In this episode of unPAUSED, Dr. Mary Claire Haver continues her conversation with Dr. Gabrielle Lyon, a board certified family physician and author of the bestselling book Forever Strong, moving from the science of muscle centric medicine into practical strategies for building muscle, managing protein intake, and training through perimenopause and menopause.
The conversation starts with protein timing and why the first meal after an overnight fast is the most important window for triggering muscle protein synthesis. Hitting 30 to 50 grams of protein at that meal can improve body composition on its own, and Dr. Lyon explains how poor sleep suppresses muscle protein synthesis and disrupts blood sugar regulation, while a session of high intensity exercise can help offset a few nights of lost sleep during travel.
Dr. Lyon and Dr. Haver also cover essential amino acids as a way to boost protein quality without eating more food, and creatine, which cannot realistically be obtained through diet alone at the doses shown to support muscle and brain health in aging women.
Much of the conversation centers on anabolic resistance, the declining response of aging muscle to protein and exercise. Dr. Lyon argues this is not an unavoidable part of aging but something women can reverse through higher protein intake and consistent strength training. She breaks down why the standard recommended dietary allowance for protein is only a floor to prevent deficiency, not a target for optimal muscle health, and why women who fall short face a higher risk of fracture and bone loss.
The two also address plant based versus animal protein, why outdated guidelines limiting saturated fat may not apply to most women with healthy cholesterol, and why personalized nutrition based on lab markers like triglycerides should guide carbohydrate intake rather than a single universal rule.
On hormones, Dr. Lyon is candid that research connecting estrogen and testosterone to skeletal muscle quality has not caught up to clinical experience, and that resistance training and dietary protein remain the most powerful tools available regardless of hormone therapy. She and Dr. Haver discuss GLP-1 medications and the risk of accelerated sarcopenia without enough protein and strength training, and why progressive overload is better understood as progressive stimulus, since changing tempo, exercise selection, or volume can build muscle without always lifting heavier weight.
The episode closes with guidance for women starting resistance training for the first time in midlife, why decades of cardio alone will not protect muscle mass, and Dr. Lyon's three priorities for healthy aging: get strong, prioritize high quality protein, and know your own standards so conflicting health advice does not derail progress.
Guest links:
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Dr. Gabrielle Lyon
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Dr. Gabrielle Lyon (Instagram)
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Dr. Gabrielle Lyon (Facebook)
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Dr. Gabrielle Lyon (LinkedIn)
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Dr. Gabrielle Lyon (YouTube)
- The Dr. Gabrielle Lyon Show (Apple Podcasts)
Books:
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“The Forever Strong™ PLAYBOOK: A Six-Week, Science-Based Plan to Sharpen Your Mind, Strengthen Your Body, and Get Healthy at Any Age,” by Dr. Gabrielle Lyon
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“Forever Strong™: A New, Science-Based Strategy for Aging Well,” by Dr. Gabrielle Lyon
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“The New Perimenopause,” by Dr. Mary Claire Haver
- “The New Menopause" by Dr. Mary Claire Haver
Articles:
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Dietary protein and exercise have additive effects on body composition during weight loss in adult women (Journal of Nutrition)
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A reduced ratio of dietary carbohydrate to protein improves body composition and blood lipid profiles during weight loss in adult women (Journal of Nutrition)
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No effects of high- v. low-protein breakfast on body composition and cardiometabolic health in young women with overweight: the NewStart randomised trial (British Journal of Nutrition)
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The effect of sleep restriction, with or without high-intensity interval exercise, on myofibrillar protein synthesis in healthy young men (The Journal of Physiology)
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Effect of glucagon-like peptide-1 receptor agonists and co-agonists on body composition: Systematic review and network meta-analysis (Metabolism)
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Body composition changes during weight reduction with tirzepatide in the SURMOUNT-1 study of adults with obesity or overweight (Diabetes, Obesity and Metabolism)
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Creatine supplementation for older adults: Focus on sarcopenia, osteoporosis, frailty and Cachexia (Bone)
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Creatine and Cognition in Aging: A Systematic Review of Evidence in Older Adults (Nutrition Reviews)
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"Heads Up" for Creatine Supplementation and its Potential Applications for Brain Health and Function (Sports Medicine)
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Creatine supplementation research fails to support the theoretical basis for an effect on cognition: Evidence from a systematic review (Behavioural Brain Research)
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Keeping older muscle “young” through dietary protein and physical activity (Advances in Nutrition)
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Age-Related Anabolic Resistance: Nutritional and Exercise Strategies, and Potential Relevance to Life-Long Exercisers (Nutrients)
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The impact of life-long strength versus endurance training on muscle fiber morphology and phenotype composition in older men (Journal of Applied Physiology)
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The Anabolic Response To Resistance Exercise And A Protein-Rich Meal Is Not Diminished By Age (The Journal of Nutrition, Health and Aging)
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Prevalence of protein intake below recommended in community‐dwelling older adults: a meta‐analysis across cohorts from the PROMISS consortium (Journal of Cachexia, Sarcopenia and Muscle)
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Effect of Dietary Protein Intake on Bone Mineral Density and Fracture Incidence in Older Adults in the Health, Aging, and Body Composition Study (The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences)
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High Versus low Dietary Protein Intake and Bone Health in Older Adults: a Systematic Review and Meta-Analysis (Computational and Structural Biotechnology Journal)
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The Role of Protein Intake and its Timing on Body Composition and Muscle Function in Healthy Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (Journal of Nutrition)
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Does Protein Ingestion Timing Affect Exercise-Induced Adaptations? A Systematic Review with Meta-Analysis (Nutrients)
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Prevalence, Awareness, and Treatment of Elevated LDL Cholesterol in US Adults, 1999-2020 (JAMA Cardiology)
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Underrepresentation of women in exercise science and physiology research is associated with authorship gender (Journal of Applied Physiology)
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Intramuscular sex steroid hormones are reduced after resistance training in postmenopausal women, but not affected by estrogen therapy (Steroids)
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The Effect of Hormonal Contraceptive Use on Skeletal Muscle Hypertrophy, Power and Strength Adaptations to Resistance Exercise Training: A Systematic Review and Multilevel Meta-analysis (Sports Medicine)
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Endogenous sex hormones, sex hormone-binding globulin, and muscle health: insights into sarcopenia and sarcopenic obesity from the Women's Health Initiative (Menopause)
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Protein interventions augment the effect of resistance exercise on appendicular lean mass and handgrip strength in older adults: a systematic review and meta-analysis of randomized controlled trials (American Journal of Clinical Nutrition)
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The effect of daily protein supplementation, with or without resistance training for 1 year, on muscle size, strength, and function in healthy older adults: A randomized controlled trial (American Journal of Clinical Nutrition)
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Effects of Tirzepatide on Skeletal Muscle Mass in Adults: A Systematic Review (Cureus)
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High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial (Journal of Bone and Mineral Research)
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Rapamycin extends murine lifespan but has limited effects on aging (Journal of Clinical Investigation)
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Longevity, aging and rapamycin (Cellular and Molecular Life Sciences)
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Low Protein Intake is Associated with a Major Reduction in IGF-1, Cancer, and Overall Mortality in the 65 and Younger but Not Older Population (Cell Metabolism)
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Adequate dietary protein is associated with better physical performance among post-menopausal women 60-90 years (The Journal of Nutrition, Health and Aging)
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Prevalence of protein intake below recommended in community‐dwelling older adults: a meta‐analysis across cohorts from the PROMISS consortium (Journal of Cachexia, Sarcopenia and Muscle)
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Vegetarian and Vegan Diets and the Risk of Hip Fracture in Adults: A Systematic Review and Meta-analysis (Nutrition Reviews)
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Vegetarian and vegan diets and risks of total and site-specific fractures: results from the prospective EPIC-Oxford study (BMC Medicine)
Other Resources:
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Evaluating Beef Fatty Acid Composition and Lipid Quality in Response to Silage Type and Feeding Intensity During the Finishing Phase (MDPI)
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Dietary Guidelines for Americans (USDA)
- 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia: A Report of the American College of Cardiology Solution Set Oversight Committee (JACC Journals)