Archives for July 2015

Back in the Coaching Saddle… After a Twenty Year Hiatus

July 23, 2015 By Marty Gallagher 6 Comments

Marty Gallagher and Cristi Bartlett

I stopped coaching at the national and international level when my superstar powerlifter, Kirk Karwoski, retired in 1996. After a ten-year rocket ride with the Kirk, the undisputed King of powerlifting, anything subsequent would have been anticlimactic. Kirk crushed the best with yawning nonchalance: he won seven straight national titles in three different weight divisions. He steamrolled to six straight world titles and set 20 + world records, including an all-time squat record of 1,003 pounds that remains unsurpassed to this day, 18 years after being set. He was widely considered to have had the strongest legs in the history of powerlifting and he built his unprecedented leg power using a strength system I introduced him to. He and I, coach and athlete, refined and fine-tuned this simplistic approach over the next decade. With each succeeding year he got substantially better.

We called our power approach “The Modified Cassidy” because this unique strength strategy was based on an approach first devised by world champion Hugh Cassidy. Hugh’s template was brutal yet effective, a minimalistic approach towards strength training (and eating) that we customized for Kirk. We were heavily influenced by innovative modifications made to the same system we used by power immortals Ed Coan and Doug Furnas. I talked to Coan weekly for years; we were like two lab scientists discussing a mutual science project—which happened to be Kirk. He was the baby gorilla we were raising in captivity: each week I would tell Coan what Karwoski had done in training and listen to Ed’s feedback. We had this ongoing three-way conversation and eventually settled on a system that caused Kirk to skyrocket. It took five years of dues paying before Kirk won his first national title. That same year he took second place at the world championships when Kristo Vilmi of Finland, edged him by 5-pounds. After that, Karwoski went on a rampage: Vilmi was the last man to beat Kirk, ever.

Kirk and I were a coach/athlete partnership: we thought long and hard each successive competitive year about what new wrinkles we would add, what modifications we would apply, how would we hone and refine our core strength system to make it better. We had a viewpoint, a philosophic strength strategy and our report card was how we did at the national and world championships. For seven years he was the best in the world—by a country mile. He didn’t defeat the competition; he annihilated the competition. He was our champion and we campaigned a specific method, a defined strength philosophy. Kirk was the best in the world for a long, long time and he could have won five more world titles had he not become bored with it all.

I did a lot of coaching at nosebleed levels, including coaching the United States to the IPF world team title at the 1991 world championships in Orebro, Sweden. Like Kirk, I too got burnt out. Truth be known, I didn’t miss coaching. I did so much of it for so long and with such a high caliber of athlete that the idea of coaching again held zero appeal. That all changed when I got a load of Cristi Bartlett. Naturally I heard about her before I met her. She was a protégé of Jim Steel, the no-nonsense, Old School, hardcore strength coach at University of Pennsylvania. Jimmy has been at Penn going on 15 years and oversees a 20-million dollar facility with responsibilities for twenty + collegiate sport teams. He needs help and Cristi worked for Jim as an assistant coach. He began telling me about her years ago and a few years back I met her.

I was really impressed with how she looked and how she moved. She was a muscled-up 190-pounds, which sounds huge, but on her it looked quite normal. She moved like a panther and had “elite athlete” stamped all over her. I was hardly surprised when told she’d been a collegiate basketball player and held a Masters degree in exercise science. Cream rises to the top and genetics, brains and youth are always a good combination in an athlete. While I was not surprised at her athletic pedigree or academic degree, I was quite surprised (shocked, actually) at how “spot-on” her deadlift technique was: she deadlifted as if she’d come straight out of the same Hugh Cassidy technical deadlift boot camp that world champions Mark Dimiduk, Mark Chaillet, Marty Gallagher, Kirk Karwoski and Don Mills were schooled in.

She had intuitively taught herself how to pull using the same technique we were taught: narrow stance, upright torso, bust it from the floor using leg power, finish off the pull with a steel-coil hip hinge held in reserve until that special instant. “Where’d you learn to pull like that?” It was the first question I ever asked her. “Oh, I sort of figured it out on my own. It seemed logical.” Now that was the right answer. She had excellent body proportions; a positive indicator for future balanced lifting. Most good female powerlifters are short and squat; they usually have good squats and good bench presses and are piss-poor deadlifters. Cristi is the rare breed: world level bench presser and deadlifter. She is also a 100% lifetime drug-free athlete.

I asked around a bit about the national and world records in the newly minted USAPL and IPF “raw” divisions. Raw powerlifting is done without any supportive gear, other than a weightlifting belt. The explosion of CrossFit has been a shot in the arm for raw powerlifting competitions. Nowadays the raw national championships might attract 400 + lifters. The USAPL and IPF are strictly judged; squats have to be below parallel; and they practice out-of-competition drug testing. Strict judging and strict drug testing work in Ms. Bartlett’s favor. Her training lifts were at or above world record level. For the first time in decades I sensed that here was an athlete capable of going all the way: become the best in the world. Few knew those “all the way” ropes better than me.

She was receptive to the idea of going to the USAPL national powerlifting championships. That competition would be held close by, in Scranton, and would occur in October, a long time off. We agreed in principle to “go for it.” She needed to compete in a qualifying meet in order to be eligible to compete at the nationals. We found a USAPL competition in suburban Baltimore on July 12^th and worked together for eight weeks leading up to the Baltimore competition. The web is a wonderful training tool: each week she would video tape her “top set” in the squat or deadlift and e-mail it to me. I would review it, critique it and then, based on all the combined factors, we would make the poundage/rep call for the subsequent workout. It was agreed that the key to her ultimate powerlifting success would be lie in increasing her leg strength.

She was already world level in both bench pressing and deadlifting but she was 100 pounds off the pace in the squat. Champions don’t continually play to their strengths; instead they attack their weakness. That is where the dramatic improvement lies. Ergo, it only stood to reason that she would concentrate on bringing up her squat: to do so would make her invincible. Rome would not be built in a day and we would treat the Baltimore meet as a mere workout, she would lift conservatively: no close misses.

Cristi Bartlett Deadlift

The actual competition turned out to be a madhouse as 100 lifters were lifting. The 28-year old exhibited coolness in her competitive demeanor; she was aggressive yet upbeat, engaged but unfazed, she was alternately in one of two states: totally relaxed sitting in the audience with her dad and Tracey, her training partner, or prior to a lift, concentrated and focused. In her squats, her first attempt was with 295-pounds and she buried the lift a full three inches below parallel. It was a “three-white-light” success. Her 315-pound second attempt squat was easier than the first. She roared out and methodically dispatched a perfect 3^rd attempt with 330. Each squat was a cookie-cutter replication of the previous perfect squat.

In the bench press she was nursing a shoulder injury, a serious injury that caused her to train light. She was not at her benching best. The competitive bench press has to be paused on the chest and then pressed evenly and perfectly: she perfectly pressed 205, 231 and finally a very easy 248. We were unaware that the national record was 252-pounds, or we would have taken 256 on her 3^rd attempt. Six lifts, three squats, three bench presses, eighteen white lights; she was perfection in motion.

In the deadlift, she hit her first (and only) snag of the day when on her 1^st attempt deadlift with 440-pounds she drew a lone red light; the side judge said she did not have her shoulders all the way back at lockout. Two judges passed the lift. She asked for 485 pounds on her second attempt deadlift. The current national record was 473 pounds. After seeing the slump-shouldered 440 opening deadlift, I secretly thought 45 pounds might be a bridge to far. Plus the competition was dragging on and on and cumulative fatigue was a real factor; Cristi had taken her first squat warm-up at 9:30 am and now it was 2:30 pm. That is a long time to maintain an edge.

To my surprise and delight, she strode out and after a long, hard pull locked out 485 pounds to set the new national record. What a GRIP! Mark Chaillet had the strongest set of hands I’ve ever seen and he could just tug and tug and tug on an 850 + pound deadlift all day long—Cristi has that same powerhouse type of “kung fu grip.”

After she locked the weight out and accepted the thunderous applause, she came off stage and I congratulated her. “That’s it—right? You don’t want a 3^rd do you?” After seeing how tough the 485 was, after seeing the adrenaline dump and the excitation of that national record, I was convinced she was done. “Whoa!” she said, “How about a 3^rd attempt?” I was puzzled, “Really?” I looked deep in her eyes; she was smiling but serious. I didn’t say it but thought; if you worked that hard with 485, what are we going for on the 3^rd, 486??? “Sure!” I said, “What’s the number?” She didn’t hesitate. “500!”

She would need to find a deeper well somewhere. To make a long story short, it was as if everything in the competition leading up to this point was the preliminary stuff. By now it was apparent to everyone in the oversized, stuffed to capacity gym, that this woman, pound for pound, was the best lifter in the entire competition, female or male. This deadlift would be more than the male class winner in the 184-pound class and it would exceed her just-set national record. It would also exceed the current 496-pound IPF world record in the deadlift.

https://youtu.be/V3eGtpDQaW4

She crushed 500. 485 was light years better than 440 and 500 was light years easier than 485. She had racked up nine perfect lifts and made 26 out of a possible 27 white lights. She ended with a world record-exceeding lift in her second-ever powerlifting competition. It was exciting as hell. It triggered a feeling in me I hadn’t felt since Kirk hung it up. As my old boss at the Washington Post, Vic Sussman used to say, “Let the facts speak for themselves.” Here is a fact: Cristi Bartlett got me back into coaching…and I am excited to see how far she can go. If she caught fire she could become the female Ed Coan, she’s that talented.

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Marty Gallagher is the author of Strong Medicine, The Purposeful Primitive and Coan: The Man, The Myth, The Method. Gallagher coached the United States team that won the IPF powerlifting world team title in 1991. He is a 6-time national masters champion and national record holder. He was the IFF world master powerlifting champion in 1992. He currently works with elite athletes, spec ops military and governmental agencies.

Finding a Balance Between Building and Repair: Part 2 Intermittent Fasting

July 16, 2015 By Dr. Chris Hardy 1 Comment

Finding a Balance between Building and Repair part 2

Prolonged calorie restriction seen in many fad diets is not a sustainable practice. Weight will be lost for sure, but a significant amount of the disappearing pounds will be from valuable muscle mass. Loss of muscle mass with prolonged caloric restriction has a huge health cost in the long term, especially for those with metabolic diseases such as diabetes and the aging population. Adequate muscle mass is vital to maintain metabolic health and prevent frailty as we age. It is also impossible to work out at high enough intensities to achieve the beneficial adaptive responses to exercise while undergoing long term calorie restricted diets. Our engines need adequate fuel to perform optimally.

Prolonged caloric restriction has been shown to extend the life span of rodents, worms, and fruit flies, but longer life spans have not been seen from fasting in higher primates and humans. What is clear is that periodic fasting has been shown to improve the health span in humans and can be highly effective in reversing chronic diseases if done properly.

The issues with prolonged calorically restricted diets for weight loss and the proven benefits with periodic fasting have led many of us to experiment with intermittent fasting (IF). Intermittent fasting is the practice of scheduling short term periods of calorie restriction, followed by normal caloric intake. Recent science has shown that many of the metabolic benefits of fasting can be achieved with IF without the loss of our prized muscle mass. For this reason, IF has gained popularity in recent years. For some IF works fantastically to achieve a lean physique and metabolic health, while others have not been so successful with their experiments with short scheduled fasting. What gives? Why do some people see great results with IF and others crash and burn? Much of the variability with results likely is from the “environmental” context IF is used. Let’s go back to first principles to establish a framework for successfully using intermittent fasting.

Intermittent fasting is an environmental stress (remember that our environment includes all aspects of our lifestyle) on the body and brain. The short-term stress of IF activates the repair and recycling system of autophagy we covered in Part I. Intermittent fasting will temporarily shut off the mTOR building pathway in favor of repair. The autophagy system improves the health and metabolic efficiency of our cells which translates into beneficial effects for our entire body. “Dosed” correctly, IF can be the missing link in your quest for optimum health, body composition, and prevention of chronic disease. The important point to remember is that although potentially beneficial, intermittent fasting like all caloric restriction contributes to your daily “stress cup” (aka allostatic load discussed in Strong Medicine).

Calorie restriction with IF contributes to your daily Stress Cup

The proper dose of IF is a moving target, as the other contributors to your daily stress cup determines how much caloric restrictions you can handle (if any) on any given day. If you have had a night of bad sleep and significant work or social stress, there will be very little room for the added stress of intermittent fasting. If you don’t take into account a nearly full stress cup and press ahead anyway with a significant fasting period that day, your stress cup will overflow (allostatic overload). This will create a substantial response from the HPA axis (stress system) and increase your cortisol levels. Your brain is protecting itself utilizing increased HPA axis activation and resulting high cortisol levels during allostatic overload situations. This response ensures the brain has adequate glucose, even if it has to get it from your precious muscle mass (from amino acids using gluconeogenesis- see Strong Medicine for more).

We can frame the “dosing” of IF using the concept of hormesis. From Strong Medicine, we know that hormesis is the phenomenon of something that is potentially bad for us can be beneficial at the proper dose. Calorie restriction certainly follows the concept of hormesis- small amounts produce a beneficial response while large amounts lead to a starvation state. A crucial concept to understand is that the same dose of fasting can be beneficial one day detrimental the next day depending on the state of your stress cup. This is how hormesis and allostasis are intertwined.

Area “B” represents the optimal dose of calorie restriction this day. The level of your stress cup is relatively low allowing a longer period of fasting resulting in a beneficial autophagy (repair and recycling) response.

This is a day when your stress cup is filled with other sources of stress such as poor sleep, social stress, or high levels of exercise. The length of your fasting this day has to be reduced (to the area of the green”B”). If you did the same length of fasting you did in the first example (yellow “B”) you would “overdose” fasting and overfill your stress cup. On especially high stress cup days, fasting periods should not be attempted.

The benefits of IF-induced autophagy will not be realized if you overdose your fasting period. This point deserves repeating- intermittent fasting is a stress on your body and has to be balanced with the other stresses in your life to do it successfully.

Exercise and Intermittent Fasting

Finding the right mix of high intensity exercise and fasting can be a very tough to consistently pull off. High intensity resistance training and interval training stimulates the mTOR building pathway, increasing/maintaining our muscle mass and promoting fat loss through the actions of growth hormone. High intensity exercise is also a significant stress (which is why it works) on the body and needs to be figured into your daily stress cup evaluation. This type of training directly after a period of fasting can be especially stressful and should be approached with caution and careful assessment of your stress cup.

General guidelines

For the lucky few that live idyllic lives (my Strong Medicine co-author, Marty Gallagher, comes to mind) and have relatively empty stress cups, you can get away reckless forays into fasting experimentation and be just fine. Most of us are not that lucky and need a few guidelines to keep us out of trouble:

Assess your stress cup daily. Fasting is never a good idea with an already-full stress cup.
Start with brief fasting periods when beginning IF. The most popular is fasting from dinner the night before until lunch time the following day.
Avoid fasting when planning high intensity exercise sessions that day (“feed your activity” concept from Strong Medicine). Fueling your post-workout time periods will help maximize mTOR and muscle building. If you are getting good results starting your work out in a fasted state, make sure you feed yourself adequately post-workout.
Avoid fasting after a night of poor sleep. Poor sleep is one of the biggest contributors to the stress cup.
Plan fasting on your non-exercise recovery days. This can help maximize effectiveness of the repair/recycling autophagy system.
If you can’t handle complete fasting try a reduced protein day. Recall that amino acids from protein are potent triggers of the mTOR building system and reduced protein intake will trigger autophagy without abstaining completely from food. Meals consisting of high fiber vegetables with additional fats from olive oil/coconut oil or avocados will work well for this reduced protein strategy.
For those of us pushing middle age it is important that we give potent stimulation of the mTOR pathway to slow the muscle wasting of aging (sarcopenia). It is harder for the aging trainee to stimulate mTOR compared to the younger person. If this applies to you, consider a weekly schedule with less overall fasting and more attention to resistance training with increased protein intake to find your optimal balance between building and repair.

Conclusion

Intermittent fasting practice that is informed by daily monitoring of your stress cup can be hugely beneficial. The key is to be flexible and not overly rigid with planning your fasting. If you are having a high stress cup day, don’t be afraid to ditch your fasting plans. Failing to take allostatic load (stress cup) into account will just hurt you in the long run and slow progress to attaining your fitness and health goals. Start slowly with short fasting periods and increase with small increments. Using the conceptual framework we have created with intermittent fasting and the stress cup you can find your optimal individual balance between building and repair.

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Chris Hardy, D.O., M.P.H., CSCS, is the author of Strong Medicine: How to Conquer Chronic Disease and Achieve Your Full Genetic Potential. He is a public-health physician, personal trainer, mountain biker, rock climber and guitarist. His passion is communicating science-based lifestyle information and recommendations in an easy-to-understand manner to empower the public in the fight against preventable chronic disease.

Breaking Down the Barriers to Exercise

July 9, 2015 By Carrie Hardy 6 Comments

Carrie Hardy Breaking Barriers for Exercise

Another day and another pep talk. I know that exercise is good for me but some days I find myself making excuses and rationalizing why I can’t exercise today. As a former scientist and current physician-in-training, I am well aware of the research that shows the benefits of exercise for health and wellness. I know that in addition to the physical benefits, daily exercise can facilitate protective, adaptive and regenerative responses in the brain. I am even married to the guy who co-wrote Strong Medicine, arguably the most important health and wellness book out there (I am in no way biased!), with pages filled with the reasons I need to exercise. So why do I have such a hard time sustaining a schedule that includes regular exercise?

From looking at the poor state of fitness in the majority of us, I know that I am not an anomaly. Most of us have similar struggles prioritizing exercise. Starting and maintaining a regular exercise routine obviously has many barriers in modern society. There are entire industries built around finding the latest “revolutionary” gadget or program to inspire us to exercise. The marketing gurus of the sporting goods and technology companies have tried to assist us (and take our money) by selling handy gadgets such as the Fitbit, heart rate monitors, and activity trackers all created to help motivate us to just move. Despite of all the latest technology at hand we still struggle.

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Those who study this subject have looked closely at barriers to exercise (and lifestyle change in general). These barriers can be broken down into three general categories:

Intrapersonal: time, knowledge, motivation, personal appearance, and overall health to initiate an exercise program.
Interpersonal: commitment to self versus others, lack of support, and lack of workout partner
Environmental: lack of equipment and lack of realistic role models.

Personal appearance! Who doesn’t want to look better naked? Some days it is really tough to face the mirror and many feel this way (whether they admit it or not). What can even be more taxing on self esteem is how we perceive we look both in our workout attire and while we are performing the exercises. Before you launch into a rant about exercise not being a beauty contest, let’s take a closer look at these very real barriers (especially for women) to getting someone to start and maintain an exercise program. I came across a very interesting research article published by Bourn and colleagues that evaluated the effects of viewing “reality” weight loss television shows on body satisfaction, mood and snack food consumption. We assume that these reality TV shows are motivating for those watching, however Bourn’s published results show that “larger women experienced less body satisfaction and less positive mood in response to weight loss program” than a control group that watched a program on home renovations (the control group). Additionally, it was reported that a “greater percentage of women with higher dietary restraint ate food whilst watching the weight loss program.” In this study, not only was watching overweight people exercise not helpful for the viewers own body image, people whom normally have more restraint with snacking ate food while watching the reality weight loss show!

I know you are saying to yourself that this is a research group and perhaps they were almost expected to feel this way. But, let’s look at a snapshot in reality. Negative thoughts about your appearance can create a rabbit hole into which we chase our self-esteem. I want to share a story about appearance during exercise. A friend of mine and I were talking about exercise and clothing. The weather is getting warmer, but not quite warm enough for just shorts and t-shirts. I freely admit that I have moments where I am concerned about appearance while in workout attire. I expressed this to my friend, who has been an athlete since she was a teenager and has the lean body composition that one would expect with a life long athlete. I was shocked to hear her express similar insecurities with her own appearance in workout clothing. Logical or not, perceived self image and appearance is a river that runs deep!

Lack of time and conflicting responsibilities seem to be partners in crime for creating barriers to exercise. There never seems to be enough time and it seems that we have to make a choice to do something good for ourselves or take care of our family first. I know I think about this often! I am a full time medical student and I feel that I need to carve out time for everything from studying, spending quality time with my family, and personal time for myself (mostly to workout).

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I scrutinize my schedule to see where I can fit in time for a 20-minute burst protocol (see Strong Medicine) or a 4-minute Tabata routine. It doesn’t seem like a lot of time but when you factor everything in, but even this amount of time can seem prohibitive. I have become creative and workout. When there is a short break in between classes or before I get dinner started (if I am home before Chris), I will pop into the garage to get some sort of workout in. Having a space set aside in your home to work out can really make a difference. Strong Medicine provided us with a look at some efficient exercises that can be done using either the burst or HIIT protocols, helping to eliminate the concerns of time being barrier while still getting in an effective workout. Using these two methods can certainly help overcome the barrier of time.

While engaging in regular exercise can help increase energy, improve mood and improve your physical appearance, make sure you start at your ability level. You may have to start with just walking. That is OK, just make sure you do it. You may not feel that is enough but it is a starting place to build your foundation. Strong Medicine has a walking program for the absolute beginner that starts out very slowly and builds gradually.

Lack of social support from family or friends and lack of partner for exercise are less discussed barriers. We touched upon conflicting responsibilities as it overlaps with time in the intrapersonal barriers but how do we overcome lack of support? Let’s look to our family first. Getting a family member to join us in exercise can increase the time we spend with loved ones as well as provide support and a workout partner for us. Here are a few ideas to start:

Find a family member or friend willing to go for a walk with you regularly. Once a routine is formed you can try out alternate exercises and intensities together. Building the exercise relationship first this the is key.
Instead of a ladies or guys night out at some bar, how about 30 minutes of exercise with your friends before dinner? Make exercise a part of the social bonding of a night out.

So now that we have made a time commitment to ourselves and found a workout partner, let’s look at our final group of barriers. These can include:

Lack of facilities/equipment,
Lack of role models for physical activity

Gym memberships and equipment can be expensive, and choices of where to join and what to buy can be overwhelming. If you are a beginner to exercise, you are born with all the equipment you need to get a good workout, your own body! Learning simple bodyweight exercises can be a great beginning. If this is where you are starting you are probably pretty safe working out on your own. The safety concerns should be minimal but if you are ready to attack advanced moves, you will want to consult a professional (Dragon Door’s PCC is an excellent place to start).

Finding motivating exercise role models can be extremely difficult. All of the images on TV or the Internet are of extremely buff individuals with bodies that appear unattainable. However, it is this image that sells products with the promise that you also can look like this. Uh oh! We are back to body image.

Perhaps we should stop looking for role models and just find motivation first. Personally, I find this quote by physician and athlete George A Sheehan helpful for motivation (maybe not so inspirational): “Exercise is done against one’s wishes and maintained only because the alternative is worse.” The fear of poor health can kick you in the butt to get you moving, but once you start making exercise a habit in daily life, you will find that the good feeling you get after a workout is its own reward and will keep you coming back for more (endorphins are wonderful!) Become your own inspiration instead of looking for it in others.

This article was originally written to discuss both barriers and motivations for exercise. Motivation, like exercise, is not one size fits all. The quote from Dr. Sheehan above should be enough to set your body in motion but you will need to find what motivates or inspires you to take control of your health and your life. Obtaining a better body and health is achievable if you prioritize exercise and make it a habit. The barriers you perceive are not insurmountable. Besides, who doesn’t want to be really, really, ridiculously good looking…

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Carrie Hardy, M.S. is a former biochemist, 4^th year medical student at Bastyr University, mountain biker, amateur photographer and a neophyte in Brazilian Jiu-Jitsu. Her passion is combining science with individualized medicine to empower individuals to lead a healthier life.

Finding a Balance Between Building and Repair: Part 1

July 2, 2015 By Dr. Chris Hardy 3 Comments

Strong Medicine Maximizing Health-Span: Introduction

For the second MHS (Maximizing the Health-Span) post, I set out to write an article focused on intermittent fasting (IF). But, I quickly realized we needed a “first principles” foundation for context first. We need to understand the underlying physiological systems that are affected by intermittent fasting instead of taking a reductionist approach. A very simplistic way of thinking about the two major body systems most affected by intermittent fasting (and also training and other lifestyle choices) is categorizing them as systems of building and repair respectively.

The body has to achieve a balance between building and repair at a cellular level. This balance will necessarily change depending on environmental demands such as physical activity and nutrition as well the aging process. Finding the right balance between building and repair at the right time is key to maximizing the health span.

Building and Repair Diagram

At the center of the building and repair systems is a protein complex known as mTOR. The technical name for mTOR is the mechanistic target of rapamycin (formerly known as the mammalian target of rapamycin). mTOR functions as a molecular switch between building and repair.

Turning mTOR on promotes building. Turning mTOR off promotes repair.

BUILDING

Building (growth) is an anabolic process that happens when mTOR is turned on. Stimuli such as resistance training and eating protein (especially the branched-chain amino acid leucine) turn the mTOR switch on. The hormone insulin also turns on the mTOR building pathway. This effect of insulin should come as no surprise to readers of Strong Medicine (SM pages 107-108) as we discussed insulin as a hormone of growth and storage.

As Dan Cenidoza covered in his Strength after Sixty post, the anabolic pathways of building are crucial to grow and maintain muscle mass especially as we age. Not enough of “turning on” the mTOR switch can lead to sarcopenia and frailty in old age.

At the extreme end of the mTOR building pathway is cancer. By the simplest definition, cancer is uncontrolled cell growth. Recent science has shown that many cancer cells have abnormally high mTOR signaling, putting them is a perpetual state of growth. People with insulin resistance (SM p. 180) have higher levels of insulin in their bloodstream at all times which keeps the mTOR switch activated. Thus, it is no surprise that those with insulin resistance/diabetes are known to have increase risk of cancer.

We also now know that high levels of sustained mTOR activation can lead to accelerating aging in many species, including humans. With this information in mind, it becomes evident that getting the proper “dose” of mTOR activation is key.

We need enough “turning on” the mTOR building (growth) switch to prevent the loss of muscle mass so crucial for healthy aging, but no so much that we accelerate the aging process and become at increased risk for diseases such as cancer.

mTOR Activation

REPAIR (AND RECYCLING)

The opposite side of the mTOR coin is the repair and recycling system. This system is activated with the mTOR switch is turned off. The main process that carries out repair and recycling in our cells is called autophagy.

Autophagy literally means “self-eating.” Autophagy is the mechanism our cells use to recycle damaged proteins and cell machinery (including mitochondria) and use their parts to make new machinery and new sources of energy. Recycling old cellular machinery helps protect a cell from premature aging. This is similar to replacing a roof or hot water heater in your house to keep it functional as a dwelling longer. We can replace some of the parts for quite a while before having to buy a new house. Autophagy does the same thing for cells.

Autophagy is a cell-survival mechanism during times of stress. Fasting is one of the most common sources of cell stress that activates autophagy. Low protein intake and low insulin levels create a perfect environment for the mTOR switch to be turned off and autophagy to take over. Autophagy allows your cells to recycle used material for use as energy during stresses such as fasting, instead of breaking down valuable things such as muscle. Preventing catabolism (breaking down) of muscle is always a good thing!

By allowing recycling and repair within the cell, autophagy effectively extends the life span of the cell. This is one of the reasons why we seen increased lifespan with fasting and calorie restriction in animal such as mice and worms (it has not worked as well in humans as we will discuss in subsequent posts).

FINDING THE BALANCE

We know that turning on the mTOR building pathway in the right doses is crucial to maintaining muscle mass through the lifespan, a key to healthy aging. We also know that autophagy is a valuable process to extend the life and health of your cells. Finding the right balance between these two processes is where it can get tricky. This balance is also a moving target throughout our lifespan. We are going to use the concept of balancing mTOR activation (building) and mTOR deactivation (repair/recycle) to discuss training, eating, fasting, and lifestyle modification in upcoming posts. We will couple this with the concepts of hormesis and allostatic load (the Stress Cup) from Strong Medicine to create a framework to form a foundation from which to decide if practices like intermittent fasting have potential to maximize the health span.

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