths that are so prevalent in the fields of health and fitness. And to replace those sacred cows with scientific based up to the minute information on a variety of subjects. We will cover exercise protocols and techniques nutrition sleep recovery the role of genetics in the response to exercise and much more. On this episode Adam and Mike welcome Dr. Doug McGuff, one of today's leading high intensity experts. This is a must listen as they discuss that there's a lot more than meets the eye when it comes to all the benefits we reap from high intensity training. If you're still looking for some more motivation to stick to your exercise program well this episode is for you.

Doug [00:01:21] If you want everything bad that can happen to a human to happen immobilize them and overfeed them. Movement is life. And I believe that movement against resistance is life elevated.

Adam [00:01:36] Hello. Welcome to the show. Adam and Mike here I have known today's guest Dr. Doug McGuff now for over 20 years. We both caught the weight training bug as young men in our teens, we are about the same age. And we've been geeking out on it ever since. He's a doctor he's a practicing E.R. doctor in South Carolina and Doug is one of those few doctors who actually happens to run his own gym. It's called Ultimate exercise and it's in Seneca South Carolina. In 2008 Doug co-wrote the groundbreaking book Body by science along with John Little and let me tell you it is required reading for all my staff and even many of our clients. Why. Well honestly it was and really is a really important book because it comes from a theoretical understanding of basic physiology and for the first time properly applies it to high intensity exercise. I can't emphasize enough what his book has done to our industry and bringing high intensity exercise to the mainstream. So anyway it's my great pleasure to introduce a guy who I really consider a mentor. Welcome to show Doug.

Doug [00:02:45] Yeah Adam it's my pleasure. I've been looking forward to it.

Adam [00:02:47] I just saw you recently at the conference, what was it... a resistance exercise conference in Minnesota.

Doug [00:02:53] Yeah.

Adam [00:02:54] And your keynote speech was fantastic by the way.

Doug [00:02:57] Thanks. Appreciate it.

Doug [00:02:59] You said something I really rang true in me because we come from similar backgrounds experiences and the timing because we're similar ages and we got introduced to high intensity training the nautilus principles relatively around the same times. We we go back a few years with this high intensity training at this point and you end you said that for the last 20 30 years that we've been lifting weights primarily to get big and strong, swoll as they say you know maybe to give us an edge in sports and if we were on an unusually perceptive day we might have actually also thought that it might protect us from injury but really is about getting big and strong. Now we're finding out so much more that we were getting from these workouts than we ever thought. You know the health benefits of exercise that go beyond just getting strong which quite honestly if you told me that just getting strong is all we got from strength training I'd be happy with that.

Doug [00:03:53] That would be awesome. Yeah.

Adam [00:03:54] I mean that's why we were doing we didn't think we were getting anything more from it. But, so Doug this is what I want to speak to you about the health benefits of strength training beyond just getting really strong. So Doug the paper you brought up was titled muscle should be the new vital sign. Something like that right.

Doug [00:04:11] Yeah. Yeah I think that that's probably accurate. I mean at least it should be you know not on a visit by visit vital sign but in terms of someone's health history I think that ought to be recorded as a health parameter body mass index is being used a lot now. But that's not truly accurate. But I think if there was some sort of measure of muscle mass or strength that could be included as a vital sign it would provide a lot of useful health information. And it's simply because skeletal muscle speaks to everything else in our body. And it's a good indicator of what your overall health passionate situation is going to be is going to be an indicator of what degree of systemic inflammation might be going on. It's a great indicator of your physiologic reserve should you become ill if you get an infection you end up with sepsis end up in an intensive care unit the degree of muscle mass that you're trending down from basically gives you the clot that you're racing against to get better. So it really is a pertinent vital sign. And I would agree with the premise of that article.

Adam [00:05:22] You mentioned that recovery in ICU use have been shown people that have higher muscle mass recovered better in ICU units.

Doug [00:05:29] Yeah absolutely. How long you have before you have to go on total parental nutrition in the ICU is very much related to your skeletal muscle mass which again directly correlates with your overall Organ Mass. That kind of starts the countdown clock because your body is going to tap in to the reservoir of your skeletal muscle not just in terms of stored glycogen for energy usage but also the amino acid pool that's within your skeletal muscle for synthesizing enzymes nutrients generating antibodies. All that is used as a storehouse for raw materials that you'll need in your fight for survival and when you've kind of tap that out then you have to go on to kind of. Into intravenous total parental nutrition which is very challenging for ICU specialists.

Adam [00:06:26] You don't want to be there at that point.

Doug [00:06:28] It's just so easy to screw up you know.

Adam [00:06:31] The health benefits. I want to start talking about some of these real physiological changes that occur as a result of high intensity exercise but before we go right into that which is really where I want to spend most of our time I want to do a review of s o r. Stimulus organism response if you can in very succinct way talk about that and when we talk about exercise we talk about the stimulus what type of exercise the protocol that we do. I want to start getting into more of the responses down the road.

Doug [00:07:01] OK sure. So you know everyone just needs to take a bout of Arthur Jones can I explain it to everyone for the very first time that your natural inclination and orientation towards exercise that is directly doing something that benefits you. The Ab roller will firm and tighten your abs, right no no. That's not how it works. I mean that exercise is some sort of formatting or threat stimulus to the body the body receives that. And then if it has appropriate resources and time it will synthesize an adaptive response but that exercise itself is just a stimulus your body generates the adaptive response and that adaptive response. Preconditions for it to occur. And the adaptive response is really not just one thing it's a myriad of things. We're coming to discover and we've always intuited that you know you and I both know I mean you remember going into a big box gym back in the 80s and you could walk through there and you had all your anemic sickly looking people on treadmills and then you had all the robust healthy looking people that you would like to look like over in the weight section and you kind of wondered if that was just a selection bias or if there was really something to it. And as it turns out our instincts about that were correct. That really is something to it. There's something almost magical about exercising against meaningful resistance.

Adam [00:08:33] Yeah it was probably the best selection bias too because I think I think when you have one when the organism that's prone to build muscle you tend to gravitate there.

Doug [00:08:41] Sure yeah.

Adam [00:08:43] And as the organism part talk about like the organism for a second where because and expectations.

Doug [00:08:51] Sure. And this kind of gets into my whole Pandora's box discussion that came up with the resistance exercise conference and you know when you look in Greek mythology the story of Pandora's box they put hope at the very bottom of the box. And that was so that you would take everything else that was in the box and release it out into the world in the process of going after Hope and in the resistance training realm. The hope is actually big muscles. That's kind of what got us all into this to begin with. Because the outcome of resistance training in the correct individual and the correct organism produces dramatic physical response in terms of muscle hypertrophy and that's what everyone is after was what was visible. And that was the hope at the bottom of pandora's box. And that's what got a lot of people hooked and kept them in it for the long term but in the process of going and going after what was at the bottom of the box we were unknowingly reaping all these other benefits that only over time did we start to have some sense that there is a lot more to this than just getting big. There seem to be more benefits and there seem to be more impact in terms of. Body composition and health. And that became more and more evident over the years from the 1980s forward. A general populace the wheels were just starting to fall off everyone was getting metabolic syndrome everyone was getting fatter and fatter. Those hidden benefits of strength training started to manifest themselves because the body composition changes that we were seeing could not simply be explained by caloric account. It could not just be that the amount of activity you were doing relative to the amount you were eating something else was going on. And that's all of those other things that were inside Pandora's box that we were bringing out through the process of trying to get bigger and a lot of people. How big you're going to get in terms of muscle mass is really dependent upon the organism that specific organisms genotype and genetic expression is going to determine the ceiling of how big they can get. And there are so many young men and nowadays young women that are pursuing a degree of muscle mass that they've seen in magazines or on Instagram or the Internet that they're never going to achieve. But they keep going after it but in the process of doing so they're reaping all these other benefits that they may not even be aware of or that they become aware of in the process of doing it.

Adam [00:11:39] But also we should think that because of these other benefits that we're getting as opposed to just getting big and strong for a lot of my clients anyway and this realization has been very useful is to tell people listen just because you're not getting as big as you like it and you're not looking like somebody that you idolize that's doesn't matter. The high intensity exercise is doing so much more for you than just this idea of getting really big or reaches a certain level hypertrophy and as are we as we also heard from the rec conference that size and strength aren't necessary completely literally correlated so we're getting very strong on this we're getting big and again the act of high intensity exercise has all these huge other health benefits.

Doug [00:12:24] Right. And the ironic thing is is the people that get really really strong are the people that tend to not get very big and the people that get very very big are the people that get very modest strength improvements.

Adam [00:12:39] I know, it's annoying.

Doug [00:12:41] There's different mechanisms.

Adam [00:12:46] Cause I may get strong, but I don't get big I think I'd rather give a little bit of that up.

Doug [00:12:48] And the size increase is an improvement of last resort which is kind of funny because it's the one thing that got us hooked into the whole process. But in terms of all the adaptive responses that are available from high intensity training. It's only muscle size that is heavily negatively regulated. So the only thing that really has a hard hard ceiling put on it in terms of response over time the most pleasurable clients to train, turn out to be the ones that don't give a rat's ass about the hypertrophy issue.

Adam [00:13:24] I agree.

Doug [00:13:26] There are in particular if you have older clients they are so appreciative of the benefits and the myriad of benefits that come from high intensity strength training because they can appreciate them because you don't really realize those things are there until they go away. I don't know if you've ever had numbing drops put into your eye but you never realize how much sensation there is around your eye and blinking and all of it until it's taken away.

Adam [00:13:55] Yes I've had that happen. It's crazy.

Doug [00:13:56] And then when it comes back to you you're just so amazed. It's like a fish and water it's like this is water is like what's water. All of a sudden you get back to these people all of these you know functional health benefits that have gone away and they can feel it. And the thing is is if you have a client is training high intensive you know muscle mass aside just let's say we have a you know an older client that's training in your facility Adam, if you pluck that client out and drop them into the middle of a gate at the airport with 150 200 people and you and I stand together. And you asked me Doug which one of the people stand around here is my client. I guarantee you I coul d point them out.

Adam [00:14:42] Mm hmm.

Doug [00:14:43] They have a different appearance all together the way that her body orients itself against gravity the color of their skin. They go. They don't stand out for any muscle mass reason. There is a signaling of health that's unmistakable when when you look at them and I guarantee you I could plug your client out of 150 people at the airport gate.

Adam [00:15:10] You know you just used the word signaling. That's a great entree into what I want to talk about with muscle. I don't think people realize that muscle is a signaling organ like the pancreas. And so let's talk about muscle as a signaling organ and that's what leads all these health benefits that we're talking about what high intensity exercise promotes what it stimulates muscle to do. And there are some things that I just want to throw out there like you know let's. I want to talk about myokynes, myokynes. I want to talk about the energy and protein metabolism characteristics of muscle when I talk about glucose uptake. I want to talk about the Simon Melov research. They've shown that exercise can actually reverse aging and human skeletal muscle. These are the things we're talking about here.

Doug [00:15:51] Yeah. And the whole myokyne issues probably less than 10 years old can't remember where she's from. Some Scandinavian country Bente K. Pedersen is the one that kind of coined the term and first discovered the notion of myokynes is basically their cytokines chemical messengers that are released by exercising skeletal muscle that it turns out that they operate in a signaling fashion both within the muscle working that's autocrine to nearby muscles that's paracrine and then to other organs and tissues throughout the body and that is endocrine. So it turns out that skeletal muscle is the largest and most powerful enduring organ in the body. Guys like us we always had a sense of that that that was the whole the benefits in terms of body composition seemed so disproportionate to anything that could be accounted for simply by caloric energy balance or accounting issues it was much greater than than the sum. And I know you remember the discussion of Ken Hutchins had about indiscriminate weight loss and you're talking about your body as a corporation that had a board of directors and you're in a calorie deficit and in one scenario you lose all tissues in your body at a calorie deficit but if you add high intensity strength training. It will all be shunted towards discriminate. Fat loss because you can't get rid of skeletal muscle because you got a stimulus for more. You can't get rid of nervous tissue because the skeletal muscle that you're adding needs to be innovated. You can't get rid of bony tissue because the skeletal muscle you're adding has to be attached to that bone and you have more added on. And he made this case for how when you have a caloric deficit in the face of high intensity strength training it which should shunt everything towards fat loss. And that was sort of beating around the bush of this whole myokyne issue group. Is that hard work with skeletal muscle is doing so much to dictate how energy is utilized in the body to dictate nutrient partitioning to dictate enhanced glucose uptake and disposal out of the out of the skeletal muscle to increase lipolysis and fatty acid breakdown to stimulate the change of adipose tissue from white energy storing inflammatory hormone releasing tissue into brown adipose tissue which uncoupling itself from the mitochondria and releases heat and contributes to improvements in body composition and loss of inflammatory fat. There's just so many things that are triggered when you do hard work.

Adam [00:18:45] And is it necessary for to be intense work as opposed to let's say just.

Doug [00:18:50] No not entirely. I mean there there are myokynes that are released by lower levels of activity and this is the difficult part with myokyne research is when we are going to measure them we don't know about the amplitude of their release and the time course of their release and whether certain myokynes are triggered best by certain types of activities. So it may be that there are certain myokynes that are released but lower intensity exercise is carried out for longer periods of time. Certain types of exercise may cause a spike in a myokyne release immediately after the exercise. In other cases that spike may not occur for many hours later we don't know whether we're sampling at the right slice of time relative to each different myokyne. Perfect example of this is one of the first myokynes that was discovered was interleukin 6 and under normal circumstances interleukin 6 is released fairly steadily from the body and particularly from the adipose tissue and it is known as a bad player. It is a very inflammatory cytokine and chronically elevated levels of interleukin 6 can actually lead to the development of cancers. So when we first started recognizing that cytokine release occurred with exercise we are finding that interleukin 6 after high intensity exercise would spike like a thousand fold. Immediately after a high intensity exercise bout and the immediate response was like oh no this can't be good. This is a bad player we're spiking it a thousand fold. We're going to make everyone sick. Have heart attacks and inflamed their blood vessels giving them cancer fill in the blank. But what we came to find out was that those acute spikes in interleukin 6 ended up down regulating the receptors for interleukin 6. So you have a lot fewer of the receptors and over the longer span of time your sustained serum interleukin 6 levels fell. It was like lowering your serum insulin levels when you had those acute spikes, you ended up creating a circumstance where over the longer span of time interleukin 6 levels and systemic inflammation was greatly blunted. So there's a lot of things that seemed counter intuitive that actually turned out to be beneficial. By this whole myokyne concept.

Adam [00:21:35] So your gut feeling however is that myokynes are good.

Doug [00:21:41] Yeah I think it's is simple is this. And I kind of concluded the talk. So humans fall under. And you mentioned this in your email the whole classification of living organisms wonder King Philip came over for good sex as the mnemonic that I learned and you had a one that was less offensive.

Adam [00:22:06] Soup probably want. I went for the sex.

Doug [00:22:10] One of the distinguishing characteristics of animals is movement. That is the key distinguishing feature of that kingdom and movement is so important to us because for animals without movement you can't get food. You can't keep from becoming food. It's as simple as that. And at the conclusion of the talk I thought movement is life. That's basically all there is to it. If you want everything bad that can happen to a human to happen immobilize them and over feed them. Movement is life and I believe strongly based on the experience that you and I have had in this field that movement against resistance is life elevated it takes it to another level. That is just much much better and I think it is really as simple as that and I do for that reason think that the discovery of myokynes has been an amazing thing and that I believe that this chemical messaging is nature's way of saying movement is good movement against resistance is even better.

Adam [00:23:23] Yeah well amen. Let's talk about Simon Melov's work a little bit because it isn't hyperbole to say that high intensity strength training can actually reverse aging. Is that hyperbole?

Doug [00:23:36] No, and he proved it and I was that research is at least 10 years old now and I like you I know you do just kind of everyone so I'll sit down with the laptop or get on a computer and just kind of plow through Pub Med and see what's out there. I just stumbled across the article and I love that article that gives you the answer in the title of the article and it's saying that resistance training reverses aging in skeletal muscle, that's the name of the article online. Well damn I'm a click on that one. It was truly astounding. They used a statistical technique called the false discovery rate to discover gene expression that was markedly different in advanced age than it was in youth. And they identified. I can't remember as close to 200 different genes as candidates and then they apply to 16 week strength training protocol to elderly subjects. And measure their gene expression before and after. And what they found is that the conclusion of the study of the gene expression had reverted to the same type of gene expression that you saw in twenty five year olds in 16 weeks. And when you actually dig into the methods section of the paper and you look at the quality of strength training that was done compared to what you and I are used to saying it was pretty darn mediocre. Yet you had these results that were just completely astounding. You know this was in mitochondrial DNA where they were looking at these genes which is very well preserved DNA. And it's also DNA that is integral to the cellular functioning of everything and the organisms. It's not just the icing it's the sprinkles on top of icing in terms of genetic expression. My immediate thought was wow this changes everything. I mean our most ancient literature is about seeking the fountain of youth. And there it was. And you and I both know that what happened afterwards was nothing.

Adam [00:25:46] Unbelievable.

Doug [00:25:46] I thought Man I'm going to. We couldn't build facilities fast enough to train clients and...

Adam [00:25:53] No if there was a pill that would do that.

Doug [00:25:56] You remember how resveratrol flew off the shelves when that research came out and junk like a 16 percent lifespan increase in flap worms. And people were like spin and big bucks buying it off the shelf. But we're talking about bona fide age reversal at the molecular cellular level in humans. And nothing happened because what was required was to get off your ass and do hard work. And that was the difference. I mean the kind of person that's willing to get up go out pay good money for someone to make them work really hard and be uncomfortable. To reap the benefits. That's just a different kind of person and that's you know I'm I'm okay with that being a minority population. I wish it would be more but it's a special kind of person and that's why I love training clients you know.

Adam [00:26:57] And you see it day and as an emergency room physician you must see the problem associated with the loss of strength.

Doug [00:27:07] Me & my wife was talking about this today before the podcast and because we went to a Starbucks today we had to run some errands and we went to a Starbucks. She always gets this white peach tea it's unsweetened she likes it. So I went to order it today and lo and behold it comes to the door and it's sweetened. So we're like tap on the window at the drive through us like we said I'm sweet and you go sweet like oh we're sorry. Starbucks has changed the formulation. It only comes sweet now it's brewed into the bag and that's the way it is. And we believe in you know we've got an alternative. We're leaving on the schedule so plenty. I really do think it almost borders on conspiracy theory that every big empty out there seems determined to force feed us the shit that's gonna make us sick. It's gonna make us fat and with metabolic syndrome and cancer and diseases because I really do think there's just so much profit in people being sick that that's what we're getting. The fact that we had corn and grain subsidies back in the Great Depression and we couldn't just unwind those now it's a requirement that we have 10 percent ethanol in our gasoline so that we can continue to propagate those grain subsidies and the fact that we have to have 10 percent gasoline in our gas tanks is probably a major driving reason why the vast majority of population in this country has been turned into human brain disposal machinery. Oh well yeah we're just sicker than hell and I mean when I go to work. I mean I can't even begin to describe to you how sick and deconditioned people are. It is rare for me to pick up a patient that has less than 30 medications.

Adam [00:28:53] Jesus.

Doug [00:28:53] It is rare for me to pick up a patient that has not been at the E.R. or in the hospital within the past two weeks is just a revolving door. I went from especially where I could like you know make major turnaround on people a major saves. And now it's just a revolving door of trying to put the wheels back on and they fall back off and come back really really slid on our overall health status.

Mike [00:29:24] This reminds me of when my dad was in the hospital he had heart failure a few years ago and we've covered this on a previous podcast but when he was there he was diabetic and this special Diabetic Menu had all sorts of incredibly high levels of carbohydrates on a special diabetic menu, there was pasta even bread like the like. And I asked to see the nutrition said. I said what's. He just ordered two grilled cheese sandwiches and she goes What do you do have a problem with the cheese? I said no I get that this is the clinical dietitian at the hospital and I was like Oh my God I printed it out. I took a picture of it. I was like Oh my God I can't believe this is the special Diabetic Menu at a hospital for someone who is recovering from a fem pop a bypass surgery.

Doug [00:30:14] It is mind blowing know I operate on the two ends of the spectrum my whole life was a barbell including my interaction with humans. It's a barbell strategy where on one end I got the sickest of the sick and on the other end I got my clients and the. The disparity between the two is just so astounding that you know the cognitive dissonance every day when I go to work and do what I do is just unbelievable sometimes.

Adam [00:30:41] Yeah well you and when we were talking in person at the conference you and I were talking about exactly this.

Doug [00:30:46] And your wife works in an ICU. Does she not?

Adam [00:30:49] She did she. She did work in ICU. Yes and she has experience similar things and now she's working in oncology. Speaking of what Mike just talked about being fed grilled cheese from a diabetic menu it also amazes me how little the cancer doctors are talking about nutrition to their oncology patients. It's pretty much nonexistent and this is like a high end Oncology Group. Those those conversations frustrate me to no end.

Doug [00:31:16] And I got a weird story. This is not science. This is purely anecdote. I had a client my place been open for more than 20 years now had a client that had you know just out of blue who had a seizure. Part of the workup got a C.T. scan is actually one of my partners diagnosed her with an astrocytoma of the brain highly malignant brain tumor. And this was probably early 2000. Just when the whole low carb ketogenic thing was kind of taken off but I knew there were some literature on ketogenic diets in relation to brain cancer and seizure disorders and things like that just made the suggestion she latched onto it and over the course of a year or 18 months the tumor shrunk and then became undetectable. But they went ahead. They recommended that she still go through some chemo and radiation therapy had a lot of radiation therapy actually develop some mild dementia as a consequence of the radiation. She had a fall and had a laceration about a week ago and I ended up seeing her in the E.R. but still alive. Still no return of tumor. This just gets to the whole oncology discussion that we're not talking about you know ketogenic diet carbohydrate restriction. The things that might be driving cancer metabolism and the other thing is is using diet and high intensity exercise as adjuvant therapy to chemotherapy and more traditional treatments I think should start to become a standard of care. I mean they can show that Interleukin 15 which is one of the major myokynes release that inhibits myostatin promotes muscle growth but also has been shown in vitro and in vivo. That means in the test tube and in the animal to actively arrest growth and kill breast cancer cells. So I mean there's a strong argument to be made for high intensity exercise as adjunct therapy to chemotherapy. I do have an oncologist that will occasionally send me clients PRE Chemo just to kind of build up their muscle mass in their strength to give them a higher ceiling to start from when they start doing chemo. But there's not really been any discussion yet of the potential anti neo plastic effects of this myokyne release and what it could mean.

Adam [00:33:48] Myokyne release through high intensity exercise which doesn't take a lot of time to do it and think about it. And some good nutrition does carbohydrate restriction movement. This stuff is in our control.

Doug [00:33:58] Right.

Adam [00:33:58] It's so within our control. We don't have.

Doug [00:34:02] Really in terms of moving the needle on doing anything beneficial. The things that are within our control move the needle a hell of a lot more than the medication regiment. I mean if they could get the kind of percentage benefit that's documented by those sort of interventions in a pill drug manufacturer would just like go completely bonkers over something of that efficacy.

Adam [00:34:28] I agree. Well we've got to wrap it up now but let's end on that. That says it all. I mean if you're not motivated to go based on all this stuff that we're finding out it is start doing some high intensity exercise get moving and maybe pay attention to your nutrition then then I don't know I don't know.

Doug [00:34:45] The time commitment or maybe one thing but the time commitment is just so minimal and the reward relative to the time is hugely disproportionate. It's just a win win you know.

[00:34:56] Big bang for your buck.

Mike [00:34:57] Doug. He's happy to be a part of the minority though.

Adam [00:35:00] Yeah. Well thank you so much Doug I really appreciate it.

Doug [00:35:04] My pleasure, it's been a fun talk.

Arlene [00:35:08] This has been the Inform fitness podcast with Adam Zickerman. For over 20 years Inform fitness has been providing clients of all ages with customized personal training designed to build strength fast. Visit inform fitness dot com for testimonials blogs and videos on the three pillars exercise nutrition and recovery.