Wild Health Podcast

Jody:  Matt and Mike, I’m confused.  There are 4 trillion books and articles about what the best diet is.  The fasting trial went awesome, but what should my everyday diet be? What is the perfect diet? Matt:  Well, a few years ago I decided that I would no longer discuss 3 things in public:  Religion, politics and diet. It’s a no win situation and the easiest way to get into a fight.  No one listens. Everyone has set opinions and just gets ticked off when you ticked off when you talk about it.  I’m out. Mike:  But we definitely have very strong opinions based on our medical training and the hundreds of books and articles we’ve read. We talk about it non-stop with each other because we don’t care if we piss each other off. Matt:  Oh, yeah, I love talking about.  Just not in public. Jody, if you turn off the recording, I’m happy to dive in. Jody:  Ok, sure.  Click. It’s off. Matt:  That sounded like you just made a clicking sound with your mouth. Jody:  What?!?!.  Come on, you know me.  Trust me. 2:00 – 4:00 Matt:  Alright, since it’s just us, let’s go.  Tell me what you do now. Jody tells us what he does now and we discuss. 4:20 – 5:30 Matt summarizes:  I just made this up.  Eat food, mostly plants, not too much.  And if you’re great, great grandmother wouldn’t recognize it, then don’t consider it food. Mike:  That sounds familiar. Jody:  Yeah, because he just ripped that directly off of Michael Pollan word for word. Matt:  How dare you accuse me……  Ok, ok. You got me. Problem is that I’ve read hundreds of books and thousands of articles on nutrition and food and I’ve yet to be able to sum it up more succinctly than Michael Pollan did in The Omnivore’s Dilemma more than a decade ago with that statement. So, if you haven’t ready that book, read it.  It’s definitely more complicated than that in general, but every other recommendation I could give comes with some caveats and explanation. That’s a great summary. And it gets you at least one pareto law there. You get at least 80% of the benefit. Michael:  Right, but we’ve got more than 2 sentences worth of time here.  Our goal is always 2 pareto laws, to get to 96%, so let’s dig in a little and go a bit deeper.  As much as you and I obsess over this stuff, I bet there’s a few things we could teach people. 5:30 – 7:00 Jody:  Can we start by explaining those two sentences. Matt:  For sure.  The beauty of them is that it conveys so much information is so few words, but a bit of clarification is in order.  First off, eat food. The next sentence explains that a bit, but a bag of Cheetos and a frankendog you get at the gas station isn’t food.  Calories don’t equal food. Your great great grandmother didn’t have snickers bars, lean cuisine meals, and powerade. So, don’t eat it. Your grandmother did have pot roast, venison, carrots, and spinach and onions from her garden.  Those are foods. Jody:  So, stay away from 99% of the things in the grocery store. Matt:  Exactly.  I was so proud of my kids the other day when a neighbor told me they were at her house and when she offered them a snack my 6 year old said “actually, we only eat things that come out of the ground.”  I acted embarrassed and apologized if it seemed rude, but I was totally pumped. My kids absolutely do not eat what I’d like for them to. They beg for ice cream and other junk that other kids get, but I was so proud that maybe it’s getting through to them. 7:00 – 12:30 Mike:  And the mostly plants part and not too much is pretty simple. The more micronutrient dense whole vegetables you can consume the better. In general we all are overfed due to the convenience of food in modern society and the social aspect surrounding meals.  So, generally, eating low calorie micronutrient dense foods is a generally safe plan, and the food that checks that box are vegetables. We’ve already talked on the podcast about calorie restriction and it’s health and longevity benefits, so go back and listen to that if you haven’t already.  Jody:  OK, that’s all good and well, but I’m trying to think what people can actually take away from this and how they can improve their diet. Obviously, following those two rules could have a massive benefit, but let’s get specific.  Why don’t you guys walk me through a typical day of food for you and let’s discuss why. I’ve seen you both without your shirts on more than I’d like to and you obviously eat a pretty good diet to have 6 packs at whatever age you are. Mike: My diet has been pretty variable over the last couple years, something we can get into later, but my general day fits one of two molds: fed or fasting. For the most part I am alternating between eating a normal breakfast, lunch, dinner on fed days and fasting from 6pm to 8pm on fasting days (26 hours of fasting). This is just what I’ve found works for me, but generally I’m interesting in achieving some of the advantages of fasting, without sacrificing too much performance or activity. More on that later. So on those fed days my breakfast is generally oatmeal, with blueberries, apples and peanut butter, made with almond milk. Plus coffee, lots of coffee. I’ll generally work out in the morning after breakfast, and lunch will be a green smoothie, made with almond milk, about 2 cups of spinach, ½ an apple, a handful of broccoli sprouts, macadamia nuts, and some sort of plant protein power. Sometimes I’ll throw some flax, hemp seeds, or chia seeds in there. As well as some turmeric. The cocktail changes daily and is a nice way to add variety. It’s also a great way to get some raw micronutrient dense foods without cooking or a lot of prep work. Dinner is all over the place, and variable based on the kids, if we’re going out, wtc. In general, I have a salad with whatever I’m eating. That salad usually has some nuts or seeds on it, often has some sliced avocado, and I make all my own dressings out of EVOO or Avocado oil- typically with apple cider vinegar.  The remainder of the meal is typically fish, veggie pasta, or grains and veggies. Some of the things I’m really jazzed on are fish tacos- been really dialing in this nectarine, avocado, cabbage and kale slaw that just makes those tacos so delicious. Also, been really into chickpea pasta which I often make with a ton of veggies and a sage and olive oil sauce. You might be able to tell, I’m mostly vegan, with the exception of fish. We can get into that later, as well. 12:30 – 13:30 Jody: What’s up with the broccoli sprouts, is that like alfalfa sprouts. Mike: Kinda, except they are like the best possible thing you can put in your body.   To list a few this molecule appears boost your immune system,  fight cancer, act as an antiinflammatory agent, and even induce apoptosis. (0) It can help prevent CVD, alzheimers, fight polution, and improve insulin resistance. Basically, name a disease and sulflorophane either helps prevent it or make it better. It’s present in broccolli, but about 50x higher concentration in broccolli sprouts. So I grow these things in a jar for 3 days, then freeze them and throw them in a smoothie. Don’t cook them as it can damage the molecule. Matt: Yeah, broccoli sprouts are a super food for sure, but everything else you eat is total crap. Mike: well why don’t you share your diet with us first, then we can make fun of each other in sync. 13:30 – 15:00 Matt:  Yeah, that’s a good idea.  Mike and I are different. We’ve had genetic testing and know that we need different diets based on our SNPs and experimentation.   So, here’s what I ate yesterday: At 0700 I’m getting kids ready for school and I had coffee.  Black coffee. Mold free. no calories from sweetener or cream.  The only thing put in it is chaga, which is a mushroom and cinnamon.  We could do a whole episode on the potential health benefits of chaga, but this drink has basically zero calories in it, so I get the benefit of a continued fast as I start my day, but I get all the incredible antioxidant and super food beneifts of coffee, caffeine, chaga, and cinnamon. Jody:  Can you dig into that before you move along?  I thought we needed to cut back on coffee. Matt:  Well, sure if you want to live a shorter, more crappy life. The benefits of coffee are clear. 15:00 – 16:00 Mike: Truth, the data on coffee is in, and in my opinion, it’s clear there are numerious health benefits of coffee. To rattle some of those off: Coffee makes you not die: Seriously in a 2008 study in Annals of Internal Med found was an inverse relationship with coffee consuption and CVD. Basically the more coffee people drink the less CVD related mortality. (1) Coffee makes you smarter: it inhibits adenosine and basically functions as a stimulant making you happier and allowing you to think faster. (2) It’s full of nutrients and antioxidants like manganesse, niacin, riboflavin, pantothenic acid. It helps detox your liver: reducing mortality from liver cirrhosis and liver cancer (3) Helps fight off alzheimer's disease (4) Jody: Sweet , what about cinnamon and that chaga deal? Mike:  Yeah Cinnamon is one of those things with virtually no downside. It has anti-inflammatory effects (5), reduces heart disease risk through lowering fasting glucose levels and LDL concentration (6),  and to top it all off, it’s loaded with antioxidants. Jody: So cinnamon is basically like a superfood that everyone should be taking? Matt, what about that weird mushroom thing you were talking about? 16:00 – 17:00 Matt: Well, first off, it’s a super cool looking mushroom that looks like a big clump of dark dirt or bark growing on birch trees in the northern hemisphere.  I would love to say I harvest it like I do my other mushrooms, but I just buy it online. I live too far south. It has tons of vitamins an minterals.  B comple, zinc, calcium, vitamin D, selenium, manganese, copper, potassium, rubidium (Jody, I know you’re always looking for good sources of rubidium), iron, and others.  It’s an antioxidant, can reduce LDL, there’s some research that it slows cancer growth, has triterpines, which are good for you (either google that or just trust me), supports the immune system by regulating production of cytokines, and several other benefits as well.  It’s a really cool food.  So, that’s my breakfast 17:00 – 20:00 Jody:  Then lunch Matt:  OK, so sometimes I eat lunch and sometimes I just continue fasting with more coffee.  If I continue fasting to really get my time restricted window down, I’ll usually have some coffee with MCT oil in it.  That MCT being converted to ketones and caffeine gives the metal boost that most people want in the afternoon without the crappy 5 hour energy or something that has aspartame or other harmful chemicals in it.  And if I have some important mental or deep work to do, then I’ll usually add a packet of lion’s mane mushroom coffee. It’s a nootropic that increases neurogenic growth factor, and really gives an amazing 1, 2, 3 punch with the caffeine, ketones, and lion’s mane without the sluggishness of food and a big lunch.  I get really productive work done. Jody:  Ok so skipping one meal, breakfast, is probably a bit of a stretch for most people already, and we’ve talked on the podcast before about the benefits of time restricted eating, but skipping both breakfast and lunch is a bit much.  What if you do eat lunch. 20:00 – 21;20 Mike:  Well, really quickly.  Just in case someone missed it, there are big benefits to time restricted eating, or as some people call it, intermittent fasting.  They’ve done rat studies where they fed them the exact same amount of calories each day, but when they did it in a smaller feeding window they did so much better metabolically.   It seems to lead to more energy, better insulin sensitivity, more mental clarity, and a lot of other benefits. I’m with Matt in trying to get that feeding window down as small as possible.  8 hours if I can, or even 4 hours if possible. Only eating from 2-6pm is my ideal goal, but as active as we are, it’s hard to get enough calories in such a short window. 21:20 – 22:00 Matt:  Yeah, exactly.  So, I usually break my fast right after I workout.  So, occasionally I will eat in the AM, but only if I’ve earned those calories.  Otherwise, you asked about my lunch. My classic go to lunch is 16 ounces of bone broth, which I make big batches of at home every couple of weeks and some almonds or walnuts with it.  I feel like a million bucks when I get that really nice shot of healthy fats and protein, and all the nutrient dense goodness that is bone broth and true nuts.  Jody:  What do you mean true nuts.   Matt:  I mean not peanuts.  They’re a legume, and I don’t count the as a healthy food for me.  Too inflammatory. 22:00 – 23:00 Mike: Here’s one place where Matt and I differ. I eat peanuts daily, as peanut butter to the tune of 2-4 tablespoons. And my CRP and inflammatory markers are nonexistent. I eat tons of other legumes as well, basically have to if your vegan. Now that doesn’t mean everyone will tolerate it as well, you‘re going to have to experiment yourself, or get your gut microbiome tested to really know if your sensitive to that stuff. If there is anything to really worry about with peanuts, it’s probably their likelihood of containing aflatoxins. Peanuts grow underground, and have a tendency to be colonized with aspergillus which is a source of aflatoxins, which may be a carcinogenic compound to the liver and raise the risk of liver cancer. 23:00 – 24:50 Jody:  Ok ok, you guys play nice. Matt, What about the whole plants thing you mentioned earlier you haven’t mentioned a plant all day in your diet yet? Matt:  Well, first off, where do you think coffee, chaga, cinnamon, and nuts come from.  Those animals? Nope. And if I don’t have my bone broth with me, then I focus on the same thing:  Nutrient density and healthy fats. So, a huge salad or giant bowl of vegetables with olive oil and salt and pepper is perfect for me.  Jody:  What about protein?  I know you workout a lot.  Shouldn’t we be focused on protein?  Matt:  Absolutely not.  Maybe if you’re a developing country.  But look, the vast majority of Americans get way too much protein. Protein is a dirty fuel.  You should get just enough for building muscle and repairing your body, but it shouldn’t be your source of fuel.  It has too many problems associated with it. You, I, and nearly everyone listening to this probably gets plenty of protein unless they’re a vegan, in which case they should think about protein. But for an omnivore, it’s just not near the top of what you should be concerned with. 24:50 – 27:30 Mike: I think a good rule of thumb is 1 gm of protein for every kg of body weight. That's the max you need, even if you’re an athlete. Protein got way over hyped in response to the low carb fad diets as an alternative macronutrient to carbs and fats (which most people still thought were bad for you). In general, I’d say worry way more about the quality of the food you are putting in you and forget about the macronutrient profile. Jody: You keep saying macronutrients, what are you talking about. Mike: Macronutrient just means the % of calories coming from proteins, carbs, and fats. I don’t think the numbers matter, unless you are going for nutritional ketosis. And the %’s will vary vastly from one healthy diet to the next, take mine and Matts for example. I eat about 50% carbs, 40% fat, and 10 % protein. I bet matt is closer to 10% carbs, 70% fat, and 20% protein. But generally, we are both eating healthy, and in ways optimized for our own performance and body type. Jody:  Got it, ok Matt, what about dinner?   27:30 – 28:50 Matt and Mike and Jody discuss why personalized diets are so important and their experience with ketogenic diet and why it worked great for Matt, but not for Mike when they tried it. 28:50 – 31:00 Matt:  Same goal.  Super nutrient dense food that comes from whole food sources, mainly plants.  My go to is an instapot concoction I make. I combine vegetables from my garden and farm.  What is ripe and in season. This is very important. I think there’s a very important nutrient density difference in local foods that you eat with the rhythms of the seasons compared to foods flown from around the world after being picked before their ripe and then gassed to make them ripen.  Big difference. So, I combine that with wild and cultivated mushrooms. Jody:  Oh, yeah, shrooms. Matt:  Not those shrooms.  These are magic, but not psychoactive.  Magic because of their nutrient density.  I inoculate logs and grow golden oyster, shiitake, lion’s mane, and a lot of other species at my farm, and we also forage and find tons of milky’s, chicken of the woods, maitake, chanterelles, morels, boletes, and so many amazingly nutritious and delicious wild foods.  Now, talk about nutrient density. Nothing is higher on my list than wild foraged mushrooms. And then I add the most nutrient dense protein and fat source I know, which is bone broth and organ meats.  Yesterday for me that was lamb liver and heart that I got from my close friend who raises sheep in a truly beautiful and humane way on pasture their entire life. Jody:  Hold up.  Did you just say lamb heart. Matt:  Yes. Don’t be like my 6 year old daughter who just says “oooh”.  It’s one of my biggest pet peaves about our society that we’ve been trained culturally to only eat the least nutritious part of the animal, the muscle.  It’s crazy, and honestly kind of boring if you ask me. You get so much more rich nutrition from the organs, and I find it a little unethical really. At my restaurant we’ve been trying to teach guests that “we don’t raise filets”.  We raise cattle. No one grows a lamb chop. We birth, care for, and raise sheep. The entire animal. We should respect the animal by consuming as much as possible, and we should respect ourselves and our bodies by feeding them the most nutritious parts. Jody:  OK, pretty sure you lost some people, but basically, bone broth, locally raised vegetables, wild foraged mushrooms, and organ meats. Anything else. 31:00 – 32:00 Matt:  Well, that’s pretty close to the perfect meal for me. If you want my true and total weirdness to come out, then I will confess that my end goal is to get to the point where all of those things I’ve planted, raised, and killed myself.  To me, that’s the ultimate meal and that’s why I have a farm and am trying to learn to hunt and learn traditional skills like butchery. Is that weird? Absolutely. And I’m not a kill joy that’s going to point out the inhumanity of feed lots when someone at my table orders a traditional filet.  But there’s something about being that connected to my food that gets me super jazzed. And obviously, I’m in KY and am never going to be able to provide my own salt, spices, or some things. But the closer to this ideal I can get the better. Jody:  alright…….so, basically you want to go back in time thousands of years and throw away all the progress we’ve made with agriculture, technology, the division of labor, and our ability to spend our time doing other productive things than just growing, hunting, and preparing food. 32:00 – 33:10 Matt:  Well, no.  Ok, kind of. I mean, I’m all in favor of appropriate technology for making our lives better.  But the key word is appropriate, which we don’t have time to unpack. I just want to be more connected to my food. What I just described is obviously not for many people, but the nutrient dense part I totally stand by.  You can do all of that with food you buy from the store or your farmer’s market. No need to get all crazy intense like I do. Jody:  So…...what’s that diet called?  Is that paleo, keto, what? Matt:  Well, I don’t think it’s got a label.  It’s definitely pretty close to those things.  You could definitely call it paleo, but it’s a bit more than that.  And it’s definitely not keto with all the wild mushrooms and vegetables, which technically have too many carbs to truly be in ketosis.  Trust me, I’ve tested by BHB levels with pretty much every variation of this. Jody:  BHB levels? 33:10 – 34:45Matt:  Ketones. Jody:  Right. That’s why I thought you were keto.   Matt:  Well, I am, sometimes.  I do occasionally try to go hard into ketosis, at which time I’ll cut out the carbs.  There are major benefits to ketones and the diet that leads to them. Autophage and similar benefits as fasting.  But I cycle this, as I think there are also tremendous benefits to all the plants that I have to cut out to start truly producing a lot of ketones.   Jody:  So, how often to cycle and how do you choose?     Matt:  Well, I’m always a fan of trying to go all ancestral and wild as possible and let nature be the guide when I can.  So, what I mean by that is that I will eat tons of the wild mushrooms when they’re in season. I eat asparagus in the spring when they’re ready to harvest.  And I eat vegetables in the summer and fall when they’re ripe and we’re harvesting in my area. In the winter is usually when I try to eat keto more. Just like people 300 years ago living in Kentucky would have much less carbs and fresh veggies available in the winter, that’s when it makes sense for me to live on meat and fat and be more often in ketosis.  I think the seasons and what is available locally is the best guide for me personally as to when I’ll eat keto, fast, or focus on super nutrient dense plants. A plant that I would the crap out of when it’s in season I’ll avoid when it’s not. Jody:  And I assume you’ll link to all the scientific articles in the show notes. 34:45 – 35:50 Matt:  Oh, for sure.  And just off the top of my head I can count…...upwards of…...zero articles to backup my thought that this is the perfect diet for me.   Mike:  Ok, that’s helpful. Matt:  I mean, seriously, we could do a whole episode on the benefits of a ketogenic diet.  I think that’s been talked about ad nauseum. The affects on insulin sensitivity, longevity, mental acuity, etc.  Very similar to the data on fasting. We could definitely link that that. And we could provide tons and tons of data on the benefits of a plant based diet in general when we’re talking about whole plants, especially leafy greens, broccoli, and vegetables with super high nutrient density and super food components.  Antioxidants, phytonutrients, blah, blah, blah. Eat your veggies. The problem is that I believe very strongly in all 3 of those things, so this method of cycling according to nature makes the most sense in my mind when it comes to practically applying this knowledge. Jody:  Mike, you do the same? Do you cycle in and out of ketosis. 35:50 – 38:30 Mike:  Nope. I mean, we can all agree to cut out sugar, processed foods, and things like that, but it turns out that the perfect diet for you isn’t the perfect diet for me because I’m a different person with different genetics.  I’m stoked for you, Matt, that you’ve had such a great experience with keto. And from what I can tell, it seems like your experience is the majority. When you look at the data out there, people on nutritional ketosis diets seem to have overall improvements in cholesterol, which suggests improved CV risk, improved insulin sensitivity, which leads to less DM2, and a lot even feel more fresh, clear headed, and even perform better- especially as endurance activities. Unfortunately, there is a minority of people, like me, who have a different experience.   About 1.5 years ago I tried nutritional ketosis. Actually I did it as a fat kid when I was 18 or so, but didn’t know enough to get labs checked. That lasted about 4 months, and I lost a ton of weight and put it all back on when I went back to carbs. But last year, early 2017, I gave nutritional ketosis another go, with the goal of improving my cholesterol and insulin sensitivity - for my overall CVD risk. I’ve always had bad cholesterol, despite generally eating a clean diet and exercising regularly. So I went into ketosis. I ate healthy, a lot like the stuff you are eating Matt, just les carbs. It took me about

Jody wants to talk about Saunas [0:01:02-0:01:57] "Give me a fever, and I can cure the world." quote by a famous really old doctor (Hippocrates). We've known Sauna is good for you for a long time. Ancient people have been using forever, and it's extremely popular in places like Finland. [0:02:01-0:02:44] Matt and Mike discuss how your pulse can go up by about 30% in the sauna and it's really good for your heart. They describe THIS JAMA study of 2300 men that shows those that visited the sauna 4-7 times a week were over 60% less likely to experience sudden cardiac death and were 50% less likely to die from cardiovascular disease than those who only visited a sauna once a week. There's a dose dependent response as well. [0:02:58-0:03:57] Matt talks about a fruit fly study that increased their lifespan on average by about 5%. That equates to 4 years for a person......but you can't apply to a person. Interesting data, though. Sitting in a Sauna can burn about 300 calories per session. You're exercising while sitting there. [0:03:58-0:04:54] Jody says he read on the internet that a doctor says you can't detox through sauna use since the kidneys and liver are what detoxes. Matt goes off on this topic refuting that claim and telling why he's definitely not impressed by a claim just because "a doctor" says it. Curiosity and the desire to continue learning are more important than credentials. [0:06:58-0:07:53] Matt and Mike discuss the studies showing that multiple heavy metals like BPA and phthalates have been found in sweat, suggesting that you can sweat them out. There is some controversy, but we think that you can detox from sweating in a sauna, and the downsides are so low that it's worth trying. Worst case scenario, you're getting some good relaxation. [0:07:58-0:08:54] Matt and Mike discuss the Finnish study a little more and how it decreased the risk for Alzheimer's by 65%, which could be partly from relaxation, but probably more from the microvascular effects of the increased heart rate and hyperthermic conditioning. [0:08:58-0:09:57] Mike discusses the temperatures you get to in sauna after Jody asks how high the temperature needs to be. Typically, infrared saunas should be 120-140F (49-60C) while traditional saunas must be above 150F (65.5C) to be effective.  I would say make it as hot as you can stand it. You want it to be uncomfortable enough so that your body makes the proper responses. [0:09:58-0:10:46] Mike and Matt talk about how hot exactly to get ( "if your skin is melting......that's too hot"). They describe how each of the different sauna types work to heat you up. Infrared saunas work by directing infrared rays at your body and penetrating the tissues, just like the sun.   xcept there aren't any UV rays, which are the potentially harmful part of sunlight. And dry saunas work by heating up the air, which heats up your body. So, the air temperature in an infrared sauna doesn't need to be as hot to work. It works more directly on your body. This means it also uses about 1/3rd of the energy of a dry sauna. 0:10:58-0:12:15 Matt talks about how sauna affects insulin sensitivity, which affects muscle growth, but also is really nice to know if you're diabetic.  Could be very beneficial for diabetic patients. It also increases HGH. Studies ( H R  and H R ) have shown that growth hormone levels more than doubled after 2 20-minute sauna visits at 176F and levels hopped up 5 times with 2 15 minutes sessions at 212F! 212, is definitely too hot, though. Don't do that! 12:58 - 14:30 These studies on HGH were dose dependent. Two 1 hours sessions increased HGH levels by 16 times. We're not going to go into the pathway of growth hormone mediating IGF-1, activation of m-tor leading to protein synthesis and Fox o activation inhibiting protein degradation.   Everyone knows that basically HGH makes you swole. You look better, are stronger, and feel better with more growth hormone. I know guys who are paying good money for HGH supplements, when it looks like they could just make themselves super hot and relax in a sauna without the risks associated with pills and injections.  Way safer, cheaper, and easier. Basically get super hot by getting super hot. 'r get super hot to get super hot. 14:30 - 16:00 Along with helping gain muscle, the heat can also help retain muscle.  A study in rodents showed that the heat-acclimated group retained 30% more muscle that the control group.  You're body is always either building muscle or breaking it down. Protein synthesis or protein degradation.  Saunas and heat stress induce production of heat shock proteins, which reduces protein degradation. So, not only does does it increase protein synthesis by increasing growth hormone like we talked about, but it stops the degradation.  There was a really cool study where they took rats, immobilized their leg, like if you got a cast, then when they remobilized and let them work the leg again and they found 30% more muscle growth when using sauna. Applicable to someone who has an injury and wants to recover more quickly. 16:00 - 17:00 Matt discusses the applicability and how it applies to humans and makes sense.  It makes sense from a simplistic standpoint as well. ven while still immobilized you can sauna and even if you can't move the extremity you get the exercise simulation benefits like we talked about earlier with increased heart rate and you get the heat shock proteins, growth hormone, increased blood flow to the leg, etc.    It's not just muscles, though.  When Matt was training for ironmans, he didn't really want to be carrying around extra muscles for that long of a race, which was like 12 hours for someone super slow like him.  And he was obviously much more concerned with endurance. He remembers Ironman Louisville one year where the temperatures and humidity were in the 90's and there was just carnage along the race course.  If only these racers had known that a few sessions of hanging out in a sauna could dramatically affect their endurance and hyperthermic conditioning and heat tolerance in general. 17:00 - 20:00 They discuss the study that shows increased endurance H R . It showed that a 30 minute sauna session 2 times per week for 3 weeks after workout increased time to exhaustion by 32%.  Now, that's a crazy number, and I don't want you thinking that means you can decrease your 5k time by 32%. The way they did the study they got this number, but in real terms what it equates to is about a 2% improvement in a 5k, which honestly is still massive.  If your PR is 20min for a 5k, then this suggests this very simple 2 wk intervention could decrease that time to 19:36. If you're a runner you realize how much intense training would have to be done to decrease your PR by 24s. This is incredible. Honestly, it's so incredible, I had a hard time believing it initially, especially since this was only done in 6 athletes.  However, it's more believable because they actually showed the physiologic mechanism of why. Blood plasma volume increased by 7.1%. RBCs and total volume were also increased. So, you kind of get the blood doping effects of P', which you've probably heard about from tour de france riders, without injecting and actually cheating. It's just 'like' cheating, but completely legal.  I love anything that basically makes you a better human to the same level as cheating without the risks. That's not the only mechanism, though. It's been proven that muscle glycogen use is decreased, meaning longer time until you hit the wall, less lactate accumulation, and better thermoregulatory control, basically you sweat more and sooner. In the end, if you're trying to get faster or more endurance, then this is totally worth doing. 20:00 - 24:40 Matt discusses the studies on depression. Studies have shown that sauna use releases dynorphins (the opposite of endorphins) which are what create feelings of discomfort.  An increase in dynorphins actually increases endorphin receptors. Your body is kind of trying to compensate is one way to look at this. Specifically, dynorphins bind to kappa opioid receptors and upregulate mu opioid receptors.  The point is, you don't just feel good right afterwards, but the increase receptors for endorphins mean you're more sensitive to the great feeling of endorphins later as well. You're primed to be pumped and happy. There was a pretty amazing study in JAMA Psychiatry.  A randomized, placebo controlled trial looking at this showed that 1 session significantly decreased depressive symptoms, and the really cool thing is that it persisted 6 wks.  Maybe longer, but that's when they quit tracking. Now, I TOTALLY didn't believe this when I first read the headline. Absolutely no way that one session of sauna decreased depressive symptoms for at least 6 weeks, maybe longer.  Didn't pass the sniff test, and as a doctor and science geek I was mad at JAMA for publishing this crap and I dug into the article with an angry disposition. So, I was pretty shocked after I read it. It's not a huge study. But it's really well done, and I owed the authors and JAMA a mental apology.  My first thought was that 'well, you can't blind this stuff. People know they're getting the intervention. It's all placebo. But they did a pretty good job. First, they whittled it down from over 300 to about 30 participants and specifically eliminated folks who seemed to be good placebo responders.  Then they did apply some heat, just not intervention heat to the control subjects and about 3/4ths of the controls thought they had gotten the intervention afterwards, so those controls should have a placebo response if that was the case, making the results less significant. But there was still a really significant result.  I'm totally impressed. 24:40 - 27:30 Mike discusses how Sauna can make you more pretty, boost your immune system, makes you smarter, and makes you prettier. Now remember, you're not getting the UV rays which age skin with the infrared saunas. So, don't confuse this as being the same as sunlight.  It seems from research on this, and just makes sense, that you can increase the rate that you turn over skin cells and get rid of dead cells by sweating.  You also clear pores of dirt and bacteria and flush out wastes. AND you increase capillary circulation. So, you should get a more healthful, young looking glow, which I can tell by your unkempt beard is super important to you. One study showed that you can potentially decrease your colds by 30% by using a sauna.  Not a huge study, though, with 50 people over 6 months, but we think we have a mechanism, which makes it more plausible.  That mechanism is by increasing WBC's, lymphocytes, neutrophils, and basophils, which suggests a stimulated immune system.  This was in a 2013 study in the Journal of Human Kinetics. As for sleeping better, it makes sense, but not very much science on this one. It makes you smarter: It's been shown to increase BDNF, which increases neurogenesis and enhances learning, long term memory, and neuronal plasticity.  This BDNF increase is also one of the reasons that ketones from a ketogenic diet make you more mentally sharp and potentially helps with neurodegenerative disorders, and also part of the reason exercise makes you smarter. It's good stuff.  A really big reason to do sauna. Probably enough in and of itself if none of the other benefits applied. 27:30 - 31:30 Matt and Mike discuss what type of sauna they recommend: Well, we have absolutely no affiliation with any type of sauna company but we have opinions. We already talked about the differences. Your core body temperature, which is what is going to give you the benefits we've talked about should get just as high with either.  The air temperature will be lower in the infrared, but you should get a similar internal temperature rise. Infrared are traditionally smaller, take less energy, and pose less of a fire hazard, so I think that's why they tend to be more popular now. That, and the fact that they take less time to heat.  About 15 minutes compared to 30-40 minutes with traditional.  And even before they're fully heated up, you're still getting benefit from the infrared rays penetrating your body and heating you up. If 140 degrees combined with the infrared penetration isn't enough for you, there's a great hack for increasing the temperature even higher that Ben Greenfield describes really well.  We'll link to his site in the show notes. In fact, if you really want to learn more about this after listening to this and digging into the articles we'll link to both Ben and Rhonda Patrick, who have discussed sauna use and hyperthermic conditioning a lot on their sites and podcasts. A lot of my initial knowledge I gleaned about hyperthermic conditioning came from hearing them talk about it and then digging into the literature once they peaked my interest. In general, either are fine. It kind of depends on your preferences.  I would caution you very strongly against using wet steam rooms, though.  It's fine at your house if you're controlling the water source, but do not use them in gyms or hotels where you don't know where the water is coming from.  Normal tap water has chlorine in it that is released into the air when you evaporate the water and you're inhaling that or any other impurities in the water. Well, that goes for traditional saunas as well.  The overheating phone incident I mentioned earlier was in a sauna in an airbnb we rented. And I knew they had a sauna, so on the way there I stopped and bought a gallon of distilled water that I could use on the rocks when I needed to.  With all the benefits of hyperthermic conditioning, it would be a shame to negate all those by inhaling chlorine gas. 31:30 - 32:30 Matt and Mike discuss  MFs briefly: So,  MFs probably deserve their own podcast, which we'll do.   But if you google around before you listen to us talk about it on the podcast and decide that they are harmful enough to worry about, then yes, there are low and zero  MF products out there. Personally, I am very concerned about them and think we're harmed way more than we realize by MF's, which by the way Jody, stand for electromagnetic fields. I hate to be alarmist, but I'm definitely doing everything I can to mitigate their risks to myself and my family. The infrared sauna I bought is a zero  MF version that definitely costs more, but I thought it was worth it. You can find plenty of good options for that. 32:30 - 36:50 Matt and Mike discuss how long you should stay in: Well, it depends on your goals and how much time you have.  First off, don't be stupid and fall asleep in one for hours at a time.  That's called cooking, not suana'ing. Most of the protocols in the studies we talked about are for 20-30 minutes, but you can definitely go longer.  The depression study got their participants up to a pretty high core body temperature for about an hour.  So, if you're using this to clinically treat something like depression then maybe longer than if you're doing it just to relax or increase endurance or muscle growth. 'f course, in most studies there was a dose dependent effect.  Remember the HGH study and the massive increase with higher temperatures and longer duration. Similar to high intensity exercise, fasting, and just about anything else you do for performance optimization, there is a higher risk for badness as you push the envelope.  Longer durations mean you definitely need to be more cognizant about how much fluid you drink, replacing your electrolytes, etc. If you really want to get crazy, which sometimes I do, you can workout in the sauna. Be careful, though. Recently I did a high intensity workout consisting of 50 lb 1 arm kettlebell swings, burpees, and goblet squats in a full on infrared sauna and I nearly killed myself.  Went way deep into a pain hole that I could not climb out of for a few days. Similar to a feeling I had one time when I got lost on a long run without water in 100 degree heat. Days of recovery. You have to be careful as you're working your way up to more intense sauna. Be careful as you start. 36:50 - 38:30 Let's test this: Jody, you don't have a sauna, but they do have an infrared sauna at the castle that you can use at least a few times per week.  So, let's do this. Try to use it at least 3-4 times per week for 2 months for a full hour. Let's go hard with this. If you workout beforehand, then limit it to 40 minutes, and if you workout in the sauna, then limit it to 20-30 minutes.  Don't fry yourself. Let's get your blood drawn and measure as much as we can and also have you do some exercise tolerance tests. We'll do a modified bruce protocol on the treadmill and a test of max deadlifts at 10 reps and overhead press at 10 reps before and after.  We'll also measure your body composition and weight. Lean muscle mass and body fat percentage. I want to get a good overall view of your health before and after. Try not to workout more or change your diet in any way, though. This is obviously completely unscientific, but we'll control as much as we can. We're tempted to have you do some stuff around measuring overall well-being, happiness, and sleep as well, but that seems too complicated and too prone to placebo anyway.  The other stuff can definitely be influenced by placebo, but probably not quite as much as subjective scores. Actually, sleep tracking would be cool as well since you can passively measure that with an aura ring.  Add that to the list. 38:30 - end Matt describes some experiments he's been doing in the shower, sauna, and working out in the sauna. He can increase his core temperature to 101.1 in the shower, but all the way up to 102.2 with an intense workout in the sauna. His core temperature does not increase just sitting in the sauna. This is probably due to his thermoregulatory system being pretty efficient in general.  

How to live forever the Fasting Episode   0- 1:00   Jody: Guys, I don’t want to die.   Matt: Shut your mouth   Jody: Sorry.  I’m just scared.   Mike: Seriously, keep your pie hole shut   Jody: What did I say?     Matt: You’re not hearing us.  Just don’t eat, man. You can talk.  Just quit shoving calories down your gullet.   Jody: And I’ll live forever?   Mike: Well…….maybe………   1:00 - 2:40   Mike: Ok, so no you’re not going to live forever, but if you want to extend your life, then honestly, simply eating less is probably the absolute best way to do it.  And that’s a pretty cheap, easy intervention.   Matt: Except it’s not completely simple. Yes, calorie restriction has to been shown to really lead to increased longevity in a lot of animal models.  It not only leads to longer life, but better longer life as well and extends median and maximal life span in rats, mice, fish, flies, worms, monkeys, and yeast.   Jody: That’s really exciting.  I can’t wait to tell my pet yeast and flies. They’re gonna be so pumped.  What about humans? That’s what I happen to be. Or pretty close to it.   Mike: Great point.  Yes, it’s pretty difficult to replicate some of these studies in human.  You can double a fly’s life span in a study and it only takes about 2 weeks to get results and no one is crying over not being able to go out for pizza with their friends.  So, it’s both hard to extrapolate this data, and it’s hard to repeat in humans.   Matt: Right, but we we do know a few things…...we think.  The fact that we see this effect in multiple species means it “probably” applies to many other species not studied, including us because it doesn’t seem to be a species specific adaptation, and when it applies to primates, it usually applies to us.  And there was that really great U of Wisc study of primates where they restricted calories by 30%, and the monkeys were living to be the equivalent of like 130 in human years. And, they were living better! Less calories reduces metabolic rate and oxidative damage and improve age-related markers like insulin resistance.  So, you don’t just live longer. You actually age more slowly, which is different. It’s better.   2:40 - 3:50   Jody: Sold.  I’ll just cut 30% off my cheesburger and fries and live forever with the amazing, disease free body I have now.   Mike: Well…….if it was that simple we wouldn’t be talking about it.     Matt: You’re gonna rain on our parade and talk about the brain integrity study, aren’t you.   Mike: Yep.  It’s almost like you and I have discussed this before.  Jody, before you or your grey mouse lemur primate go balls to the wall with calorie restriction you should check out the study at Nature.com just this year.  Yes, these lemurs lived longer.  50% longer. So, translating that to humans that’s like going from 80 to 120, and they seemed to live better like the other studies with reduced aging-associated diseases and preserved brain white matter. BUT, they had accelerated loss of grey matter in the cerebrum.     Matt: Ok, ok.  So, yes, Jody probably doesn’t have much grey matter to spare. But what does this mean exactly? They still had all those benefits, just like all the other studies as well, and this one, single downside. Seems like the balance of benefit to harm is still pretty heavily in the benefit category, right?   3:50 - 4:50   Mike: Well, probably.  And like you and I have discussed in the past, we may be able to moderate or eliminate that downside by getting a little more clever than a simple, strict 30% calories restriction forever.   Jody: The suspense is killing me.  Any chance we skip the talk of IGF, gene transcription, protein synthesis modulators, etc and just tell me what to do.   Matt: We got you.  We’ll give you some action points, but let’s geek out just a bit more for the science nerds out there.  Let’s dig into this lemur study. I love this study because these primates are very similar to humans, not just metabolically, but also when it comes to their brain aging.  They get amyloid lesions, which correlates to Alzheimer’s in humans, so we think they’re a very good model to compare to. So, let’s discuss. Jody, why would you care about your grey matter and if it atrophies?   Jody: Seems bad.  What do you mean?   Matt: Well, you’re brain isn’t going to look worse in a bikini with atrophied grey matter.  Your thick skull has it hidden. So, why do you care?   4:50 - 5:40   Jody: Well, I don’t want to pee my pants and forget my kid’s name when I’m old.   Matt: Exactly.  It’s obviously the effect that’s important.  And luckily for us, they studied that’s it. The headline of the story is that the grey matter atrophied, and that’s what everyone was talking about.  But when you look at these monkeys’ performance on motor and cognitive tests they actually didn’t really have a drop off. So, I would absolutely hate for anyone to throw the baby out with the bathwater based on this and say not to calorie restrict because of this MRI finding that no one showed actually had a clinical effect.   Jody: So…...it doesn’t matter if the grey matter atrophies.  Or it does matter.   Matt: That’s an easy answer.  I have no idea. I’m just saying, we have real clinical benefits, and there are what LOOK like negative effects on MRI, but absolutely no proof of clinical negative effects.     Jody: So, you’re not worried about grey matter atrophy?   5:40 - 6:50 Matt:  I definitely didn't’ say that.  I want my grey matter to be plump and robust as possible if I had a choice, but I don’t want to give this more credit than it’s due. You’ll notice that CR actually had sparing effects on the white matter.  So, I have no idea what this means. Performance wasn’t affected one way or the other in this small primate study. There’s clearly a big benefit to calorie restriction, and if we somehow can mitigate this quote-unquote problem, then I’m all for it.  If I figure out how, then I’m all in. Otherwise, I’m still a big fan of CR. Let’s just talk about how exactly now.   Jody. Yes, lets.  Because the more I think about it, I’m not sure I actually want to cut 30% off my cheeseburger the rest of my life.   Mike: Well, I don’t think you necessarily have to.  You see the reason CR works is because, we think it reduces things like the igf-1 axis and the tyrosine kinase pathway. Both of these functions are active in the fed state and can lead to aging, cancer, diabetes, heart diseases. But CR and fasting also works by activating cellular mechanisms for autophagy and apoptosis. Autophagy means to eat one-self.   Jody: Dude, that doesn’t sound good.   6:50 - 8:40   Mike: I know, but what if your cells are just eating the weak broken-down parts of themselves. That's an oversimplification of the process, but basically calorie restriction induces a fasting state that leads to your cells looking to themselves for nutrients and energy. They automatically activate autophagosomes which scavenge the cell for broken proteins, old organelles, mitochondria, and other structures in disrepair. In essence, it’s a way for your cells to be out with the old and in with the new. Without fasting, or calorie restriction, you’re cells don’t go into autophagy and don’t get the chance to clean out themselves. Apoptosis, is similar, although it happens on a higher level, leading to cellular destruction of old broken cells and eventually replacement with new ones. Both, mechanisms occur in response to CR or fasting and are the panacea of longevity research right now. The idea being that cell rejuvenation and regeneration leads to management of and prevention of chronic diseases such as diabetes, CVD, Alzheimer's, autoimmune diseases, basically anything that can kill you.   So, getting to my point, you don’t have to activate these pathways with strict chronic calorie restriction for the rest of your life, turns out you can turn these pathways on and off relatively quickly, and still gain some of the benefits without losing 30% of your calories. For example, anybody that follows this literature knows about the man, the myth, the legend.  Valter Longo. He’s shown pretty good results with his fasting mimicking diet, which is not as difficult as traditional fasts, probably has the same benefits, and I have personally used………..   8:40 - 12:35   Matt: Ok, so I have some issues with the FMD. My first issue is that they sell a product to go along with it.  Now, when I first heard this I completely dismissed the whole thing outright. Honestly, it made me a little mad. I had always felt like the CR data was not only very convincing because of its sophistication, but also because I’m very, very skeptical of medical research as a whole because there’s just so much stinking money from pharmaceutical companies and so many conflicts of interest that it’s hard to trust.  But what could be more free from conflict than something that is the absence of consumerism or paying for pills. Who benefits from you buying and eating less? So, it just really ticked me off to see a product all of the sudden tied to the research. Of course, I then found out later that Dr. Longo donates his shares to a non-profit and doesn’t take money from it. So, I have massive respect for Dr. Longo and his work and I’m not suggesting anything nefarious of the man, but I’m still a little skeptical of this product.  I don’t think it should be hard for people to get the same benefits, just as easy, without buying something. Having said that, I totally get that having a pre-packaged meal may mean higher compliance and benefit for more people. I get it. There’s just something about eating food from a wrapper that will always bother me, especially if I can get the same results without doing that. So, for me, what I recommend to my family and do myself is a similar 5 day FAST with homemade bone broth instead of their packed product.  Obviously, you have to be careful about your protein intake in general if you want to true benefits of fasting and the autophagy, but someone with my metabolism can take a pretty good amount of bone broth and get those results.  We’re not going to go into the signaling and issues around too much protein right now. I really don’t think we’re approaching those levels of protein with what I propose. And I feel comfortable having my mom, who doesn’t have my metabolism take 12-16 oz of bone broth per day during her fasting period.  And, honestly, there are so many great benefits of such a nutritionally dense food as bone broth that I prefer that to their packaged product even if both were free. I think it’s a better choice personally. All that collagen, minerals, etc. Yes, I understand that making bone broth is more difficult than buying the products.  But if you could see the look on my dog’s face when she gets the leftover bones, that’s priceless man. Of course, you could totally do a 5 day water fast if you’re super hard core. But one of the things I liked about Longo’s most recent study is that he had a 75% compliance rate. I do not think that would have been possible with a strict fast.  And no reason to torture people if we really could get similar results without the pain.   12:35 - 14:00   Jody: Ok, so 5 days per month of FMD, either with their product as a support like bone broth.  I would love to have your glowing skin and youthful joints, Matt, by getting that extra collagen protein in my diet.  What about intermittent fasting? Useful? Do that also? Instead of this?   Matt: Well, define intermittent fasting. What do you mean?   Jody:  I mean, skipping breakfast basically.  Eat dinner at 8p and don’t eat again until noon the next day.  So, 16 hour fast each day.   Matt: Right, so that’s what most people mean with IF.  I think a better term is just time-restricted feeding. And I’m a huge fan.  I do that exact protocol, and I try to restrict my feeding window to as small as possible.  8 hours, from noon to 8 is good, but if I can get it down to 6 hours from 2-8 or even 4 hours and eat only between 2-6pm, or even just eat one big meal in the evening then I think there are great benefits to that.  Studies have shown that to be an independently positive thing to do for body composition and other markers even if you eat the exact same amount of calories. So, yes, doing this is great regardless of whatever else you do with more prolonged fasts.   14:00 - 15:15   Mike:  I think it’s important to recognize the differences though between time restricted feeding and prolonged fasting or a fasting mimicking diet. To truly activate autophagy you need to be in a fasting state, and for the most part, we think you need to diminish your glycogen stores. Now that might be possible if you throw in a hardcore workout into a short fast, but for the most part, we think it takes 2 days or more to activate autophagy. I have not seen or heard of autophagy occuring at any meaningful level with just 24 hours of fasting. And not with time restricted eating. Not to say those are bad for you, just they don’t activate autophagy. Personally, I do both. Time restricted eating, and less regularly, I’ll go a FMD or a prolonged fast. That way you get the metabolic and hormonal advantages of time restricted eating, along with the apoptosis, autophagy, and longevity advantages of prolonged fasting. 15:15 - 19:30 Matt:  Plus when you refeed after a prolonged fast you get stem cell activation that re-grows healthy cells leading to organ and tissue rejuvenation.  So, that’s why I don’t straight 30% calorie restrict every day like in these studies. That’s a great study protocol to apply to rats or monkeys for years at a time.  But that’s tough. It sucks to eat 30% less of the cheeseburger the rest of your life. I think it’s much easier to time restrict my calories, but still totally feast at the end of a long day, and then only occasionally muster up the willpower to do a prolonged 3-5 day fast.  Most days, I’m active. 4 kids, multiple jobs. I need the calories. But time restricting both gives me health benefits and more freedom with my time honestly. Having to only worry about 33% to 66% as many meals as other people means I can spend that time and energy on reading esoteric studies on time restricted feeding.   (Discussion about when to eat during the day between Mike and Matt.  What time is the best time to eat based on the science and what works for your family and life situation)   19:30 - 21:25 Jody: Sweet, I’m sold.  So, tell me EXACTLY what to do?   Matt: Well, I think we’re close to agreement, but here’s where it gets tricky.  Mike and I agree on a lot of things but animal fat is not one of them.   Mike: Yeah, I’ve got the genetics that prevent me from managing dietary saturated fat appropriately, so I go with Longo’s vegetarian version of the FMD, plant based products and protocol. When I’ve done the FMD, I’ve done 800 cal/day for 5 days. I usually skip breakfast, just have black coffee. Then have a small lunch and dinner. Usually soup and a salad. Lots of veggies, maybe some pasta in the soup, or lentils. Sometimes some hummus and carrots. But the overall goal is the same. I go for 50% calories from fat, 40% from carbs and 10% or less from protein. The low protein is key so you don’t activate the IGF-1 axis or tyrosine kinase pathway. You need a relative amino acid   21:25 - 23:00   Matt: And I’m not against that.  I just think we can do better. Look, I eat the vast majority of my calories from plants and am a huge believer in the healing powers of plants and all the phytochemicals and benefits of a plant based diet.  But I also believe we’re totally evolved to derive big benefits from the right type of animal nutrients. Grass fed, humanely raised, homemade bone broth is my jam. I say follow the guts of the protocol with respect to total calories, but I’m gonna give you my bone broth I make.  My bone broth has about 100 calories per 10 oz. 5g fat and 7g protein. And I want you to eat super nutrient dense foods the rest of the time that have amazing benefits for detoxification (broccoli), brain health (sardines and walnuts), and sanity (coffee)   23:00 - 25:35 Here it is Day 1: 1100 calories 32 oz (2 jars) - 320 calories - (lots of pink himalayan sea salt, pepper, and some turmeric) 16 oz broccoli with 1 tbsp grass fed butter - 250 calories (100 calories from butter) 3/4  cup walnuts - 375 calories 1 can of sardines in EVOO - 150 calories All the black coffee you want and all the water you can drink   Macros: Protein g - 12 walnuts, 22 bone broth, 12 brocoli, 18 from sardines (64 total) Fat g - 12 from butter, 39 from walnuts, 1.5g from broccoli, 18 from bone broth, 9 g from sardines Carbs: 8 from walnuts, 30g from broccoli, Fat: 64% protein: 22%  carbs: 14%   Day 2-5: 800 calories Same, but reduce to ¼ cup walnuts   Walnuts optional on all days - probably better results without walnuts   FMD percentages: Day 1: fat - 56%, protein - 10%, carbs -34% Day 2-5 - fat 44%, protein 9%, carbs - 47%   25:35 - 27:00   Mike:  To summarize: The macronutrient percentage for fat and carbs likely doesn’t matter, but the protein does. You should keep your protein intake somewhere around 7-10% of total carbs.   The overall benefits you’re going to get from an FMD, just to simplify is: Immune system improvement Apoptopsis of precancerous or cancer cells Weight loss and improved body composition Reduction of CRP and oxidative stress Better mental performance from increased brain-derived neurotrophic factor Improvement of glucose tolerance and insulin sensitivity Healthier and probably increased stem cells -all leading to increased longevity…….unless you get hit by a bus.  So, try not to get hit by a bus.   Jody: Cool.  Those are pretty specific instructions.  So, I’m going to do this for 5 days and then what do I do the other 25 days. And I’ll get blood tests at day 1, day 5, and day 30, right?     27:00 - 28:45   Matt: Yep.  Come to the clinic and we’ll hook you up.  And you probably need to take a month between each 30 day test to get back to your baseline.  That way we take the scienciness of this from a 1 out of 10 up to a 2 out of 10. Twice as scienc-ey if my unscientific math is correct. For the other 25 days you should eat normal, but time restrict to 8 hours.  Noon to 8pm as your eating window. That work for you?   Jody: Yeah, I can do that.  What about other people listening to this.  Should they do this? They should probably consult their doctor, right?   Matt: Sure.  Or don’t. Honestly, that statement you see on everything of “consult your doctor” annoys the crap out of me.  It tends to imply an all knowing doctor that just doesn’t exist. I mean, if you’re sick in general, have a physician you really trust and really knows you and stays super up to date with this literature, then great.  Go for it. But I know lots of doctors. And I know lots of non-doctors who just keep up with what’s new. Medicine in general is always at least a decade behind the latest research. So, someone who cares, and reads can be just as informed as a doctor.  So, never trust someone just because they’re a doctor. I know this will be unpopular with other doctors, but I’d say 95% of what I know and believe I know despite my medical school training. They told us that 50% of what we learned in medical school is probably wrong.  In my experience over the last decade I’d say that’s gross underestimation.   28:45 - 30:05   Mike: Come on, I think you’re doing two things here.  First, you’re underestimating the number of doctors out there who really care and keep up with the literature.  And you’re overestimating the number of informed patients out there who are going read 100 books and 1000 articles per year like you and I do because we love it. Most people just want to be told what to do.   Matt: Ok, you’re right.  I just don’t want people to give doctors too much credit. The M.D. behind the name means nothing. Ask your doctor what their favorite books on nutritional science are.  If they rattle off 4-5 immediately, then take their advice. If they’re obese and can’t name 1, then please go to someone else, or do the research yourself. That’s all I’m saying.  Also, if you’re going to do a straight water fast, then I’d say you do need medical supervision. Labs, monitoring, etc. Fasting isn’t dangerous, but like anything, the more hard core you go on it, the more risks there are that come along with those extra benefits.  I think if you’re doing this FMD protocol, this is going to be safe for 95% of people who are healthy, not pregnant, etc. If you’re nervous, sure, consult your doctor. Also, this isn’t medical advice. I’m talking to Jody only here. This is informational only. I’m talking to you, lawyers out there.   30:05 - 31:00   Jody: Cool.  So, what if I want to eat optimally those other 25 days?  What type of diet in general should I do? And any drugs I can take to live forever?   Mike: Ha!  Do you have a few more hours?  Matt and I can debate the merits and pitfalls for keto, paleo, vegan, etc. Matt, what’s the most optimal diet?   Matt: Yeah, let’s actually tackle that in the next podcast.  I know we both have some pretty strong beliefs about that. I think we agree on 90% of things, but it’s really fun to argue the the finer points.  In general Jody, do this: As Michael Pollan says in the Omnivore’s Dilemma:  Eat real food, mostly plants, not too much.  And as a nice heuristic to use, don’t eat it if your great, great grandmother wouldn’t recognize it.  So, nothing out of a box or wrapper or with a list of ingredients you can’t pronounce.   31:00 - end Mike:  I can get behind that.  Would love to hash out all the controversy around saturated fat, cholesterol, gluten, dairy, and dive deep into personalized diets based on genetics.   Matt:  I can’t imagine anything more fun.  And, yeah, the pill question. That’s gonna take some time.  We’ll dive into that also. And while we’re at it, we should talk about the other things that may increase lifespan and quality:  specific molecules (aka drugs), meditation, exercise, etc. Those things deserve their own specific podcast, though. For now, “let food be thy medicine”, Jody. Master that, and we’ll talk about some next level stuff just coming out that may have a really profound effect on longevity.  I’ll bring you the food for my part of the experiment. That’s the stuff I eat every day, so I’m stocked up at all times with those things. Why don’t you take some before and after shirtless pics doing those super sexy poses people do in magazines. I think you’re gonna get some good body comp results.   Mike:  And the Prolon goods are in the mail from me.   Jody:  Can’t wait.  I’m on it.  

Mike:  Jody, why are we here? Matt:  And why there microphones in front of our faces? Jody:  Simple. Guys, we've had a ton of conversations where afterwards I feel like "man I wish I recorded that" or "the world should hear this". I'm a normal guy.  You two are trained as docs, and I'm not obsessively reading about human performance enhancement, longevity, and all the stuff you like to do, so it's a pretty sweet hack for me to be able to talk to you. Whether it's email, text, or phone calls and say like "Hey just summarize the stuff you've been reading and tell me what I what I can do." Matt:  Well, talking about that stuff, that's fun for us. Mike and I we live and breathe this. We basically won't quit talking about when anybody asks us about it. We've done a lot of things in our life like adventure races and stuff where were obsessed with constantly figuring out how to optimize our bodies for those things and push the limits of what we can do. Especially since we have very little of what they call "talent" and now that we're getting older we've really become obsessed with longevity also and how we're going to be around for our kids, grandkids, are great grandkids. We want to kind of do both. Absolutely crush it now and live forever or at least close to forever. Mike:  Yeah all that stuff for sure Matt, but what you're talking about Jody just sounds like a bunch of fun.  I mean if you're talking about having us do a podcast I assume, that's why we have the Mics here, right?  So let's be honest: man I love making fun of my Matt and if you're giving us the opportunity to record it and make fun of you as well then man sign me up.  I mean I've been his podcast thing for like 7 years now so the idea of recording some of that doesn't sound weird. Jody:  Right. So, the medical community already knows you guys as the Ultrasound podcast guys, so why pivot to longevity and performance optimization? Matt:  Well first off, I think you're the one asking us to record this but if you're asking why are we interested in those things instead, well we've always been interested in them.  I mean we're just super curious in general and love exploring new ideas and kind of pushing the limits, which I think is why people enjoy listening to the ultrasound podcast. We've done a lot of courses and taught a lot of Physicians and we love that, but as you know as soon as we turn off the mics and leave the lecture stage all we really talk about with each other is optimizing performance and whatever longevity hacks we found recently. Mike:  Exactly. I mean you should see some of the text messages about all the crazy self-experimentation stuff that we are doing with fasting, different diets, taking Ketone salts and Esters and how it affects our individual BHB levels in conjunction with different weight training interval sets and then correlating that with max effort running trials and super nerdy stuff but that's what we're into.  I mean, granted, debating the methodological flaws of calorie restriction studies may not be super great listening but we're really into all this stuff so I could see how some people might benefit from hearing are conclusions on how to apply this stuff to their lives. Or who knows, maybe they'll hate it but they'll enjoy some of this banter. Jody:  I get it, but I mean you guys are Er docs.  Why not just double down on that if you're going to do another podcast.  Why teach people about this stuff Matt:  So, on my last shift, this guy came in and we intubated him.  We saved his life by putting a breathing tube in for him when he couldn't breathe.  He was a morbidly obese guy with cancer and was a really difficult intubation, and I'm  thinking afterwards how cool it was that we were able to use cutting-edge technology, video laryngoscopy in this case, to save this guy's life and how that just came out in the last decade.  So it's really amazing how technology is progressing and allowing us to do things like that and then I thought about this poor guy a little more deeply and realized that I may have added 3 to 6 months to his life at best.  What if he was equipped with the knowledge that I have about healthspan, nutrition, and longevity, though. Would even have cancer? Would he be obese? I mean I went into emergency medicine because I really loved it. The adrenaline that comes from a save like that or the privilege of getting to meet people in their darkest hour and help them out is truly amazing.   But honestly, 90% of the people I see I just shake my head and think if only they knew some basic things that aren't hard to implement they wouldn't need me. They wouldn't be in the ER.  So, I have no idea if anybody would listen to this if you recorded but if they do and it makes a difference then I'm going to be really really grateful for that. And if they don't, honestly I just like talking about this stuff. Mike:  Yeah I mean pretty much same here.  I still love emergency medicine but that doesn't mean it's the only aspect of medicine I'm interested in.  The thing that got me interested in medicine in the first place was actually biochemistry. I know, nerdiest statement ever, but I was in college for chemical engineering at the time and trying to lose some weight. I was actually a fat kid until I was about 20 and I never learned anything about healthy eating or dieting as I grew up in the Deep South and had terrible Fitness and a terribly diet.  I was like 260 lbs around year 2000 and I finally got fed up and started learning about the biochemistry and some of the metabolic stuff. I got serious about it, started working out, lifting, cardio, and learning about metabolism, cortisol, and insulin responses to foods and exercise. I was pretty obsessed and eventually it pushed me into medicine.  But you can't really go into residency for longevity or performance science so I ended up in what excited me the most, which was emergency medicine.  But that doesn't mean I ever give up my personal obsession with human performance which has recently morphed into this idea of healthspan and Longevity. Matt:  We still love emergency medicine, but our real obsession is longevity and performance optimization.  We constantly talk to our friends and family about it any time they ask and if we can help some strangers by you hitting record when they give you advice, then I'm all in.  I think as doctors we definitely have a responsibility to use your training and knowledge to help people whenever we can. Jody:  Sweet! So how are we going to do this?  I'm thinking I could ask you guys a question that I'm wondering cuz I'm sure other people wondering it also.  Like, should I take vitamin D? What's the best way to get super strong and super ripped? What the hell is a float tank and should I do it?  Can I live forever? What's the best diet? Does cryotherapy work? You know I've have got thousands of questions Matt:  Yeah, that's awesome.  All that stuff. I mean that's exactly the type of stuff we love talking about so I'm getting pumped just thinking about the crazy argument Mike and I are going to have about this stuff. Jody:  Yeah, about that.  I know you and Mike tend to go overboard sometimes and super deep into the studies and those kind of things, so we got to keep this applicable and simplify in the end. Matt:  No, I agree.  So what we need to do is make this be useful, not esoteric crap and just droning on about biochemical pathways.  At the end of each podcast episode we should do a 96% Pareto squared summary. Jody:  Perfect.  Exactly. That's what I was thinking.......except what is that?   Matt:  So Pareto's principle basically says that 80% of the benefit comes from 20% of the causes or inputs.  So for example, if we talk about how to get you caveman strong, then we'll talk about the two to three simple things you can do that the biggest bang for the buck.  The the 20% that gets 80% of the benefit. Then if we do that one more time and give the most important things in top 20% we get 80% of the remaining 20% Then we're squaring Pareto and giving you 96% of the benefit.  Then Mike and I can fight over the last four percent but who really cares? Maybe somebody, but we're going to try to break it down and get you benefit without having to dig for that last four percent. Pareto Square it. Mike:  We'll be publishing Matt's math here at the bottom of the podcast because I'm sure nobody actually followed that. Jody:  I'm going to trust you for now on the math.  Let's do this though Mike:  Jody that we're getting ready to have some fun too so I agree I'll answer your questions but I want to get to torture you a little bit on the back end so after each time we get to test on you you going to be our guinea pig will do a super scientific in of Jodi study where we test our conclusions and we test them on you so for example we test your testosterone and then you let us [0:07:56-0:08:15] you try some four methods that we give you to increase it and then we retest and see how you respond we got to do as many lab test as we want before and after we put you through the different diets the cry therapy protocols all that stuff have I ever back down from ridiculous challenge that can endanger my life that's why we love you and we got to find some sweet after music right now