Episode Transcript
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0:02
Welcome to Everyday Wellness Podcast. I'm
0:04
your host, Nurse Practitioner Cynthia Thurlow.
0:07
This podcast is designed to educate, empower,
0:10
and inspire you to achieve your health
0:12
and wellness goals. My goal
0:14
and intent is to provide you with
0:16
the best content and conversations from leaders
0:18
in the health and wellness industry each
0:21
week and impact over a million lives.
0:29
They had the honor of connecting with
0:31
the delightful Dr. Bill Campbell. He
0:33
is a professor and director of
0:36
the Performance and Physique Enhancement Lab
0:38
at the University of South Florida.
0:40
His research focuses on helping people
0:42
optimize their physiques within a maintainable
0:44
lifestyle. He also created Body by
0:47
Science, which is a research review
0:49
that summarizes the latest and best
0:51
research focusing on fat loss and
0:53
building muscle. Today, we talked about
0:55
some of the biggest misconceptions and
0:57
mistakes regarding fat loss, effective
1:00
ways of measuring body fat
1:02
versus lean mass, textbook averages
1:04
of body fat percentages of
1:06
men and women, and differentiating
1:08
between essential body fat versus
1:10
visceral body fat, the
1:12
mechanisms that drive hunger and
1:15
slowed metabolism when your body fat
1:17
is way too low, the
1:19
impact of crash dieting and yo-yo dieting,
1:22
the menopause transition and what contributes
1:25
to weight loss resistance, concerns
1:27
related to protecting muscle, which
1:29
really focuses in on strength
1:32
training, adequate protein intake, and
1:34
lifestyle. His specific concerns surrounding
1:37
time restricted and intermittent fasting if
1:39
you're not getting adequate protein intake,
1:41
defining what diet breaks are, and
1:43
lastly, lifestyle, which includes some of
1:45
his favorite supplements. Not surprisingly, one
1:48
of them is creatine monohydrate. I
1:50
know you will enjoy this conversation
1:52
as much as I did recording
1:54
it. Welcome,
1:58
Dr. Campbell. I know
2:01
we've been, it's taken a couple of months to
2:03
coordinate our calendars, but really looking forward to this
2:05
discussion. Yeah, me too. Thank
2:07
you very much for the invitation. Yeah. So
2:10
as a researcher, I'm curious, are
2:12
there pet peeves or
2:14
common misconceptions surrounding fat loss?
2:16
Do you see, you know,
2:18
information on social media or
2:20
well-meaning social media influencers that
2:22
kind of extrapolate upon kind
2:24
of broad level concepts that
2:26
you think are like kind
2:28
of pet peeves for you?
2:31
Yeah, I don't know about pet peeves, but there
2:33
are things that I constantly see. And not to
2:35
say I don't have a lot of pet peeves,
2:37
I do. But
2:39
for research, I have
2:42
to always put myself, well, what if I
2:44
wasn't a scientist? How would I think about
2:46
things? And I would think no differently than
2:48
the masses. Now, I will say this, a
2:50
major pet peeve I have is researchers who
2:53
have conflicts of interest who don't
2:55
disclose them. And I
2:57
never, I'm always happy
2:59
when scientists supplement their
3:02
salary with selling supplements,
3:04
books, programs, whatever. But
3:06
in certain situations, there's a clear
3:08
conflict with what they're researching and
3:11
what they're selling. And again, that's
3:13
perfectly fine. But when it's hidden,
3:15
there's a pet peeve since you asked. Let
3:18
me move to just what I
3:20
see a lot of what I call
3:22
general population people doing. So
3:24
let's, I'm a fat loss researcher. So this is
3:26
my scope. So they'll do X,
3:29
Y, or Z diet, and it works for
3:31
them. And they'll
3:33
say, okay, this is the one that everybody should
3:35
do. And as a
3:37
scientist, it's like, well, that worked for
3:39
you, but so likely, so would have
3:41
eight other options had you stuck to
3:43
that diet. Or somebody
3:45
will start taking a particular supplement and
3:47
they'll go on a diet and they'll
3:49
start an exercise program. And they're
3:52
getting better sleep. And then they'll
3:54
say, man, since I've been sleeping, I have
3:57
really lost all this fat. Sleep
3:59
is important. And sleep is important.
4:02
Sleep is very high on my list. But
4:04
when you have all of these different
4:06
variables coming into the equation, a
4:09
lot of people are just ignorant and they think,
4:12
okay, they just latch on to one item. And
4:15
it's like, well, that wasn't the only thing.
4:17
So there's ignorance and pet
4:19
peeves. Yeah. Well, and it's interesting
4:22
for listeners, whether they know this or not,
4:24
there's some events if I speak at them,
4:26
especially medical conferences, even podcast sponsors, I have
4:28
to disclose upfront, although I make
4:30
it a habit of never discussing my podcast sponsors
4:33
when I'm talking at a medical event. But I
4:35
agree with you about the conflicts of interest. And
4:38
this is the power of the end of one as
4:40
it pertains to if something worked for one person, that's
4:42
great. But it doesn't per se mean that it works
4:44
for everyone. And I think about one
4:46
thing in particular as a clinician, I've many friends
4:48
that have had a lot of great success with
4:51
ketogenic diets as an example. Yeah. And
4:53
ketogenic diets, if that works for you, that's great. But
4:55
if I look at the research on the
4:58
gut microbiome and people that don't do well
5:00
on a ketogenic diet more often than not,
5:02
it can have a lot to do with
5:04
the composition of microbes in the gut microbiome.
5:06
And so there's many, many things that can
5:09
impact success or lack thereof with a particular
5:11
intervention. So I 100% agree with you. Now,
5:14
when we're talking about body
5:16
fat and for women of a certain
5:19
age, certainly it becomes probably more problematic
5:21
or bothersome as we're navigating perimenopause and
5:23
amenopause because there are so many physiologic
5:26
changes that are ongoing. One of the
5:28
most common questions I receive is what's
5:30
the most effective way to measure it?
5:34
And I know this is, you know, there are
5:36
bod pods that are, you know, accessible
5:38
for people, you know, DEXA scans. From
5:40
what I understand about DEXA scans, it
5:42
can be hugely influential as
5:44
to who is actually reading the scan
5:46
to determine, you know, body fat percentages.
5:49
As a scientist, what do you think
5:51
is the most effective way of measuring
5:53
body fat overall? Yeah, so I
5:56
tend to not kind of
5:58
gravitate towards research-based devices. So
6:00
those would be DEXA, BodPods,
6:03
MyLab uses InBody or BIA,
6:06
the research grade. We
6:09
also use ultrasound. So those are
6:12
the best devices on the market, but none
6:14
of them are perfect. And you make a
6:16
good point. I was recently
6:18
working with somebody and they got a DEXA
6:20
at one facility and then they went to
6:22
a different facility and they thought, Hey, why
6:25
did I gain all this fat? And I haven't been doing the things
6:27
that would make me think that I have gained fat. And
6:29
my answer was you didn't gain fat. You
6:32
switched DEXA machines one, two, there
6:34
were different people that were doing
6:37
the different technicians analyzing those scans because
6:39
you have to, it's not just that
6:41
you get on the table and it
6:43
spits out a number, you have to
6:45
adjust the, I'll just call them the
6:47
lines when you're doing this. So
6:49
you have a lot of variations.
6:52
So I tell people, let's
6:54
make sure that whatever device
6:56
you choose, InBody,
6:58
DEXA, BodPod, skin folds. So let's just say
7:00
it is a skin fold or DEXA, just
7:02
make sure the person doing it is always
7:05
the same person and that they are a
7:08
well-trained individual. So the next thing I
7:10
say is you always want to do
7:12
these under standardized conditions. So
7:14
the best thing what we do in my
7:17
research lab is first thing in the morning
7:19
or in the morning after an overnight fast.
7:21
And ideally you did not exercise the day
7:23
prior. And then the next
7:25
thing that I say is don't get hung
7:27
up on whatever number you are.
7:31
If you've been dieting, just look at changes
7:33
because if I lay down on a DEXA
7:35
now or I did a BodPod or I
7:37
did an InBody, my body fat might
7:39
be 22 on one, 17 on another and 19 on
7:41
another. But
7:43
if I dieted for six weeks and
7:46
I lose fat, all three of them, regardless
7:48
of what they said today, they're all going
7:50
to show that I've lost fat. One might
7:52
show I lost 2%, 3%. So
7:56
just to be the most helpful, pick
7:59
one device. and
10:00
they are not. So 27%. What
10:02
does that look like, in terms
10:04
of morphology? Well, that woman would
10:06
not have abs. A male, the
10:08
reference male at 15% would
10:10
not have defined abs at that level. And
10:13
by the way, the reason women would have
10:15
reference woman has more fat than
10:17
a male is because of essential body fat,
10:19
so more natural fat in breast tissue around
10:22
the reproductive organs that men
10:24
don't have. So the
10:27
average, and I don't
10:29
even, I'm not saying unhealthy, just average is
10:31
often higher than what a lot of people
10:33
think. Well, I
10:35
think our perceptions get so skewed from what we
10:38
see, you know, if it's a fitness competitor, what
10:40
we see online, what we see in the movies,
10:42
you know, those are people that it is their
10:44
job to look a particular way. But I'm sure
10:46
when they're not filming a movie
10:48
or a series, they may look very, very
10:50
different. And I think the other thing is
10:53
you mentioned, you know, the concept of sustainability,
10:55
you know, those fitness competitors look like that
10:57
one or two days out of the year.
10:59
What is it about fat
11:02
mass or body fat that makes it
11:04
challenging to sustain at too low of
11:06
a level over time? Yeah,
11:08
that's a great question. And
11:11
essentially, when you get your
11:13
body fat to very low
11:15
levels, essentially, your body works
11:17
in every domain it possibly
11:19
can to fight against sustaining
11:21
that. So your
11:23
drive to eat or your
11:25
hunger levels go up, your
11:27
metabolism goes down. So you
11:29
and your cues to food
11:31
increase, you have
11:33
again, it's the biology
11:36
go works against extreme,
11:38
lean levels. And now the opposite
11:41
is also true. As we approach
11:43
like morbid obesity, the body will
11:45
speed up metabolism to
11:47
help prevent the body to keep gaining
11:49
weight. So if whatever extreme you put
11:51
your body in, the body will naturally
11:54
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11:56
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for 20% off. And
15:47
how does that, does this play
15:49
into why yo-yo dieting is ultimately
15:51
over time so harmful? I mean,
15:53
I think maybe listeners understanding that
15:55
gaining and losing the same 10,
15:57
15, 20 pounds over
16:00
time can negatively
16:03
impact our metabolism over the
16:05
long haul. Yes.
16:07
And I would say, and I'm going
16:09
to base this on research that we've
16:11
done, or basing it on other people's
16:13
research, the biggest harm to
16:16
maintaining a lean body or
16:18
setting yourself up for failure is
16:22
a crash dieting mindset. So
16:24
Yo-Yo Dieting comes in with that. But even
16:26
worse is, so let
16:29
me just get to the Yo-Yo Dining. The more
16:31
dieting attempts somebody makes, especially if
16:34
they're young, the
16:36
greater the likelihood of being overweight or
16:38
obese later in life. And
16:40
I don't study childhood obesity. I haven't
16:42
done that research, but this is particularly
16:45
concerning to me. If a
16:47
young child is becoming
16:50
overweight or obese, it is very
16:52
difficult for them to have a,
16:54
it's the outlook on their future
16:57
is not optimistic at
16:59
all. And even if they diet
17:01
and lose it, again, you're saying
17:04
Yo-Yo dieting or intentional weight loss
17:06
efforts, those aren't good. Now, so
17:08
that's the Yo-Yo aspect of this.
17:11
So predicts a not ideal future.
17:14
And then the other thing is this crash
17:16
dieting mindset. So the worst thing that somebody
17:19
can do is to starve
17:22
themselves for extended periods of time
17:24
where they lose a lot of
17:26
weight and they're seeing success
17:28
on the scale. But what's actually
17:30
happening is they're losing a lot of
17:32
lean mass and metabolism is being suppressed.
17:35
And what happens then is
17:37
that there's a condition called
17:39
hyperphagia and hyperphagia. As soon
17:42
as your diet is over, you've lost all
17:44
this weight. You have friends, relatives saying, Oh,
17:46
you look great. But you
17:48
starved yourself to that condition. And
17:50
hyperphagia is an extreme desire to
17:52
eat. It is hunger levels that
17:54
are literally off the charts. And
17:56
what happens is as soon as
17:59
your diet is over, over, the crash diet
18:01
is over, you cannot maintain
18:03
your current physique. And you have
18:05
something that leads to fat overshoot,
18:07
which is where within a very
18:10
short period of time, sometimes
18:12
within a fraction of the time that it
18:15
took you to lose this body fat, you
18:17
have now gained more body fat than what
18:19
you had before you started the diet. Now,
18:21
I want to add one more caveat to
18:24
this, because I'm very much
18:26
in the middle of a paradigm shift
18:29
in some of my thinking on fat
18:31
loss. I used to say constantly,
18:34
a slow rate of fat loss
18:36
is ideal. And that
18:38
is true. But I'm now doing
18:40
current research in my lab on I'll
18:43
just call it like fat loss sprints,
18:45
where it's very aggressive for just a
18:47
few days. So
18:49
but here's the key, it is not an
18:51
extended it's what's different between that and crash
18:54
dieting is it's targeted
18:56
for a few days of extreme
18:58
behaviors, very low calories, but pretty
19:00
high protein and high exercise volume,
19:03
mainly aerobic or walking exercise. And
19:06
if we look at hey, what was the fat
19:08
loss over a month? Well, if they only spent
19:10
four or five days doing this, it's still a
19:12
relatively slow rate of fat loss. But
19:15
we've chosen to just accelerate
19:17
it in a very short window and then
19:19
get out. So there's a lot of nuance
19:21
to this. And again, I wouldn't have said
19:24
this two years ago, but I've seen early
19:26
research. And now we've done some of this
19:28
work in my own lab, we haven't published
19:30
all of this yet, which makes me think
19:33
that this may be a better option. And
19:35
we're currently doing this across the menopause transition
19:37
in a case series study in women. Ooh,
19:39
now, so this is a very much of
19:42
interest to listeners, of course, because I feel
19:44
like maybe if women
19:46
didn't have challenges with body fat, or
19:48
feeling like they had weight loss resistance,
19:50
perimenopause is where these things start to
19:53
show up. And I feel like it
19:55
really gets magnified into menopause and post
19:57
menopause. And so talking
19:59
about that research that you're referring to,
20:02
what is it that is so unique about
20:04
women in a low hormone
20:07
state that makes them more susceptible
20:09
to weight loss resistance and increases
20:11
in body fat? I'll start with
20:13
an answer that nobody's gonna like.
20:16
I don't know. And
20:18
I don't think anybody knows for sure.
20:20
And I don't know if you know
20:22
this because I know we started communicating
20:25
maybe two years ago, but I've shifted
20:27
almost all of my research to studying
20:29
weight loss resistance in menopausal aged females.
20:31
I don't know if you knew that.
20:33
We're doing, I think, the largest study
20:35
ever in a survey study in women
20:38
who have a fitness lifestyle that
20:41
are going through menopause. Back to
20:43
your question, why? Well, the easy
20:45
answer is the changing hormonal environment,
20:47
particularly estradiol levels are lower. That
20:50
probably is the lowest hanging fruit
20:53
that could be changed to
20:55
help offset weight loss resistance. The
20:58
other thing is inflammation. So a
21:00
lot of people will take the,
21:02
will have the opinion that going
21:04
through menopause is essentially an inflamed
21:06
state. And if you can address
21:08
that, then you really help this
21:10
weight loss resistance. So I
21:13
can't point to specific studies on the
21:15
inflammation, but some of
21:17
the experts in my
21:19
space that I have a lot of respect for,
21:21
that's what they think. And
21:23
I'm hoping to do, you know, let
21:25
me just say the question you asked
21:27
is the question that I am committed
21:30
to at least spending the next 20
21:32
or 30 years of my professional life
21:34
to try to answer. And
21:36
you probably know this, there are
21:38
many fitness professionals, researchers that don't
21:40
even acknowledge the concept
21:42
of weight loss resistance. I
21:45
would say I was in that camp not
21:47
too many years ago. And
21:49
then something very interesting happened. Wife experience.
21:51
My wife is now postmenopausal and she's
21:54
given me permission to share this, but
21:56
she gained weight during this phase of
21:58
her life. And she. could not lose
22:00
it. And guess who she's married to
22:02
a fat loss researcher. And you know,
22:05
she's kind of like my guinea pig, like all
22:07
throughout my career, I've put her on all my
22:10
machines devices and have her do crazy diet for
22:12
the first time she couldn't lose weight. And then
22:14
I'm like, you know, I've heard hundreds
22:16
and hundreds, if not now, thousands of other women
22:18
claim this. Now I'm, I
22:21
cannot deny. She was down to I think we
22:23
had her down to 1100 calories
22:25
for several weeks and would not lose
22:28
weight. So I don't know why
22:30
I think it's probably a
22:32
hormonal transition, particularly estradiol, and probably an
22:34
inflammation state that maybe not even can
22:36
be detected outside of the cell. Again,
22:38
that's why I would love to say,
22:40
Yeah, this study, this study, this study,
22:43
I can't at least not yet. Well,
22:45
I think we all appreciate your transparency
22:47
and love that you willingly share that
22:49
your own personal experiences through your wife.
22:51
I think that one of the things
22:53
that I think definitely contribute to some
22:55
degree of weight loss resistance is this
22:57
loss of muscle mass. So sarcopenia is
22:59
not a question of if but when
23:02
and and I will still say and
23:04
I'll shout it from mountaintops, too
23:06
many of us myself included, did not
23:09
appreciate or value in our 20s and
23:11
30s how important skeletal muscle mass is
23:13
how critically important it is. So as
23:15
we're losing it, we're losing insulin sensitivity,
23:18
I think it's multifactorial. I think there's
23:20
many things that contribute. But
23:22
I definitely think about you know, in
23:24
that low estrogen state high follicular stimulating
23:26
hormone, we're much more catabolic, we're breaking
23:29
down muscle pretty readily, and less
23:31
we're actively working against it. But you
23:34
mentioned protein, and I think protein for
23:36
so many of us, I
23:38
feel like, you know, things come full
23:40
circle. When I was first a clinician,
23:42
it was, you know, everything fats were
23:44
bastardized and eat more heart healthy grains
23:46
and all that stuff and don't eat
23:48
saturated fat ensures hack don't eat butter.
23:50
And, you know, the pendulum is swinging
23:52
back towards you know, protein centric diets.
23:54
And we know protein is helpful for satiety.
23:56
It's helpful for you know, amino acid
23:58
composition when you're working within
24:01
your research thinking about how important
24:03
protein is, what are the things
24:05
that you feel like women need
24:08
to really understand about the benefits?
24:11
And it's not to suggest carbs are bad and
24:13
fat is bad, but why is protein so important
24:15
for us as we're getting older? So the first
24:17
thing, just again, taking a broad
24:19
approach to this, throughout all of my
24:21
weight loss studies that we've done in
24:23
my lab, our primary
24:25
goal is fat loss, but
24:28
we devote every resource available
24:30
to us to protect muscle,
24:33
every resource available because fat loss at
24:35
the expense of of losing muscle mass
24:38
is a recipe for gaining everything back and
24:41
being in a worse situation. So how do
24:43
we protect muscle during a
24:45
fat loss phase or just as we
24:47
age? I'll get to protein,
24:49
but the first thing is resistance
24:52
training. So if
24:54
we are dieting, that's a catabolic
24:56
stimulus on the body. So
24:59
where are areas in our life that
25:01
we can impute an anabolic stimulus? Well,
25:03
that's what resistance training does. And you
25:05
don't have to love resistance training. Minimal
25:09
amounts is very beneficial. So you don't have to live
25:11
in the gym, you don't have to go every day.
25:13
And then the second thing is back
25:16
to your question is a an optimal
25:18
protein intake. So protein
25:20
is an anabolic nutrient, it
25:22
is what builds skeletal muscle.
25:25
And like you said, it also makes you feel fuller. And
25:28
it helps maintain our metabolisms, especially
25:30
when you pair it with resistance
25:32
training. Now, as we get through
25:34
to midlife, what happens is
25:37
what we used to eat with
25:39
protein, when it would stimulate a
25:41
given amount of muscle protein synthesis.
25:43
Well, as we age, as we
25:46
get into our 40s, 50s and
25:48
beyond, everybody, males and females, experience
25:50
something called anabolic resistance. And part
25:52
of that explanation is that protein
25:55
levels do not do
25:57
what they used to do. So we
25:59
need to actually. have more protein as
26:02
we age to get the same anabolic
26:04
stimulus that we did when we were
26:06
younger. Yeah, I think it's
26:08
interesting. I have two athletic teeny boys and
26:10
I will talk to them about how you
26:12
could probably have a whiff of protein and
26:15
that will stimulate muscle protein synthesis versus I
26:17
have to have 40, 50 grams of protein
26:19
because they laugh at me. They're like, why
26:21
are you so fixated on how much protein
26:23
you're consuming? And I just remind them, I'm
26:25
like, I need a good bolus several times
26:27
a day. And perhaps this is a good
26:30
tie into talking about the role of time
26:32
restricted eating, intermittent fasting. What are
26:34
your thoughts, kind of broad concepts on
26:36
this for middle age people? It doesn't
26:38
necessarily have to be for women. Now, for
26:40
full disclosure, I've built a whole platform talking
26:42
about fasting, but I have started to find
26:45
I need a wider feeding window to make
26:47
sure I'm getting enough protein so that I'm
26:49
building muscle. What do you
26:51
feel like or where do you feel like
26:53
time restricted eating can fit into the
26:56
program of weight training, adequate protein
26:58
intake? Can it be? Can they
27:00
exist concurrently is what I'm trying
27:02
to say? Or is time restricted
27:04
eating putting us at risk for
27:06
losing lean body mass? I
27:09
think I have the same perspective you
27:11
do or where you've evolved with this.
27:13
So the potential harm of very short
27:15
feeding windows is that
27:18
you don't have a lot of protein
27:20
distribution. So let me give two different
27:22
scenarios. If somebody's goal is to build
27:25
as much muscle as they possibly can,
27:27
that's their primary goal, then my advice
27:29
would be consume about a
27:32
gram of protein per pound of body
27:34
weight or 0.75 grams
27:36
per pound if getting a gram per pound is
27:38
too difficult. And this would be goal body weight.
27:40
And then once you have that as your, hey,
27:43
this is how much protein I want to aim
27:45
to consume today, if the goal is I want
27:47
to build as much muscle as possible, you
27:50
want to approximately evenly distribute
27:52
that about or
27:54
across three to five protein feedings
27:57
throughout the day. So if
27:59
you're feeding with windows only four hours,
28:02
that's not very evenly distributed. So
28:05
for that person, I would say that
28:08
a time restricted feeding or if we're
28:10
going to call it intermittent fasting, that
28:12
may not be the best approach for
28:14
your stated goal. Now,
28:17
let's look at somebody else and this would describe
28:19
me, I more struggle with
28:22
gaining body fat. And
28:24
I'm actually I mean, I would like
28:27
to build muscle, but I put more
28:29
of my effort into losing fat or
28:31
not gaining fat. So for
28:33
me, and a time restricted feeding
28:36
lifestyle works better for me, I'm not
28:38
hungry in the morning. So I don't
28:40
need in the morning. And
28:43
then I'm as I'm hungry throughout the
28:45
day, I'm able to get those calories
28:47
to other caveats to this. If somebody
28:49
wants to just use a hybrid approach,
28:52
have your feeding window, but just
28:54
have protein when you wake up. That
28:56
way, you're getting this protein bolus or
28:58
an anabolic stimulus. And then the other
29:00
thing, and this was a study that
29:03
I'm referring to that was published early
29:05
last year, where they gave male
29:07
this was I think male and female subjects,
29:09
100 grams of protein
29:11
in one sitting. And previously, a
29:13
lot of the research suggested that
29:15
a lot of this huge amount
29:17
of protein, like over 30 grams
29:19
was wasted. And what this study
29:21
found was it's not wasted at
29:23
all. The problem with those earlier
29:25
studies, they stopped measuring muscle protein
29:27
synthesis three to four hours after
29:29
ingestion, whereas this study went 12
29:31
hours. And what they found was
29:34
100 grams had significant benefits
29:37
to increasing muscle protein synthesis.
29:39
So now I think a
29:41
great application of this for
29:43
somebody who enjoys intermittent fasting
29:46
time restricted feeding on your
29:48
two ends of your feeding
29:50
windows have large protein boluses,
29:53
because we know that the benefits will
29:55
carry during your fasted window. I think
29:57
that's really significant. And it's interesting, you
29:59
know, being in this space, I
30:02
was speaking out against OMAD a long time
30:04
ago and we would get angry messages.
30:06
People were angry, they were disappointed because
30:08
there were people who had gone from
30:10
maybe being obese to being a healthy
30:13
weight by just doing one meal a
30:15
day. And I would remind them, I
30:17
understand how that has allowed you to
30:19
achieve your goals, but over time, how
30:22
much muscle mass did you lose? Because with
30:24
a significant weight loss, you are going to
30:26
have some loss of muscle, you will have
30:29
some loss of fat. The loss of muscle
30:31
I think is potentially more catastrophic. And so
30:33
I just like to remind people that the
30:35
average person cannot in four hours consume enough
30:37
protein to be able to bolster. Although I
30:40
love that addition of that study where you
30:42
get this 12 hour timeframe because
30:44
that's oftentimes a concern is that people will
30:46
say, well, how can you have 60 grams
30:49
of protein in one meal? Aren't you concerned
30:51
that your body can't use it? I was
30:53
like, oh, my body can definitely use it.
30:55
So I think, you know, reassuring people that
30:58
consuming higher protein diets is not then lead
31:00
to, you know, losing out of the benefits
31:02
of protein. Yes, I want to
31:05
add one more another thought that came up.
31:07
A lot of your audience, I think you
31:09
said is females that are plus 35, 30s,
31:12
40s, 50s. There's a few studies where, well, let
31:17
me just be stereotypical for a moment, a
31:19
lot of especially women, they
31:21
consume non optimal
31:24
amounts of protein, very, very limited
31:26
amounts of protein. And in these
31:28
few studies, and I'm thinking of
31:30
two to two, and then
31:32
my lab did one in resistance train
31:35
young people, but these are in middle
31:37
aged or even postmenopausal females when they
31:39
were consuming very small amounts
31:41
of protein. And the only change that
31:43
researchers introduced was increasing protein intake. That
31:45
was the only change. One of these
31:48
was a dieting study. The other one
31:50
was literally just eat more protein. The
31:52
results were and I'll just say, like
31:54
literally surprising to me, they not only
31:57
gained lean mass and they're There's zero
31:59
exercise here, which I used to think
32:01
you have to exercise to build muscle.
32:03
Not at all. And they
32:06
lost body fat. So the
32:08
way that I conceptualize this, the
32:10
biggest improvements in health and body
32:12
composition are when you have somebody
32:14
that's starting with a very low
32:17
amount and just increasing it. Losing
32:19
body fat, even though they're eating
32:21
more calories and gaining muscle mass
32:24
without resistance training. So I kind
32:26
of hear to something called a
32:28
protein anchored flexible dieting approach. But
32:31
protein is the center of my research
32:33
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32:35
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that and give attribution. Thank you. breaks,
36:00
or you refer to it as nonlinear
36:02
dieting. What are the benefits? If someone's
36:04
been, whether they've been in time restricted
36:07
eating, they've been at a caloric deficit
36:09
for a period of time, how does
36:12
this dieting break? How
36:14
does this benefit us metabolically
36:16
and otherwise? Dr.
36:18
Justin Marchegiani So most of
36:20
the research, including the research from
36:23
my lab, and we did this
36:25
in resistance-trained women. It
36:28
really, diet breaks don't really
36:30
help physiologically, so they're
36:32
not gonna build more muscle, they're not
36:34
gonna cause more body fat, as when
36:36
calories are the same between somebody who
36:38
never takes a break. But practically
36:41
speaking, and data from my lab and
36:43
from the lab in Australia, we both
36:45
found the same thing with diet breaks.
36:48
The psychological assessments
36:51
of hunger and
36:53
something called disinhibition, and I'll explain what
36:55
that is. They both were significant findings
36:58
in our studies. The reason these are
37:00
important is because my study was six
37:02
weeks, the Australian diet break study, I
37:05
think was 12 weeks. So
37:07
they weren't that long, they weren't really
37:09
long studies. The Australian studies found that
37:12
subjects who had diet breaks every few
37:14
weeks, and let me define that, you're
37:16
on a diet, so you're reducing your
37:18
calories, and every few weeks, you say,
37:21
okay, I'm gonna stop dieting this week
37:23
for seven days, and I'm gonna go
37:25
back to my maintenance calories. So that's
37:27
an important delineation. You're not eating at
37:30
a buffet, you're not just, it's not
37:32
a cheat day where you're eating anything
37:34
you want, you're increasing your calories, which
37:37
seems like a lot of extra calories
37:39
since you've been dieting, but you're not
37:41
overeating. What they found was that the
37:43
diet break group had significant lower drive
37:46
to eat and significantly lower hunger levels.
37:49
What my lab found, we
37:51
use some different psychological questionnaires,
37:53
something called a three-factor eating
37:55
inventory. What we found was
37:57
that disinhibition scores were significantly
37:59
improved. And This inhibition means
38:01
that you tend to lose
38:03
control of what you will
38:05
eat when you're in a social context
38:08
or you have more anxiety or stress.
38:10
So the subjects in our diet break
38:12
group had much better
38:14
control over their subjective feelings
38:16
of their hunger and their
38:18
ability to not overeat during
38:21
this study or at the end of
38:23
the study. So where this becomes impactful
38:25
is it seems that
38:27
diet breaks help you have
38:29
better control over hunger. And
38:31
over time, that is
38:33
what will dictate diet success or fat loss
38:35
success. So if my study would have been
38:38
extended, let's say for three months or the
38:40
other study would have been longer, I think
38:42
we would have started to seeing physiological differences
38:45
that were not yet manifested because they were
38:47
too short. I will also say just in
38:49
my own life, I will never, and I
38:51
live my whole life dieting. I gain weight,
38:54
I lose weight. Sometimes it's on purpose, sometimes
38:56
it's not. And I'm a fat loss researcher,
38:58
like I love this stuff. But
39:00
I will never put myself on a
39:02
diet again that does not have a
39:05
diet break. Typically what I'll do is
39:07
I'll diet Monday through Friday and I'll
39:09
increase my calories on the weekends because
39:11
I tend to eat more on the
39:13
weekends. So I'll design my diet strategy
39:15
around my lifestyle. Do you think of
39:17
diet breaks? Because sometimes I'll
39:19
hear people use the term refeeds. Like
39:21
they'll go through a period of caloric
39:24
restriction and then they'll do
39:26
refeeds for a few, whether it's a few weeks. I
39:28
know I think for you, it was defined as one
39:30
to two weeks and that allows you to be more
39:32
anabolic, which means you're building muscle. But
39:35
I think for anyone that's listening, especially
39:37
those that have been chlorically restricted, they've
39:39
been doing time restricted eating, maybe they've
39:42
been doing fasting for five, 10 years,
39:44
I think there is benefit from liberalizing
39:47
things. And it could be that maybe it's 100, 150
39:49
extra calories of
39:51
protein. I'm not talking that you're going out
39:53
every day and having like a brownie Sunday,
39:55
although I'm sure you could adjust your macros
39:57
to do that accordingly, but helping people. understand
40:00
when we're talking about these diet breaks, it's
40:02
not a cheat day. It's not a cheat week or
40:04
two. It is liberalizing things
40:06
enough where you're still benefiting your health,
40:09
but allowing you to have a degree
40:11
of comfort where you mentioned the disinhibition.
40:13
I think that's really interesting that people
40:16
who have a propensity for wanting to
40:18
continue to eat are then satiated. And
40:20
that's what we're really speaking to is
40:22
that degree of satiation and sustainability
40:25
because the reason why diets oftentimes
40:27
fail is they're not sustainable long
40:30
term. Yes, the best diet is
40:32
the one that you can adhere to. And that's
40:34
why we talked earlier, ketogenic
40:36
diets, I'm not a big fan
40:39
because most people cannot adhere to
40:41
them. But a certain segment of the
40:43
population does very well on them. And I think that's
40:45
a great choice for them until they
40:47
get to where their goals are. And then again, if
40:49
we start to see some deficiencies, nutrient
40:52
deficiencies, hey, we need, you know,
40:54
we want to address that. Adherent
40:56
sustainability is everything. Absolutely.
40:58
And where does lifestyle fit in? If
41:00
we're talking about things like sleep and
41:02
stress, I mean, these are topics we
41:04
talk about a lot. Where do those
41:06
things as well as do you have
41:08
favorite supplements or their ergogenic aids that
41:10
you feel like are beneficial, that, you
41:12
know, looking at the research that have
41:14
shown some consistent patterns that are of
41:16
benefit to women in particular. So lifestyle
41:20
to me, the lowest hanging fruit
41:22
is sleep. So again, I study
41:25
muscle and fat essentially. And
41:28
multiple studies have shown sleep
41:31
deprivation, whether it's a
41:33
little bit each time for several weeks, a
41:36
complete night of zero sleep, or
41:39
four hours for two weeks, only
41:41
getting four hours of sleep for
41:43
two weeks, I'm just referring to
41:45
different studies, it always has adverse
41:47
consequences on our body composition. And
41:50
in particular, we lose muscle mass when
41:52
we're sleep deprived, and we gain body
41:54
fat. Now, some of that is because
41:56
we're just eating more food because disrupted
41:58
sleep will elevate. hunger. But
42:01
one of the studies that I'm referring
42:03
to, it actually caused a distribution of
42:05
higher fat in the visceral region.
42:08
So think of that as the
42:10
where you do not want to store fat
42:12
because now you're having more metabolic resistance, just
42:15
it's the most unhealthy place to store fat
42:17
is in your now you need some but
42:19
we're talking about excess visceral fat, a lack
42:21
of sleep actually caused
42:24
a shift in where
42:26
our body stored fat which was very interesting
42:28
and this was a the most controlled
42:30
study I've ever read on sleep and that you
42:33
used MRI to measure this. So
42:35
it was a very high quality study. It's interesting.
42:37
We had Sean O'Mara on a few months
42:39
ago and he's the visceral fat guy. He loves
42:41
to talk about it and wants everyone to
42:43
get an MRI and and talks about the dangers
42:45
of this deep visceral fat that it's not benign.
42:48
I used to have patients that would tell
42:50
me that as they got older, their inseam kept
42:52
getting smaller and smaller and it was because
42:54
their bellies were getting bigger and they were
42:56
trying to fit their pants around
42:58
their belly at the expense of their
43:00
inseam. So it was like this, you
43:02
know, it's like Santa Claus. You think
43:04
about Santa Claus's body habitus that that
43:06
was what was happening and I would
43:08
remind them that, you know, that's the
43:10
deep inflammatory cytokine rich, problematic
43:13
kind of fat as opposed to the fat that
43:15
we as women generally complain about that we might
43:17
have on our hips or our thighs, which that's
43:19
more subcutaneous and although pesky is is
43:22
not as inflammatory. Are
43:24
there particular, you know, stimulants supplements that
43:26
you like to use or you've used
43:28
in your research supplements are kind of
43:30
a hot topic on the podcast largely
43:32
because I just always find it interesting
43:34
to ask guests like what are the
43:36
things that are part of your supplement
43:38
stack or that you or your wife
43:40
really find beneficial or you've used in
43:42
your study work that you have found has
43:44
been beneficial for body fat. My
43:47
career started as doing a lot of sports
43:50
nutrition research or dietary supplement research, but I
43:52
don't take that many dietary supplements. I'll just
43:54
say the ones that I take. I
43:57
take creatine, creatine, protein,
44:01
fish oil, and a multivitamin,
44:03
multi-mineral supplement. That's pretty much
44:05
all I take. If
44:08
I were, let's say I wanted to lose
44:11
fat quickly, I would leverage caffeine. Caffeine is
44:13
a really, I wanna say it's powerful, but
44:15
it's a modest fat loss supplement. It's not
44:17
gonna melt fat away, but it does everything
44:20
you want it to do. But we have
44:22
to be careful. We don't wanna take it
44:24
too late because then we're gonna not sleep
44:26
and then that's gonna work against our efforts.
44:28
So yeah, and I'm trying to think right
44:31
now, my wife is my incomplete focus and
44:33
hers by default is on HRT. So we're
44:35
going with the big movers
44:38
in her physiology, but she takes a lot of
44:40
the same multivitamin that I do. She does take
44:42
fish oil, vitamin D by the way. A lot
44:44
of people are deficient in vitamin D and don't
44:46
know it. So in our multivitamin, it has vitamin
44:50
D. So if you're, I would also take
44:52
vitamin D for minority in my multivitamin. No,
44:54
I love that. I love the simplicity. And
44:56
we are very much pro HRT if that
44:58
is for you. And I think for a
45:01
lot of people, it's easy to get oral
45:03
progesterone. It might be more
45:05
challenging to get transdermal estrogen as a
45:07
starting point. Testosterone, I keep hoping that
45:09
we're gonna have FDA approved testosterone for
45:11
women and we aren't there yet. So
45:13
most women are either using teeny
45:16
tiny portions of androgyl, which is
45:18
for men, or they're having it
45:20
compounded. But I think testosterone for
45:23
most women in terms of body
45:25
mechanics and body composition seems to
45:27
be hugely impactful. Well, I've
45:29
so enjoyed this conversation. I hope I can
45:32
convince you to come back when we both
45:34
have a little bit more time together. Please
45:36
let listeners know how to connect with you
45:38
outside of this podcast, how to learn more
45:40
about your research and your work. Yes, again,
45:42
thank you for inviting me. I know I
45:44
should come back when we get our survey
45:47
study, our menopause survey. Please do. That would
45:49
be a great conversation to
45:51
have. I'm easy to find them.
45:53
I'm only really on Instagram. So
45:55
my Instagram handles Bill Campbell PhD
45:58
and I try to respond.
46:00
to every question, every DM,
46:02
every comment, try to. I think
46:04
I do a pretty good job. So, and I'll just say
46:06
I am literally obsessed with
46:10
menopause, fitness,
46:12
HRT, exercise, diets in
46:14
this phase of life. So if anybody has
46:16
questions, and again, a lot of this point,
46:18
I don't have a, some of this like
46:20
earlier, I don't know the answers to everything,
46:22
but there is nobody more passionate about this
46:24
space than me right now. Maybe you. No,
46:28
well, thank you. This has been an interview that we've been
46:30
trying to make happen for a while. And I'm so glad
46:33
to know that we were able to make it happen. And
46:35
obviously have to have you back when your research
46:38
has been completed on that survey. Because I think
46:40
in many ways, you know, I've had Dr. Lisa
46:42
Moscone on the podcast, and she said, in 2016,
46:44
she was appalled at the lack of research
46:48
being done on women in
46:50
perimenopause and menopause. So thank you for the
46:52
work that you do. It's,
46:54
you know, it really does take an army
46:57
to get things done. And I think the
46:59
more that we can understand based on research,
47:01
the more that we can advocate and inspire
47:04
others to be able to take the best care
47:06
of themselves that possible. Yes, yeah. Thank you again
47:08
for asking me the questions that I love to
47:10
talk about. Awesome.
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