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 It's not working.
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We're getting sicker.
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Every single year we're getting sicker, we're getting fatter, and we're getting more depressed as a country.
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And I think the key problem with this is that... Welcome to the School of Greatness.
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My name is Lewis Howes, a former pro athlete turned lifestyle entrepreneur.
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And each week we bring you an inspiring person or message to help you discover how to unlock your inner greatness.
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Thanks for spending some time with me today.
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Now let the class begin.
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 You went from, I guess, being a doctor to saying, well, how can I help people in a holistic approach to preventing chronic illness and disease?
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And I'm hearing you say that it starts with metabolic health.
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Is that correct?
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Yes.
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So what is metabolic health then for people and how can they optimize this?
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 Yeah.
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So, well, first of all, I think you hit the nail on the head.
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There is a movement and a tribe of doctors who are sort of waking up and realizing that we are missing the elephant in the room of modern American healthcare.
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And the elephant in the room is that, first of all, the vast majority of things that are killing Americans today are conditions based in our dietary and lifestyle choices over the course of our lifetime.
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 which means that we have a huge amount of agency in changing our fate in terms of these diseases.
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How many diseases would you say are caused by food and nutrition alone, our diet?
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 nine of the 10 leading causes of death in the United States are either not only just caused by food and lifestyle, but are directly attributable to dysfunctional blood sugar or are worsened by elevated blood sugar.
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Nine of the 10.
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What's the 10th one?
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Well, to go through the ones that were like what we're talking about.
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So we're looking at things like
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 Alzheimer's dementia, which is now being called type 3 diabetes because it's so related to blood sugar.
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Heart disease, type 2 diabetes.
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Cancer is very much driven by blood sugar.
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Chronic kidney disease, which is very much a problem of the small vessels in the kidney becoming narrowed in part because of metabolic dysfunction and erratic blood sugar control.
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 chronic lower respiratory infections of one of the leading causes of death.
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And we know that people with unstable elevated blood sugar have much higher mortality, even with something like influenza or pneumonia, having high blood sugar actually can get into the fluid of the lung and feed the bacteria that leads to some of these issues.
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And of course, with COVID, we've known now since the very beginning of the pandemic, that having metabolic dysfunction, diabetes is a key accelerator and driver of mortality.
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 and morbidity.
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There's some odd ones on there too.
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For instance, suicide is actually on the top 10 list of killers in the United States, and people with diabetes or metabolic dysfunction actually have higher risk of suicidality.
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So it's all across the board.
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So what's really fascinating is the way in which these dietary and lifestyle factors are essentially
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 linking so many of the conditions that are killing Americans today.
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And the way we've approached it is we've looked at these as all isolated silos.
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We think of them as all different things like, huh, we wouldn't treat diabetes the same way we treat cancer or kidney disease the same way we treat Alzheimer's.
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But when we look at these through the root cause approach that you talked about,
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 And sort of the fancy term for this in medicine is systems and network of biology.
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What is the network between diseases rather than how are they all different?
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When we treat at that level, it's so much more efficient and we can actually generate good health in the body as opposed to just reacting.
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 to symptoms and managing conditions.
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So I think that's what a lot of doctors are waking up to.
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They're sick and tired of being reactive, practicing sick care, practicing this end-of-the-line medicine, and they wanna help generate health in people's bodies.
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And that's a totally different way of practicing.
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 That's inspiring.
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And so what I'm hearing you say is blood sugar management or control is one of the key factors of either being healthy or potentially linking to one of these other, I guess, diseases.
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Is that right?
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 That's right.
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Yeah.
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And, and what it really comes down to, which kind of gets at your question of what is metabolism, um, metabolism is fundamentally the way that we make energy in the body.
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So we eat food and, you know, food has, um, you know, fat and glucose in it and either fat or glucose, glucose is sugar.
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 can be used to convert into a type of energy that our cells can use, which is called ATP.
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So we take in this substrate, but we have to convert it through our mitochondria in our cells to a form of energy we can use, a currency that our body understands and can use.
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That process of conversion is metabolism, and this is happening in every single one of the 37 trillion cells in our body, and it has to work properly.
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So break it down for me then.
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Fat or glucose?
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 Or I guess carbohydrates enters the body through the foods reading, right?
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What happens after that?
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How is it processed in the body through the cells through the mitochondria?
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How is it processed?
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Yeah, so looking at carbohydrates for instance They go into our digestive tract.
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They're broken down and absorbed into the bloodstream broken down into simple sugars and
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 like glucose and fructose.
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These go into the bloodstream, and let's say we're talking about glucose, which is blood sugar.
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This signals to the body, particularly an organ called the pancreas, to release insulin, which is a hormone.
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That hormone allows you to take that sugar out of the bloodstream through the cell membrane into the cell.
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Once it's inside the cell, it's broken down even further and then goes into the mitochondria to be
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 go through a chemical processing that then creates ATP, which is this molecule that can be then used to essentially power all the millions of cellular processes that are happening every second.
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ATP is the power.
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It's the fuel.
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It's the battery in our body.
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 Okay, and so the way it's processed is it's based on the foods we eat, whether it be fat or sugar that comes through.
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Does that determine how the quality of the energy or what does that mean?
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Is it all equally the same when it converts in ATP or?
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 Well, I think the way to think about it is to really focus on the mitochondria.
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This is the energy factory of the cell.
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This is the powerhouse of the cell.
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And the thing that people really need to understand is that our diet and our lifestyle in the modern Western world, so past 50 to a hundred years, so much of it is actually damaging the mitochondria of our cell and creating problems in that conversion process.
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So for instance,
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 When we eat too much sugar, okay, and these days the average American is eating a lot of sugar like a hundred times More than we were like a hundred years ago into the rest of human history It's like this massive overload of this substrate what that does is it causes stress on the mitochondria and creates damage and
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 One analogy I sometimes use is, imagine you had a factory that was making something like cheese, and all of a sudden you get 100 times more of the raw product, like milk, delivered to the factory.
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The workers would be like, we don't know where to put this.
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We can't work.
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They go on strike.
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There's nowhere to store it.
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There's no refrigerators.
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It would all go bad.
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All of a sudden, you actually
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 produce less cheese even though you have more substrate.
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We are giving so much of the substrate to the body that it's gumming up the system, it's breaking down the factory and creating problems.
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The molecular way this is happening is that each time you have these glucose spikes from eating these refined
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 Products or added sugars your body's releasing more of that insulin.
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It's saying okay more glucose in the bloodstream So we have to produce more insulin to get it out of the bloodstream and over time the body sees all this insulin Circulating and it's like we can't bring more of this into the cell.
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There's too much and so it actually puts up a block which is called insulin resistance, which is that a
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 Cellular process that leads you towards problems like diabetes.
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And so what's happening now is the body that's why you're storing fat or you're storing other Dead cells that you don't need to keep in the body I guess right or right because insulin is the signal saying tons of glucose around for energy So we don't need to burn fat for energy.
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So insulin is also a block on fat burning so it's this chemical signal saying too much glucose around blocking it from getting into the cell and also
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 telling the body not to burn fat.
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So of course, for people who are dealing with trouble losing weight, insulin is the hormone we really, really need to be thinking about.
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And so we reduce our insulin sensitivity.
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Now we have
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 lots of glucose circulating in the bloodstream, but it's not able to efficiently get into the cell.
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And then you've got all these other things that can hurt our mitochondria.
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And really a mitochondria energy-centric view of health can really help us.
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Some other things that can hurt the mitochondria are oxidative stress.
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So I know you talked about this a little bit on the podcast with David Perlmutter, but aside from glucose, eating too much fructose, so this comes with like sodas or fruit juice or things that have really high concentration of fructose,
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 It's not gonna actually stimulate insulin in the way that glucose does, but what it does is it goes into the cell and it's converted into something called uric acid.
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And that uric acid creates oxidative stress, which is sort of this damaging reactive molecule in the mitochondria and creates mitochondrial damage.
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So now, again, you've got more trouble processing energy in the mitochondria.
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Environmental toxins are actually a huge problem as well.
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They can directly damage the machinery of the mitochondria.
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So we're thinking about things like
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 pesticides and a lot of the fragrances in our personal care products and a lot of the, the, you know, fragrances and chemicals in our home care products, these things actually go into our bodies, damage our mitochondria, make it difficult to produce energy.
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Um, effectively chronic stress can damage our mitochondria through cortisol and through our stress hormones.
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So it's, it's interesting to think about how all these different aspects of modern life fundamentally feed down into damaging this precious
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 part of our cell that creates energy.
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And when we have... The mitochondria.
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The mitochondria.
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And when we have problems creating energy in our body, this can happen in any cell type.
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 Again, 37 trillion cells, dozens of organs in the body.
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Where this is showing up most prominently in the body is where you're going to see symptoms.
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And this is why metabolic dysfunction and blood sugar dysregulation can look like so many different things.
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It can masquerade as so many different symptoms.
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And in the conventional system, we see those all as separate.
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But when we think about it as this is actually just where a fundamental core problem is showing up in different
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 Cell types and so if you can address that you can potentially kind of melt a lot of things away So just as some concrete examples if metabolic dysfunction is showing up in the blood vessels Well, if it's sort of most prominently showing up in the penis that could look like erectile dysfunction if it's happening in the heart It could look like you know heart disease
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 Um, if it's happening in the liver, it could look like fatty liver disease.
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If it's happening in the ovaries, it could look like polycystic ovarian syndrome, which is the leading cause of infertility in the United States, which is a metabolic problem.
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Um, and if it's happening in the brain, it could look like Alzheimer's dementia.
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And so it's got all these different faces, but fundamentally is rooted in a core dysfunction in how our body is converting food.
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 to energy, and a lot of that has to do with this chronic overnutrition, overloading our cells with too much to process, gumming up these systems, and then the many other lifestyle factors like toxins, stress, sleep deprivation, and sedentary behavior that can also hurt the mitochondria.
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So blood sugar management and metabolism management, is that right?
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Is that the main things we should be thinking about?
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How does blood sugar and metabolism work together?
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 Yeah, so the way that those sort of things link up is that if your blood sugar is quite erratic, like let's say it's going up and down in big spikes and valleys.
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Every day, yeah, you're having lots of sugar, you're just eating poorly, you're stressed, you're overwhelmed.
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 The majority of foods on the shelves in our grocery stores now have added sugar, like well over 60%.
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So it's not unusual for an American to be on that blood sugar rollercoaster up, down, up, down, up, down.
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And that's called glycemic variability.
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And that process of glycemic variability is very damaging to our metabolism through the mechanisms we spoke about of causing insulin resistance by stressing the body to make
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 too much insulin over and over.
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But those high blood sugar spikes in their own right can cause damage as well.
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When your blood sugar acutely goes really high, like after eating a Pop-Tart or eating a pastry or something like that, or a big bowl of pasta, that spike can lead to inflammation.
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 it can lead to oxidative stress, um, because of the way that it's overwhelming our systems and creating free radicals.
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It can also cause a process called glycation, which is where sugar sticks to things in the body.
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Um, and so if you, if you can imagine if your concentration of blood sugar is really high, it's kind of going to just stick to things more like your blood vessels and proteins, and that's not good.
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That, that, that's like a signal for the body that something's wrong.
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And so, um, all of these things kind of coalesce to just creating
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 The more that we can minimize our glycemic variability and go from spikes and valleys to more gentle rolling hills, the better we are, the better we're going to basically be treating our cells.
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 It's not just the sort of cellular optimization we're trying to do.
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It's also the way you feel.
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I think a lot of us have had that experience where we have a really high-carb meal, a big dessert, and we feel like we kind of have a crash afterwards.
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It's like that post-meal crash.
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We feel lethargic.
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We may need to have another cup of coffee or even feel jittery after it, like a big high-carb meal.
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 We really understand how that works.
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The body sees a huge load of glucose from a high-carb meal.
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The body then surges out that insulin, overcompensates, soaks up all that glucose, and you crash.
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And in that crash state is when we feel fatigue.
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 It's potentially some anxiety and it's when people usually feel cravings.
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So by learning more To bring yourself back up because you've kind of crashed And I think the majority of American bodies are on that cycle because you think about what we eat It's like breakfast.
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It's cereal juice toast pop-tarts pastries and
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 you know, sweetened coffee beverages, that's all refined sugar and refined grains.
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Then you go to lunch and it's bread, tortillas, wraps, chips, you know, all of that stuff.
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And then you go to dinner, pasta, potatoes, whatever, and then it's dessert.
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And it's like, if you're just going along the normal American cultural treadmill of what's normal to eat,
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 you're on a glucose rollercoaster.
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And that means that your day might be highly labile in terms of the energy, mood, performance, cravings.
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And so learning just simple ways to balance out that glucose rollercoaster can be an amazing life hack and really a superpower for essentially getting your day under better control, making you feel better,
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 in the moment, and of course, creating the cellular conditions to set you up for long-term longevity and health and prevent that whole downstream insulin resistance cascade that we know is related to so many causes of death in the United States.
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 So let's speak to people that are listening or watching who maybe have active lifestyles, they like to work out, so they need energy for working out, they're driven, they're passionate in their careers or entrepreneurship, they have a lot of friends and activities they like to go to, so they need energy throughout the day.
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 How can they get the energy without the glucose rollercoaster happening?
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What are the best foods to be eating throughout the day?
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How many times should we be eating?
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And does it really matter, or does it really depend on each individual's body type?
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Yeah, so I think for the type of person you're describing, the key concept we wanna think about is achieving metabolic flexibility.
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So metabolic flexibility means that
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 we are able to use different forms of energy to make ATP based on what's available.
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And what I mean by that is if there's sugar around, we can efficiently burn sugar to make ATP, but if there's not, the body's fine.
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It's like, cool, we've got fat to use for energy.
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 The average person is not metabolically flexible and the reason is because they've been on the glucose rollercoaster.
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Their body is so used to seeing glucose that those pathways are super active and they're constantly on that sort of like craving hit.
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They want more of it.
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 they haven't really given their, because glucose is the preferential fuel the body will use, it's the first thing it's going to grab.
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It's kind of like that easier thing to use.
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It will never go and burn fat if there's glucose.
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It will not burn
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 significant amounts of fat if there's glucose readily available.
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So something that we can do, essentially train our bodies, is to give it opportunities to burn fat.
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So this is where you start thinking about things like time-restricted feeding or fasting or potentially doing a fasted workout, where you're actually kind of intentionally keeping your blood sugar levels in the low normal range.
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 Signaling to and of course the downstream effect of that it's gonna be insulin will be low because if you're not having a glucose spike then insulin will be low and That insulin being low takes away that signal to not burn fat.
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So now your body's like cool insulins low glucose is low I'm gonna tap into my fat stores when it starts to burn the fat exactly Exactly, and if you work out for in the morning without eating you're more likely to be burning fat.
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Is that what I'm hearing you say?
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That's right
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 And there's actually a lot of athletes that are using this type of metabolic science to their advantage.
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There's a whole community of endurance athletes now that are doing low carb training.
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And the purpose of that is that they don't want to be super dependent on glucose during their event where they're just like every half hour having to take a goo or a bar or an energy drink or something like that and have these big spikes throughout their
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 event instead they've actually trained their bodies to use fat during an endurance workout and There are literally marathoners now who will run the entire thing Fasted they can so efficiently burn fat But that's not that those pathways have to be kind of worked and developed to be able to do that and that's metabolic flexibility So how do you train metabolic flexibility for yourself?
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I?
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 I would say the key thing is to minimize these excessive glucose spikes, to give your body an opportunity to be more in the stable, healthy, low range for more time of the day, to keep insulin in a lower and healthy range so that your body knows to burn fat.
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One way that you can do this
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 is, of course, with a continuous glucose monitor, which are becoming popular now, wear it, see what spikes your glucose, modify it, and try and get to a more stable range.
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Interesting.
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Or measure your ketones, which a lot of people are doing now.
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And this is a finger prick device, or there are breath monitors.
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You can also check in your urine.
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And ketones are a byproduct of fat burning.
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 So if your ketones are super low or zero, it means you're not burning really any fat.
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And if your ketones are higher, like above 0.5 or up into the ones and twos, you are proving to yourself
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 that you have gotten to a state where your glucose and insulin are essentially stable enough that you're burning fat for energy.
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And so something I like to see if I'm tracking these things is, okay, if I've kept my glucose quite stable and low for a couple of days, based on the choices I'm making around diet and lifestyle, I start to see ketones rising up.
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And that to me is proof of metabolic flexibility.
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And I can test things like, okay, if I do the Peloton ride,
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 first thing in the morning after not eating, does it increase my ketones later in the day and start to do some experiments like that.
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And another thing that people can do is ask their doctor to do a fasting insulin test.
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It's not a test that's normally done on a regular yearly panel, but it's a really powerful test because again, if insulin is quite elevated, it's going to be kind of that block on fat burning.
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 And if insulin is a low and healthy range, it's a signal that your body's probably likely very insulin sensitive.
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You're not far down that insulin resistance pathway.
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I like to see it between about two and six and shockingly the reference range.
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And a lot of labs will say that like anything under 25 is normal, but that would be very, very, very elevated.
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And so you want it to be tight and low to know that you're just giving your body that opportunity to, to burn fat and to work those different pathways.
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SPEAKER_03
 So many people are talking about fasting or intermittent fasting these days.
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Is it different for men and women on the ways to fast in order to burn fat or is it the same for both?
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 You know, I would say it's different for every single person.
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And definitely for different genders, but it's different day to day.
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I think intermittent fasting and time-restricted feeding, it can be a stress on the body.
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And so I tend to think of it as, we've got a certain,
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 capacity within the body to manage different stressors.
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And we know that certain stressors can be helpful in building adaptations in the body to help us improve.
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So like cold exposure, heat exposure, fasting, high intensity interval training.
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 But there's also stressors in our life that are maybe somewhat out of our control, like work stress or family stress or things like that.
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And we don't wanna overload our body.
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And so if a woman is potentially in a part of her cycle, for instance, where her body's also already quite taxed,
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 You wouldn't do it then.
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You wouldn't do it then.
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And on a day that I'm, I don't have as much sleep on a day that, you know, I might be doing a big podcast or something like that.
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Like today, you know, I'm probably not going to add, you know, um, I'm going to be thinking very deeply about food though, because you also don't want to be eating a big meal and then crashing right during that time when you have to perform.
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So it's more about keeping things.
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 keeping things really stable and not being highly fluctuate, you know, fluctuating.
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Um, so I think about it more that way.
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I think that fasting is great if you're otherwise very well resourced, um, with sleep, um, with resilience, psychological resilience, um, not putting your body probably under intense physical stress during that time.
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I tend to do more like zone two workouts, you know, sort of low intensity during fasts.
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Um, so as not to,
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 add too much stress and ultimately too much stress can lead to breakdown and so kind of like bringing those things just thinking of everything in a really holistic picture.
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SPEAKER_03
 If you stress the body too much, does the blood sugar go up?
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Or what does that do to blood sugar and metabolism?
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SPEAKER_00
Yeah, stress has a fascinating relation with blood sugar.
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So psychological or physical stress can both cause blood sugar to acutely go up, even if you're fasted, even in the absence of any glucose.
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And the reason for this is that
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 Any stress signal to the body will release stress hormones like cortisol and catecholamine, like noradrenaline, epinephrine, things like that.
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These signal to the body that there's a threat.
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SPEAKER_00
And the body has trouble interpreting the difference between a physical or a psychological threat.
0
SPEAKER_00
And so it's going to produce the same stress hormones.
0
SPEAKER_03
So if there's an event that happens in life, let's call it something we witness or something we see or something we hear or experience.
0
SPEAKER_03
 We think of a thing that causes a stress hormone to go to the body.
0
SPEAKER_03
Is that what I'm hearing you say?
0
SPEAKER_03
There's a thought that we have associated with the event or the stressful or the thing that we think is stressful.
0
SPEAKER_03
And then that causes a stress hormone to enter the body.
0
SPEAKER_03
Does it go throughout the entire body?
0
SPEAKER_03
Does it go to the heart?
0
SPEAKER_03
What happens?
0
SPEAKER_03
And then does it just spike the blood sugar up?
0
SPEAKER_00
 Exactly, so it goes to the whole body and I would say simply put in many ways our mind has huge control over our metabolism.
0
SPEAKER_00
That's what it sounds like.
0
SPEAKER_00
Yes.
0
SPEAKER_03
Because we can think of thought and stress ourselves out and have high blood sugar just based on thought alone.
0
SPEAKER_00
You can think your way into metabolic dysfunction, I think.
0
SPEAKER_03
Can you think your way out of it too?
0
SPEAKER_00
 In in in some ways you can and it should be a part of our strategy for optimal metabolic health so the way it works is that These stress hormones they travel throughout the body and they actually tell the liver we've got a threat There's a lion chasing us.
0
SPEAKER_00
We need to run.
0
SPEAKER_00
We need to have fuel for our muscles so that we can flee You know, it's fight-or-flight so the liver
0
SPEAKER_00
 Actually stores about two hours of really quickly accessible glucose in the form of something called glycogen It's change of glucose and it's it's like our debit account.
0
SPEAKER_00
It's short-term.
0
SPEAKER_00
It's ready to go, but it's only a couple hours worth Okay, so you've got your circulating and then you've got your stored glucose stored in the liver like all the time all the time Yeah, unless you burn it for those two hours, then it's exactly depletes and you deplete your liver glycogen so that hormone says dump it so you flood this the bloodstream with blood sugar to feed the muscles and
0
SPEAKER_00
 And you can imagine if you are doing a high-intensity interval training workout and go to 90% of your VO2 max in like five seconds, that is a stress signal, but you're going to use that glucose.
0
SPEAKER_00
So you're going to see that rapid spike, and it's actually fascinating to see on a continuous glucose monitor.
0
SPEAKER_00
Like I will do a sprint workout or a CrossFit workout, and it's like within two
0
SPEAKER_00
 two minutes my glucose is going up and it can look like a big food spike, but the muscles are there using it.
0
SPEAKER_00
And the really cool thing about muscle is that it's one of the only cell types in the body that doesn't need insulin to take up glucose.
0
SPEAKER_00
So it actually can just take it up from the contraction.
0
SPEAKER_00
So it's not like it's really feeding into that pathway of insulin resistance like we were talking about, like it's a sink for that glucose.
0
SPEAKER_00
So there's a supply, um,
0
SPEAKER_00
 sort of use match, which is good.
0
SPEAKER_00
But when you think about psychological stress, you're literally just like, you're sitting in your chair, you're on your computer, you get an email that's stressful.
0
SPEAKER_03
And you're like, how are you reacting to it?
0
SPEAKER_00
Your body has that spike, but you're not moving.
0
SPEAKER_03
Isn't that crazy?
0
SPEAKER_00
Yeah, you're not using those muscles, it's just sitting there causing damage.
0
SPEAKER_00
And you can think about like, we're doing this probably 100 times a day in our regular life.
0
SPEAKER_03
Or ruminating on something from the past, or stressing about something in the future, or reacting to,
0
SPEAKER_03
 you know, the news or whatever it might be that we can react to that, how much of the psychological aspect is related to the disease in our life versus just the straight food itself without the psychological, I guess, thoughts that come with it.
0
SPEAKER_00
 You know, I think it's so multifactorial.
0
SPEAKER_00
I always really say, I think that food is the foundation.
0
SPEAKER_00
You know, food is the substrate.
0
SPEAKER_00
Food is both what physically builds our bodies, and it's also the molecular information that tells our body how to function.
0
SPEAKER_00
We eat about one metric ton of food per year, two to three pounds per day.
0
SPEAKER_00
This is just straight up,
1
SPEAKER_00
 It's chemical information that builds our body and tells our body what to do.
1
SPEAKER_00
We're turning over constantly.
1
SPEAKER_00
The body we have today is not the same body we have in a week from a physical, atomic perspective.
1
SPEAKER_00
We're shapeshifters.
1
SPEAKER_00
We're constantly changing.
1
SPEAKER_00
So food is incredible.
1
SPEAKER_00
It's magical.
1
SPEAKER_00
It's this incredible thing that we're just constantly transmuting into ourselves.
1
SPEAKER_00
 So we've gotta get that right.
1
SPEAKER_00
But while it's necessary, it's not sufficient for optimal health.
1
SPEAKER_00
You still gotta dial in the other factors.
1
SPEAKER_00
And when I really think about the pillars, I'm thinking about seven things.
1
SPEAKER_00
I'm thinking about food, I'm thinking about stress management, exercise, sleep.
1
SPEAKER_00
 our micronutrient status, so not just like the macros we're getting, but what are the actual micronutrients, vitamins, minerals, and antioxidants, our microbiome, how that's doing, and then our exposure to environmental toxins.
1
SPEAKER_00
So yes, while food is the foundation, you've really got to get those other things dialed in.
1
SPEAKER_00
Any one of those things can
1
SPEAKER_00
 shift you off course.
1
SPEAKER_01
So you said food, stress, exercise, sleep, macronutrients?
1
SPEAKER_00
Micronutrients.
1
SPEAKER_01
Micronutrients.
1
SPEAKER_00
Which we often overlook.
1
SPEAKER_01
Okay, what are those?
1
SPEAKER_00
This is all the vitamins, minerals, and antioxidants that come from whole foods.
1
SPEAKER_00
So like things we don't often think about like manganese, and selenium, and vitamin C, and polyphenols, and all, you know, trace minerals like chromium,
1
SPEAKER_00
 that actually, they come from whole foods and unfortunately because our soils are becoming super depleted now because of our industrial agriculture practices and because of overuse of pesticides that are really hurting our soils, the nutrient composition of our food is declining and we're eating less whole foods.
1
SPEAKER_00
But when we think about metabolism and the mitochondria again,
1
SPEAKER_00
 So your mitochondria is filled with all these little enzymes, these little protein enzymes that are essentially doing the work.
1
SPEAKER_00
They are the factory line that's taking that food and converting it to ATP.
1
SPEAKER_00
And every single one of those amazing little protein machines needs these micronutrients to actually work.
1
SPEAKER_00
And the way to think about it is they are lock and keys that bind into little pockets of these enzymes and create
1
SPEAKER_00
 tiny, tiny structural changes that actually make it work.
1
SPEAKER_00
So if we're deficient in selenium or magnesium or manganese or zinc or whatever it is,
1
SPEAKER_00
 these aren't working properly.
1
SPEAKER_00
And the majority of Americans are deficient in at least one critical micronutrient, because we're not eating real food.
1
SPEAKER_00
And because stress can actually deplete a lot of these chemicals.
1
SPEAKER_00
So I really think about, it all goes back to thinking about those molecular machines that are converting food to energy and what they need to function properly, and micronutrients is a big one.
1
SPEAKER_01
I've also heard examples of people who
1
SPEAKER_01
 let's say, eat perfectly, but still have challenges.
1
SPEAKER_01
Maybe their relationships are off and they're in a stressful environment in their relationship or their marriage or whatever it might be, or they just react poorly, they worry often to things they see and experience.
1
SPEAKER_01
They're a warrior.
1
SPEAKER_01
And so every time they worry, there's a, I guess a stress hormone is spiking, right, and sending hormones to the body, which is spiking blood levels, is that right?
1
SPEAKER_01
Blood sugar.
1
SPEAKER_01
 So it sounds like the psychological side of things is also extremely important to understand, and that every time you're allowing your body or your mind to ruminate on a consistent basis, it's sending a signal to the body in a negative way, which is helpful if there's a real life threat, but not when it's on a repeat every day.
1
SPEAKER_01
Is that right?
1
SPEAKER_00
 That's exactly right.
1
SPEAKER_00
It's that chronic low-grade stress that can be really damaging.
1
SPEAKER_00
Something that's been really fun to experiment with is there's now heart rate variability monitors like OuraRing or WHOOP or Leaf Therapeutics.
1
SPEAKER_00
What these do is heart rate variability is a metric that you can track that looks at actually the
1
SPEAKER_00
 time between each heartbeat and oddly enough we want the time between each heartbeat to actually not be consistent like a metronome we want it to have some variability yeah like maybe 0.7 seconds and then one point i'm sorry 0.7
1
SPEAKER_00
 Yeah, seconds, 1.1 second, .9 seconds, that's variability.
1
SPEAKER_01
Why do we want that?
1
SPEAKER_00
It really is a symbol of a dynamic system.
1
SPEAKER_00
You know, you want elasticity in the system and that can sometimes have some irregularity to it.
1
SPEAKER_00
Sort of the way I kind of think about it is like a stiffer system is gonna be a little bit more regular and there's sort of that, and these are subtle.
1
SPEAKER_00
You know, it's not like you can feel it in your pulse if you just feel your pulse, but you can pick it up.
1
SPEAKER_00
And so we want more heart rate variability.
1
SPEAKER_00
 And usually less, lower heart rate variability is an objective measure of stress.
1
SPEAKER_00
And I've worn these things and been giving a talk on Zoom or something like that and I'm looking at my data afterwards and my heart rate variability plummeted during the talk or I'm processing email, my heart rate variability goes down.
1
SPEAKER_00
And then of course glucose may go up.
1
SPEAKER_00
And so you see these things happening together.
1
SPEAKER_00
 And the immediate thing I think is, this is where our tools come in.
1
SPEAKER_00
This is where the deep diaphragmatic breath, where the mindfulness, where having awareness of this happening, and then there are so many things we can do to modify that stress response, even telling your body you're safe.
1
SPEAKER_00
You know, everything's actually okay can have a huge difference.
1
SPEAKER_00
So really dialing into awareness, and then where can I apply the tool?
1
SPEAKER_00
So I would say I take about,
1
SPEAKER_00
 a hundred times more diaphragmatic breaths now than I did a couple years ago because I realized, wow, if this is happening all the time throughout the day without my awareness, that's gonna add up over the next 30, 40, 50 years and have a huge impact.
1
SPEAKER_00
But it's not actually just the chronic low-grade stress.
1
SPEAKER_00
There's been a lot of research showing that acute traumatic events, like loss of a loved one or divorce or childhood events, so adverse childhood events, which are usually, there's an acronym in ACEs,
1
SPEAKER_00
 Um...
1
SPEAKER_00
 people who have many of these tend to actually have worse metabolic health.
1
SPEAKER_00
And this actually may be related to changes in the brain that affect metabolism.
1
SPEAKER_00
So really changing sort of our set point for stress thresholds early on in life.
1
SPEAKER_00
And so sometimes we'll have that patient, like you talked about, who's doing everything right.
1
SPEAKER_00
They're eating really healthy, but they're just really not quite making that progress towards driving what they want.
1
SPEAKER_00
And a lot of those patients I'm thinking about, what is like the deep core,
1
SPEAKER_00
 Wounds and that what's the set point that's causing you to feel that this world is not a safe place that is causing you to be inherently hyper vigilant And doing that work even on myself has been so positive because I think what you start to unpack as you go down that journey is that
1
SPEAKER_00
 Your perception of the world and whether it's safe is very much dictated by your lifetime of experience.
1
SPEAKER_00
And I think for those of us who have been on a journey of therapy and now people are very interested in, of course, how psychedelics can fit into this and then other modalities.
1
SPEAKER_00
 long-term meditation, deep meditation events and things like this that can really unwind some of those kind of amygdala-based, fear-based responses in the brain.
1
SPEAKER_00
I think there's huge potential there for that to potentially unlock a new level of health because what it's doing is changing the fundamental way you see the world as a place of threat or a place of safety.
1
SPEAKER_00
 unfortunately, I think, in our modern world.
1
SPEAKER_00
 fear has become a currency that we've used to profit in a lot of ways.
1
SPEAKER_00
If we can get people to be fearful, we can get them coming back for information that assuages that fear, and we see that with social media, we see it with the news.
1
SPEAKER_00
There was that undercover reporting of one of the CNN executives who said, was recorded saying, if it bleeds, it leads, that we need to get people fearful for them to come back and watch,
1
SPEAKER_00
 what that's doing to our stress hormones, to our brain set point, to our desire to have dopamine stimulation, to kind of get some pleasure in the face of all this fear, the way that's affecting our cellular biology is profound.
1
SPEAKER_00
And so, you know, I think
1
SPEAKER_00
 all of this movement that we're seeing right now towards helping people, towards normalizing mental health care, normalizing, you know, psychedelic use is not an end all be all, but I think it's interesting how that's now being talked about as a way to really help people unlock some of this chronic, you know, fear.
1
SPEAKER_00
I think it's gonna have, you know, could have positive impacts on the body, because if we're living with chronic fear, our bodies are not functioning properly, and many of us are.
1
SPEAKER_01
Did you live with chronic fear for a while?
1
SPEAKER_00
 I think that the healthcare system, the conventional healthcare system, unfortunately uses fear as a way to control patients in a lot of ways.
1
SPEAKER_00
You think about a conversation between a physician and a patient and it's like, you know, your cholesterol's a little high, you need to take a statin
1
SPEAKER_00
 And the patient might say, well, can I have some time to like work on diet and lifestyle?
1
SPEAKER_00
Well, I mean, it's your choice.
1
SPEAKER_00
I mean, I'd recommend the statin right now, because obviously I don't want you to have a heart attack, but like, you know, sure, if you want to try a diet and lifestyle, like that's the type of thing that's happening every day, like where this fear of bad outcomes, um,
1
SPEAKER_00
 is, I think, driving very much a pharmaceutical and invasive intervention type of strategy.
1
SPEAKER_00
 that really was unsavory to me because it's very disempowered.
1
SPEAKER_00
It's like, if I can drive fear in a patient, then I can essentially get them to do whatever intervention I recommend.
1
SPEAKER_01
And as a surgeon- Medicines, procedures, anything.
1
SPEAKER_00
Right, exactly.
1
SPEAKER_00
Oh, well, if we don't treat this ear infection with antibiotics, then it could travel to the brain and create a brain infection.
1
SPEAKER_00
And it's like most ear infections resolve on their own without antibiotics.
1
SPEAKER_00
And overuse of antibiotics is causing
1
SPEAKER_00
 huge, huge problems with our gut, which then leads to mental health issues and metabolic problems.
1
SPEAKER_00
And it's like, but if people are scared of the potential outcome that may be very rare, then of course you can kind of get them to do stuff.
1
SPEAKER_00
And I think that, I don't think that doctors are intentionally doing this.
1
SPEAKER_00
I think we have an incentive system in Western healthcare that really drives people towards intervention.
1
SPEAKER_00
But I think that
1
SPEAKER_00
 You know, I also think that with COVID, we saw this happen where, you know, this fear of, you know, anyone, you know, being harmed from COVID or, you know, that we, you know, kind of got people to do anything and everything and we're kind of losing this.
1
SPEAKER_00
 we're losing kind of that rational sense of the risk that is inherent in living.
1
SPEAKER_00
We get in a car every day and there is risk involved in that, but we choose to do it.
1
SPEAKER_00
And I think that there's just a lot of sort of fear-based thinking that happens in the healthcare system that unfortunately disempowers patients and pushes them to do interventions more quickly when I think that
1
SPEAKER_00
 There is so much opportunity to help coach them with diet and lifestyle, which takes longer, it's harder, but ultimately it generates health rather than just putting a Band-Aid on disease.
1
SPEAKER_00
There's no medication that actually generates health.
1
SPEAKER_00
 Only diet and lifestyle strategies generate health.
1
SPEAKER_00
And so that's obviously the foundation of our medical system, but unfortunately we're not very well trained as physicians to know that information or to coach on it.
1
SPEAKER_00
But yeah, to answer your question, I think a large part of my personal journey has been trying to overcome fear.
1
SPEAKER_00
Personal fear.
1
SPEAKER_00
Personal fear.
1
SPEAKER_00
I think one of the biggest examples of this is my mom just passed away about a year ago from cancer.
1
SPEAKER_00
 just as any normal person, I spent my life fearing my parents' mortality.
1
SPEAKER_00
It's like, oh, this is going to be horrible and devastating.
1
SPEAKER_00
I think a lot of people worry about premature loss of a parent.
1
SPEAKER_00
I think going through that experience and it actually being a very beautiful transformational experience,
1
SPEAKER_00
 It was sort of a surprise and she had two weeks between her diagnosis and her death.
1
SPEAKER_00
We had this beautiful time together as a family.
1
SPEAKER_00
She was actually very much on the same page about sort of holistic health as me and knew in her heart that she was dying very rapidly.
1
SPEAKER_00
She chose to
1
SPEAKER_00
 stay at home, be with the family.
1
SPEAKER_00
We were all together, had this spectacular two weeks.
1
SPEAKER_00
The hospital system, through every possible medium, was trying to pull her into the system.
1
SPEAKER_00
It was pancreatic cancer, so it's like, you need a liver stint, you need a liver biopsy, you need a blood transfusion, you need to start chemo immediately.
1
SPEAKER_00
And the reality was, she knew I'm dying right now.
1
SPEAKER_00
She ended up dying in two weeks.
1
SPEAKER_00
None of the interventions would have helped.
1
SPEAKER_00
We wouldn't even had a, you know,
1
SPEAKER_01
 Would it have lasted maybe a few more months or a few more weeks?
1
SPEAKER_01
Maybe, you don't know.
1
SPEAKER_00
I actually don't think at all.
1
SPEAKER_00
I think that... It might have caused more stress and more... Well, and it was COVID, so she would have been in the hospital and we could have not visited her.
1
SPEAKER_01
Oh, that'd be tough.
1
SPEAKER_00
So anyways, that experience of seeing her approach,
1
SPEAKER_00
 Seeing her pure joy in the face, she was just ended her last two weeks very joyfully, was very at peace.
1
SPEAKER_00
We had that time together.
1
SPEAKER_00
She was not just like locked in the hospital doing interventions that would not have helped very much.
1
SPEAKER_00
I realized, oh, something I've been fearing my entire life happened.
1
SPEAKER_00
 was the most transformational growth experience I've ever had.
1
SPEAKER_00
I still feel way more connected to my mom than I ever could have imagined.
1
SPEAKER_00
No one can tell you, oh, you're going to still feel connected until you maybe experience that.
1
SPEAKER_00
And it kind of made me realize.
1
SPEAKER_00
 fear is kind of not useful.
1
SPEAKER_00
So I think that something like that, and I think probably lots of people have their own examples, just kind of makes you realize the futility of living in fear, and what does it do?
1
SPEAKER_00
It damages your body, it doesn't really change the outcome.
1
SPEAKER_00
A little bit of healthy fear is useful, of course, like you don't want to cross the street without looking, but the idea that we should be fearful all the time,
1
SPEAKER_00
 then that's gonna protect us is such a fallacy.
1
SPEAKER_00
So turning to Stoic philosophers, turning to some sort of Eastern texts, Buddhist and Taoist texts, like sort of looking into traditions that have thought this way has been a really useful part of my journey and I think needs to be a part of how the healthcare system reforms because we weaponize fear of death
1
SPEAKER_00
 as a way to control patients into doing anything we want, and I think fundamentally overcoming your fear of mortality, which is the
1
SPEAKER_00
 the only thing we can be certain of in this world, and really approaching that with a sense of awe, and a sense of curiosity, and a sense of what can this teach us about how to live, I think is an absolute foundational part of what we need to do as individuals, but also the healthcare system, because otherwise we're just using fear as this thing, fear of death as this thing,
1
SPEAKER_00
 to just wrangle people into as many interventions and as pharmaceuticals as possible with the off chance that people think it's gonna somewhat reduce their chance of mortality.
1
SPEAKER_01
So what I heard you say in there was that there's no medicine that can actually make you healthier.
1
SPEAKER_01
Is that correct?
1
SPEAKER_01
Or that could actually solve the issue on the medicine itself?
1
SPEAKER_00
 The vast majority of all medications, I probably wouldn't say all on a record, but I would say the vast majority do not generate health in the body.
1
SPEAKER_00
They manage symptoms.
1
SPEAKER_00
Now, if you take away a diabetes medication from someone, their diabetes is not gone.
1
SPEAKER_00
It's right back there where it was.
1
SPEAKER_00
 Whereas if you get someone to really foundationally improve their cellular function, which can only be done through consistent dietary and lifestyle habits, they can truly reverse their disease.
1
SPEAKER_00
But there's no medication that reverses diabetes.
1
SPEAKER_00
There's no medication that reverses heart disease.
1
SPEAKER_00
There's no medication that reverses Alzheimer's dementia.
1
SPEAKER_01
They just kind of manage the symptoms.
1
SPEAKER_00
They manage the symptoms, you know, and maybe.
1
SPEAKER_01
Maybe some relief a little here and there.
1
SPEAKER_00
 relief, life extension for some of them, but they do not create health.
1
SPEAKER_00
And what health is, health is optimal cellular functioning.
1
SPEAKER_00
We are just a big bag of cells, and each cell needs to be functioning properly for us to have health.
1
SPEAKER_00
What is a symptom?
1
SPEAKER_00
What is disease?
1
SPEAKER_00
That is cellular dysfunction happening on the individual level,
1
SPEAKER_00
 If that's happening in mass, that might be tissue dysfunction.
1
SPEAKER_00
If that's happening in a bigger way, it's organ dysfunction.
1
SPEAKER_00
That's when we see symptoms of disease.
1
SPEAKER_00
We have to really zoom in on what's happening in the cell.
1
SPEAKER_00
A cell is getting its information from what you're eating,
1
SPEAKER_00
 What it's being built from, which is your food, what stress hormones it's seeing binding to its little cell membrane, what's happening with your hormones, which of course is dictated by stress and by sleep and by exercise and by food, it's the super complex milieu that can
1
SPEAKER_00
 only be optimized by the choices that we're making every day, day in and day out, consistently.
1
SPEAKER_00
Even by the sunlight we're exposing ourselves to in the morning, and Andrew Heuermann talks about this all the time, but literally the consistent exposure of sunlight first thing in the morning is chemical information to your body through the sunlight's energy to tell your cells how to function.
1
SPEAKER_00
You can't put that in a pill.
1
SPEAKER_00
It has to happen through these millions of years of evolutionary evolved processes, and so yes, medications can't
1
SPEAKER_00
 with their one pathway that they might be intervening on truly generate foundational cellular health, which is what we need to achieve.
1
SPEAKER_01
They don't bring wholeness back to the cell.
1
SPEAKER_01
I guess there's what, some creams or something that might help you heal a cut or something like that, but we're talking about like a chronic illness medication, right?
1
SPEAKER_00
 Yeah, but even if you think about a cut, you know, I mean, a cut is like, it seems so simple, but it's actually so complex.
1
SPEAKER_00
It's like, for a cut, if you think about people with disease, like diabetes, for instance, one of the reasons that people with type 2 diabetes die is because of chronic wounds.
1
SPEAKER_00
They have wounds that won't heal.
1
SPEAKER_01
Interesting.
1
SPEAKER_00
Oh, yeah.
1
SPEAKER_01
Are they internal wounds or external wounds?
1
SPEAKER_00
External wounds.
1
SPEAKER_00
People can get, something that happens with people with diabetes is they often have nerve damage.
1
SPEAKER_00
 because of the way the blood sugar is affecting the nerves, so then their feet become numb.
1
SPEAKER_00
And then they might get a cut on their foot, they don't feel it.
1
SPEAKER_00
And then that festers.
1
SPEAKER_00
And because of their high blood sugar, their immune cells don't work, so they can't heal the wound.
1
SPEAKER_01
And then they die from the wound.
1
SPEAKER_00
And then they get a huge systemic infection that might lead to death or an amputation.
1
SPEAKER_00
So the majority of lower limb amputations are caused by diabetes, diabetic ulcers that are like wounds.
1
SPEAKER_01
 People have type 2 diabetes in the u.s.
1
SPEAKER_01
Do we know the number?
1
SPEAKER_00
Oh, yeah.
1
SPEAKER_00
Well, there's a hundred and twenty eight million Americans with pre-diabetes or type 2 diabetes of those 30 million have full-on type 2 diabetes 30 million of the what 300 and what is that 300 something?
1
SPEAKER_00
Yeah, it's about 13% of the population has time to diabetes Yeah, and it was less than 1% in the 50s and 60s.
1
SPEAKER_00
So
1
SPEAKER_01
 And pre-diabetic, you're saying 100 million.
1
SPEAKER_01
What does pre-diabetic mean?
1
SPEAKER_01
Who is someone who might be pre-diabetic?
1
SPEAKER_00
 Well, it actually can be quite surprising.
1
SPEAKER_00
There are lots of young, healthy people walking around who look otherwise fit, who have prediabetes and don't know it.
1
SPEAKER_00
90% of people with prediabetes do not know that they have it.
1
SPEAKER_01
How do you know if you have it?
1
SPEAKER_00
Well, the easiest way to do it is through a blood test.
1
SPEAKER_00
So you basically get a fasting blood sugar test from your doctor, and if it's between 100 and 125 milligrams per deciliter of fasting glucose, that's considered prediabetes.
1
SPEAKER_01
 100 to 125.
1
SPEAKER_01
What do you wanna be at?
1
SPEAKER_01
What's a healthy range?
1
SPEAKER_00
So what's considered normal is 100 or below.
1
SPEAKER_01
100 or below.
1
SPEAKER_00
But I would say that that is way too lenient of a range because what we've figured out is that people in the low end of normal are much less likely to develop long-term problems with heart disease, stroke, or diabetes.
1
SPEAKER_00
So even if you're in the high normal range and your doctor says to you,
1
SPEAKER_00
 oh, your fasting blood sugar is 97, you're great, you're normal.
1
SPEAKER_00
You should see that as a huge red flag.
1
SPEAKER_00
You are metabolically dysfunctional if that's the case.
1
SPEAKER_00
And so really where you wanna shoot for is about 70 to 85 milligrams per deciliter.
1
SPEAKER_01
 Do people get a test that they can order and do this themselves?
1
SPEAKER_01
For sure.
1
SPEAKER_00
You can actually buy it at CVS or at the pharmacy.
1
SPEAKER_00
What's it called?
1
SPEAKER_00
You just prick your finger.
1
SPEAKER_00
What are these called?
1
SPEAKER_00
They're called glucometers.
1
SPEAKER_00
They're literally $20 on Amazon.
1
SPEAKER_00
There's Keto Mojo.
1
SPEAKER_01
You just prick your finger and then it'll tell you right away or in a few minutes?
1
SPEAKER_00
In five seconds, yeah.
1
SPEAKER_01
Then it just tells you what your level's at.
1
SPEAKER_00
 what it is, and it's cool to check it actually day to day, like for a few weeks, because one thing you'll find is that, let's say you have one poor night of sleep, like let's say you had a big work thing due and you got six hours instead of eight hours, your blood sugar in the morning might be 10 points higher.
1
SPEAKER_00
Oh, for sure, yeah.
1
SPEAKER_00
Or let's say you had a really late meal the night before, your blood sugar might be higher the next morning.
1
SPEAKER_00
So what it starts putting together for you is, this is very dynamic,
1
SPEAKER_00
 And if I did these activities day after day, year after year for my whole life, I'm building.
1
SPEAKER_00
So figure out what allows you to be in that 70 to 85 range.
1
SPEAKER_00
Maybe it's like a really awesome workout in the middle of the day prior and getting to bed a little bit earlier and getting morning sunlight exposure and doing some deep breathing in the morning.
1
SPEAKER_00
 And all of a sudden you're like, oh cool, my blood sugar is 72 milligrams per deciliter.
1
SPEAKER_00
Or fasting for 16 hours or something like that.
1
SPEAKER_00
But figuring out what works for you to stay in that low range and then dial it in for as many days of the week as possible as you can.
1
SPEAKER_00
The other really interesting thing about fasting blood sugar as a test is that
1
SPEAKER_00
 You know, the body, like we were talking about with the insulin resistance, it's very adaptable.
1
SPEAKER_00
And when the body starts becoming insulin resistant, so it's saying, we're seeing too much glucose around, we're producing, like, we're going to create an insulin block.
1
SPEAKER_00
What the body does is it's like, well, we've got to get this glucose out of the bloodstream.
1
SPEAKER_00
So it starts producing more insulin.
1
SPEAKER_00
 So your insulin levels will actually start rising as you become insulin resistant to push more of that glucose into the cells.
1
SPEAKER_00
And so a study in The Lancet, a big medical journal, showed that you can actually keep your blood sugar levels normal for like 13 years prior to them elevating, and all the while insulin is rising, but it's compensating to keep glucose low.
1
SPEAKER_00
Unfortunately, because we don't check fasting insulin in this country,
1
SPEAKER_00
 we're missing that window where people are clearly becoming insulin resistant, but their glucose still looks normal on their yearly check.
1
SPEAKER_00
So to just make this concrete, you and I could both go to the primary care doctor and have a fasting glucose of 80 milligrams per deciliter.
1
SPEAKER_00
And so the doctor says to both of us, you're both in perfect health.
1
SPEAKER_00
If I'm really insulin resistant, because I'm on that glucose rollercoaster, and I'm getting poor sleep, and I'm chronically stressed and not managing it, and I have childhood trauma that I haven't addressed, blah, blah, blah, all that stuff.
1
SPEAKER_00
 I could be at 80, but I'm doing that by my insulin being elevated to like 35 or 40, and your insulin might be two.
1
SPEAKER_00
So your body's not working hard at all to keep your insulin at 80, and my body is having to produce that so much insulin.
1
SPEAKER_00
So I am clearly on the path towards metabolic disease, diabetes, and all the associated conditions, heart disease, stroke, cancer, Alzheimer's, dementia, fatty liver disease, gout, infertility, retinal dysfunction, blah, blah, blah, blah, blah.
1
SPEAKER_00
And you're in the clear, but our doctor tells us that we're the same.
1
SPEAKER_00
 So this is why I recommend that every patient ask their doctor for a fasting insulin check because you have a sense of what's actually happening under the hood.
1
SPEAKER_00
And if you're in that early range, and of course, this is talking about people who are in the normal range, that's not even included in the 128 million Americans who actually have a diagnosis of prediabetes.
1
SPEAKER_00
So this is like people in the normal who still may be on their route to problems.
1
SPEAKER_00
So it's now becoming like,
1
SPEAKER_00
 the majority of the country is dealing with a fundamental problem in how they make energy in the body, which is a core process that allows every cell to function.
1
SPEAKER_01
And you're saying there's seven factors to this, but what would you say are the main couple?
1
SPEAKER_01
Is it food and lack of exercise or what?
1
SPEAKER_00
I would say the four most important pillars are food,
1
SPEAKER_00
 sleep deprivation and interruption in sleep, just the beeping and the buzzing and the blue light late at night that interrupts our sleep quality, the chronic low-grade stress and the fear that so many people are dealing with, and then the sedentary behavior, the fact that most Americans are sitting more than eight hours a day.
1
SPEAKER_00
 Sitting creates inflammation in the body.
1
SPEAKER_00
It keeps that glucose in your bloodstream and not going into the muscles.
1
SPEAKER_00
And the exercise one, I think, a really empowering, just a tip for people, it doesn't have to be like, go out and run five miles, or do a high intensity aerial training workout, or do a CrossFit workout.
1
SPEAKER_00
It literally is as simple as walking, maybe walk 15 minutes after a meal, especially if you have a high carb meal.
1
SPEAKER_00
 Even walking for two minutes every half hour has been shown to statistically significantly reduce insulin and glucose levels throughout the day.
1
SPEAKER_00
It's actually the study was a minute and 40 seconds.
1
SPEAKER_00
So it was looking at for people who just walked for 30 minutes in one chunk of the day, but otherwise sat during the day versus people who walked for 30 minutes, but broke it up into one minute and 40 seconds every 30 minutes throughout the waking day.
1
SPEAKER_00
Those people that moved more frequently, but the same quantity,
1
SPEAKER_00
 had much lower glucose and insulin.
1
SPEAKER_00
And I think the reason is because if you think about sitting all day and then walking for 30 minutes, you've basically just been atrophying your muscles all day.
1
SPEAKER_00
You're just this blob sitting there.
1
SPEAKER_01
Versus... The continuous of it constantly.
1
SPEAKER_00
 And again, thinking back to the cells, you're activating these pathways.
1
SPEAKER_00
It's all just information to the cell.
1
SPEAKER_00
Activate the pathways, get them moving, clear the glucose every 30 minutes.
1
SPEAKER_00
And so it's not like this is a lot of stuff you have to do.
1
SPEAKER_00
A simple walk makes a big difference.
1
SPEAKER_00
But I think from looking at all this literature, one of the biggest takeaways I've realized is that moving more frequently, even if it's low intensity, is key.
1
SPEAKER_00
It can't just be that one chunk.
1
SPEAKER_01
 Yeah, and maybe if you're in our office or something or you're not walking or have the ability to walk, maybe you can do some air squats or push-ups or just anything where you're moving your body.
1
SPEAKER_01
Some split squats, whatever it might be.
1
SPEAKER_01
Just body weight stuff.
1
SPEAKER_00
For a minute, minute 40 seconds.
1
SPEAKER_00
Lift your knees up in the air or something, yeah, whatever.
1
SPEAKER_00
Yeah, exactly.
2
SPEAKER_00
 I love that.
2
SPEAKER_01
That's interesting.
2
SPEAKER_01
Yeah, my knees.
2
SPEAKER_01
Yeah.
2
SPEAKER_00
Yeah.
2
SPEAKER_01
Wow.
2
SPEAKER_01
This is fascinating.
2
SPEAKER_01
So 13% is that we said has type 2 diabetes in the u.s.
2
SPEAKER_01
Mm-hmm is type 2 diabetes reversible Absolutely.
2
SPEAKER_01
Yeah, I mean but beyond that it's not reversible.
2
SPEAKER_01
Is that right?
2
SPEAKER_00
 Well, type 2 diabetes is sort of the, that's like, once you get into that range of type 2 diabetes, of course there's a spectrum of how bad it is, right?
2
SPEAKER_00
And it's always easier to reverse these things earlier on.
2
SPEAKER_01
Type 2 diabetes is the, there's not a type 3 or type 4?
2
SPEAKER_00
No, type 2 diabetes, so basically... What does that mean when you have type 2 diabetes?
2
SPEAKER_00
 So it means, based on our criteria, it just means you meet a particular threshold of blood sugar levels.
2
SPEAKER_00
So if you're first thing in the morning fasting blood sugar, you go to the doctor, they take your blood.
2
SPEAKER_00
If it's below 100, non-diabetic.
2
SPEAKER_00
100 to 125, pre-diabetes.
2
SPEAKER_00
126 or above, type 2 diabetes.
2
SPEAKER_01
Wow, and you can reverse that.
2
SPEAKER_01
The earlier you catch it, back to the 100 to 125, and then hopefully below that.
2
SPEAKER_00
Yeah.
2
SPEAKER_01
With nutrition and lifestyle.
2
SPEAKER_01
Absolutely.
2
SPEAKER_00
 Yeah, and there's actually been studies showing, I mean, Virta Health, Sarah Halstead, she's an amazing, this company is showing reversal of type 2 diabetes with a low-carb, high-fat diet and coaching.
2
SPEAKER_00
I mean, it's not even an exercise intervention.
2
SPEAKER_00
It's just diet, and they showed that in 12 weeks, they could actually.
2
SPEAKER_01
Coaching, what type of coaching?
2
SPEAKER_00
Just a nutritional coaching, like with a doctor.
2
SPEAKER_01
Yeah, just, hey, are you doing this every day?
2
SPEAKER_00
Exactly.
2
SPEAKER_01
And like, just checking accountability.
2
SPEAKER_00
Exactly.
2
SPEAKER_00
They're not even including exercise.
2
SPEAKER_00
Like, it's that simple.
2
SPEAKER_00
 And they are showing amazing reversal of diabetes to the extent where the American Diabetes Association, they did not actually recognize reversal of diabetes as something that's possible until this past year.
2
SPEAKER_00
They're actually calling it remission, which I think is a funny term.
2
SPEAKER_00
It's basically reversal.
2
SPEAKER_00
I mean, you're changing cellular function.
2
SPEAKER_00
You're becoming more insulin sensitive.
2
SPEAKER_00
You're lowering your circulating glucose levels.
2
SPEAKER_00
 The reason why you want to get on top of this early, though, is because the longer you have diabetes, again, coming back to the mitochondria, the more damage you're doing to those cellular structures.
2
SPEAKER_00
It's harder and harder to reverse it.
2
SPEAKER_00
It's harder.
2
SPEAKER_00
It's harder.
2
SPEAKER_01
How big of a business is type 2 diabetes in the US alone?
2
SPEAKER_01
A year.
2
SPEAKER_00
Incalculable.
2
SPEAKER_01
 How much money is spent on the management of type 2 diabetes?
2
SPEAKER_00
You'll see lots of different numbers, usually somewhere between $200 and $600 billion.
2
SPEAKER_01
$200 to $600 billion?
2
SPEAKER_00
Yeah.
2
SPEAKER_01
Just for type 2 diabetes?
2
SPEAKER_00
Well, our health care costs are $4 trillion per year, about 17% of our GDP.
2
SPEAKER_00
We spend more than, of course, any other country in the entire world.
2
SPEAKER_01
70% you said?
2
SPEAKER_01
How much?
2
SPEAKER_00
 17, 17%, yeah, yeah, 17%.
2
SPEAKER_00
Four trillion dollars.
2
SPEAKER_01
Four trillion is healthcare in the USA.
2
SPEAKER_01
Yeah.
2
SPEAKER_01
What is Canada?
2
SPEAKER_00
I don't know.
2
SPEAKER_01
Okay, gotcha.
2
SPEAKER_00
But if you look at the curve, it's like all these little dots down in the lower left corner and there's like the US up here in terms of cost.
2
SPEAKER_01
And 200 to 600 billion of that is in the type two diabetes.
2
SPEAKER_00
Metabolic management.
2
SPEAKER_00
Management.
2
SPEAKER_00
Yeah.
2
SPEAKER_01
Holy cow.
2
SPEAKER_00
And,
2
SPEAKER_00
 On top of this, our life expectancy is going down.
2
SPEAKER_00
So what's ironic about the American healthcare system, and for three years, our life expectancy has been going down.
2
SPEAKER_00
You would think, right?
2
SPEAKER_00
This is sort of what perplexes me about physicians right now, is that as a physician, you're really like a steward of the system.
2
SPEAKER_00
You are the person sort of,
2
SPEAKER_00
 calling the shots and doing the treatment.
2
SPEAKER_00
You look at this system, and okay, every single year we're increasing healthcare costs.
2
SPEAKER_00
Every single year it's an increasing part of our GDP.
2
SPEAKER_00
We're now spending $4 trillion on healthcare.
2
SPEAKER_00
We're literally throwing money at it, and outcomes are getting worse every single year.
2
SPEAKER_00
If you're not stopping and thinking, what is going on?
2
SPEAKER_00
 What are you doing with your time?
2
SPEAKER_00
It's not working.
2
SPEAKER_00
We're getting sicker.
2
SPEAKER_00
Every single year, we're getting sicker, we're getting fatter, and we're getting more depressed as a country and just throwing money at it.
2
SPEAKER_00
I think the key problem with this is that the modern American healthcare system has produced miracles, literally.
2
SPEAKER_00
 Yeah, a hundred years ago first today if you transported someone from 1900 to today and they looked at what's you know Life expectancy and infant mortality and and what happens when we get an acute illness, they would they would be shocked.
2
SPEAKER_00
It's Unbelievable, but that's because we are very good at managing acute illnesses So if you have an infection, you know something like childbirth if you break your arm if you're in a car accident we can manage these things and
2
SPEAKER_01
 Whereas before, we weren't good at that, and so people would die or have massive complications with those.
2
SPEAKER_00
Absolutely, yeah, and so that's great.
2
SPEAKER_00
We can manage that, but chronic disease is where we are abjectly failing, and chronic diseases are 90% of our healthcare costs.
2
SPEAKER_00
They are the things that are killing Americans, and they are based in diet and lifestyle, and those are the things that we are doing, having worse outcomes the more money we spend.
2
SPEAKER_01
 So 90% of the four trillion, is that what it is?
2
SPEAKER_00
Goes towards chronic disease management.
2
SPEAKER_01
Chronic diseases, which is what else besides type two diabetes is included in that?
2
SPEAKER_00
These are the diseases that are like long-term, are considered to develop over time, and are generally rooted in diet and lifestyle.
2
SPEAKER_00
Like heart disease.
2
SPEAKER_00
Heart disease, Alzheimer's, dementia, chronic respiratory illnesses, chronic kidney disease, chronic liver disease.
2
SPEAKER_00
 You know, there's like depression, anxiety, chronic pain, chronic fatigue syndrome, gout.
2
SPEAKER_00
There are things that don't just like come and go, like a cold or come and go.
2
SPEAKER_01
So 90% of the money is going towards chronic disease and illness.
2
SPEAKER_00
That's right.
2
SPEAKER_01
 And what I'm hearing you say is chronic disease and illness can be prevented with nutrition and lifestyle.
2
SPEAKER_00
Or reversed.
2
SPEAKER_01
Or reversed.
2
SPEAKER_00
In many cases.
2
SPEAKER_00
Of course not all.
2
SPEAKER_01
Most of the cases, I'm assuming.
2
SPEAKER_01
A lot of the cases, right?
2
SPEAKER_00
I think a huge burden of that disease could be prevented or reversed.
2
SPEAKER_00
Obviously there's gonna be cancers that you can't reverse with diet and lifestyle, but a lot of the cancers we're seeing today could likely be prevented.
2
SPEAKER_00
But we're not trained on how to do that effectively as physicians or any practitioner.
2
SPEAKER_01
 How much money could we save if we just invested in the prevention and the lifestyle and nutrition training and coaching versus just spending money on these things that are masking and not solving the problem?
2
SPEAKER_00
I think trillions of dollars.
2
SPEAKER_00
Wow.
2
SPEAKER_00
Yeah.
2
SPEAKER_00
And the funny thing is that what taxpayers don't realize is that they're paying for this like four times over.
2
SPEAKER_01
It's crazy.
2
SPEAKER_00
We are paying taxpayer money to, of course, fund health care, Medicare, Medicaid, all these things.
2
SPEAKER_00
 We are then going to the doctor and paying our co-pays, we're paying our insurance premiums, we're paying for that service.
2
SPEAKER_00
We are also paying taxpayer money for the farm bills and for the food subsidies that are making all the disease-promoting foods cheaper for Americans.
2
SPEAKER_00
So we spend $31 billion on our farm bills, which directly subsidize the foods that cause disease, making them artificially cheaper.
2
SPEAKER_00
So this is corn, sugar,
2
SPEAKER_00
 soy, wheat, and other foods like that does not go towards the vegetables and the fruits, which are actually part of a separate, very small horticulture bill, which is like not even, like a fraction.
2
SPEAKER_01
It's a tiny little amount.
2
SPEAKER_00
 So they're paying for those that then make us sick.
2
SPEAKER_00
And then, of course, we're paying for the environmental damage of those terrible farming practices of the foods that make us sick that are then ruining our topsoil and creating horrible runoff in our rivers and oceans.
2
SPEAKER_00
So literally, like you walk into the store and you grab, you know, Skittles, or you grab, you know,
2
SPEAKER_00
 And I think what people don't realize is that if that had a real price tag on it, it would be like $150, because it's the health care costs, it's the cost of the food, it's the cost of the taxpayer money for health care for others, it's the cost of the environmental damage, and it's the cost of the farm bills.
2
SPEAKER_00
 We're paying all that.
2
SPEAKER_01
That's crazy.
2
SPEAKER_00
And yet it's $3.
2
SPEAKER_00
Yeah.
2
SPEAKER_01
Yeah.
2
SPEAKER_01
What I think what's cool, what you're doing and a lot of other of your peers are doing is trying to give people information and access to take back control of their own health and prevent a lot of these things from happening by just making better choices every day.
2
SPEAKER_01
Having the information and the education of
2
SPEAKER_01
 what makes you sick and what keeps you healthy with all these different factors we've talked about, and also just staying on track with it, you know, staying on track consistently to prevent and stay healthy as long as possible.
2
SPEAKER_01
The challenge is there's so much temptation in the world, there's so much temptation
2
SPEAKER_01
 and so much available at all the times to make poor choices, whether it becomes nutrition, diet, sugar, all these different things, processed foods.
2
SPEAKER_01
It's very challenging for a lot of people.
2
SPEAKER_01
Even myself, I consider a healthy person, active.
2
SPEAKER_01
I just ran a marathon three days ago for my first marathon.
2
SPEAKER_00
Congratulations.
2
SPEAKER_00
Thank you.
2
SPEAKER_01
 but I still feel like oh, but I still I'm not in the best shape that I could be in right because of the Nutritional aspect I can go months of eating super clean and healthy and then other months where I'm like, I feel great Let me just have some sugar every day now so it's the
2
SPEAKER_01
 It's the accountability, it's the structure, it's the accessibility to so much processed foods, which I think is challenging for a lot of people.
2
SPEAKER_01
And I think that's what's one of the hardest things, is just the discipline it takes.
2
SPEAKER_01
The personal discipline.
2
SPEAKER_01
So how do you manage it personally, knowing all this information?
2
SPEAKER_01
Do you still eat a lot of sugar, or are you kind of like, cut sugar out of your life now?
2
SPEAKER_00
 Yeah.
2
SPEAKER_00
Well, first of all, I think the points you made are so important.
2
SPEAKER_00
Like it is hard and, and that's why, that is why I'm excited about technology that helps people eat better because like, like continuous glucose monitoring.
2
SPEAKER_00
And of course what we've started with levels is because it's not like
2
SPEAKER_00
 I wanna walk around and see everyone being a cyborg with technology on their arm.
2
SPEAKER_00
I'm actually a very crunchy granola person.
2
SPEAKER_00
I'm not the most tech-savvy person, and I wanna just be in the back country unplugged.
2
SPEAKER_00
That is my ideal.
2
SPEAKER_00
However,
2
SPEAKER_00
 the cards are stacked against us so monumentally in the way we've talked about.
2
SPEAKER_00
The past 50 to 100 years, the human body has had to be bombarded with all these external signals that it's never had to deal with in the tens of thousands, hundreds of thousands of years of evolution, and it's breaking our bodies.
2
SPEAKER_00
We have broken bodies by and large in America as evidenced by the fact that six in 10 American adults have at least one chronic disease.
2
SPEAKER_00
We're breaking.
2
SPEAKER_00
And so,
2
SPEAKER_00
 Those cards are sort of stacked against us.
2
SPEAKER_00
Of course, there's governmental factors.
2
SPEAKER_00
There's all this stuff.
2
SPEAKER_00
There's food marketing.
2
SPEAKER_00
Our school lunches for kids are awful.
2
SPEAKER_00
And so in the face of that modern reality, tools to empower ourselves to make decisions that are better I think are very important.
2
SPEAKER_00
 And ideally, you could use these tools to gain awareness, to gain learning, to gain knowledge of how to eat and live in a way that keeps your blood sugar more stable, that keeps your metabolic health on point, and then maybe you don't have to use it anymore.
2
SPEAKER_00
Maybe it's just a window.
2
SPEAKER_00
I'm not wearing one right now.
2
SPEAKER_00
I've been at this for three years, and I can go months now without wearing one.
2
SPEAKER_00
I mean, it can be very helpful for accountability at this point,
2
SPEAKER_01
 but you know what works and what doesn't work now.
2
SPEAKER_00
Yeah.
2
SPEAKER_00
Yes.
2
SPEAKER_00
And it's a nuanced balance.
2
SPEAKER_00
And so that's what I'm so excited about is empowerment.
2
SPEAKER_00
I think that is the key word.
2
SPEAKER_00
Um, because your doctor might say to you, um, oatmeal's you've got high cholesterol, so eat oatmeal.
2
SPEAKER_00
Like this is a heart healthy whole grain.
2
SPEAKER_01
That might be bad for you.
2
SPEAKER_00
 Well, put your blood sugar monitor on, you know, on your arm and eat the oatmeal and see what happens.
2
SPEAKER_00
And maybe for you, your blood sugar stays quite stable and you don't have a big spike.
2
SPEAKER_00
But for me, because I've tested this one serving of Quaker rolled oats caused me an 80 point glucose rise and crash, which is about
2
SPEAKER_00
 four times higher than the highest I want to go.
2
SPEAKER_00
I want to go up like 20 points after a meal.
2
SPEAKER_01
You want to stay like here, not here.
2
SPEAKER_00
Exactly.
2
SPEAKER_00
So for my body, terrible metabolic choice.
2
SPEAKER_00
For yours, maybe it's okay.
2
SPEAKER_00
But the fact that the doctor's saying it sort of works for everyone, that's where we can kind of get into trouble because every single body is different.
2
SPEAKER_00
We are so biochemically individual.
2
SPEAKER_00
 And what works for you and me might be very different in terms of what causes a blood glucose spike.
2
SPEAKER_00
And it can also be different day to day.
2
SPEAKER_00
Again, if I'm sleep deprived, it might hit me a lot harder than on the day that I'm not.
2
SPEAKER_00
So knowing what those variables are can be really useful information.
2
SPEAKER_00
So for me,
2
SPEAKER_00
 When I started wearing continuous glucose monitors, when we started levels, I was almost 100% plant-based, and what I learned super quickly was that there were- Before the monitor, you were plant-based.
2
SPEAKER_00
And I'm still like 93% plant-based, but I'll eat a little bit of really thoughtfully sourced animal protein now.
2
SPEAKER_00
 But what it did for me was make me realize that within my plant-based diet, there were certain foods that were causing really big spikes, and how I could modify plant foods and balance them with adding fat, protein, and fiber to my carbohydrates to keep the spikes much less.
2
SPEAKER_01
Because you could be plant-based and be unhealthy.
2
SPEAKER_00
 Absolutely.
2
SPEAKER_00
Oh my gosh.
2
SPEAKER_01
You can be having sugar all day long and be spiking left and right.
2
SPEAKER_00
So you can just be, you know, trashing your health that way.
2
SPEAKER_00
And I think that one of the things I'm most excited about with this personal biofeedback data about nutrition is that I think it's going to pull the rug out from diet wars and from all these really.
2
SPEAKER_01
So show the proof.
2
SPEAKER_01
Here's the evidence.
2
SPEAKER_01
Yeah.
2
SPEAKER_00
 Because someone who's carnivore, and this has happened, can be ripping on vegans on social media.
2
SPEAKER_00
And if I can come out and say, here are my blood sugar curves, they're flat, my insulin is three, my cholesterol is XYZ, my inflammation markers are this, my vitamin D is this, and my omega-3 levels are this.
2
SPEAKER_00
 Like, how can you fight with me?
2
SPEAKER_00
Like, this is working for me.
2
SPEAKER_00
And it might actually look identical to their lab work because the body is such a complex system.
2
SPEAKER_00
There are many different redundant pathways to kind of getting to the same outcomes, but the key is you have to be so thoughtful about how you're doing it.
2
SPEAKER_00
The run-of-the-mill vegan diet is probably not gonna be great for people.
2
SPEAKER_00
Neither is the run-of-the-mill carnivore diet.
2
SPEAKER_00
 And so just having insight into that, but I think it's, again, it's like the proof is in the pudding, and that's where I'm excited to see more data helping to quell some of the debate of what's better, because each body's different, and you know.
2
SPEAKER_01
That's interesting.
2
SPEAKER_01
So tell me about levels then.
2
SPEAKER_01
What are you guys doing at levels with this, is it called Constant Glucose Monitor, is that what it's called?
2
SPEAKER_00
Continuous Glucose Monitor.
2
SPEAKER_00
Continuous.
2
SPEAKER_00
Yeah, CGM.
2
SPEAKER_01
 where you put on, you essentially put on a monitor in your skin, right, for two weeks, is that what it is?
2
SPEAKER_01
And then it monitors your blood levels for 24-7 for two weeks.
2
SPEAKER_01
Anything you consume or don't consume, it tells you what's happening.
2
SPEAKER_01
You have an app that shows you and tracks it.
2
SPEAKER_01
So why is this essential for someone to be curious about and to potentially wanna try this out?
2
SPEAKER_00
 Yeah, the reason why it's something that I think is relevant to pretty much everyone is because of the rates of what we're seeing in our country.
2
SPEAKER_00
Like, if you're just living your life, standard American diet, more likely than not, you're gonna end up with a metabolic disease.
2
SPEAKER_00
That's just now common reality.
2
SPEAKER_00
And so having some information to both see what the trajectory is over time, have a real sense of ownership over what's going on metabolically in your body, I think that's really empowering.
2
SPEAKER_00
Like right now,
2
SPEAKER_00
 you kinda get crumbs of information from your doctor once a year, but imagine if you could really have ownership over that foundational asset of your health.
2
SPEAKER_00
So that's one thing, is just the awareness.
2
SPEAKER_00
And then the bigger piece is to have this closed-loop biofeedback on everything you're eating and everything you're doing to keep glucose more stable, because we want to get off those ups and downs swings, not only to improve our day-to-day functioning and the subjective experience of our days, the energy,
2
SPEAKER_00
 the mood, the cravings, the fatigue, but also to set us out for the long-term avoidance of the glucose-related metabolic diseases.
2
SPEAKER_00
That's really the reason to use it.
2
SPEAKER_00
What I love about it is, just like with the oatmeal example, try a food, see what happens,
2
SPEAKER_00
 The cool thing is, even if you do spike, it doesn't necessarily mean you have to get rid of that food forever.
2
SPEAKER_00
It means that you can potentially modify it and work with it.
2
SPEAKER_00
Let's take the oatmeal example, for instance.
2
SPEAKER_00
If you love oatmeal, you're just like, I do not want to live without oatmeal.
2
SPEAKER_00
That's fine.
2
SPEAKER_00
One thing we've seen in our data set, we've had about
2
SPEAKER_00
 Close to 25,000 people go through our program.
2
SPEAKER_00
We have over 50 million glucose data points, so we have a lot of information here.
2
SPEAKER_00
People who eat rolled oats, like instant oats, which are fairly processed, spike higher than people who eat less processed forms of oats, like steel cut oats or groats, which are kind of like a chewy, very whole food form of oats.
2
SPEAKER_00
So eat one of the less processed ones, potentially, or
2
SPEAKER_00
 add fat, protein, and fiber to that carb.
2
SPEAKER_00
The carb alone, if you're eating what I call like a naked carb, essentially a meal that's just like dominant carb.
2
SPEAKER_01
No fat, protein.
2
SPEAKER_00
Yeah, like two bananas or oatmeal or Skittles.
2
SPEAKER_00
 You think about some candies, like Skittles are basically just like sugar, whereas like a Snickers bar actually has peanut butter and nuts and chocolate.
2
SPEAKER_00
And crazily enough, Skittles have an over 80 point glucose spike in our data set.
2
SPEAKER_00
And Snickers is like 35 or something.
2
SPEAKER_00
So it's like half.
2
SPEAKER_00
And because Skittles are more of a naked cart.
2
SPEAKER_00
And so
2
SPEAKER_00
 Skittles are actually the highest spiking food in our entire data set.
2
SPEAKER_00
Yeah, number one.
2
SPEAKER_00
Just a straight sugar ball.
2
SPEAKER_00
Straight sugar ball.
2
SPEAKER_00
Skittles, candy corn, milk duds, it's like they're all very similar.
2
SPEAKER_00
Jelly beans.
2
SPEAKER_01
It's like sugar coated on sugar with more sugar.
2
SPEAKER_01
It's crazy.
2
SPEAKER_00
 So yeah, so you want to avoid that naked carb situation.
2
SPEAKER_00
So I see oatmeal with chia seeds, which has tons of fiber and protein, a little bit of almond butter, which has fat protein and fiber.
2
SPEAKER_00
Add a few maybe low glycemic berries, like a couple blueberries or raspberries or whatever, which have a good amount of fiber and antioxidants.
2
SPEAKER_00
 Maybe some flax seeds on top, which is going to be fiber and fat.
2
SPEAKER_00
Mix it all together and you're going to probably absorb the glucose slower.
2
SPEAKER_00
It's going to slow digestion.
2
SPEAKER_00
The fiber can actually block the amount of glucose that gets into the bloodstream.
2
SPEAKER_00
The fiber also has the effect of feeding the microbiome, which has downstream positive effects on metabolic health.
2
SPEAKER_00
 Keep the oatmeal, but modify it.
2
SPEAKER_00
And if you're not wedded to oatmeal, then start experimenting with other breakfasts.
2
SPEAKER_00
So for me, I'm like, I couldn't care less about oatmeal.
2
SPEAKER_00
So if I saw that it spiked me and I think I never ate it again, I'm like, I don't even like this.
2
SPEAKER_00
I just thought it was healthy.
2
SPEAKER_00
So like, for me, that's gone.
2
SPEAKER_00
And if you look in our data set at,
2
SPEAKER_00
 what some of the best scoring breakfasts are, we see things logged like eggs and avocado, eggs and greens, we see frittata, we see chia pudding, we see, actually one that we see is like green, there's a particular smoothie that we actually see logged a lot, it's called the Fab Four smoothie, it's popularized by Kelly Levesque.
2
SPEAKER_00
She's amazing, and she, it basically is a really well-balanced smoothie that's low sugar,
2
SPEAKER_00
 high protein and fiber and healthy fats.
2
SPEAKER_00
And there's some vegetables in there as well.
2
SPEAKER_00
And a lot of our community logs that.
2
SPEAKER_00
And so it's actually got a very low glucose spike.
2
SPEAKER_00
So what you can see from this amazing data set is that there's all these options that have like less than 20 point glucose spike.
2
SPEAKER_00
So choose those.
2
SPEAKER_00
Choose those options.
2
SPEAKER_00
As opposed to.
2
SPEAKER_01
Interesting.
2
SPEAKER_01
So someone signs up for this, I guess there's a waiting list right now, but when they,
2
SPEAKER_01
 What does it do for them?
2
SPEAKER_01
Does it coach them on the foods to eat?
2
SPEAKER_01
Does it tell them, oh, you know, you just ate this and that's not good for your system right now.
2
SPEAKER_01
Add this to it if you want to keep eating it.
2
SPEAKER_01
It kind of coaches you for those two weeks or what's it do?
2
SPEAKER_00
Yeah, it does everything that you just said, basically.
2
SPEAKER_00
So the so a levels member.
2
SPEAKER_00
 We'll actually use it for a full month to start.
2
SPEAKER_00
The sensors are on the arm for two weeks.
2
SPEAKER_00
The first month of levels is two sensors.
2
SPEAKER_00
You put one on for two weeks, you peel it off, you put a new one on, and so it's 28 days total.
2
SPEAKER_00
Throughout that process, it's doing exactly what you're saying.
2
SPEAKER_00
You log your food, you take a photo of it, and then you get a score for each of those meals.
2
SPEAKER_00
 The score is essentially a one to ten zone score is what it's called that tells you about the glucose impact of that meal So you're shooting for tens?
2
SPEAKER_00
And one is like lower.
2
SPEAKER_00
So interesting for example, I could eat sushi Which of course has white rice and sometimes the white rice has sugar actually added to it and for me like sushi is
2
SPEAKER_00
 usually scores like a two or a three.
2
SPEAKER_00
Like I have a very, very high spike.
2
SPEAKER_01
And you want it to be a one?
2
SPEAKER_00
You want it to be a 10.
2
SPEAKER_00
10, okay.
2
SPEAKER_00
You want it to be a 10.
2
SPEAKER_00
So that's like a pretty, like that would look like a big sharp spike and crash.
2
SPEAKER_00
Gotcha, gotcha.
2
SPEAKER_00
So what I learned and what the types of things that we talk about in the Levels app is like, okay, well based on what other people have logged, if you log sashimi, you're probably gonna score like a 10.
2
SPEAKER_00
Right.
2
SPEAKER_00
A nine or a 10, because that's of course just like straight fish.
2
SPEAKER_00
 people are now logging cauliflower rice sushi, which is kind of interesting, which has like almost no glucose spike.
2
SPEAKER_00
And there's actually restaurants offering this now.
2
SPEAKER_00
Or, I mean, I think like me, there's some people who just don't want to give up sushi.
2
SPEAKER_00
Like that's not like oatmeal.
2
SPEAKER_00
Like for me, I'm like, I'm not giving up sushi.
2
SPEAKER_00
So then there's other things that I'll suggest.
2
SPEAKER_00
Like for instance, add preload your meal with before the sushi, have a salad with protein and fat.
2
SPEAKER_00
Cause there's been research that's shown that if you eat like
2
SPEAKER_00
 again, fiber, fat, and protein before a carbohydrate, if you sequence the meal differently, you actually have a lower glucose response.
2
SPEAKER_00
So you can eat the exact same sushi, but if there's some other stuff in your stomach first, it's processing it differently and it's changing the hormonal response to the food.
2
SPEAKER_00
Or it will say, you're going up, your glucose is going up, take a 10 to 15 minute walk right now.
2
SPEAKER_01
 No way, and it'll bring it back down.
2
SPEAKER_00
Oh, yeah, for sure.
2
SPEAKER_00
I mean, it can definitely bring it.
2
SPEAKER_01
Does this tell you live data?
2
SPEAKER_01
Is it like, OK, you need to add this, or you need to go walk, or?
2
SPEAKER_00
It's telling you in pretty close succession, yeah, and helping you.
2
SPEAKER_01
Because if it sees a spike, it's going to say, when you're in this range, go take a walk, or add this, or eliminate that.
2
SPEAKER_00
Yeah, and actually, if you have a spike and you haven't logged anything, we'll say to you, hey, what happened here?
2
SPEAKER_00
What did you do?
2
SPEAKER_01
Interesting.
2
SPEAKER_00
 And some people will see spikes if they're exercising, like we talked about, because of the stress response.
2
SPEAKER_00
Usually if someone's going above about 70 to 80% of their max heart rate, they're going to see a spike because that's the stress response type thing.
2
SPEAKER_00
And people will be able to exclude that from their scores because we know it's not a food-induced spike.
2
SPEAKER_00
It's not like the same as sort of a potentially damaging food-induced spike.
2
SPEAKER_01
This is fascinating because it gives you information on your body.
2
SPEAKER_00
 Yeah, and then we'll give people tons of swap options.
2
SPEAKER_00
For instance, if they log a tortilla, let's say they log tacos and they have a really big spike, we have a ton of content on here's 10 other tortilla alternatives that we know don't spike as much.
2
SPEAKER_00
For instance, jicama tortillas from Trader Joe's, there's keto tortillas.
2
SPEAKER_00
 I just got to LA yesterday, first stop, Air One, got their almond flour, keto, I'm like in love with them.
2
SPEAKER_01
You spent $70 on those.
2
SPEAKER_00
Oh yeah, they're like $40 a piece, but I love those tacos.
2
SPEAKER_00
Butter lettuce is great.
2
SPEAKER_00
So there's different options.
2
SPEAKER_00
So we'll give people those resources, give them Costco shopping lists.
2
SPEAKER_00
That's pretty cool.
2
SPEAKER_00
Yeah.
2
SPEAKER_01
 Okay, now I'm excited to try this.
2
SPEAKER_01
What do people need to do if they want to get on the wait list or sign up to be a part of this?
2
SPEAKER_00
Yeah, so they just go to levelshealth.com and put your email address in and you'll be in the loop about the wait list and getting off it.
2
SPEAKER_01
Because you're kind of like rolling it out like every few months to new people, right?
2
SPEAKER_00
Yeah, exactly.
2
SPEAKER_00
Yeah, and then that'll also sign you up for the newsletter which has just like a ton of amazing information about a lot of the stuff we talked about today and a lot more tips.
2
SPEAKER_00
 Certainly people don't need a continuous glucose monitor to apply these metabolic health strategies.
2
SPEAKER_00
You can learn from what people in the program have learned and apply that to yourself.
2
SPEAKER_00
And so we try and put as much of that on the blog as possible so that people can learn.
2
SPEAKER_01
That's fascinating stuff.
2
SPEAKER_01
And are you on social media a lot yourself too?
2
SPEAKER_00
 I'm on social media at Dr. Casey's Kitchen, so D-R Casey's Kitchen, and then Levels is at Levels.
2
SPEAKER_00
And we post a lot of experiments that our members are doing.
2
SPEAKER_00
Yeah, and so get some fun ideas for people to try.
2
SPEAKER_01
How many people are using it at one time, do you know?
2
SPEAKER_01
Because you said 25,000 people have done it over the last couple of years, but how many people are on it right now, do you know?
2
SPEAKER_00
It's a good question.
2
SPEAKER_01
Is it hundreds, is it a thousand?
2
SPEAKER_00
Oh, I'd say a couple thousand, yeah.
2
SPEAKER_00
I don't know the exact number for sure, but around that.
2
SPEAKER_01
That's so interesting.
2
SPEAKER_01
 Really cool stuff, I've heard a lot of great things about it, so now I'm gonna have to try it myself.
2
SPEAKER_01
And I guess I'll be wearing a patch for a couple of weeks, right, for a month.
2
SPEAKER_01
But it'll be cool, be good to see the research on myself.
2
SPEAKER_01
Really cool, so guys, go to levelshealth.com, check it out, Dr. Casey's Kitchen, if you wanna see more about Casey as well.
2
SPEAKER_01
What else should we be thinking about, or how else can we be a support to you or Levels?
2
SPEAKER_00
 Oh, my gosh.
2
SPEAKER_00
Well, I think the best thing you're doing is just having these fabulous people on your podcast.
2
SPEAKER_00
You've had so many wonderful people in the levels community on and I think just spreading the word about holistic health and metabolic health.
2
SPEAKER_00
I mean, it's amazing how I think
2
SPEAKER_00
 Podcasts like yours and Andrew Heumann, David Sinclair, Dr. Perlmutter's podcast, Mark Hyman's podcast, Drew Pruitt.
2
SPEAKER_00
These things are becoming the thing that people look to to figure out how to actually create health in their lives.
2
SPEAKER_00
They're not necessarily getting it from their doctor.
2
SPEAKER_00
I think it's a really exciting time that we're in.
2
SPEAKER_00
I'm very grateful for the work that you do.
2
SPEAKER_00
That's cool.
2
SPEAKER_01
I appreciate it, Casey.
2
SPEAKER_01
All right, this is a question I ask everyone at the end called Three Truths.
2
SPEAKER_01
I think you know what's coming.
2
SPEAKER_01
Imagine it's the last day on Earth for you.
2
SPEAKER_01
 And you've lived an incredible life, done everything you want to do.
2
SPEAKER_01
But for whatever reason, you've got to take all of your work with you to the next place.
2
SPEAKER_01
So no one has access to this conversation or your blogs or content or anything you've ever done.
2
SPEAKER_01
But you get to share three lessons you've learned from life with the world, and that's all we have left to kind of be remembered by you.
2
SPEAKER_01
What would you say are those three lessons or three truths?
2
SPEAKER_00
 I think one of the biggest ones for me in terms of what brings joy and satisfaction to my life is to focus on the little things and just true awe in all the amazing things going around us.
2
SPEAKER_00
I think if you just step back for like one second, you know, and look at what's going on around us, we're in this incredible cosmic journey, you know, we're hurling through space, we're made of,
2
SPEAKER_00
 trillions of cells, innumerable atoms.
2
SPEAKER_00
It's like every time we eat, we're literally taking in matter from the universe and converting it into our body and like shifting our shape every day.
2
SPEAKER_00
We're part of this incredible just continuum of energy and matter.
2
SPEAKER_00
 I think it's just so awe-inspiring.
2
SPEAKER_00
So just step back, look at the awe, the fact that the sun is shining and telling your brain what to do.
2
SPEAKER_00
It's fascinating.
2
SPEAKER_00
So I think focusing on the little things and just having a sense of awe and reverence for everything around you brings me just such intense joy every single day.
2
SPEAKER_00
It can help elevate you from some of the day-to-day stresses.
2
SPEAKER_00
So awe, live with awe and focus on the little things.
2
SPEAKER_00
And of course, that loops into being in the present moment