← The Peter Attia Drive

#365 ‒ Training for longevity: A roundtable on building strength, preventing injury, meeting protein needs, guidance for women and youth athletes, and more | Gabrielle Lyon, Mike Boyle, Jeff Cavaliere

Sep 22, 2025 2h 15m 90 insights
<p><a href="https://peterattiamd.com/trainingforlongevity/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=250922-pod-trainingforlongevity&amp;utm_content=250922-pod-trainingforlongevity-podfeed"> View the Show Notes Page for This Episode</a></p> <p><a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=250922-pod-trainingforlongevity&amp;utm_content=250922-pod-trainingforlongevity-podfeed"> Become a Member to Receive Exclusive Content</a></p> <p><a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&amp;utm_medium=referral&amp;utm_campaign=250922-pod-trainingforlongevity&amp;utm_content=250922-pod-trainingforlongevity-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a></p> <p>In this special episode of The Drive, Peter hosts a strength and conditioning roundtable with three experts in the field—Gabrielle Lyon, Jeff Cavaliere, and Mike Boyle. Together they explore why maintaining muscle mass, strength, and power is essential for healthspan and longevity, and examine how resistance training supports metabolic resilience and injury prevention across the lifespan. The conversation covers practical strategies for getting started and staying consistent, the importance of a protein-centered diet tailored to age and activity level, and approaches to resistance training for peri- and post-menopausal women—including tendon care and optimal programming. They debate single-leg training versus heavy bilateral lifts, share knee-friendly lower-body options, and highlight exercises that belong in the "graveyard" due to poor risk-reward ratios. Finally, the group discusses youth sports specialization, emphasizing the long-term value of variety for developing lifelong athletes.</p> <p><strong>We discuss:</strong></p> <ul type="disc"> <li>Personal career journeys and philosophies of each guest that shaped their approaches to strength, conditioning, and lifelong health [3:30];</li> <li>Why so few people engage in resistance training despite its proven health benefits [8:30];</li> <li>Mike's low-stress, high-consistency method for training beginners to resistance training [18:45];</li> <li>How resistance training enhances metabolic health and body composition even in lean, highly active endurance athletes [25:30];</li> <li>The dominant role of nutrition in shaping physique and achieving low body fat, the synergistic effect of resistance training, and the unrealistic expectations about muscle growth and fat loss [28:30];</li> <li>Why Jeff advocates for five meals a day, and why meal timing matters less than overall protein intake and caloric consistency [38:00];</li> <li>Optimizing protein for every stage of life: quality, quantity, and guidelines for diverse diets and body types [44:15];</li> <li>The advantages of unilateral lower-body training over heavy bilateral lifts: impact on strength, athleticism, recovery, and functional movement [51:45];</li> <li>Rethinking heavy squats and deadlifts: risk-reward, aging bodies, and the case for reverse lunges and other single-leg alternatives [1:01:15];</li> <li>Adapting with age: Gabrielle on injuries, hip dysplasia, and the shift to smarter training [1:10:15];</li> <li>Exercises that belong in the "iron graveyard": unnecessarily risky exercises and their safer alternatives [1:19:15];</li> <li>The downside of early sports specialization in children and the long-term benefits of encouraging kids to play multiple sports [1:25:00];</li> <li>Advice for preventing an Achilles injury: calf strength, ankle mobility, and listening to pain signals [1:33:15];</li> <li>Shoulder pain: how to keep training the upper body when shoulder pain limits pressing movements [1:40:45];</li> <li>Effective strength training strategies for women before, during, and after the menopausal transition [1:43:15];</li> <li>Best practices for strength training and athletic development in children, and the pitfalls of early sports specialization [1:50:30];</li> <li>How to foster healthy habits and an interest in fitness beyond playing sports [2:00:00];</li> <li>Something each guest has changed their mind about in the last five years [2:04:00]; and</li> <li>More.</li> </ul> <p>Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a></p>
Actionable Insights

1. Address Sarcopenia in Health Strategy

Recognize that solving the adiposity problem is insufficient; a comprehensive health strategy must also actively address and prevent sarcopenia (muscle loss) for long-term health.

Actively engage in specific, intentional training to reduce the rate of physical decline as you age, understanding that while aging is inevitable, its pace can be significantly influenced by consistent effort.

3. Prioritize Injury Prevention for Longevity

As you age, prioritize injury prevention above all else in your training, as devastating injuries can lead to prolonged setbacks and make it extremely difficult to return to activity.

4. Increase Skeletal Muscle Mass

Prioritize increasing skeletal muscle mass, as it helps improve body composition, correct rising glucose levels, and reduce visceral fat, even for lean individuals who are highly active.

5. Consume Minimum 100g Protein Daily

Aim for a minimum daily protein intake of 100 grams for both men and women, as this is the starting point for adequate protein consumption, regardless of body weight.

6. Prioritize High-Quality Animal Protein

Focus on high-quality animal-source proteins (eggs, dairy, fish, chicken, beef) not just for amino acids, but also for essential bioavailable nutrients like calcium, iron, zinc, and selenium, using plants primarily for fiber and phytonutrients.

7. Personalize Diet by Health Status

Tailor your diet based on age, activity, and metabolic health; if metabolically unhealthy, maintain or increase protein intake during calorie restriction to protect lean tissue.

8. Calculate Protein for Target Weight

For overweight individuals, calculate protein intake based on your target body weight (e.g., ideal body weight at 16% body fat) rather than your current weight, to support lean tissue.

9. Prioritize Digestive Health with Fiber & Water

Actively prioritize digestive health by consuming more fiber and drinking more water, as chronic dehydration and fiber deficiency can lead to serious issues like the need for bowel resection.

10. Increase Daily Fiber Intake

Consciously increase your daily fiber intake by adding fiber supplements, incorporating it into shakes, and actively checking fiber content in all foods you consume.

11. Prioritize Balance Training for Aging

Dedicate time to balance training as you age, as declining reaction times, proprioception, and strength increase the risk of falls, which can severely impact quality of life.

12. Practice Balance with Eyes Closed

When practicing balance (e.g., standing on one leg), close your eyes to simulate real-world fall conditions and train your proprioceptive sense without visual feedback, which is crucial for preventing falls in the dark.

13. Advance Balance with Head Turns

For advanced balance training, while standing on one leg with eyes closed, slowly turn your head to further challenge your proprioceptive system and improve stability in dynamic, low-visibility situations.

14. Commit to Two Workouts Weekly

Consistently showing up for just two workouts per week for a year, even without extreme intensity, will lead to remarkable physical changes and improvements.

15. Aim for 75 Hard Minutes

Target at least 75 hard minutes of exercise per week, as this is a realistic and achievable commitment that can lead to significant improvements in health.

16. Cultivate Discipline for Results

Even if you don’t enjoy the discomfort of exercise, cultivate discipline to push through, as seeing results over time can become a powerful motivator to continue.

17. Avoid Post-Workout Crippling Pain

For beginners, training should not leave you crippled the next day; aim for slow, steady progress (1% better) to ensure comfort and consistency, preventing discouragement.

18. Prioritize First 15 Minutes of Warmup

Dedicate the first 15 minutes of your workout to foam rolling, stretching, and mobility work to address tissue limitations, which is crucial for injury prevention and overall health, especially for adults.

19. Complete Hour-Long Workout Protocol

Follow a comprehensive hour-long workout protocol that includes foam rolling, stretching, mobility work, dynamic warm-up, medicine ball throws, jump training, 36 minutes of lifting, and achievable conditioning, ensuring you’re in and out efficiently.

20. Implement Progressive Overload

Achieve progress in strength training by consistently advancing the weight, reps, or sets, with a primary focus on gradually increasing the weight lifted.

21. Simplify Resistance Training

Don’t overcomplicate resistance training; a strong foundation can be built with just six core exercises: row, squat, deadlift, bench, pull-up, and curl.

22. Adults: Avoid Barbell Squats/Deadlifts

For adult clients, avoid barbell bench presses, deadlifts, and squats, opting instead for unilateral lower body exercises due to better safety and efficacy.

23. Leverage Unilateral Strength Advantage

Incorporate unilateral (single-leg) training, as research suggests you can be stronger and have more strength capability on one leg than on two, making it highly effective for lower body development.

24. Embrace Unilateral Training for Athletics

Embrace unilateral training, as it aligns with our natural neurological wiring for movement (e.g., jumping off one foot) and can lead to superior athletic development compared to bilateral lifts.

25. Choose Single Leg Training Over Bilateral

Opt for single-leg training over heavy bilateral lifts, as it offers equal or superior benefits without compromising results, especially when considering injury prevention.

26. Incorporate Reverse Lunges

Make the reverse lunge a staple in your lower body training, stepping backward and slightly out to maintain a wide base for support, making it a safer and highly effective strength exercise.

27. Refine Reverse Lunge Technique

When performing reverse lunges, slightly rotate your torso towards the front leg as you descend; this ‘screws you into place’ and enhances stability for the working leg.

28. Learn Goblet Squat and Sumo Deadlift

Learn and practice the goblet squat and sumo deadlift, as these are foundational movements that can be safely taught and provide excellent benefits without the risks associated with barbell back squats.

29. Use Goblet Squat to Learn Form

To learn proper squat mechanics, hold a dumbbell or kettlebell between your hands and allow the weight to guide your body straight down, as this naturally positions you biomechanically for a perfect squat.

30. Master Bodyweight Squat Baseline

Ensure you can competently perform a bodyweight squat, as this is the functional baseline for daily activities, then progress to unilateral exercises for loading and strength development.

31. Substitute Upright Rows with High Pulls

Avoid upright rows due to their potential for shoulder impingement; instead, perform high pulls by keeping elbows lower than wrists and externally rotating the shoulder, achieving the same benefits without the risk.

32. Substitute Unsupported Chest Flies

Avoid unsupported bench chest flies due to the risk of overstretching the shoulder capsule; opt for safer alternatives like a fly machine or floor flies, which provide eccentric overload with less injury risk.

33. Replace Risky Exercises with Safer Alternatives

If an exercise carries significant risk without offering unique benefits, replace it with a safer alternative that delivers equal or superior results, especially for injury prevention.

34. Incorporate Ample Rowing for Shoulder Health

Perform a lot of rowing exercises to improve posture, balance out shoulder imbalances, and enhance joint range of motion, which can aid in recovery from shoulder injuries.

35. Use Standing Cable Press for Shoulder Pain

If experiencing shoulder pain, incorporate standing cable presses into your routine, as it’s often a pain-free alternative that allows you to continue training your chest and shoulders effectively.

36. Restrict Movement for Healing

Don’t be afraid to temporarily restrict your training to a single, pain-free movement (e.g., standing cable press) to allow an injured area to heal, with the goal of eventually returning to other exercise variants.

37. Acknowledge and Address Pain

When assessing pain during exercise, treat any equivocation (e.g., ‘only after I warm up’) as a ‘yes,’ indicating that the movement hurts and requires investigation and modification.

38. Maintain High Form Standards

If you are an athletic individual or lifelong exerciser, hold yourself to a much higher standard of form, as the ability to compensate can mask poor mechanics and lead to injury over time.

39. Avoid Repeated Harmful Exercises

If an exercise consistently causes pain or injury, no matter how minor, re-evaluate its necessity and consider alternatives, as repeatedly engaging in harmful movements is counterproductive to long-term health.

40. Prevent Achilles Injury with Calf Mobility

To minimize the risk of Achilles tendon injury, regularly foam roll and stretch your calves (including the soleus and tendon), and perform basic ankle mobility work like ankle rocks.

41. Utilize Front Foot Elevated Exercises

Incorporate front foot elevated exercises (e.g., placing toes on a plate) to better engage the foot and gastrocnemius muscle, which can be beneficial for ankle mobility and Achilles tendon health.

42. Improve Ankle Mobility for Joint Health

Prioritize improving ankle mobility and addressing tight calves, as poor ankle mobility can lead to compensatory issues and pain in the knees and other joints.

43. Enhance Ankle Mobility to Reduce Achilles Risk

Increase ankle mobility and reduce calf tightness to decrease tension on the Achilles tendon, thereby significantly lowering your risk of a devastating Achilles injury.

44. Strengthen Calves with Seated & Standing Raises

Strengthen both the gastrocnemius and soleus muscles by performing equal amounts of seated and standing calf raises to ensure comprehensive calf development and ankle support.

45. Optimize Sleep for Ankle Mobility

Be mindful of your sleep position, especially if blankets keep your feet in a plantarflexed position for extended periods, as this can hinder ankle mobility and calf flexibility.

46. Dedicate 5 Minutes to Ankle Mobility

Integrate an additional five minutes of dedicated ankle mobility work into your routine three to four times a week to proactively address and reduce the risk of Achilles tendon injuries.

47. Avoid Training Sore Calves

Do not train or engage in intense activities if your calves are sore, as pushing through calf strains can significantly increase the risk of an Achilles tendon tear.

48. Achieve Aesthetics Through Nutrition

Achieving a very lean physique (e.g., 7% body fat) is primarily a result of consistent nutritional discipline and sacrifices, not specific training splits or exercise routines.

49. Maintain 90% Nutritional Consistency

Aim for at least 90% consistency in your meals (e.g., 32 out of 35 meals per week), as this level of discipline allows your body to overlook occasional imperfect meals and achieve desired results.

50. Eat More Frequent Protein-Centered Meals

To better manage hunger and improve portion control, especially for those seeking nutritional discipline, incorporate two additional protein-centered snacks between main meals.

51. Ignore “Don’t Eat After 6” Rule

Disregard the ‘don’t eat after 6 PM’ rule, as your body, especially with sufficient muscle mass, can effectively utilize calories, protein, and carbohydrates whenever they are consumed throughout the day.

52. Aim for 1:1 Protein-to-Carb Ratio

Consider aiming for a one-to-one ratio of protein to carbohydrates at each meal, depending on your metabolic health and activity level.

53. Prioritize Exercise Post-Growth

Once you are done growing, shift your metabolic focus from insulin usage to exercise stimulus, as resistance training becomes critically important for maintaining an anabolic response.

54. Prepare for Menopause with Fitness

Women should prioritize fitness and strength training before perimenopause and menopause, as being fitter going into these phases significantly improves metabolic health and daily life activities.

55. Maintain Foundational Training in Menopause

During perimenopause and menopause, women should continue to follow foundational principles of strength training, hypertrophy, and cardiovascular activity, as specific training alterations based on sex are not strongly supported.

56. Challenge Underachievement in Women’s Training

Women should be encouraged to push themselves more in the weight room and challenge the tendency to underachieve, as their internally driven nature can sometimes lead to not lifting as heavy as they are capable.

57. Incorporate Weekly High-Intensity Cardio

For women, incorporate aggressive intervals or a VO2 max workout once a week to significantly elevate your heart rate, which is beneficial for cardiovascular health and overall fitness.

58. Utilize Airdyne/Assault Bike for Cardio

Use an Airdyne or Assault bike for cardiovascular training, as it is a highly efficient way to challenge your cardiovascular system with minimal orthopedic stress or injury risk.

59. Address Female Knee Valgus Tendency

Women should be aware of and actively coach against the tendency for knee valgus (knees caving inward) during activities like jumping, as it places increased stress on knee ligaments and can be addressed through proper positioning and strengthening.

60. Use Bands to Correct Knee Valgus

To correct knee valgus, especially in women, use a resistance band around the knees during jumps and landings to teach activation of the hip abductors, improving knee stability.

61. Be Aware of Hormonal Laxity in Women

Women should be aware that hormonal fluctuations throughout the month can increase joint laxity, potentially making them more susceptible to certain stresses and injuries during training.

62. Focus on IMAT, Not Just Body Fat %

Shift focus from overall body fat percentage to intermuscular adipose tissue (IMAT) as a more predictive metric for disease and metabolic health, especially insulin resistance.

63. Delay Formal Gym Training for Kids

Allow children to be kids and engage in unstructured play (playground, bike, swing set) rather than formal strength and conditioning training before age 11, as early specialization can be detrimental.

64. Prioritize Form Over Strength for Kids

For children starting resistance training, prioritize teaching proper lifting form (e.g., goblet squat, sumo deadlift, clean, chin-up, push-up) over immediate strength gains.

65. Debunk Stunted Growth Myth for Kids

Dismiss the myth that weightlifting stunts growth in children; the misconception originated from studies on malnourished child labor, not properly supervised resistance training.

66. Reconsider High-Impact Youth Sports

Be cautious about highly aggressive and specialized youth sports like figure skating and gymnastics, as they can place extreme physical demands on young bodies, potentially leading to long-term issues.

67. Coach Kids on Exercise Form and Feel

When teaching children exercises, focus on proper form and biomechanics, and clearly explain where they should feel the movement, as they may lack awareness of how to perform ’exercises’ correctly.

68. Start Kids with Bodyweight & Assisted Lifts

Begin children’s training with bodyweight exercises to learn mechanics, then use assisted lifts like a goblet squat (dumbbell/kettlebell) to help them learn proper form by guiding their center of mass.

69. Emphasize Slow, Controlled Movements for Kids

Teach children to perform exercises slowly and with control, as attempting to speed through movements often compromises good form and can lead to bad habits or injury.

70. Foster Lifelong Activity Through Youth Sports

Use youth sports to ignite a passion for lifelong physical activity, recognizing that the primary goal is to establish health habits that extend far beyond competitive play.

71. Prevent Youth Sports Burnout

Be mindful of overdoing youth sports, as excessive specialization and pressure can lead to children developing a lifelong aversion to athletics by their late teens.

72. Encourage Early Movement for Tendon Health

Encourage children to engage in physical activity and movement from a young age, as earlier exposure to activity helps develop more resilient tendons, reducing injury risk later in life.

73. Avoid Early Sports-Specific Training

For children (especially under 12), avoid sports-specific training in the weight room; focus on general athletic development, as 90% of training is universal, and sport-specific nuances are irrelevant at a young age.

74. Diversify Kids’ Sports Activities

Encourage children to participate in a variety of sports and activities beyond their primary interest to develop general athletic attributes and prevent early specialization injuries.

75. Prioritize Broad Skill Development for Youth

For children, prioritize broad skill development through diverse activities like swimming, water skiing, or other sports over early specialization and year-round competitive play, even if they express strong interest in one sport.

76. Avoid Early Specialization in Youth Sports

Resist the pressure for early sports specialization, as broad sampling of activities tends to produce better athletes in the long run, rather than early succeeders who often benefit from early maturation.

77. Broad Sports Sampling Up to Age 12

Encourage the broadest possible sampling of sports and physical activities for children up to age 12 to develop a wide range of general athletic attributes.

78. Encourage Diverse Movement Skills for Kids

Even if a child loves one sport, encourage participation in diverse activities like swimming and soccer to develop a broad range of movement skills and overall athleticism.

79. Enroll Kids in Combative Sports

Encourage children to participate in combative sports like judo, as it teaches valuable life lessons about self-reliance and resilience.

80. Consider Gymnastics for Early Development

Enroll young children in activities like gymnastics to foster fine motor skills, overall physical development, and musculature from an early age.

81. Reduce Overuse in Youth Sports

Re-evaluate extensive and multiple seasons per year in youth sports, as the high volume of repetitions and mileage contributes significantly to increased injury rates, including Achilles tendon tears.

82. Avoid Heavy Bilateral Lifts for Athletes

For elite athletes, be cautious with very heavy back squats and deadlifts, as they may dampen the nervous system and potentially hinder athletic performance, making unilateral alternatives preferable.

83. Learn from Olympic Lifters & Rehab

To improve athletic performance and functional movement, study the training methods of Olympic lifters and rehabilitation protocols, which often emphasize unilateral and closed-chain exercises.

84. Prioritize Client Retention

For coaches and trainers, focus heavily on customer service and building relationships to ensure clients feel comfortable and motivated to consistently return for workouts.

85. Build a Supportive Community

Create a comfortable and welcoming community environment in your gym or training group to help people feel a sense of belonging and encourage consistent attendance.

86. Engage New Clients Actively

For new clients, text them on the day of their first workout and the following day to check in on their experience and how they feel, fostering a relationship and encouraging their return.

87. Follow a Structured Program

Adhere to a structured, ‘recipe-like’ training program rather than picking exercises from a ‘menu,’ as consistency in a well-designed routine yields better results.

88. Challenge Self-Imposed Limitations

Re-educate yourself on your physical capabilities, recognizing that you might be stronger than you think (e.g., lifting a 40-pound toddler vs. a 40-pound weight), and challenge self-imposed limitations in strength training.

89. Support Podcast for Exclusive Content

Become a premium member by subscribing at peteratiyahmd.com/subscribe to access exclusive content and benefits, taking your knowledge of health and longevity to the next level.

90. Prioritize Family, Appreciate Small Wins

Intentionally prioritize time with your children and learn to appreciate their daily ‘wins,’ fostering gratitude and ensuring you don’t take precious moments for granted.