Extend Podcast with Darshan Shah, MD

Episode 16: JJ Virgin—The Real Reason You’re Not Building Muscle (+ What to Do Instead)

Date: December 17, 2024
Guest: JJ Virgin, Four-time New York Times bestselling author, expert in fitness and nutrition

Episode Overview

This episode dives into why so many people—especially women—struggle to build or maintain muscle as they age, and what needs to change to actually achieve strong, functional, and metabolically healthy bodies. Dr. Darshan Shah and best-selling author and nutritionist JJ Virgin break down the science and actionable protocols around muscle growth, debunking old myths and presenting a fresh perspective on exercise, nutrition, longevity, and women’s health.
Topics include: differences in muscle fiber types, why muscle determines metabolic health, best assessment metrics, plateau-busting workout protocols, dietary priorities (especially protein), and supplementation for muscle and healthspan extension.

Getting to Know JJ Virgin & Her Passion (02:09–03:00)

• JJ describes herself as a lifelong fitness and nutrition enthusiast.
• She’s particularly excited about the new era of exercise science and its increased focus on women, stating,

  "We're finally actually looking at women. I love what Dr. Stacy Sims says: 'Women are not small men.' It’s really exciting." (02:54, JJ Virgin)

• Exercise physiologists are now leading voices in health and longevity, marking a shift from fitness as vanity to fitness for health and performance.

Outdated Fitness Myths & The New Science (03:47–05:40)

• Both guests emphasize the scientific link between exercise—especially strength training—and longevity.
• Debunking the concern that women get “bulky” when lifting weights:

  "Forty years of doing this, I’ve never seen a woman who is lifting weights and dialing in their diet get bigger; they get tighter muscles... your metabolic Spanx." (04:31, JJ Virgin)

• Cultural pressure on women to be skinny instead of strong is identified as misguided and damaging.

Personal Story: Choosing Strength Over “Skinniness” (06:17–07:02)

• JJ relates a pivotal experience as a teenager, being told to lose 20 pounds for modeling:

  "I started losing strength, and it was a moment that changed everything because I thought: do I want to be strong or skinny? And I chose strong." (06:57, JJ Virgin)

• “Strong is the new skinny” becomes a recurring theme.

Muscle, Metabolism & The Concept of “Skinny Fat” (07:14–08:16)

• Discussion of sarcopenic obesity (thin outside, fat inside—‘TOFI’).
• Building muscle increases metabolism and reduces risk of metabolic diseases.
• Dr. Shah:

  "Your metabolism lives in your muscle." (07:43)

Muscle as a “Retirement Account” & Realistic Gains (08:01–08:21)

• JJ stresses the importance of “packing on muscle as a retirement account.”
• Stresses the realistic rate of muscle gain (up to 2 lbs/month is excellent, especially for women).

Training Protocols for Men & Women—Aging “Powerfully” (08:47–11:06)

• JJ pushes back against the idea of “aging gracefully”:

  "Forget aging gracefully. No, we do not want to age gracefully." (08:47)

• Explanation of fast-twitch vs. slow-twitch muscle fibers and why fast-twitch training (power, sprint, CrossFit-type activities) is more important as we age, particularly for women.
• Critique of old advice:
  • "Don’t lift weights until you lose weight." (Myth she's debunking)
  • Avoidance of back extension exercises for those with bad backs is also called out as counterproductive.

Overcoming Injuries & Training Around Limitations (11:24–13:30)

• Both hosts share personal examples: JJ delayed a knee replacement for 30 years by building surrounding muscle.
• Darshan Shah highlights the shift in post-surgical care to early ambulation for better recovery outcomes.

Exercise Components & Prioritization by Age (13:30–18:31)

• Importance of distinguishing between:
  • Muscle mass, muscle strength, and muscle power.
  • Aerobic/VO2max training and balance/agility training.
• Muscle loss begins as early as age 30 (up to 1%/year), strength loss up to 4%/year, and power loss up to 8%/year (15:33).
• JJ’s rule: “Strengthen weaknesses,” not just strengths, in fitness routines.

Metrics: How to Measure Progress (18:31–23:53)

• JJ’s Protocol:
  • Dexa scan every six months for body composition.
  • Daily use of a bioimpedance scale for trends (total body water as a marker for muscle).
  • Weekly waist-hip measurements.
  • Grip strength as a proxy for muscle strength.
  • Push-ups and pull-up hang tests for functional strength (25:16).
• Power is measured through vertical jump and rate of movement, not just strength.

Functional & Compound Movements Are Key (28:08–29:24)

• Focus on compound, multi-joint exercises (pushing, pulling, squatting).
• Use of functional movements like squats, deadlifts, lunges, and overhead presses; isolation moves are secondary.

Programming, Plateaus, & Mixing It Up (31:09–34:34)

• JJ recommends 8–12 week programs to allow progression.
• Deloading, tapering, power weeks, changing set/rep schemes, and high-intensity functional training (e.g., HIIT circuits with movement snacks) are strategies to overcome plateaus.
• “You have to do those things that are hard and uncomfortable… Exercise is a controlled environment to do hard things so that when you get out in the wild, those things are easy for you.” (38:24, JJ Virgin)

Training Frequency & Practical Hacks (48:45–50:18)

• JJ targets each major body area 2–3 times per week.
• Integrates exercise “snacks” and movement throughout the day, not just in formal sessions.
• “If you’re not exercising, if you go to the gym, you do a flexed arm hang, some push-ups, and some air squats—winner, total winner. It all counts.” (50:18, JJ Virgin)

Cardio, Steps & VO2 Max Protocols (41:18–46:02)

• JJ prioritizes movement and step-count (8,000–10,000/day, with rucking vests for extra loading).
• High-Intensity Interval Training (HIIT) is favored, especially for women.
• Recommends the Norwegian 4x4 for VO2max: Four minutes hard, three minutes recovery, repeat four times (44:05).
• Notably, she isn’t as enthusiastic about long “Zone 2” training for women, preferring vigorous intervals and functional movement.

Protein: The Cornerstone of Nutrition for Muscle (59:00–62:18)

• Current RDA for protein is set too low; most women especially under-eat protein.
• Protein “phobia” among women is a real barrier.
• To maximize muscle, satiety, and metabolism:

  “Eat protein first. It’s the ultimate GLP-1 booster, you’re not going to have cravings. You’re going to be less hungry.” (62:18, JJ Virgin)

Notable Quote

“If all you did was take the same amount of calories and divert some off of fat and carbs and put it toward protein, you’d lose weight because you’d expend more calories in metabolism and you’d be less hungry.” (61:01, JJ Virgin)

Practical Protein Guidelines (67:56–69:12)

• Target range:
  “0.7–1g per pound of target body weight per day. If you can dose it to your fat-free mass, even better.” (67:56)
• More protein may be needed during injury, acute illness, or recovery periods.
• Higher protein intake is protective, not dangerous, for most people.

Carbs, Fats & “Protein First” Dietary Model (70:29–72:14)

• After setting protein, adjust carbs and fats based on activity level and metabolic health.
• Universal warnings:
  • The standard American diet (low protein, high fat AND high carb) is metabolically disastrous.
  • Ultra-processed food should be actively avoided.

    “Ultra-processed foods make up 70% of calories in the U.S. Mind-blowing.” (79:16)

Supplements: JJ’s Foundational List (83:45–92:13)

JJ’s Core:

• Creatine (her favorite supplement, especially for women):
  “I would be taking creatine from the time I was a teenager… It changes time zone adjustment, brain health, [and] muscle.” (84:38)
• Omega-3s (test index and personalize)
• Vitamin D3/K2
• Magnesium
• MitoPure (Urolithin A) for mitochondrial health
• NAD+ boosters (NR, NMN, or blends)
• Essential amino acids (especially for plant-based diets, women 40+)
• Collagen (for gut and skin)
• Electrolytes
• Oral BPC-157 peptides and PeptiStrong (currently experimenting)

Dosing Tip

• Creatine Monohydrate is most studied, but she’s optimistic about Creatine HCL for better absorption.
• For those worried about water retention: “Start with 1g, build up, and track with bioimpedance to confirm it’s intracellular water (good) rather than bloating.”

Fitness & Health for Women—Special Considerations Around Menopause (93:33–99:12)

• Begin muscle- and stress-building habits before menopause for best outcomes.
• Stress tolerance—“train your nervous system” with high intensity intervals.
• Hormone tracking: Get a panel in your thirties, use symptoms as guideposts for perimenopause changes.
• JJ shares a story about taking ginseng and noticing a need to lower her HRT dose, underscoring the importance of hormone receptor sensitivity.
• Menopausal women need to be pro-active with resistance training, stress management, and potentially bioidentical HRT, but lowest effective dose is ideal.

Memorable Quotes

• “Strong is the new skinny.” (06:57, JJ Virgin)
• “You don’t train to get better at the gym, you train to get better at life.” (28:41, JJ Virgin)
• “If you want to get fitter, don’t go to the... easy class. Go to where people are way stronger and fitter than you.” (36:39, JJ Virgin)
• “If your meal was protein, fat, fiber, you’ll improve your blood sugar and satiety. If you’re hungry between meals, you didn’t do it right.” (81:14, JJ Virgin)
• “We can be in our best shape ever in our 50s, 60s, 70s, and 80s. We have more knowledge, research, tools. I’m more excited now than I’ve ever been.” (99:44)

Timestamps for Key Segments

• 03:47 – What science says really matters for longevity: Muscle & VO2max
• 06:17 – JJ’s “strong over skinny” epiphany story
• 11:06 – The myth of not lifting weights until you lose weight
• 16:36 – Why building muscle in your teens and twenties matters
• 18:37 – How to use DEXA, bioimpedance, and grip strength to assess changes
• 28:41 – Compound vs. isolation movements (“Train for life, not just the gym”)
• 44:05 – Norwegian 4x4 HIIT method for VO2max
• 62:18 – Protein's unique impact on satiety and hunger
• 67:56 – How much protein do you really need?
• 79:16 – Ultra-processed food consumption stats
• 84:38 – Creatine for women (“favorite supplement on the planet”)
• 93:33 – What women need to know for menopause and hormone management

Actionable Takeaways

1. Prioritize Strength Training: It’s never too late, but women especially need to lift weights to extend healthspan.
2. Ditch the Scale: Focus on muscle mass, body composition, and functional metrics.
3. Protein First at Every Meal: Aim for 0.7–1g/lb (target body weight), distributing it across the day.
4. Track Your Progress: Use reliable tools: DEXA, body water scales, grip strength, and fitness benchmarks.
5. Move All Day: “Exercise snacks” and step-count targets are just as important as gym sessions.
6. Beat Plateaus by Mixing It Up: Vary intensity, rep schemes, and try different modalities regularly.
7. Supplement Wisely: Creatine, essential aminos, omega-3, vitamin D3/K2, and mitochondrial support are highly recommended.
8. Pay Attention to Hormonal Changes: Get tested early, track symptoms, and prioritize stress management.
9. Ultra-Processed Food = Trouble: The more you avoid it, the better your results.
10. Functional Movements Beat Isolated Ones: Train for real-life utility and longevity, not just aesthetics.

Where to Learn More

Find JJ Virgin and her new programs at:
jjvirgin.com

This summary captures all major protocols, philosophies, and actionable insights, delivered in the engaging, practical, and slightly irreverent tone that both Dr. Shah and JJ Virgin bring to the conversation. Perfect for anyone seeking to overhaul their approach to midlife (and beyond) muscle, fitness, and longevity.