 So, consider that, that your 60-year-old self is a continuation of you today. It will remember the aspects of this conference. It will remember that guy telling you you should think about your future self. It's the same lifespan. So, with that in mind, we start with strength and muscle mass, because that's what we care about at this age. Sarcopenia is a loss of muscle mass through aging. It's an inactivity thing. Most of it is not due to some sort of inbuilt genetic or phenotypic expression. Well, the phenotypic expression is you've been sitting on your ass, and that's why all the muscle went away, because that doesn't require much. Muscle is required for strength. The loss of muscle means loss of strength. And it's the only thing that's independently associated with functional ability in the elderly. To put it another way, what good is having an amazing heart if you can't get out of your chair? This is the ground in which every other function in your life arises from. And balance is in a magical lump of wonder stuff here. You need muscle tissue, and you need a sharp nervous system to enact those muscles in order to balance. And so, when you lose muscle, the balance goes away as well. They're not separate things. They're part of the same spectrum. So, to further drive this home with some science, this is going to be quite sciencey. You're going to see a lot of these references. I'm going to make it entertaining throughout. I'm going to put on my website the entire bibliography in case you're curious of what I'm referencing here. But in this particular 12-year study doing nothing, these individuals between 55 and 65 lose 20% to 30% of their strength just being sedentary. And just a year of strength training increases strength by up to 29% in women and bone mineral density in the hip and back. And if it does it in women, it's going to do it much better in men because we have a favorable hormone profile for this sort of thing. It doesn't mean women can't gain strength or puzzle clearly, but we do it even better. And if these individuals through training gain 28% and stop training, this particular study, 12-week study, they gain 28% strength on average. If they stop training for 31 weeks, almost triple the amount of time they're training, they only lose half of what they gained. And so when you're talking about a program you can stick with over the course of your life, people get hung up on doing enough, doing enough, kind of a perfect program. The reality is that your body, for your body, muscle is expensive, very expensive, and it's not going to slosh it off willy-nilly. Think about it like a corporation. If you train your muscle tissue, it becomes a highly paid VP. If you're sedentary, it's suddenly getting paid like a VP, but it's working like a mailroom intern, so your body will get rid of it. You have to make that muscle important to your body, and that's what keeps it on. And so over the course of a lifetime, here's how this might look. This is out of a book, Bending the Aging Curve by Joseph Signorelli. If you train over the course of your life, by the time you get to 90, you'll have roughly the amount of muscle of an untrained 50-year-old. And if you perform an intervention later in life, in middle age, you would still, at the age of 90, have the amount of muscle of an untrained 70-year-old. Again, those 20 years are way different than moving from the age of 20 to the age of 40. As far as functional ability is concerned, that is enormous. And they do this, they test this by pulling core samples of the quadricep muscles out of individual's training and check the... They do some staining to determine fast-switch motor units. And what tends to happen over the course of time is you get older, you get this atrophy fibrosis where fast-switch muscle fibers that don't get used, the powerhouses, the biggest, strongest motor units, they revert irreversibly to connective tissue and you can't get them back. So everything you need to be powerful to get you out of a chair, to move, to be quick, to climb a tree, to do whatever, it's not there and you can't train to get it back. So that's why even if you train, you're still much worse off than someone who's been training their entire life for the man's to rebuild and turn over those fast-switch motor units are there always. This is just a graph, right? Here's how it looks with MRI. So what you got here is a 40-year-old triathlete, slice MRI, look at that wonderful ham steak, and you compare it to the 70-year-old triathlete, also the exact same ham steak. In fact, he might be a little leaner if you look at the outline of the fat mass here. And then you compare it to a sedentary 74-year-old man. Let me just look at just how little bone mass he has, how there's all this intramuscular triglyceride going on, and these guys, it's very little. And so this was a survey study. These individuals, they trained three to five days a week. They didn't determine how they trained. Certainly not entirely with weights. But if you look at weight training studies, even late in life, what you'll see is that 12 weeks on 92-year-old men in this case, 12 weeks of resistance training increased the cross-sectional area by about 44%, and that's in 92-year-olds. And that's in a controlled environment. If you do something that's only, say, a B on a scale of perfection of a routine, it's not everything you can do, but it fits with your schedule. You won't ever have to have the perfect routine later in life. It's sort of like investing. You're going to get this compound interest working for you over time so that you don't have to try and save for retirement at 60 because you screwed up all of your life by not doing what wasn't perfect but was pretty dang good. Bone density. You wouldn't think this matters to men. Normally it doesn't. Normally we're heavier, we work harder, but our increasingly sedentary lifestyles, we start to see osteoporosis in men. It's the loss of bone. It's correlated with reduced function, frailty, and also downer's hump is actually a series of micro fractures in your thoracic spine, gradually contributing to you rolling over. Strength has to go down to proceed osteoporosis. If you are training, it's not just the loading of the skeletal tissue but where the muscles connect to the bones, they work and those get stronger. So you're constantly stressing your bone. It's a symbiotic relationship. You might have heard T-scores or bone density curves. Most of you are young enough now that you're still below where bone would naturally level off. 35 to 40 in men. Up to that point, you can continue to add to your bone mass and push that ceiling up. By the time you get to that point, you max out and all you can do for the rest of your life is maintain that level under the best of circumstances. It's another type of physiological headroom. So that's another reason why you should be training because if you have this giant space of extra bone, it's not anything you'll ever have to worry about later in life. In women, again, bone mineral density, strength and muscle mass, elderly women, they all improve with increases in physical activity, but strength training improves not only the bone density, but you also, before the bone manifest, you see a blood marker in both men and women show up called osteocalcin. And researchers were confused or say, oh, is this something that tells us that they tend to happen in strength and or body mass index studies and they say, oh, it seems to be that people with a good BMI exhibit a high number of this, but if you actually look at the data, it just means they're working hard enough. It's a blood marker that your bones are being stressed enough to grow. So you don't need to go and get bone density scans unless you're really paranoid about that or have that running in your family. So it has been shown to improve bone mineral density, but most studies are too short to show enough of an improvement, which would be 20%, to reduce the fracture from a fall. I mean, that's way off, but if you're stronger and you have more muscle tissue, you're going to prevent the fall. You won't need to prevent the break. And again, it doesn't take much to do that. Talking about body composition, fat mass in the abdominal region is the first step that leads to metabolic syndrome. Lean body mass shifts that profile away because adding body fat is basically turning you into women. It's a feminization process. The more fat you have, the testosterone to estrogen ratio starts to change. And so what ends up happening, you know, it's associated with aging and it also reduces the resting metabolic rate, which then proceeds to add even more body fat. And you know, I talk about, you laugh, oh, it's feminizing. Well, it is. I mean, the screen's bright, but you can see he's got a bit of gyno going on here. He's got this big, hard, pregnant belly. And that is what we talk about when we talk about metabolic syndrome. It improves it in men and women, where calories are controlled for and where they're not. So that's what I'm talking about with strength training is the force multiplier. It corrects all of your dietary indiscretions to a large degree, not entirely, but to a large degree. And it reduces visceral adipose tissue. This is in and around the organs. Insulates the organs, protects them from jarring, because you've got to think you're basically a cavity from the bottom of your rib cage to your pelvic floor. This doesn't expand very much. If you start to gain visceral adipose tissue, it's squeezing in on your organs, making them work harder to do the same stuff they would always be doing without an extra metabolic or biochemical benefit to you. They have to push out against it. Then this is why skinny guys, ironically, slide aside, win eating contests, because fat mass doesn't stretch. It doesn't. We think about fat guys, oh, they can put down a lot of food. Their stomach is no different, and that fat isn't going to budge. So that's why your tiny little ripped guys shove down 65 hot dogs, because they have room to expand. Your tissues don't have room and are getting internally crushed when you have a lot of visceral adipose tissue, which makes the heart work harder, which is why they call it heart attack fat.