Episode 575: Dr. Jonathan Schoeff: Peptides and the Marketing Behind Modern Longevity - Part 2

Habits and Hustle

Dr. Jonathan Schoeff discusses GLP-1s, fasting, muscle preservation, and longevity metrics, emphasizing metabolic flexibility and strategic fasting over extremes.

Key takeaways

• GLP-1s don't necessarily cause muscle loss; lean body mass includes organs and fat, not just muscle.

Transcript preview

Speaker 1 (0:00) Hi guys, it's Tony Robbins. You're listening to Habits and Hustle. Crush it. Welcome to the Habits and Hustle podcast, where I sit down with the world's biggest thinkers, entrepreneurs, athletes, and experts to uncover the habits, strategies, and mindset shifts that actually move the needle in your health, happiness, and success. And today, I'm back with Dr. Jonathan Schiff, a surgeon, longevity expert, and co-founder of the longevity lab. who was still very actively practicing medicine, I should say. After part one, we knew there was a way too much leftover that we had to keep on going. So in this part of the conversation, we get into this stuff everyone is talking about, but very few people actually understand, which is GLP-1s, muscle loss, fasting, testosterone, biomarkers, grip strength, movement, sleep, longevity metrics, which are actually worth paying attention to. What I love about Dr. Jonathan is that he does not make health more complicated to sound smart. He breaks it down in a way that makes you question the trend, understand the mechanism, and come back to the basics that actually moves the needle. What he shares in this episode will change the way you think about GLP1's fasting, muscle, and health markers that you should actually be tracking. So let's dive in. Enjoy. Yeah, no matter what. Yeah, then you can... Are they all skin better that you like? I do like the skin better formulations. I know it's goofy. I know. It's goofy. Why is it goofy? It's not goofy. Oh, well, because as a guy... As a guy, yeah. Well, you're like very, you know, you take care of yourself. Well, I'm taking care of. That's how it works. Okay, well, either way. You don't... I do what I'm told. Well, it's working. Yeah. Okay, now we can get into the GLP one stuff. Okay. Let's do it. that red at trutide is, are you on any of these GLPs? Life changing. No. I've used all of them. You have used all of them. Absolutely. Well, well, simoglutide and up. So Sima gluteide, terseptide, redatutide. I've used all of them. So if people are having, like, so between trizepetide and redetruthyte, I know one works on two receptors, one works on three receptors. So you believe it's a tool and you don't believe everyone should be on them. Even though you're talking about the insulin resistance and to build muscle. So here comes the contradiction, right? Totally. So if muscle is the biggest longevity organ to keep your insulin low, yet GLP-1s have been obviously known to like break down muscle and eat away at your muscle. They've been blamed. They've been alleged. Alleged. Yes. Let's use that. Okay. So you don't think that the GLP ones? It's not that simple. No. No. Well, I mean, I know the data. Okay. So if you look at step one trial, which was the first simoglutide weight. loss trial, 2021. Okay. What did it demonstrate? This is really important. 40% loss of lean body mass, LBM. So the problem is, and I just saw a post on this just the other day, lean body mass is not skeletal muscle. Okay? They're not the same thing. The 40% is lean body mass. So if you want to make the argument or say you're a personal trainer, you want to get your hustle and or you want to do some peptides this, then the other, then you say, oh my gosh, 40% loss of skeletal muscle. No, it's lean. body mass and realize that lean body mass includes skeletal muscle as one component in healthy fit individuals that may may reach the 50% mark in other words 50% of your lean body mass in a very fit well-muscled individual can be skeletal muscle okay that's in a really fit person yep so it goes down from there in other words no one lost 40% of their muscle that's not reality so it's it's lean tissue so it's lose fat mass but it also includes organs mass. So non-alcoholic fatty liver disease, which is what read of Trutide, 100% reduced their fatty liver, which is, that's a game changer from a health perspective. In that case, that's a part of lean body mass. So losing, improving the metabolic function of your liver, losing liver fat is a very good thing. And that's lean body mass too. So it's just not as clean as, you know, ozimpic chews up, muscle. Now, I do agree that early on, and this was the age old story with any drug, misuse and abuse. That's always what brings it down. So, yes, when personal trainers and nurses and all these people were handing out Ozimic without any clarity, any reason, bear in mind, Ozympics, like anorexic's best friend. I mean, it was abused at an extreme level. I think it still is. But the thing about Simoglutide was that by far and away is the most profound appetite suppressant. So yes, were people starving? Yeah. Yeah. And if you look at the scientific literature, the nutrition literature about highly restrictive dieting, you can lose up to 75% of lean body mass. How do we know that? All you got to do is watch the biggest loser. Right. You can just like exactly. So you can say that it's because the app, you're just not eating. If you're in a profound calorie deficit from restriction, whether you're called an anorexic or someone on Simaglutide, yes, you risk muscle. I agree with that. But it doesn't have to be that way. In fact, I think GLPs create a very unique environment to actually augment muscle. I mean, what I see in my practice every day with our protocols is literally pure fat loss. They don't lose a pound of muscle and they lose pure fat. Strategic fasting. I mean, that's the secret sauce. But GLPs fit incredibly well into that overall strategy. Wait a minute. So strategic fasting, is there a way to fast where you can only, where you only lose fat and not? Yeah, 100%. Muscle? 100%. I've got, I mean, I could line them up. Well, you're fasting now, right? I am fasting now, yes. How long are you fasting for? Oh, just fast for the day. So whatever you want to call that. So I call 24-hour fasting, technically maybe 34-36, it doesn't matter a ton to me. Okay, but are you a person who doesn't care about food? No. You mean like, how do you mean? What I mean by that is like, right, but like, so you're someone who maybe like sees food as fuel, not as like, as friend. I think all people should see food as fuel, not as friend. You have to look, and this is one of the conversations. So when I need a new client. Oh, okay. Because I love food. I know. So I'll tell you a true story. Okay. I had a client several years ago that I asked. I said, what's your relationship with food? And she said, I have a very loving marriage with food. I said, well, I'm going to be the guy that causes a divorce. But food, remember, what's your relationship with food? Alcohol. Anything on the list. Yes, do they all have the potential to have detrimental health? effects, sure. Does that mean they're detrimental to your health in existence? No, not at all. I do try to help people retool their thought process around food as primarily a fuel. It's a fuel first. Enjoying your food, 100%. I'm all for it. Being dependent on your food, that's very different. And right, I think that's the line that gets blurred in America. Okay, wait a minute. Okay, so there's, okay, that you're like, so fasting to you, okay, why is it so important? And how do you do it where you can maintain your lean muscle mass? And if someone's not a faster, how do they become a faster when they love food? And like they can't even imagine not eating and use it as an energy source. Like, I don't know, if you're someone who's an actual, if you work out a lot or you're super. The idea of not eating is super difficult for me. It can be. Yeah, it can be for sure. Now you can answer all those questions. I know, Alex. Oh, I gotta remember. Okay. So why fast? First of all, it is the most potent, powerful activator of a biologic pathway called AMP K, A-M-P-K. You've heard of, let's see, all the, the, the, the, have you heard of rapamycin? Yes. That's a big a T-A thing. Yes, of course. Okay. So rapamycin in up regulates amp K. That's why you would take it. So it shuts down mTOR, which is a growth pathway. In the body, there's growth and repair. Let's make it super simple, yin and yang, right? You can have, they can be coincident. You can be doing activities minute to minute that are favoring growth while also allowing for repair. But as we age, as you can imagine, you technically, and this is what all the longitudinal data would say is you need relatively more time. to repair because there's just think of it basic there's more opportunity for error what is cancer it's unchecked growth by definition so if we don't allow that time for repair the body can be exclusively based in this in a in a growth mode what what you see right now in longevity as a whole right you have two camps think of it very simply you have an mTOR camp like a gabriel lion grow grow grow muscle muscle muscle lusine insulin everything to activate growth which I have a huge, profound respect for Gabrielle Lyne in what she's done, like women's health, just inspiring people. But that high protein, resistant training, progressive overload, that's a growth mindset. Then you see the other camp, which is the repair mindset. So that's, the growth is mTOR, M-T-O-R, repair A-M-P-K. I know it's geeky, but that repair pathway, what does someone who embraces repair pathways look like? Okay. They fast a lot, ketogenic diets, so on something. They're typically frail. Does that make sense? Yeah, I mean, I don't like that mindset. I'd rather be on the growth side. Correct. So this is the challenge. You have to be both. It doesn't work in isolation. So we've entered a very extreme time. And this is why some people are spouting off like, oh, what's going to come from all the high protein rage? Now, I don't have those concerns. I think invariably, when you look at the average protein consumption for an American is so low. that increasing that, there's no harm attached that. But this is what makes me a longevity expert is I understand the potential detriment of growth and repair. And I use those two pathways strategically. Instead of being at the mercy of the human body and human biology, we should be able to actually strategically control these mechanisms. The most powerful tool we have to tell the body, its repair time is fasting. No, not intermittent fasting, but legitimate, sustained, water-only fasting greater than 24 hours. Okay? So we can use that mechanism. I can fast on a Saturday and do a complete reset in my body so that my, our end game is something called metabolic flexibility. I know this is geeky, but I stick with. Metabolic flexibility is synonymous in the human body. The best example of metabolic flexibility in human body is insulin sensitivity. What metabolic flexibility is this. It is the most efficient use of fuel sources based on condition and environmental need. So using fat when you're not running from a bear or the cops and using carbs when you need rapidly available fuel. This is the limitation with the ketogenic diet. Eliminating carbs is not the answer. Okay. Okay. Do you see what I'm saying? I do, but wait. So it's all a spectrum. It's a spectrum. So you're saying, though, okay. Do you need another shot? I do, really. I think I need like a box of these shots. I think I have one. Yeah, I think you do. Exactly. You have it in your bag. So basically then, you're saying that we should be fasting for longer than 24 hours, not a water. Like, you're saying it's a water fast? You can have water basically. That's what you're drinking. Oh, yeah. So you didn't fast because you had a magic mind. Yeah, but I looked at the ingredients. The ingredients. Yeah. It has alulus in it. So you're allowed to have things on your. your fast? Sure. Zero calorie, zero carbohydrate, for sure. So yeah, non-nutrative. So alulose is a non-nutrative sweetener. So that little magic mind shot has 50 calories. Okay. So that's okay? Sure. So what are you allowed to have on a fast? Coffee. I say black coffee. But why? What could you put some cream in then? Because of the impact of fat on the fast. Now, it has less of an impact, but there is an element of energy balance that influence a fast, okay? So why can you have a magic wine on a fast? Because there's nothing in it. It was just what we, I was looking at Lions, Maine, Rodeola. So a great blend of, of nutraceuticals, vitamins, minerals, and then alulosis is a non-nutrative sweetener. So basically people can have that on a fast. Sure, yeah. You want a five-hour energy? Go nuts. You want a Celsius? Be my guess. I don't know, whatever you like to do. I would strong, so on a fast, I recommend my client's minimum of 400 grams of caffeine, or 400 milligrams, excuse me, minimum of 400 milligrams, okay? Somewhere between, for my male clients, usually four to 600 milligrams. That's a reasonable threshold for a woman, probably in the 200 range, okay? So definitely caffeine because it's an accelerant for fat burning, okay? So we want the key, this is the way it works. And this is why it's so simple. Okay, this is the crux of fasting. And I can explain why. So why do we fast? We fast to first and foremost, reset the system. Force the body into one condition and one condition only, which is ultimately defined by ketosis or ketone production. But that's not why we're doing it. We're doing it to zero out our insulin levels for that period of time. insulin is the gatekeeper. So if you're into the aesthetic body comp goals, fast. If you're into the autophagy clearance of senescent zombie cells, fast. If you're into long-term health, health span, lifespan, life span, longevity, by definition, fast. It's all fasting. But fasting physiology, what drives it, above all else, is normalizing insulin. So when you have insulin, it's fascinating. Insulin is very, very, very engaging with fat cells. And insulin is pretty simple. It's a master switch. And this is, oh, this is going to bring us full circle to Reda True type. Why does Red A True, what makes it so unique? So we talk all about insulin resistance. Insulin resistance is a byproduct of a failed system, lifestyle mediated. Insulin itself is not bad at all. Think of, you remember Goonies? Did you ever see a movie, Goonies? Of course, yeah. You know, sloth? I don't remember. Chunk. Yeah, yeah, yeah. You know, chunks, the big ball guy, the one, the guy they kept in the basement. The sloth? I had to look that name up by. Think of insulin as sloth. It's like the big, dumb, older brother. He's not intelligent, but he's highly protected. Yeah. Okay? That's what insulin is to the human body. It's protecting the human body from the most toxic, poisonous agent. This is a true statement that exists in circulation, which is glucose. Okay. I said it. Yes, you did say it. But that doesn't have anything to. Don't. That's not carbs. That's not sugar. It's glucose in your bloodstream. How often do you fast? It depends on what my current, the period that I'm in at any given time. So I will always fast intermittently, whether it be weekly, monthly, duration changes. But if I'm in a structured growth period. So I'm my training. intensity, rep range, nutrition right now. I'm on a 1.2 grams per pound, protein intake. So everything's geared towards muscle growth. I'm anticipating probably about a three-month interval. Okay. So during that period, the focus is growth. I'll use fasting once a week or every other week just to make sure that I'm accounting for that repair upgrade. And how long are you doing it for? 36 hours, you said? I typically, it's 34 to 36 hours. And here's why. The problem, the problem. with fasting, why does it go sideways? It's because no one knows what they're actually trying to accomplish. I think you were saying this. I know people who have fasted seven days, 10 days. Five days. There's a five-day pass. To clean out the senescent cells, autophagy. That's what I've heard. But how do we know that's happening in five days? Because I will prove it to you, if you look at my clinical data, that's for some people, in five days of fasting, they still haven't. clear their glucose store sufficient to induce ketosis, which is ketosis autophagy are linked, linked pathways. Five days, someone, I had a client who's fasting glucose was still above 100. Do you know what that? That is insane. We live in a overfueled, undermoving society. Okay. Obesity is a disease. It's a pathology of overfueling, right? And so if you're overfueled, under-muscled, and you don't move, welcome to America. That's the problem. So for some people you're saying five days might not touch them? Yes. 100%. So they go two weeks? Well, who knows, right? It's, if, would you ever get into an airplane where you know full well the instrument panels out? No. Of course not. No one's going to do that. So that's exactly what you're doing when you randomly pick a number that you heard Joe Rogan talk about in fast for X number of days. There's zero data. The difference, the crux of the whole conversation is that your body actually will tell you the exact prime time duration of your fast. And it will change over time. It should. So how do you know for you? I follow serum ketones. Tell us me exactly where I need to be. So how do people do this? Well, right now, I'll tell you two things. One option is poking your finger. If you've ever seen like a diabetic poke their finger. Okay. That's old school. Yeah. There is a product made by Sibio, S-I-B-O. It is the first. continuous ketone monitor. People wear glucose monitors. Yeah. Now I'm wearing a glucose monitor, continually checking glucose, and continually checking ketones. That has totally changed the game for me. Not currently, no. But I do. Okay. Yeah, no, I don't have a, because I ripped my monitors off pushing a sled the other day. Oh. I was kind of irritated. My guy was beating me down and I was just like put, and I ripped them all out. So anyway, I got to put new ones on. And I don't wear them all the time. Just use the, this is the criticism around CGM and the general population. Oh, my gosh, you know, people are just getting a bunch of data. Well, if it's data that is understood and interpreted and applied, it's incredibly valuable. If it's just numbers on sheet, sure, it's worthless. Okay, so if someone just starts today, we used to say just do 24 hours, 36 hours. No, we have, no, it's about the goal. If they want to clean up the senescent cells, and they want for body composition, and they want all the. at all. Reset. Yeah, of course. Right. So the relationship very plainly, and I will be honest, as a purist, I don't have human data, specifically antisenessant data or autophagy-based data, very hard to do outside of like an academic lab. But the clearest correlation through a common pathway of ampK upregulation is that more ketones equals more autophagy. It's a very simple way to look at it. So your speedometer is all the same, right? So if that speedometer is going up, you're producing more ketones. You are by definition accelerating autophagy while you're also accelerating fatburn. The beauty is you're getting lean and fit and looking your best while you're clearing the bad stuff. This is why it drives me nuts. All the longevity experts are like biohack this, biohack this, just fast, shut up and fast. You'll be just fine. Really? And guess what? It's free. In fact, actually, you save money. Yes. If you saw the amount of food I eat on a regular basis, my fast saves me $100 at least. Easy. Really? I mean, are you not hungry? No, not even slightly. Not even slightly. Are you able to work out on that, though? Good question. So yes and no. I would be very strategic about focusing. So movement is everything during a fast. Okay. Let's do this. So if you'll buy that, there is a directed relationship, more ketones, more autophagy. So that's your ultimate longevity tool. More ketones only comes from one source. There's not like option A or B. Okay. If you have ketones in your bloodstream, they are coming from fat being broken down into free fatty acids and distributed in the bloodstream. This is the mechanism with which it happens, okay? and the only thing that controls that is insulin. How do we know that to be true? Look at a type 1 diabetic. Do you know what kills type 1 diabetics? Acutely is something called diabetic ketoacidosis. When you have no insulin in your bloodstream, your fat just starts getting chewed through. More fat in the bloodstream, which is what we want, right? Fat burn. You want to be lean fit equals more ketones. It's a linear relationship. Yeah, no, I'm following. Does that mean the same for, but women and men are different? Yes, it means the exact same. No, women and men are humans. So it doesn't matter. Sorry. So I thought like women is different with hormones and all these things. We'd like you to believe that. Okay, this is another aside. Stay with me. There is something on the horizon, okay, that is going to transform our understanding of women's health. There's a company called Quinn Labs, okay? I met their founder, oh, some A4M event, I think. You go to A4M? Yeah. What are you going there for? To learn to. Oh, okay. Yeah. I want to know what's happening. Do you speak there? I'm hopeful. I submitted my application. I'm hopeful to speak this year, yeah. Oh, okay. On Longevity Fest? Yeah. Yeah, I really, I clearly have a lot to say. Clearly. I don't hold anything back. No, no, no. And I can put a crowd to sleep with the monotone. Yeah. No, no, no. You're doing great. You're not putting me asleep. I do need another magic mind. No, sorry, go ahead. Yes, so the relationship, though, is very clear. So what I stress to people is you have knowledge. It's not the duration. It's the intensity. Just like it's not the duration of exercise. It's the intensity, right? If you can accomplish whatever muscle growth that is max benefit for your aesthetic, for your performance, episode in 30 minutes versus an hour, which do you pick? 30. Of course. If you could put a million dollars in your bank account in one month guaranteed, or you could kind of slave away for the next five years and maybe. Of course, a month, yes. So the only thing I haven't proven yet, which is where I'm headed with this in my clinical practice, is that indeed, the intensity of ketosis correlates to the intensity of autophagy, meaning the higher the ketosis, the higher the autophagy. So what if you could do max cellular cleanup that the literature, the scientific evidence, says five to seven days of non-eating, well, if you could accomplish that in 34 hours. I'm doing 34 hours every time. It's a no-brainer. Because the problem with prolonged fasting is starvation physiology. Cortisol spikes. Cortisol is the most catabolic hormone in the body. Start breaking down muscle. And the tragedy is, and this is why I monitor for all my clients, we monitor glucose and ketones. Because I can tell you when your cortisol spikes. How? On a dime. Well, your glucose spikes. And guess what happens when your glucose spikes? spikes. What? Insulin. And guess what happens when insulin happens? No more fat burn. And you're done. So people are going through a fast. They may have a cortisol dump, shift into what's called, I would call it starvation physiology, but they start breaking down muscle in producing glucose in the bud stream. Insulin hits, and all of a sudden their ketones go to zero. So you're saying women, like premenopausal women with hormones and all these things should be fasting? Absolutely, a trillion percent. A trillion percent. And I'll tell you, so this goes back. So what's Quinn Labs doing? Right. They're bringing a wearable to market. It's going to start as a finger stick, just like I'm talking about for ketones. So write these things down. Sybio, continuous ketone monitoring, going to change the world. Quinn Labs essentially continuous or frequent interval estrogen and cortisol. This is going to