Pushing The Limits

Athletes, especially long-distance runners, sustain a lot of injuries in their career. Their injuries mainly affect the lower extremities, like the calf or the foot. Wearing the appropriate gear and proper shoes, as well as using orthotics, can make a lot of difference.  Dr Colin Dombroski joins us in this episode to explain the benefit of orthotics to foot health. He also talks about common running injuries and how wearing the correct shoes can prevent these. If you are a runner and want to know more about orthotics and the science behind shoes, then this episode is for you.   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition and mind performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join their free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   Consult with Me If you would like to work with me one to one on anything from your mindset, to head injuries,  to biohacking your health, to optimal performance or executive coaching, please book a consultation here: https://shop.lisatamati.com/collections/consultations   Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: Discover the benefits of orthotics and modern imaging techniques in foot health. Learn more about common running-specific injuries and ways to prevent them. Know about the brain-foot connection and the knock-on effect of footwear. Resources The Foot Strength Plan by Colin Dombroski The Plantar Fasciitis Plan by Colin Dombroski Born to Run by Christopher McDougall The Ben Greenfield Fitness Podcast SoleScience Connect with Colin: Website | Email | Facebook | Skype: solescience   Episode Highlights [03:14] Colin’s Background Colin designs and manufactures custom foot orthotics.  His researches revolve around general footwear, lower extremity therapy, and how these things interact to make people better. Colin works on 3D printing orthotics, which shows how the foot works or moves in real-time.  He works with people to get them back on their feet and do what they want to do. [04:36] How Foot Imaging Works Colin uses a 3D motion analysis lab to study the workings of the lower extremities. Alternatively, he also partners with the WOBL lab to do biplanar fluoroscopy. This procedure maps out somebody’s foot in 3D space.  It helps understand what is happening to the foot in real-time; it shows feet in a shoe under different circumstances.  Colin looks into the best way to make an orthotic for someone. Imaging helps to see what is happening in the foot when a person is barefoot, in a shoe, or using orthotics.  [09:56] Are Orthotics Generally Good? Orthotics are neither good nor bad; we cannot generalise.  It may be suitable for someone with arthritis but may not be beneficial to someone with no problems.  Orthotics are used as tools to help people with recovery and performance.  Colin’s job is to tell people whether they need orthotics or not.  When they have done their job, they’re removed. [12:57] Rehabilitation vs Orthotics In mild foot aches, over-the-counter devices can work well.  Orthotics are not a first-line treatment for some conditions.  Look at other things first before going down the route of orthotics.  Foot strengthening is very beneficial.  Do simple things that make feet work as feet.  [16:55] Does Wearing Shoes Result in Weaker Feet? Not walking for a few blocks is just as harmful as having shoes that do not fit you.  Poorly fitting shoes can be bad for you.  Women wearing high-heeled shoes for a long time can have a lot of foot problems later on.  Colin recommends we exercise moderation when wearing heels.  [25:15] How to Prevent Running Injuries Injuries usually result in a mismatch between the style of a person’s foot and the kind of shoe they wear.  Footwear should fit into your foot design so you don’t cram your toes.  Some shoes may fit while you are buying them in a store, but they may end up not fitting at all or when you are already running long distances. If you don’t know how the sock liner, width, toe spring, and heel drop of the shoe interact, the potential for injury is more significant.  Listen to the full episode to learn more about the running injuries that Colin has encountered and how to prevent them. [32:42] Running on Concrete vs Running on Natural Terrain The natural terrain is easy to run on compared to concrete.  Mitigate the force of initial contact to avoid injuries.  Listen to the full episode to learn more about what type of shoe you need for different surfaces. [34:29] On Transitioning Your Footwear If you want to go barefoot, do it gradually. Scientific literature has discussed the importance of transition shoes. If you’re going to drop your 10- to 12-millimetre heel drop shoe to 4, you need to have a 6- to 8-millimetre transition shoe.  [37:22] How Often Should We Change Shoes? Do not let shoes sit on shelves for more than two years because the material stiffens. In general, alternating shoes are good after 6800 kilometres.  However, this still depends on how quickly you wear out the outsole of your shoes.  Having shoes with different heel heights for different types of running would be very beneficial.  [42:59] The Brain-Foot Connection When you ignore stabilisers and prime mover muscles, you get a mismatch in balance and performance.  It’s important at the lower leg holistically.  Colin acknowledges that we get a different sensation if we’re barefoot versus when we have socks and shoes on. However, it’s a misnomer to say that putting on footwear reduces your proprioception or sensation. Your brain adjusts to the sensory input being thrown its way. [48:39] Achilles Injuries Achilles injuries result when people change the drop of their shoe or change their running style too quickly.  There is a genetic predisposition for people with Achilles issues.  Using things like heel lifts in footwear takes some load off the Achilles, allowing it to heal. Any ankle restriction can make you use your Achilles differently.  Listen to the full episode to learn about the importance of a multidisciplinary approach in looking at conditions.   7 Powerful Quotes ‘If someone's not getting the right kind of results, it could be that they just need to be adjusted. But then some people don't believe that they need to be adjusted. They believe your foot functions best one particular way’. ‘I think that a lot of people have lost the ability to connect with their brain and their feet and they need to get that ability back’. ‘It's not putting everything into a box of good or bad, you know, but it's looking at it holistically’. ‘We get back to my point where [we do things in] moderation. There's a time to spend time in the sand, there's a time to spend time in the trail, and there's time to get on the road’. ‘If you can get that little bit of variability where you're lengthening some days, you're shortening some days, you're doing different things and your body is used to that, then you're going to be more adaptive. But if you lock into that one pattern, it's going to be so much harder to change’. ‘You also need to have a really good understanding of the whole anatomy of the body because you have to be holistic in your approach’. ‘You know your limits better than somebody else. But I think that there's also a time when you do need to respect the knowledge that someone's gone and spent time attaining.   About Dr Colin Dombroski Dr Colin Dombroski is a podiatrist and a foot specialist of 20 years; he is also an author and a researcher. He works in the world of shoes, orthotics, rehab, and range. He specialises in any feet issues, from plantar fasciitis to Achilles injuries.  Connect with Colin through his website. You may also reach out to him through email or Facebook.   Enjoy the Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so they can know more about the proper shoes to use for running.  Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript Of The Podcast Welcome to Pushing The Limits, the show that helps you reach your full potential with your host Lisa Tamati, brought to you by lisatamati.com. Lisa Tamati: You're listening to Pushing The Limits with Lisa Tamati, your host. I have a fantastic gift again for you today. Gosh, I managed to come up with some amazing people. So I have the guest Dr Colin Dombroski, who is a podiatrist and expert on everything foot. He's known as the foot specialist. He is the author of two books, Healthy Strong Feet, and The Plantar Fasciitis Plan. He's a researcher, and also has a shoe—a specialist running shoe shop. He knows everything about the cutting edge of foot health.  So this is a topic that's really important, obviously, for all the runners listening out there. Or if you're having any sort of issues with your feet, maybe you're dealing with plantar fasciitis, maybe you have to have orthotics, or you've got arthritis, or you've got bunions, or you've got problems with your Achilles or further up the kinetic chain, then this is the episode for you because we're going to be talking about the cutting edge of science. Dr Colin is really up on the latest thing. He has all the fancy gadgets in his lab that he does. And so it's a really, really interesting conversation that I have with Dr Colin.  Now before we go over to the show. If you are also looking for—doing a running training plan that fits your life and without having to think about how to assemble the entire plan yourself, then please come and check out what we do at Running Hot Coaching. We have a brand new package that we now offer and there's a fully customised package to you, to your goals, to your injuries, your lifestyle, anything that's holding you back, and we can customise it to you. And you'll also get full video analysis done with this package and a one-on-one consult with me in a personalised plan for your next event. Whether that be a marathon, a half marathon, ultramarathon, 10K, it doesn't really matter that's up to you. And you get 12 months of access to Running Hot Coaching’s whole resource library and all the other plans that are available on me, so it’s a super, super deal.  You also get access to our community of over 700 runners from around the world that we get to coach nowadays and hang out with them. And also we do live events on occasion and do regular educational webinars and so on. So everything running. If you want help with it, then we would love to help you get in—make the best out of your running. Okay, so check that out at runninghotcoaching.com.  Right, over to the show now with Dr Colin Dombroski.  Lisa Tamati: Well, hello, everyone. Welcome back to Pushing The Limits. It's your host, Lisa Tamati here. And today I have Colin Dombroski with me, all the way from Ontario in Canada. So welcome to the show, Colin. Fantastic to have you. Dr Colin Dombroski: Thanks so much for having me. Lisa: It's really, really exciting. So I am going to be talking to you today about feet. You are the foot guy. You are known as the foot guy. Colin, can you give us a bit of a brief background, why are you known as the foot guy? Dr Colin: Well, I mean, I'm a Canadian certified podiatrist first and foremost. So I'm trained in both the design and the manufacturer of custom foot orthotics, foot orthotics in general, footwear and lower extremity therapy care, and how those things interact to get people better. And so, we started that back in 2002. And since then, I've gone on to do PhD work in Health and Rehabilitation Science, and research and everything from the basic 3D printings of orthotics to how the foot’s actually moving in a shoe using things like a biplanar fluoroscopy and CT imaging to really understand what's actually going on, as opposed to just kind of guessing and thinking about it or looking at video without actually being able to see inside the shoe.  And so we've seen tens of thousands of patients. We've worked with people over the last 20 years, really working to get them back up and on their feet and doing the things that they want to do to stay healthy. And for some people, it's as simple as walking around the block and for other people it's going to the Olympics in Tokyo. Lisa: Wow, fantastic.  So you're deep into the science... Dr Colin: Yes. Lisa: ...of the absolute cutting edge of what we can do now for foot issues and optimising foot health. So tell us a little bit about some of the fancy stuff that you can do, like, how that—you said there you can look into the inside a shoe or...  Dr Colin: Yes. Lisa: ...rather than just looking at video. How does that work? Dr Colin: I'll tell you on the research side, there's all kinds of fancy stuff that we were able to do. And so, right now I have an academic appointment through Western University in the School of Physical Therapy. So, I'm lucky enough to be able to do research in what I do specifically. So—and we can do that in a couple of different ways. One is that we actually have a full 3D motion analysis lab at our main business in London Ontario. So it's seven Vicon cameras, much like the way you would see motion analysis for video games or for the movies.  Lisa: Wow. Dr Colin: Well, we use that to study how the lower extremity works in the human body. And so we can either put markers on the foot and cut windows into the shoe, so we can see how things move. That's one way to do it. The other way that we've done it is working with another lab called the wobble lab, and they have two movie x-rays, or what's called biplanar fluoroscopy. And then what we can do is have a CT of somebody's foot, we can take those bones out, we can map them in three-dimensional space. And at 17 times per second, we can move that bone model on top of the actual movie x-ray model to understand what's happening to the foot and the bones in real-time in a shoe, under different circumstances, whether that's no orthotic, orthotic, and we can compare that to their walking barefoot as well. Lisa: That is insane Colin. I have no idea. Dr Colin: Yes. it's a cool thing. And if you go on the website, if you go on—I think we have a fluoroscopy video up on stuff about feet. But if we don't, there's certainly one up on the research section of SoleScience, and you're able to actually watch, you can see what we're looking at through this thing.  Lisa: Wow. Dr Colin: And it's really cool to know. And what's really interesting when we look at this stuff is that we wanted to know when we make somebody an orthotic. What's the best way to do that for someone? There's different ways that we can capture somebody's foot, whether we use a foam or a wax method or a plaster mould of somebody's foot, we wanted to know kind of based on a couple of different styles, which one might actually control the motion of their foot a bit better. And we were able to show that one was more effective than another—made a small amount with a very specific foot type.  So, if you have a flatter foot, there are ways of making it that are more effective. But what was really interesting out of that was to look at what was actually happening with the foot when someone was just walking barefoot, when they were just walking in their shoe, or when we put an orthotic in there? Because you know if I can go on a bit of a tangent, there's lots of scary stuff on the internet these days about how, ‘Oh, you don't want to walk in shoes and orthotics because it makes you act like you're walking in a cast. And why would you want to do that'?  Well, what's really interesting is that when we looked at someone's foot walking barefoot, and we compared that to the most supportive thing that we use, they still kept up to 96% of their original motion.  Lisa: Wow.  Dr Colin: So, think about that for a second, 96% or one motion.  Lisa: Yes.  Dr Colin: So, you're really at that point, if someone's keeping that much of their original range of motion, you really have to wonder, ‘What are we actually doing with these things?’ And I'm going to argue that it's more than just the shoe on someone's foot. It's more than just the device in that shoe, that there could be a lot more actually going on with these things than we fully understand even though we have the best research methods to be able to look at it.  Lisa: That's amazing. I mean, I'm really, really interested because with orthotics, I've recently gone and got my mum an orthotic and you don't know my mum's story. But she had a massive aneurysm five years ago, has dropped foot on the right side, incredible rehabilitation journey, written a book on it. But we're not having such success with the orthotic yet. We are having success with a Dictus where it's helping lift her foot. And I've had in the past two experiences with orthotics when I've had different issues, like, I can't remember now what specifically, I think it was plantar fasciitis. And I've tried different things, admittedly a while ago, and things have obviously moved on. But I haven't had that much success.  So I'm like, as a running coach, I should know more about the latest in science as far as orthotics go. And whether they're my initial reaction back then was, ‘Well, I don't think orthotics are really working for a lot of people’. That's been the feedback from other people as well. So obviously, the science has moved forward and it is offering new insights and you can actually see in real-time what our bones are doing. I mean, it's just absolutely mental, that's crazy and cool. So do you think—isn't it like walking around with a cast on your foot? We've got this whole barefoot craze that's been in the last few years and then we've got brands like Hoka One One coming out with really cushions. So, I think people are a little bit confused as to what they should be doing.  Dr Colin: Yes, and rightfully so. Lisa: Our orthotic is good. Our orthotics in general is—can we generalise when it's very specific. Dr Colin: Nope. Not at all. We can’t generalise it all and that's the problem when it comes to this stuff is that people are trying to fit everybody into a box. And saying that either it's really good, or it's really bad. It’s either of those things? Like, to the end of the day, if you really need them, if you have rheumatoid arthritis, and you're unable to walk around the block, and I'm able to get you active again, they're really good for you.  Lisa: Yes, absolutely. Dr Colin: Right? But if you have no risk factors, if you have no biomechanical abnormalities, if you have no foot deformities and no other issues, then what's the benefit of wearing them at the end of the day? And so to that end of things, a lot of the time, I feel as though we're missing the middle ground. We're missing the fact that people can use these things, either as a tool to help them with recovery and performance that we can then work to wean them off, if they so choose, or if they need to be, or we use them because there's a real thing where structure dictates function and injury.  But again, why are we looking to see whether or not people are either yes or no, off or on? It's more of a continuum. And I kind of like to look at people and the fact that over on this end of the spectrum, here, you've got people who are so gifted biomechanically that they can do anything they want to do, despite doing it wrong. They can go couch to marathon in old worn-out shoes with poor sleep with bad nutrition, and they can do it and they don't get hurt. And you've got people on the other end of the spectrum that can do everything, right, and work with the best coaches and get the best equipment and eat and sleep and everything else. But they're plagued with injury, right?  Most people are going to be somewhere in the middle, the question though, so, which side of the spectrum do you lie more towards? And that's where I feel my job comes in, is to figure out where that is, and then how to appropriately apply these things, whether or not you actually need them. And I build a business on telling people when they don't need them.  Lisa: That's brilliant.  Dr Colin: And when they don't need them anymore. So, it's actually quite shocking when someone comes into my office for their ninth orthotic, and I say, ‘Well, tell me about it'. And so they—we talk about stuff, and we come to the conclusion that they just don't need them anymore.  And they're shocked, they think that these things are like a lifelong sentence. And they're not. For some people, they are the difference between being able to be active or not. And for other people, there's simply a tool, and we use that tool appropriately, and we remove it. Lisa: That is absolutely gold, Colin. And what a fantastic approach in, like, working with people with disabilities and stuff, I know there are definitely times when we do need them, and they're going to benefit and it is very much about the skill of the person who's fitting the orthotic and knows, obviously, what they're doing. And there’s a lot of advertising out there; rubbish sort of advertising that you see with different standard gum, pick it off the shelf type things, what's your opinion on those types of orthotics?  Dr Colin: Well, I mean, if those—so, if something like that, like if an over the counter device works for you, for—let's say you have a mild case of metatarsalgia. Let's say you have a small ache in the front part of your foot when you're active, and you've done all the rest of the conservative therapy things. You're strong, you're flexible, everything else is ticked off, and you're still not doing well. Sometimes removing that little bit of mechanical stress can be enough that allows the tissues to heal and you can move on. Right? So in those cases, yes, they work quite well.  But in some cases, if you have a foot type that doesn't match up with that shaped plastic that's pushing against your foot, it might not work so much. And kind of to your point where you were saying you had them for plantar fasciitis before, and they just didn't work for you, it could be a multitude of reasons why they didn't work for you. And we see that all the time.  And if someone's not getting the right kind of results, it could be that they just need to be adjusted. But then some people don't believe that they need to be adjusted. They believe your foot functions best, one particular way. And they say, ‘Here, this is for you. This is the way it should be, get used to it'. Lisa: And then it's the whole side of: you should be doing strengthening exercises and rolling and stretching. What's your take on the whole on that side of it? So the rehabilitation side of it as opposed to the orthotic side of the equation? Dr Colin: Well, so my—the way that we teach about orthotics is that orthotics for some conditions are not a first line treatment unless you have significant risk factors. If you're diabetic, then yes, 100% we're making you orthotics. But for a lot of people especially let's take plantar fasciitis for instance. If you come to me and you've had plantar fasciitis only for a few weeks, there is a whole host of other therapies that you can try before you even need to think about that. Is removing the stress off the tissue, the strain off the tissue with the device and footwear appropriate? Heck yes, it is. But there are other things that you need to look at first before you even go down the route of orthotics which is actually why I wrote my first book. And it's to tell people the things that they can do at home to be able to get themselves better for four to six weeks before they have to see somebody like me to think about orthotics.  Lisa: Okay, so what was the title of that book, Colin? Dr Colin: Oh, it's called The Plantar Fasciitis Plan.  Lisa: The Plantar Fasciitis Plan and that is available on Amazon? Dr Colin: Yes.  Lisa: Okay, so in New Zealand, we might struggle with Amazon, but we don't have Amazon down here, believe it or not.  Dr Colin: I have no idea. Lisa: We can access it, but some things can ship from over the air and some not so. But we'll put the links in the show notes for sure for those listening who are overseas and want to read that book. Okay, so you mentioned... Dr Colin: And to speak to your last question...  Lisa: Absolutely. Dr Colin: ...which was, what do you think about the whole foot strengthening part of it?  Lisa: Yes.  Dr Colin: I think it's very important, I think that a lot of people have lost the ability to connect with their brain and their feet, and they need to get that ability back, it's shocking how many people I see that can do something as simple as move their toes, or lift their arch, or do some of the simple things that they need to do to make feet work as feet. Right? And so, getting them back to that foot connection is only a positive thing. Like, the only good things are going to come out of that. Lisa: So, is this like, is this a problem of the modern human because we've walked around in shoes. Did humans, before shoes come along, did we all have great feet? Strong powerful feet because we were barefoot from the get go? So is this a problem of the modern human but like with—I've just done a couple of episodes on breathing and the way that we are chewing is affecting our structure of our mouth and therefore we're not having such good breathing and so on. Is that similar sort of case? Dr Colin: I really think that when you talk to a question about that, it's really hard to compare those two things because we're just not there right now. You know what I mean? So, yes, if we didn't wear clothes, and we didn't drive cars, and we didn't eat the way that we did, yes, things would be different than where they are. But like, we drive our cars to go five blocks down the street to get to Starbucks, we don't walk. So, that alone is just as deleterious as footwear that doesn't fit you properly.  So when it comes to shoes, again, there's lots of scariness out there on the internet, talking about how these things, again, make you walk like your cast or is deforming your feet. And yes, I would agree that a poorly fit shoes that are way too tight cramming your toes, putting stress on nerves and tissues certainly can be a bad thing for you. But do I think that there's this gigantic conspiracy out there that's making the collective feet of the world less strong and everything else? No, I really don't, to that end. And again, as a recovery tool, they can be marvellous things if done correctly. Lisa: Yes, it's a really good approach. I mean, it reminds me of my dad's feet. My dad who recently passed, unfortunately. But my dad had the most amazing, strong, powerful feet, he grew up in the first 13 years of life and not wearing shoes. Came from a very humble background with eight children, and they only had one pair of gumboots in the family. So he grew up with these incredibly powerful feet.  By the time he was in his 50s, 60s, 70s, and 80s, he could walk around barefoot all day, never have any sort of problems. The state of his heels weren't the best. But muscular feet, really strong powerful feet, because he didn't wear shoes until he was older and then still like to go barefoot whenever possible, actually connected to the earth, weed garden all day, and their feet at the most jungles. So I did see it in that. Quite the effects of having that real connection to Mother Earth if you like in developing those sort of strong muscles in our feet.  And then on the other side of the equation. I see people with diabetics or close to being pre-diabetic problems with extremely tender feet and poor circulation in the feet and their feet are just not moving well and have always been in shoes. So it's like opposite ends of the scale via. So, where was I going with this? There's a real broad range of where people are at. Another thing that I think is to consider is women in high heeled shoes, what's your take on that sort of a problem? Like, were lifting your heels up and having a shortened calf. And that's sort of a problem. Dr Colin: Well, I mean, that for too long of a period of time just gives you a whole myriad of problems from metatarsalgia, and progressing bunion issues, and nerve problems, and chronically short Achilles because of that shortening specifically, yes. I mean, we see that all the time. I'm very much a fan of moderation when it comes to these things.  And so for a lot of my patients, if they want to spend an evening, every now and again, where they're primarily sitting in a pair of heels, then I feel as though the trade-off for what they get out of that is okay, comparatively. Again, it's not putting everything into a box of good or bad, but it's looking at it holistically.  Lisa: Brilliant. I think it's a really good approach. Dr Colin: Yes, if you're a retail worker, and you're spending 10 hours a day, on your feet, heels are definitely not the thing you want to be wearing. Lisa: Yes, you've got to sacrifice the elegance, ladies. Sometimes you help that little pushes. Dr Colin: A little bit sometimes. And you know where I end up seeing that a lot? It’s in lawyers. A lot of my patients who are lawyers. There is definitely a culture of dress code and professionalism that comes from wearing heels. And I see a lot of injured lawyers because of that, specifically.  Lisa: Isn't that interesting? So yes, really take heed because I do think doing that on a daily basis, yes. The odd night out in a pair of heels to look elegant is fine, but not doing it every single day, were you really shortening, I mean, just, I'm always sort of relating things back to my life. But with mum having aneurysm, being bedridden pretty much for 18 months before we could get her standing. And I didn't understand at the beginning about drop foot, I missed the boat. And by the time I realised what drop foot was, that had happened very, very quickly, that her foot was now dropped until we're still working on that right through now, to be able to lift set front of the foot up and having to use a Dictus in her case, which lifts the front of the foot up. So it happens very—it happens quicker than what you think. Dr Colin: It can, certainly. Yes. Now the brace that your mum's using, do you mind if I asked you a quick question? Is she using an over-the-counter one or a custom one? Lisa: So it's an over-the-counter Dictus one as I didn't know there was such a thing as a customised Dictus. So it's just a leather strap that goes around with a rubber that goes over inside these two little hooks at the bottom of the shoes that pulls the shoe up. So is there something better, Colin? Dr Colin: Well, so, take a look for something called an Allard ToeOff AFO. And we use them a lot in clinics for patients with drop foot and they're actually designed to be to run marathons and events and they're quite robust.  Lisa: Okay, I’ll take note of that. Dr Colin: And it might be a great training tool too. They're very light. You should wear them under a pair of pants. A lot of people like the fact that they don't see the direct brace.  Lisa: Yes, yes. Yes, exactly. This one's quite ugly. So, is it Allard?  Dr Colin: A-L-L-A-R-D. Lisa: Oh, brilliant.  Dr Colin: So as in Allard ToeOff.  Lisa: Allard ToeOff, I will check that out. See, this is a selfish reason why I get to talk to experts.  Dr Colin: There we go.  Lisa: Because you never know when it's gonna help somebody you know? It's fantastic. I'll check that one out. Yes, because that is a real problem. And there's so many—this is not a rare thing, drop foot. It's a very, very common thing with people with strokes and aneurysms and the like.  Dr Colin: It is. Lisa: So, there's a lot of people dealing with it so going into the rehabilitation side of things. We have a shoe that has a rocker so she's able to toe-off slightly better in that rocker and keep her center of mass moving forward. Rather than sitting really back which she was doing. So yes, so I'm always looking for the next best thing for my mum from the show. So, appreciate that. Dr Colin: No problem. And since you're a runner and all that stuff, the Asics Metaride is my favourite carbon shoe rocker. We've got so many people who really require surgery, fusions, things like that because of osteoarthritic toes or ankles or mid feet that can get into a shoe like that.  Lisa: Wow. Dr Colin: And for people who are that age, they're not nearly as flashy looking as some of the other carbon rockered shoes that are available. Lisa: Yes, but who cares as long as they function properly. Okay, Asics Metaride. Okay, we'll check those one out too. Now let's jump ship and change direction a little bit and go into running specific injuries. So we did touch briefly on playing to the shortest. But what are some of the common injuries that you see? And what are some of the ways that we can prevent? And how does it have a knock-on effect? Like what happens in your feet, knocks on the kinetic chain, doesn't it? Dr Colin: Of course. Yes. So what I take a look at, the one of the biggest things are going to be mismatches between the style of foot that somebody has and their mechanics and the kind of shoe they wind up getting into. And so there's nothing like being able to mismatch the way that your foot wants to move, and then a shoe that's going to either work completely and pushing it in the same direction. So for instance, if you're a supinator, where your foot rolls to the outside, and then you get into an anti-pronation shoe, which a lot of people are—there's actually been research to show that runners are poor judges of their own foot type.  Lisa: Right. Dr Colin: And if they get into that kind of footwear that makes them into more of a supinator. I can't tell you how many lateral column foot pain problems we see and perennial overuse problems and things like that. So simply mismatching your footwear to what your foot is doing can be one of them.  Lisa: Okay. Getting on and off the shelf is not, and diagnosing yourself is probably not a good idea if you're a serious runner who wants to do some serious racing. Dr Colin: Well, maybe it's a good idea to run your findings by someone else who can take an objective third-party look at you. And so some people think, ‘Oh, my foot is so flat, I need to get into this kind of footwear'. And that might not always be the case when it comes down to it. So the footwear component of it is so big. Making sure that it actually fits the way that your foot is designed. So if you have a particularly wide forefoot and a narrower rear foot, looking for things that actually match up with that, so that you're not cramming your toes into a pair of shoes. Lisa: As a run coach, if I can just pipe in there that has been one of the biggest mistakes that I've seen so many athletes buy. They go into a shoe shop that does foot analysis, and they proceed them on a treadmill and so on. So they may have the right type of shoe, but they're after buying the shoe in a cold state. So i.e., they've just walked into a shop, they haven't been on their feet all day, they haven't been running for 30K's, their feet are not swollen.  And then they go and if they do marathons, or especially ultramarathons, their feet are swelling. And especially I've seen this in women where we tend to swell tissues in my opinion, not scientifically-backed or anything but my observation is that women's feet swell more than men. And the size of the shoe is then way too small, especially in the toe box. And this often leads to pain on the top of the foot and the cutting off of circulation there. And I've seen problems with the shins and so on.  Have you—is it a thing? Have you seen this sort of a trend as well, where they're going into the shop, and it's fitting in the shop on the day that they buy it, but when they're long-distance runners, that becomes a problem, especially when they're running under heat? Dr Colin: 100%. Yes, I mean, fatigue is one of those things that wrecks everything. But at the end of the day, when you're not fatigued, and you're ready to take a pair of shoes, and you're trying it on, you don't know how the inside of your ankle is gonna rub against that shoe until you've spent 30, 40, 50k in it to really understand what's happening there. So the idea that something is going to ‘break in’, in quotation marks is something that I like to try to shy away from as much as I possibly can.  The biggest issue that we see from most people is they just fit them incorrectly, right? They fit them too short. And so if things do swell, if there's movement or any of that stuff, you're going to get problems along with the feet, whether it's friction and blisters or black toenails, or what have you. The length of that, and then especially the curve of the toes, makes such a big difference.  And so, a lot of footwear stores these days might not carry the full breadth of width available. And so for instance, New Balance comes in ladies from a 2A to a 2E and everything else in between.  Lisa: Wow. Dr Colin: So it comes in a 2A, and a B, and a D and then a 2E. So when you have to carry four widths of shoes from a size 5 to a size 13...  Lisa: That’s expensive.  Dr Colin: ...including half sizes, that's expensive. And that's only for one colour.  Lisa: Wow.  Dr Colin: Right? So when you think about that, you understand why you might not be able to find the full breadth of width in a lot of these things. Because shoe stores will have a hard time selling through and if they can't, they can't make money and stay open. So, but if you're one of those people that are on either end of the spectrum, then you need to find a place that will cater towards those kinds of things and that understand the nuances and the differences within brands. So, I mean I've seen people go up a full size in between different models of shoes within the same brand of a company.  Lisa: Wow.  Dr Colin: So, for instance, the New Balance 880 and the New Balance 840 fit completely different. The sock liner is three times as thick, the width is more, the toe spring is different, the heel drop is different, all of that stuff. And if you don't know how each one of those things interact with someone, then the potential for injury is just greater.  Lisa: Wow. And yes, I can definitely relate to that having had—I've had many different sponsorship agreements over my career. And some of the companies, a couple of them, I had to actually leave because I just could not wear their shoes and they were so different in other ones that I just absolutely loved and were able to stick with. And I've got a very wide foot. And so I have to be in a men’s shoe. But when I was doing desert races in extreme heat in Death Valley and the likes, I had shoes that were two sizes too big for me.  Dr Colin: Wow. Lisa: So, that's what I worked out was the sweet spot. So at that point, I wouldn't get the blisters and I wouldn't get the black toenails, and I wouldn't get the foot just swelling so much that it's boosting out the sides of the shoes and putting pressure on top of the foot and causing—and I've had it all awful shin problems by having that circulation cut off at the top of the foot.  I remember a race I did in Germany 338 kilometres in five days. So, we're doing 70 kilometres a day. And after day one, my shoes were just way too tight. And by then the damage was done. And an old-timer, who was in the race, said to me, ‘Hey, you need to cut your socks and open your shoes right up'. And that was a piece of advice that I carried with me being from the norm because, and I ended up doing that very often. So even something like a pair of socks that is too tight around the ankle can cause shin problems. I mean, I've experienced that firsthand, and on the top of the funnel as well. So it really makes a heck of a difference, isn't it? Dr Colin: Oh, it's so does and you know, when you're looking at the trail shoes and things like that, the choices become even more frustrating.  Lisa: Yes, yes, yes. Yes, let’s talk trail because what trail—we weren't as humans, like, we didn't evolve to run on concrete and pads. So what's your take on how bad is it to be running on roads and concrete versus the natural terrain of a trail so to speak? Dr Colin: Well, I mean, certainly the natural trait of a trail is going to be easier for you to run on versus concrete and asphalts and those types of things. And when we looked at the literature, and some of the research said that it's—there's been a lot of fun running research that's come out in the last 15 years. But a lot of our initial contact strategies, so whether you stride on your heel, your midfoot or your forefoot, a lot of it has to do with mitigating the force of that initial contact. And so if you're running on an incredibly hard surface, you might adapt to changing your initial contact to be able to mitigate those loads of that initial load.  Whereas when you have a softer, spongier service to do on, you have a bit more leeway to be able to stride in a different pattern. And so for people who are rehabbing from injuries, yes, getting into something that's a little bit spongier is certainly going to be more forgiving. Now, you can take that all the way to running on the beach, and that causing some problems as well just from the increased biomechanics that that causes too. So to get back to my point where moderation.  Lisa: Yes.  Dr Colin: There's a time to spend time in the sand, and there's a time to spend time in the trail, and there's time to get on the road. Lisa: And this trend it transition times, like when the barefoot craze hurt when my friend Chris McDougall’s book came out Born to Run and it sort of revolutionised everybody's thinking was like, ‘We gotta go barefoot because Barefoot Ted was doing it’. And we saw a lot of injuries come out of that. And no, no, no detriment on the book. It was a fantastic book. But people just went too fast, too far too fast. And we really need a transition time if we wanting to go barefoot. Would you agree with that? Dr Colin: Oh, it's not a matter of me agreeing with it, that that's just a matter of scientific fact.  Lisa: Yes.  Dr Colin: I mean, if you want to go from—which so I do agree with it. To that end, yes. There's nothing that's going to increase your risk of getting hurt more than taking off your footwear and going for a barefoot run. If you're used to wearing a maximalist style of shoe, taking it off going barefoot for 21K, you'll be lucky if you don't come back with a stress fracture. And certainly, my practice has been a mirror of that, right? I mean, at the end of the day, I see injured runners all day every day. That's what I do.  So, I like to joke that the greatest predictor of running injuries is running. But to that end, if you want to make these changes, I think they're great for people. And I think that they're able to make these changes in a proper informed way. And so even looking to what some of the scientific literature says they talk about a transition shoe specifically, right? If you're going to go from a regular 10 or 12 mil heel drop shoe to 4, 0, having a 6 to 8 mil transition shoe wouldn't be a bad idea.  There's one company that will remain nameless that when they changed all their heel heights from 12 mil to 8 mil, and no one really understood what that meant. I can't tell you the number of Achilles problems and things that came into the clinic two years after that.  Lisa: Wow. Dr Colin: Because making even that 4-millimetre change in someone who puts in 60 to 80 kilometres a week, and they're used to loading their tissues in a particular way when you all of a sudden change that with up to three times your bodyweight up to 10,000 steps, that's a huge change for your body all of a sudden. Lisa: Wow, that is insane. Just from a very small change. And look we all—lots of people just swap different shoes ‘Oh try those ones, or this time, I'll buy those’.  Dr Colin: Yes, exactly. Lisa: And so is it—and this is the other thing, brands keep changing. Dr Colin: Yes, every season. Lisa: ‘Ugh, damn. It's something new, it was perfect. And now it's gone again, I can't get it’.  Dr Colin: Yes. Lisa: So by a couple of pieces, when you do get something that's right.  Dr Colin: 100%. But even that, don't let them sit on the shelves for more than two years. Lisa: Oh, okay. Why is it? Do they degrade after that you sort of leave them?  Dr Colin: Actually the materials get stiff, the longer you leave them there. And so, that pair that felt really cushy a couple years ago, they let them sit for a couple of years, they're going to be harder...  Lisa: Oh, gosh. Dr Colin: ...when you take them out of the box.  Lisa: Oh, okay.  Dr Colin: So you can't just let them sit for years on the shelf. Lisa: And onto that note. How many kilometres? Like, how often should you be changing? I've always said between six and 800 kilometres max, what's your take on that? Is there a new science around that? Dr Colin: Science is interesting when it comes to that. I mean, there isn't a lot of actual hard science on that. The soft science of it is to look at the bottoms of your shoes and see. If you're a heavier person, at your initial contact, and I don't mean heavy, like actually just a larger BMI. But some people, my wife is a light woman but she sounds like she's going to come through the floor, two floors down when she walks. And so she'll wear out the outsole of a shoe much faster than somebody who strikes the ground a little bit lighter. And so if you look at the bottoms of your footwear and let's say you're only 400K into a pair of shoes, but there's an angle now where the lugs are totally sheared off one side, that shoe was now forcing you to walk that way. And it's not helping your biomechanics at all.  And so yes, I think as it—as a general rule, 6 to 800 kilometres is okay. But if you're not, if you're training on consecutive days, and if you're training in one pair of shoes, you're going to break down the EVA material much faster because that material needs about 36 hours to rebound fully, before it's ready to go again. But if you're training 24 hours, you're going to break down your shoe much faster. Lisa: Wow, that's a good point. I knew that. And I'd forgotten that fact. Thanks for reminding me of that because yes, alternating shoes on different days is something that I used to say, and I’ve forgotten completely about that one. So, that's a really good point. So, having a couple of pairs of shoes on the go, is a really, really good idea. Dr Colin: Yes, 100%. And to that end too we were talking about, with transition shoes, and whatnot, having them even a different heel heights for different types of running would also be great. I mean, so while you're doing a fartlek training, or tempo run, or a long day might be different than what your ratio is, or the all day everyday shoe. And so that little bit of variability, I think, is a really positive thing.  When you get locked into one movement pattern all the time, then your body comes to predict that. And if you can get that little bit of variability where you're lengthening some days, you're shortening some days, you're doing different things, and your body is used to that, then you're going to be more adaptive. But if you lock into that one pattern, it's going to be so much harder to change. Lisa: That seems to be the thing for everything in biology column. It seems to be a push and pull in a variety. You don't want to starve for too long, you don't want to eat too much for too long, you don't want to be too cold or in a thermoneutral zone for too long, you want—the body wants variety change. Not the same diet every day, not the same everything every day, and just by varying things up, we're giving our body a chance to get what it needs, and to have that variation—that push and pull that biology in all levels that I've been looking at seems to be cycling things. Cycling diet, cycling supplements, cycling shoes, cycling, changing in variety keeps the body guessing and keeps it changing, and keeps it so it doesn't go, ‘I've got this. And it's a piece of cake'.  Actually, I thought it just popped in my head. What do you think of Kipchoge shoes? The sub-two-hour marathon, the Nike shoes. Dr Colin: Oh, yes. Yes, I mean, wow, there—this is a fun time to be alive for nerds like myself. So yes, I mean, there's some really cool stuff that Nike’s doing in some of their footwear. And they're—I mean, one of the leaders. But I mean, everyone now is coming out with a carbon plated shoe, and really aggressive rockers, and a lot of this stuff from a performance standpoint. And it'll be interesting to see how it's controlled and how it's covered. And to what lengths can we go to be able to increase the performance of humans? We developed things like oxygen deprivation to be able to increase your red blood cell counts, to be able to increase your performance. Changes in footwear like this are not that dissimilar from that. It's just a question of, how much can we use them? And how does it work with you?  Lisa: Yes.  Dr Colin: Yes, and what's gonna be legal.  Lisa: And at the moment, it is, isn't it? Like it's...  Dr Colin: It is.  Lisa: Yes. And I had a friend, who's a holistic movement coach, I had on the show, actually, a few weeks ago talking about feet as well, the health of feet. And he said, ‘I didn't want to like those Kipchoge shoes', but I— because he's very much into barefoot when possible and developing strength in the feet. He said, ‘But I put’...  Dr Colin: Well, that certainly is the opposite.  Lisa: He said, ‘I have to admit, I run a hell of a lot faster when I'm soaked’. Dr Colin: Sure. Yes. But that comes back to the point of moderation, right? Is that there's a time for that shoe, just like there's a time to be barefoot. And it's using it in the appropriate fashion. Lisa: Wow, that's brilliant. And okay, let's talk about the knock-on effect of how the feet which have and you know this 100 times better than me, there's just a ton of nerves, a ton of bones as most complex structure that we have, the proprioception, and the connection between the brain is just so important that we actually have that neurofeedback from our feet. So, what sort of a fix do—what sort of things can we expect to have happen on a good side from proprioception when we're doing lots of activity? And we're doing lots of different movement types and varieties of training? And how does it help our brain? The brain-foot connection, I think, is what I'm trying to ask you here. Dr Colin: Well, I mean, anything that's going to make you more aware of what your foot’s doing in space is, again, only going to be a positive both from a balance and a performance perspective. It's striking to me that I can see some people perform incredible feats of athleticism, but then can't balance on one foot to do a pistol squat.  Lisa: Yes.  Dr Colin: Do you know what I mean?  Lisa: Yes. Dr Colin: Because they just don't have control over their ankle. And so when people think of their feet, that's one thing. But I mean, the actual foot itself, though, those deep intrinsic layers of muscles are more stabilisers than they are prime movers, right? The prime movers are going to be higher up in the leg, and the tendons of those larger muscles in the leg support the ankle, right? They're the ones that are tibialis posterior, and the perennials and the things that actually wrap around the ankle. So it's a matter of looking at the lower leg holistically, not just the foot itself.  Yes, those little foot muscles are important. But I think oftentimes, some of the higher stuff up is overlooked as well as the actual prime movers and the actual real good stabilizers that way because those things are going to fatigue out relatively fast, and then you're left with the larger muscles to be able to do some of those things. But when you're not paying attention to one of those two, then you're going to get a mismatch in balance and performance. And so it's a matter of being able to look at more. It's about being able to use your abductor hallucis appropriately, being able to use all of those intrinsics to raise up your arch a bit and reduce some strain in your plantar fascia.  I would never go as far as saying you're going to change the structure of your foot by making your foot muscles strong, but certainly, you're going to get a better grip on the ground and you're going to be able to use your feet like feet and not just like a meat slab that hit the ground to be able to get to the next step. Lisa: Yes, is it a bit like if I was to go around with gloves all day, and I wouldn't have the dexterity that I would need to do typing and learn to play an instrument or anything like that. Is that what's happening with our shoes, when we’re in shoes all day, every day, we're just taking away that connection to the brain and the brain's ability to be able to make those subtle adjustments with those little tiny muscles doing their thing? Dr Colin: You can look at it two different ways, right? Because one might say that yes, if you're barefoot and you know you've got skin on the ground, you are going to get a different sensation than if you have sock and then something else between you and the ground. Right? There's just different feedback when it comes to it.  But to say that putting footwear on reduces your proprioception, or your sensation completely, is a bit of a misnomer. Because if you have something that's, let's say, a little bit squishier, and your foot’s moving around a bit more, well, that's also a signal to your brain too in terms of where to fire muscles, and how to fire muscles and using those muscles on top of it. So, I think we can go in both directions. And again, there is a time when it's going to be appropriate. And there's a time when you want to be barefoot and getting that sensory input in just a different fashion to say—because, at the end of the day, I just don't think it's realistic in the society that we live in that we're not going to be out of it completely.  Lisa: We don’t want to come from class, and you know... Dr Colin: And so yes. So it's a matter of figuring out how to do that, in a fashion that's most appropriate, given the circumstances that you find yourself in. Lisa: A bit of a left-field question and a bit of a non-scientific well, oh well, there's probably stuff coming out now. What's your take on having though the connection to Mother Earth and grounding? And that type of thing, and being in the dirt, so to speak, and having the actual contact with the earth? Is there anything to that side of things? Or is it just no scientific data really around that? Dr Colin: There's absolutely nothing wrong with that, at the end of the day, and from a data and a science standpoint, I'm the first one to tell you that I'm not 100% up on that. Lisa: Yes.  Dr Colin: But I was listening to another podcast. It was Ben Greenfield recently.  Lisa: Yes, I like him. Dr Colin: Who was talking about some of—yes, yes, yes, same—as some of the science around that specifically. And I believe that there might be some science that has come out, I just haven't read it to be able to be up on it to be 100% honest with you. Lisa: Yes. I mean, I've heard various things and even like getting your hands on the dirt and gardening and how much of a good effect that can have on your body and your mind and your mood and things like that. Dr Colin: Yes. Lisa: And I mean, we are in science starting to actually see why is it important to go out and have early morning sunlight and circadian rhythms and all of these sorts of things...  Dr Colin: True, true. Lisa: ...and connection to the ground and the effects of the medicine, and I don't think we're there yet with all the science. But my take is—on that is yes, go out and spend 10 minutes a day with your hands and the dirt and connect with the ground. And if nothing, the being in nature is definitely going to calm you down and make you feel better.  Dr Colin: 100%. Lisa: Yes, so that's already, I think—okay, so just looking at some most common running injuries before we sort of wrap up the call. If we can look at like plantar fasciitis and perhaps Achilles and calf muscle injuries and perhaps knees. It's a picture you will cover in a few minutes, isn't it? If we want, the second podcast, Dr Colin. Dr Colin: Yes. We can do a podcast on each one of those actually. Lisa: Well, actually, I think I will be getting you on because your knowledge is next level. Dr Colin: Thank you. Lisa: So let's talk a little bit about say Achilles.  Dr Colin: Sure. Lisa: It's one of—it's a very common problem.  Dr Colin: It is. Yes, yes, it really, really is. And Achilles is a difficult one. Again, depending on where things are at and what we know, whether it's insertional, or midportion, there are definitely are two different protocols when it comes to it. So, from the physio side whether you do eccentric loading, which is raising up on two feet, lowering down on one or whether you're doing a different kind of strengthening programme that really is sort of the physio side of that end of it, where I tend to come in on that and where I tend to see a lot of Achilles injuries are people who wind up changing the drop of their shoe too quickly. And so they're used to running in something that's either too low or too high and then make it an abrupt sudden change, or they change their running style too quickly.  So, it's very common to see people who go—who are heel strikers who want to try forefoot running for the first time and if they do it improperly when you load the ground with your heel, I mean, yes, we know that if you overstride braking forces and everything else are really bad for you and smashing your heel into the ground might not be ideal for everybody.  But if you're running on your forefoot, you're striking, your initial contact is with your forefoot, then you touch your heel. Then you push off your forefoot again, right? So, one is heel midfoot toe, one is forefoot heel, forefoot. So, to that end, you're going through a much larger cycle of Achilles loading. And so for some people, especially who—if gene, you were talking about genetics earlier, we know that there is a genetic predisposition for some people, or Achilles issues specifically if you're one of those people, then that can certainly be a bad thing if you do it too quickly.  And so to that end, we talked about the very first thing we do is deload the Achilles. So using things like heel shoe, heel lifts, and footwear, to be able to, for a short period of time, take some of that load off the Achilles, allow it to heal and then gradually reloaded it as they've been working with their physio to be able to gain back strength and mobility and everything else. The one thing that I like to look at everybody who comes to my clinic because I think it's so incredibly important, is their ability to move their ankle appropriately because their calf musculature is flexible enough.  Lisa: Yes.  Dr Colin: And I'll get into trouble there because some people say, ‘It's not coming from your calf, it's coming from your hip'. It can be coming from your hip certainly if you have things that are changing your pelvic tilt, and it's lengthening your hamstring, and it's doing that, and then you're getting the effect of change that comes with it, it's a matter of just looking at it to understand where that change is coming from. But any ankle restriction in your range of motion can make you use your Achilles in a different way, the simplest way for your body to compensate for that is to out-toe and pronate more, well, you're going to get a rotational stress on your Achilles, for some people that's just going to be too much combined with the kind of running programme that they're doing. And so one thing to think about for sure. Lisa: Wow, this is like, you're a foot specialist, but you also need to have a really good understanding of the whole anatomy of the body really, don't you? Because you have to be a holistic in your approach because, and then this is one of the issues that I have with the medical world in general, now speaking is that they’re so siloed. If you've got a lung problem, you go to the lung specialist, or the pulmonary, if you've got a heart and then the ear, nose and throat are separate, and yet it's to do with your lungs, like, we need to have a holistic ‘Look At It systems’ in the body or the—not even systems, but the entire body, so everybody has to have it.  Dr Colin: Yes. Lisa: And it's difficult because you have to have a specialised education in feet, you can't be an expert in feet and an expert in hips.  Dr Colin: Yes.  Lisa: But you do need a general education to be able to understand: what the roles of the other therapists or doctors or whatever it is in order to have a good understanding. And I think that holistic approach were possible, into sort of disciplinary communication, is really, really important. Would you agree with it? Dr Colin: Oh, that's the only way that I work is multi-disciplinary. And so if there's one specialist that thinks that they can fix everything, then that usually makes me want to run away screaming. And because there's just isn't enough flexibility in your thinking to understand that, maybe what you're doing won't be enough for somebody. And again, can't tell you the number of people that come in to say, ‘I've seen my ex-specialists who said, there's nothing else that can be done. We get them back running within six weeks'.  Lisa: Wow. Dr Colin: You know what I mean? It's only because we were flexible enough in our thinking to be able to say, ‘Yes, we're gonna change this little thing over here. That might be the thing that's going to get you back to what you want to be doing'. So, it’s so... Lisa: I could go in a rant on that, really. I could go on a rant about the amount of times that people have been told, ‘You can never run again'. I was told I would never run when I broke my back when I was a young lady. And that were wrong, 70,000 kilometres later.  Dr Colin: Yes. Lisa: If I'd lifted up to so-called experts who, with my mother who had a massive brain aneurysm five years ago and who said that initial, ‘You’ll never have any quality of life again’. She's got massive brain damage. They were wrong. I spent five years rehabilitating her, but they were wrong, and she's completely normal again. So, it's not just accepting—what I think is important to realise is the limitations of your knowledge and saying, ‘Hey, I don't know, I'm at the end of my abilities'. You might have to look somewhere else, or outside the square, or try something else to talk, to so and so.  Dr Colin: Yes. Lisa: And that's fine. That's good if we get there but not blanket saying, ‘Well, you can never run again because you've got a knee injury.’ The amount of times, amount of runners who have come on doctors said I should never run again because I've got some slight knee problems, and I was like, ‘Really?’ Dr Colin: Yes, no, I agree. So, a case in point in my own life, I have congenital arthritis. That's so bad. I had my first hip reconstruction at 17.  Lisa: Wow. Dr Colin: That left me with a four-centimetre leg length discrepancy. So I've got some real orthopaedic problems. And was racing mountain bikes at almost the pro-level in Canada in downhill at the time, and wanted to pursue that. And I was told, ‘Never ride a bike again', this kind of stuff. And I'll be doing a half Ironman in Muskoka in July...  Lisa: Wow. I love it.  Dr Colin: ...25 years later.  Lisa: Exactly.  Dr Colin: So, yes. At the end of the day...  Lisa: And if we keep founding way round the problem. Yes. Dr Colin: Yes, I mean, you know your limits better than somebody else. But I think that there's also a time when you do need to respect the knowledge that someone's done and spent time attaining. But if they'll put aside all of your own expectations and things, then they're not doing you a good service.  Lisa: No, no. And sometimes they're wrong, and they're just not up—what I'm also saying, and we're getting off on a tangent here, but it is a—if your life is different there's definitely a 20-year lag between what's actually the latest in science and what's actually happening in clinical practice.  Dr Colin: Yes, true. Lisa: And not so much in the area like you have, but saying things like critical care and things like this, it's just so far behind the eight ball because there's so many hoops that they have to jump through in order to get anything changed, that the science can be saying, ‘Hey, this is what you need to be doing'. And they'll be like, ‘Yes, we need another 20 years before we got adopted'. Dr Colin: Yes, knowledge translation is difficult.  Lisa: Yes, it just seems to be this huge lag, and in some areas of medicine but I've gotten completely off-topic. But I love talking with people that are on the cutting edge of stuff, and I find your knowledge is absolutely next level.  Colin, I think we're gonna have to get you back because we didn't even get to plantar fasciitis and hips and knees, and all the rest of it and... Dr Colin: I'd love to.  Lisa: Yes, what you're doing... So, before we wrap it up, where can people find out your books and obviously, you've said on Amazon, but give us your websites, and where people can follow you on Instagram and all that sort of good stuff. Dr Colin: So we're just starting to build out a website called stuffaboutfeet.com. So that's probably the best place to get me right now. You'll be able to see some of the books that are on there, other podcasts that I've done, you'll watch some videos, and then that's going to be built up just more and more and moreover the coming weeks and months.  And through that site, you'll be able to get to me whether it's a personal email or you want to get on the socials or what have you. And so I've been kind of locked away in both the research lab and the clinic office for too many years. And now we're going to get me a bit more online and doing a few more of these things. Lisa: Yes, and you're so talented at this interviewing and stuff. So it's really easy to be able to share your knowledge and to get it out there. And then you can have much more of a massive impact worldwide rather than just locally, which is fantastic. You know that we can do that now with technology. So I love getting world-leading people on the show and sharing the amazing insights. And you definitely right up there, Colin. So thank you very, very much for sharing your insights today. So stuffaboutfeet.com, was that right? Was that correct? And that you've been listening to Colin Dombrowski.  Colin, any last words that you would like to share with people out there? Dr Colin: You know, I really hope at the end of the day that you use your knowledge, the best to be able to get out there and do the things that you want to do. And don't put yourself in a box, really understand that you're capable of the things that you think that you are, it's just a matter of figuring out how to do them appropriately.  Lisa: Yes. And getting the right people with the right info.  Dr Colin: Yes. Lisa: And we've just done that, haven't we? Brilliant. Thank you so much, Colin. Dr Colin: Thank you. That's it this week for Pushing The Limits. Be sure to rate, review and share with your friends and head over and visit Lisa and her team at lisatamati.com. The information contained in this show is not medical advice it is for educational purposes only and the opinions of guests are not the views of the show. Please seed your own medical advice from a registered medical professional.

Starting a business can be incredibly tricky. Statistics say about 80% or more of enterprises end up failing. If you’re a business owner or a founder, you know how there are so many factors to consider. Overcoming obstacles every step of the way is far from an easy feat. Moreover, starting a business requires a ton of research, but research alone won't guarantee success. So what's the secret? In this episode, Daryl Urbanski joins us to share the secret to building businesses and scaling them. You’ll learn about how his background taught him to be one of the leading business experts of this generation. He also discusses how to overcome obstacles and take your business to the next level. If you want to learn how to be a successful entrepreneur, tune in to this episode!   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition and mind performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join their free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   Consult with Me If you would like to work with me one to one on anything from your mindset, to head injuries, to biohacking your health, to optimal performance or executive coaching, please book a consultation here: https://shop.lisatamati.com/collections/consultations.   Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research and incredible tenacity to prove them wrong and bring my mother back to full health within three years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: Hear Daryl’s insights on raising children and lessons gained from martial arts. Learn the secret to overcoming obstacles and building successful businesses. Find out what you need to become an entrepreneur.   Resources NMN Bio by Elena Seranova Lifespan by David Sinclair The Dream of Life by Alan Watts Learn more about Daryl’s group coaching and pay-for-performance model! The Best Business Podcast with Daryl Urbanski   Episode Highlights [7:02] How Daryl Started Out Daryl was orphaned as a kid, and his stepdad was an entrepreneur. His father showed Daryl that an entrepreneur was someone who is of service and respected by their community. He wanted to be like that too, so he shovelled driveways and did a newspaper route for money at a young age. Since Daryl was an orphan, he felt the need to be self-sufficient and self-directed. At 17, he joined a company that was one of the early pioneers of early marketing, got interested in growing businesses, and the rest is history. [10:45] Katimavik Daryl was part of Katimavik, a Canadian social program in which ten children aged 17-21 live, travel and work across Canada.   Katimavik was a turning point in Daryl's life.   Daryl initially lived in a dangerous city. Katimavik was his way out.   It was a source of many experiences for Daryl.   [21:52] Youth Development In raising his daughter, Daryl has a thing called neglect under supervision, where he tries to carefully neglect her in some ways to let her develop, grow and overcome obstacles. He won’t stop her from falling, but he’ll try his best to catch her. Growing up in a city is more about surviving in social dynamics than the social and environmental dynamics you find when you grow up on a farm. Children would benefit from more physical activity in their lives. They'd develop differently, and would not feel the need to lash out violently. Children need a better sense of responsibility and consequences — power and skill are earned. [27:17] Lessons from Martial Arts  Martial arts teaches progression: your skills will develop over time, through with observation and training. You learn about people and how your emotions impact decision-making. Martial arts isn’t just about training but also about recovery and rest. The best way to get out of a bad situation is to prevent it from happening. When he first learned martial arts, he thought it was about doing things to people. In reality, it’s about self-control and boundaries. Martial arts also taught Daryl about overcoming obstacles and testing himself. [39:04] The Secret to Building Businesses There are many great places to start, and one of the hardest ones is getting something new going. Always start with a market. Find a problem you’re willing to solve for people. The purpose of a business is to locate a prospect and turn that into a customer who returns. Figure out what problem you want to solve, then design it and do it in a scalable way. The critical success factors for businesses are self-efficacy, strategic planning, marketing, strategy, market intelligence, money management, business operating systems, business intelligence and government and economic factors. [46:05] The Next Level Ask yourself where the customers are and where they want to go. Can you take them there? Fix what makes your customers unhappy, find out how to get busy and aim for consistency. What helps your team grow is documentation and training. Create systems. How do you communicate your vision and keep the team productive? [50:23] Getting Out of the Startup Gate  The hardest part is dealing with the imposter syndrome and self-doubt. It’s all about managing stress and avoiding burnout. Many people sacrifice their health to make money but end up spending all their money trying to get their health back. It is better to collect money first and then develop a product. [56:39] Daryl’s Current Core Focus  Now, Daryl is focused on group coaching. For people who want more dedicated attention, he has a virtual VP of Marketing service. He also has a pay for performance model, where people only have to pay if they make a profit. [1:00:05] On Keywords and Google Trends Keywords can tell you how many people are thinking about this particular thing. Keywords are a powerful tool from a market intelligence standpoint. From keywords, you learn what people are looking for, where they are and more. Make your marketing about your customer. [1:04:03] What You Need to Be an Entrepreneur  Be transparent. People need to trust you for them to give you their money. You’re going to need all eight success factors, but most importantly, answer the question: ‘What problem are you solving’?   7 Powerful Quotes from this Episode ‘Life is full of challenges and hurdles, and through overcoming those we develop our character’. ‘Pain often…makes you stronger and makes you more able to withstand—that’s what exercise is all about. You hurt yourself, you get stronger’. ‘It’s not just training, but it’s also how to recover and rest…Silence is part of music just as much as music is’. ‘Prevention is so much better than cure…the best solution is, don't let them do it to you in the first place. Know it, recognise the signs and protect yourself before it happens’. ‘It’s not even about being the best, the smartest, the brightest. It’s about making the least mistakes’. ‘You don’t know what you’re capable of until you do it’. ‘Evolution is about growth and challenge and overcoming obstacles’.   About Daryl Daryl Urbanski, Founder, President of BestBusinessCoach.ca & Host of The Best Business Podcast is best known for his ability to create seven-figure, automated income streams from scratch. First as Senior Marketing Director for Praxis LLC, now Neurogym, he generated over USD 1.6 Million in under 6 months with a single marketing strategy. This became almost USD 7.5 Million in just under 3 years. After repeating this success with multiple clients, he set on a mission to help create 200 NEW multi-millionaire business owners. How? They’ll do better when they know better. Daryl has quickly climbed the entrepreneurial ladder, gaining respect from thousands of business owners worldwide. From author to speaker, marketer to coach, Daryl's multifaceted business approach sets him apart as one of the leading business experts of his generation.   Enjoy the Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends, so they overcome the obstacles in their lives or start their own successful businesses. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript Of The Podcast! Welcome to Pushing The Limits, the show that helps you reach your full potential with your host Lisa Tamati, brought to you by lisatamati.com. Lisa Tamati: You're listening to Pushing The Limits with your host, Lisa Tamati. Thank you once again for joining me. Today I have another exciting podcast with a man named Daryl Urbanski. Now, Daryl is a very well known business coach. So today, quite something different for you. This is all about what it takes to be an entrepreneur. Daryl is also a martial artist. So, he uses a lot of analogies from his sporting as we do in this podcast, from a sporting life and how that helps him in his career and also helping others build businesses. Now, he's helped over 1,000 businesses in his career in 50 different industries, and this guy knows how to grow and scale and overcome problems. So, he's a real expert in this area, and I really enjoyed our conversation.  Before we head over to Daryl in Vietnam, just wanted to remind you, if you're into finding out all about your genes, and what they have to say about you and how you can influence your genes to live your optimal lifestyle and be your best self, then make sure you check out what we do in our Epigenetics Program. So, this is all about understanding your genes and how they are expressing at the moment how the environment is influencing them, and then optimising everything, from your food to your exercise right through to your mindset, your social, your career, all aspects of life are covered in this really revolutionary programme.  Now, this programme is not something that we've put together; this has been put together by literally hundreds of scientists from 15 different science disciplines, all working together for over 20 years to bring this really next level cutting edge information about your genes and how you can find out how to optimise them. No longer do you need trial and error; you can work out what the best diet is, when the best time to eat is, exactly the right foods to eat right down to the level of, 'eat bok choy, don't eat spinach', that type of thing. And as—but it's so much more than just a food and exercise. It also looks at your health and anything that may be troubling you and future and how to deal with it. So, it's a really comprehensive programme, and I'd love you to check it out. You can visit us at lisatamati.com, hit the Work with Us button and you'll see our Epigenetics Program.  We've also got our online run coaching as normal, customised, personalised, run training system, where we make a plan specific to you and to your needs and your goals. And you get a session with me—a one on one session with me and a full video analysis of your running so that we can help you improve your style, your form, your efficiency, plus a full-on plan that includes all your strength training, your mobility workouts, and great community, of course. So make sure you check that out at runninghotcoaching.com.  And the last thing before we go over to the show, I have just started a new venture with Dr Elena Seranova, who is a molecular biologist from the UK, originally from Russia, and she is a expert in autophagy in stem cells, and she has made a supplement called NMN. Now, you may have heard of this nicotinamide mononucleotide. It's a big fancy word, I know. But you will be hearing more about this. It's been on the Joe Rogan show; it's been on Dr Rhonda Patrick show, some big names now talking all about this amazing longevity compound, anti-aging compound. Now, this is based on the work of Dr David Sinclair, who wrote the book, Lifespan: Why We Age and or How We Age and Why We Don't Need To. He is a Harvard Medical School researcher who has been studying longevity and anti-aging and is at the really the world's forefront of all the technologies to do with turning the clock back and who doesn't want to do that?  So I've teamed up with Dr Elena to import nicotinamide mononucleotide, our supplement from NMN bio into New Zealand and Australia. So if you are keen to get your hands on some because this was not available prior in New Zealand, I wanted a reputable company, a place that I could really know that the supplements that I'm getting is quality, that it's been lab-tested, that it was a scientist behind it, a lab behind it, and this is a real deal.  Now, I've been on this now for four months and so as my mom and my husband, and I've noticed massive changes in my life. Certainly, weight loss has been one of those things, that stubborn last couple of kilos that I've been fighting have gone without any muscle loss which has been really very interesting. It improves also cardiovascular health, your memory cognition, the speed of your thinking; all the things that start to decline as you age. And the reason this is happening is because we have declining levels of NAD, another big word, nicotinamide adenine dinucleotide. And this NMN is a precursor for NAD.  So, lots of big words, lots of science. f you want to find more about that, you can head over to lisatamati.com, under the Shop button, you will find out all about our anti-aging supplement NMN, and we're about to launch a new website which will be nmnbio.nz, but that's not quite up there yet, but it probably is by the time this podcast comes out. So, check that one out to nmnbio.nz, bio, just B-I-O. If you want to stop—well, not completely stop aging, but if you want to slow the clock down and get the best information that's out there then make sure you read Dr David Sinclair's book, Lifespan it's an absolute game-changer. You'll be absolutely amazed at some of the stuff that's happening and what they consider my mononucleotide can already do. So check that out. Okay, without further ado over to the show with Daryl Urbanski.  Lisa Tamati: Well, hi, everyone and welcome back to Pushing The Limits. Today I have the lovely Daryl Urbanski with me who is sitting in Danang in Vietnam. And Daryl, this is gonna be a little bit of a different episode because usually I've got some health science-y thing or some are elite athlete doing—well, not to say that Daryl was not an elite athlete because he is into martial arts. But Daryl’s specialty and what he's come to share with you guys today is, he is a business expert and a marketing expert, and also a mindset expert, I would like to say. So Daryl, welcome to the show. Fantastic to have you.  Daryl Urbanski: Yes, it's an honour and pleasure to be here. We've had some good conversations, like minds, two birds of a feather. Just an honour and a pleasure to be here. Lisa: Yes. Thank you so much, Daryl, for coming on today. So, Daryl and I cross pass by his lovely lady who organises half my life as far as the business side of things goes. So it's been a fantastic liaison. And—but Daryl was actually here on his own accord. And he's—so Daryl, I want you to give us a bit of a brief background, where have you come from, how did you end up in Vietnam? And what do you do for a living? Daryl: Right, so I'm Canadian. So I'm from Canada, travelled all over the world, and I don't know if it's too short. So that's where I come from, I ended up in Vietnam. That's a long story. So I guess I'm Canadian. I'm in Vietnam. I help businesses or websites get customers and keep them to make more money. And that's really kind of it in a nutshell. It's been a long journey.  When I was a kid I was an orphan and my adopted family, actually my step adopted dad's the one that really raised me and his brother, my uncle. We would visit him every time we went to Toronto, and he was a bit of an entrepreneur. He also did some property management in that and every time we went to visit I almost felt like he was kind of like the Godfather. What I meant was people were always coming by with like, a gift basket or to thank him for something. So the impression that was put in my mind was like to be an entrepreneur is to be of service to the community, and to get people's respect and adoration for the good that you're bringing. And that was really like—I know, there's all sorts of different like your salesmen, and everyone's got different images. But that was when I was a young kid, I was like, ‘Wow, I want to be valued by my community, too’. So that really laid an impression on me at a young age.  Again, I didn't have the lemonade stand, I didn't mow lawn, but I did shovel driveways. We have so much snow in Canada in the wintertime. We would shovel driveways for money. I did have a newspaper route. And just at a young age, I just kind of felt, maybe because I was an orphan, but I felt the need to be self-sufficient and self-directed. Yes...  Lisa: How to be your own ship, really.  Daryl: Yes, sort of. Yes, I just—I also had issues like I did air cadets when I was a kid. There's some other kids, they were using their authority outside of cadets to try to, like, lord over people and stuff. And right away, I kind of learned at a young age, you kind of have to be careful—you can manage up, let's just put it that way. It's not just managing down, but you can manage up, and you can choose who's above you too, it's a two-way street. So I really laid an impression on the young age. And then when I was 17, I added a co-op in university with the company called marketme.ca and they were just one of the early pioneers of online marketing. Got me into the whole business growth avenue and that... Lisa: The rest is history. Yes, now that's fabulous. So you from like, in my young years, like I was an entrepreneur from the get-go. I never fit in in anybody's corporate square box. Tried—I tried, I failed. Did you have that feeling like you were just outside of like, you just wanted to be in charge? Because you've been in business, basically, since you were 17 years old. And you've learned a heck of a lot on this massive business journey that you've been on. And you've helped—I know that you've helped over 1,000 businesses in 50 plus industries. And you've really grown into this role of helping businesses scale up and grow and develop your own systems around this.  But did you have an idea when you were that 17-year old that this was where you were going, and this is the direction? Or has it sort of meandered throughout time? Daryl: No, I was—because I think I had a lot of, they say, like everything, I'm not maybe everything that I am and not knowing my biological roots, and that as a kid left me really to kind of be given the path of self-discovery, you could say from a young age. A lot of confusion, maybe anger in my younger years as well. But what really made the difference, at least in the earliest days, was that when I was 17, I ended up at Canadian government programme called Katimavik, which means ‘meeting places’. Inuit, which a lot of people call them Eskimos. But now we say the people of the North, the natives of the North they’re Inuit, which means snow people. Eskimo means meat-eater or flesh-eater. So they don't like being called Eskimos, you call them Inuit, but Katimavik is an Inuit word, and it means ‘meeting place’. And it's a government programme that's been on and off over the last 40-50 years in Canada.  And really what the—when I did it with the terms of the programme where it's a social programme sponsored by the government, 17 to 21-year-old youth, and then what they do is they put a group of 10 kids together, and the group of 10 kids is supposed to represent Canada. So, what that means is that they grab some from the east coast, the west coast from up north they try to make it, so it's representative. Like we had half guys have girls. French, we have three French speakers, right? Then the English speakers. We had an Inuit guy Kenny, who when he came, he actually didn't even speak English. We always knew when the phone was for Kenny because we didn't—it all be like, '[mumbles] Kenny this is for you, I don't know what's happening, either it's a bad connection, or this is someone who talks in their language'.  And that programme, what we did—when I did it was we spent three months in British Columbia, three months in Alberta, and three months in Quebec and in every province, there was a house. In that house, there is a project manager, project leader... Lisa: Wow. Daryl: ...basically he was someone that would go to the house, and they were there, the whole duration of the programme. And this isn't a pitch for the programme, but I feel like it was—my life was really before and after.  Lisa: Wow. Daryl: Because life skills I got from this...  Lisa: That's cool.  Daryl: ...so every place would have a project leader, and they would organise full-time work for all ten kids. And you were like a volunteer full-time worker, and in exchange, the government and I think this businesses may be paid a reduced hourly wage, I don't really know the details of it. But you worked for free, and in exchange, the government paid your grocery bills, they paid your rent and your travel expenses, and you got 20 bucks a week for like toothpaste and whatever else you wanted. And that was—it was a fantastic programme. I learned so much when I was in Alberta and British Columbia. I worked at a native band office, which is in Canada, we have a lot of native land, and that's land, like, we were the original immigrants. We took over the landmass, and then we gave the natives, ‘This is your land’, and so it's like a country within a country, and a band office is like their government office.  Lisa: Right. Daryl: So, I actually worked at an Indian band office, Similkameen Valley band office and Iwe helped build sweat lodges. We did all sorts of stuff. I work there newsletter, helped communicate with the community. In Alberta, I was a seventh-grade teacher's assistant at a middle school, and a social worker assistant and I worked with a librarian as well. And then in Quebec, I was actually a mayor's assistant for three small town, 150 people. But you had a full-time job in each place, and then after work when you came home, the 10 of you were basically instantly signed up for any community events that were going on.  I remember in the small town of Karamea we built something like 20 out of the 25 of their Christmas floats for their Christmas parade. We did soup kitchens, music festivals, like, you name it, and there's just like, instantly—if there was something out of the community like the project leader would know about it and just drag us, and we just show up be like, 'Hey', and it was like ten pairs of hands. Like just we were coming just to make things happen.  So every three months, you had a full-time job, evenings and weekends, except for Sunday. You basically anything in the community, you were instantly signed up as a volunteer, and every two and for two weeks, every three month period, you would build it, you would stay with a local family for two weeks to like, see how they live. And that was really insightful because I didn't know any other family or how the family operated. But then I got to see inside the workings, like,  I remember this one family, I stayed with the three, the parents, the father was in finance, and he was always, like, his suit and his hair's so proper. He was very strict and very like this. And his kids on the other side, they had like mohawks, spike collars and black nails and eyes. And it was so funny because I felt like it was a yin yang. I felt like the kids were the exact opposite in the extreme of the parents, and just watching the dynamics of people. And also every week, a boy and a girl would stay home from their full-time jobs, and they would be the mum and dad in the house because we had a budget like for groceries and they would have to cook and clean. So that nine months experience when I was 17, I came out of that with more life experience than a lot of people and… Lisa: What an incredible programme and how lucky...  Daryl: Yes. Lisa: ...for you, like, because so many kids go off the rails, as they say at that point yet, and they get lost and to have the sort of a structure of development and experience must have been a real game-changer for you. Daryl: Yeah, I mean, we moved around a bit when I was a kid, but we ended up settling in a city called Kingston, Ontario, which also happened to be the penitentiary capital of Canada. And so it was a unique community because you've got Queen's University, which is one of the top three universities of Canada. You've got the second-largest military base. It's almost one of the largest government employment cities. So you've got these high-income earners in the public sector, and then you've also got this great university. Some of the largest businesses out of Canada, actually, even in Kingston, like we've got one of the largest real estate investment trusts. There's a company that makes the shafts for all the pro golf clubs outside of Kingston. It's kind of weird, you got these unique massive spikes of success. But then because of the penitentiaries, a lot of families move to Kingston to be closer to the family. So then you have these areas where there's like when you get out of jail, you just settle in the town that you're in, and so it's weird, and I actually didn't think I was gonna see my 21st birthday.  Lisa: Wow. Daryl: I was in high school, and I didn't—I had a friend that was found in a lake rolled in a carpet...  Lisa: Oh, gosh. Daryl: ...and things like that. And I didn't think I was really gonna make it.  Lisa: So, really dangerous areas to be growing up as a youth. Daryl: But then, I always say when you live in a city, you don't live in that city, you live in your bubble in that city. So my bubble was mixed. It was a mixed bag. I was in the middle—I grew up in a nice suburb, but through school and all that, I got involved with lots of different things. But in this group one day, they spoke at my high school, and they're talking about, 'Yo, we're getting to travel Canada for free'. Like, I was like, 'Hey, that sounds great. I need to get out of here. I don't see a future. I don't see a future', and I signed up and that was what I did. And then after that because of being involved and so I almost got kicked out.  Now, after the first two months, I was on my last warning, you get three warnings, and you get sent home. And every time you make them, you have to write a commitment to improve. And I was like, I just thought I think that project leader didn't like me, but I was like, on it by a hair. And it was so funny because I remember when I made the first three months, we moved to the second location, I was like, 'Wow even if I get kicked out now. Now I've learned everything that I could learn from this programme'. Three months, Alberta and I met all sorts of new people and new experiences. And I was like, 'Wow, I made it to six months. Now that I'm going to Quebec, now I've learned everything, I mean, so good'. And then the next three months, and then I finished it like, 'Wow, I made it to the end. Now I've learned...  Lisa: You're an expert. Daryl: ...programme, right. But now here it is years and years later, and I met because they were like family, the other ten kids, right? And I still catch up with them every now and then, like I learned through, 'Why? You got a kid? You got three kids'? Lisa: In other words, we all say we're no’s all the time. And then we're actually just at the beginning of our next journey.  And it's all stepping stones to the next part of learning and stuff. But what a fantastic I wish we had a programme like that here because I mean, it must cost a lot to run and be really difficult to organise. But man, they could change lives, say for kids who are just lost and don't quite know what's the next step and how many of them are be. Daryl: It's a fantastic programme. It's actually I don't think it's running in Canada anymore. Again, because of the cost that it gets government funding, it gets taken away. The Trudeau lineage is the one that started—they tend to be behind it. There was a big scandal in Canada 'we something charity' and it sounds like that they were going to give a billion dollars in one organisation that does something like that. But of course, it got into, like, where's money going and people arguing and is that a good use and I think nothing happened at it. But it's a shame because... Lisa: It changes your life. Daryl: Well, I think right now there's a ton of people, especially the younger kids who need a sense of responsibility. I think in some ways, I don't want to go on a big rant. But I think life is full of challenges and hurdles. And it's like, through overcoming those we develop our character. And some people, they just have such a cushy like...  Lisa: Yes.  Daryl: .Things have become so politically correct. We've softened all the hard edges. I remember seeing in Toronto, they replaced a bunch of the kids playgrounds, because kids were falling and getting hurt.  Lisa: Yes, yes.  Daryl: Like, yes, but that's, like, you climb a tree, you fall, like, you don't... Lisa: There's no consequence to anything anymore. And there's no, like, yes. Daryl: It's like participation awards versus achievement awards. Like, we really, in some ways, become a society of participation awards versus achievement awards. And that's... Lisa: I totally get it. I totally agree. Because I mean, I'm showing my age, but I grew up in the early 70s and stuff, and it was a rough ride. I'm lucky to be alive. Daryl: Not everyone. Not everyone made it in adulthood. Yes. Lisa: And, but you know what, I wouldn't change that for the world because I don't want to be wrapped up in cotton wool and bounce around like a bunch of marshmallows for the want of a better expression. I want to be able to climb trees and cycle. I had to laugh yesterday. We live in a little village that, sort of, no police around here. And you've got all sorts in, and it's a lovely village, it's a sort of a beachy resort-y place. But you get the kids, they got no helmets on, and the other ones are on scooters, and there's three of them hanging off it and other people with their youths, and the kids are on the back, which is all illegal, right?  Daryl: Right. Lisa: And I'm not saying it is good, but I do have to smile because it reminds me of my childhood because that's where... Daryl: A little bit recklessness, a little bit of foolishness. We don't want it, but the world has real limits.  Lisa: Yes. Daryl: And especially as a parent, like I have a daughter now and it's like, I call it careful neglect. I try to carefully neglect her in some ways to force her to develop and grow.  Lisa: Beautiful. Daryl: It's like neglect under supervision, that's probably the best way to do it. Because if I always do it for her, and then I'm not there like they say kids who grew up with a single parent tend to be more independent than kids that have two parents, although kids with two parents tend to do better overall. I want a blend of that. The kids with single parents, they are more independent because that's expected of them. There's not all—you can't...  Lisa: backup.  Daryl: It's not all the swaddling.  Lisa: Yes, no, I totally agree. And like, not even just for kids, but like dealing with my mum with her disability, I had to—and people would criticise me heavily, but I used—I make her do the hard stuff. Like, if she's struggling to get out of a chair at night and she's tired I don't get up to help her and not because I'm an asshole but because I need her to learn which muscle it is to push and people would, like when we're out in public that'd be standing there watching me watch her struggling and I'd get abuse sometimes. Like, ‘why aren't you helping’? Daryl: Yes, yes. Lisa: That's all I'm doing. I have to do it all the time with her because I'm teaching her new difficult tasks all the time. I'm having to put her through some painful regimes and training. And because I've been an athlete all my life, I understand that pain often, when in training, in difficult training sessions and stuff make you stronger, and make you more able to withstand. I mean, that's what exercise is all about: you hurt yourself, you get stronger, you hurt yourself, you get stronger. And with mum's training, it's very often like that. So okay, she's not a kid, but it's the same principle. I have to let her go.  Or winching out when she got her driver's license, and I would let her drive my car and go around town. I mean, I'm still panicking half the time, a nice—and for the start, I would shadow her, like from behind. She didn't know that I was following her way right through the town where she went so that she had that backup. But she didn't know she had that backup. Daryl: As I actually had been saying that to Kathy, but my daughter, I'm like, I won't stop her from falling, but I'll do my best to always catch her.  Lisa: Yes. Daryl: I'm not gonna try to stop because sometimes you're like, 'Your daughter and you try to pad the room'. And I'm like, 'I gave her a pair of scissors'. This is when she was really young, gave her scissors, 'Don't, she'll cut herself', and I'm like, 'Yes, and it'll be a valuable lesson'. 'You're right'. And I'm right here, and it'll be a vet ship. She'll learn a valuable lesson; I don't know if she doesn't, I feel like that's partially where we have things like all these school shootings and that. These kids aren't growing up on farms. They've never been kicked by a horse or a goat, or they've never hit themselves in the foot with an axe. So they playing these video games of extreme violence and sexual violence in the movies and they feel these emotions, like really common as a teenager. They have access to such powerful tools.  I'm Canadian, but in the States, they sell guns at Walmart and so you've got a kid that's angry, he's got no real sense of the reality of the world around him in terms of like, what happens if you fall out of a tree and break your ankle, that's so distant because they grew up in a city and it's just, it's more just surviving and social dynamics versus a social and environmental dynamic.  Lisa: I totally agree. Daryl: And I go to school, and they lash out with guns, I really feel that if those kids grew up with more hard labour in their lives, more physical—even if they just had more physical training conditioning. You play hockey, you get hit too hard, like something like that, it would have less school shootings because they still feel the same emotions, but one, they'd have different outlets, and they would also kind of respect it better. It's like my jujitsu. You mentioned I do jujitsu.  Lisa: Yes. Daryl: I feel like it's very—when you guys are new, you get a lot of these strong guys, and they try to tough on everybody. And they just, it's useless. And they get beaten up by the more skilled ones. So then when they develop skill, they're kind of like a 'Hey, like, I know what it's like to be the one getting beaten up'. Lisa: Yes. Which is the correct method. Daryl: Like, the power, the skill is earned. So, you treat it with better respect. Lisa: Humility is always a good thing. And I think learning.. I've taken up skimboarding with you, and I don't bounce very well at 52. But it's really important that I do something that I'm really useless at.and I'm having to learn a new skill. And I sometimes ski myself because if I don't get the stage, that's when you start losing those skills. And I don't want to lose any of my abilities, and I've still got good reactions and stuff like that, so I want to keep them. So I constantly want to push myself outside that boundary.  So let's dive in a little bit to your martial arts, and then we'll get onto your business side of things because what you've done the years is just incredible. What sort of lessons have you learned—I mean, that was one—but what sort of lessons have you learned from doing Jiu Jitsu in the discipline that's required for this very tough sport? Daryl: Yes, that's great. So yes, I did jujitsu for about six, seven, maybe eight years. I haven't trained, probably in a couple years now. I've been doing more kind of CrossFit and my own physical training, but I think the lessons are through any—you learn about progression over time. You learn things like the fundamentals are fundamental. You kind of learn the basics, but then you get bored with those, and you want to learn the fancy, advanced stuff, but then it's hard to apply it and get it to work. And then through just time and observation and training with the greatest you understand it really is about the fundamentals. Virtue is doing the common uncommonly well.  The fundamentals that we learned are the stuff that's actually working against the highest level black belts. The basics that you learn, you see that happen at the highest level World Championships in the biggest competitions, and the really great to the ones that can do the basics and just walk through everyone with them. Like, 'How are they able to do that so well'? Everybody knows what's happening. Everyone knows what to expect, but they can't stop it from happening anyhow.  Another lesson was it's a game of inches in the beginning because jujitsu is kind of like a submission wrestling, submission grappling.It's not so much punch and kick.It's more about pull, roll, and just and using things like gravity. So there's things about drilling how practise makes perfect. You learned the rule, like 10,000 hours that it's if I've been training for 200 hours, and you've been training 10 hours, generally speaking, I have a major advantage. If I've been training 2000 hours, you've been training 100 hours, typically speaking, I'm gonna just mop the floor with you because I've—there's nuance detail and you can almost endlessly drill into the fundamentals.  And then there's just the progress. You've talked about learning new skills. Last year, I learned how to handstand walk. I can now handstand walk about 20 feet, I'm gonna be 38 in a couple of months.  Lisa: Wow, I can't do that.  Daryl: Yes.  Lisa: I'm jealous. Daryl: It’s specifically for the skill development, for the neurological developments, to like to balance in a totally different way and physical development. So I mean, you just see you learn about people, you learn about how your emotions impact your decision making in certain respects. You learn about how it's not just training, but it's also how to recover and rest. And we talked about this I think before I interviewed you for my podcast, like, silence is part of music just as much as music is, the difference is it's intentional. Lisa: Yes. Daryl: Silences, intention. So it's about doing things with intent. Taking a concept like I want to learn and get good at this and breaking into pieces. And I was talking about this to my friend yesterday. Actually, I forget how it came up. But he's talking about something, and work, and the situation, and how to avoid, and I remember I was training and I was fortunate to do some training with Rickson Gracie in my early parts of my training career, legendary fighter guy.  And I remember I kept getting caught in these triangle chokes. Triangle choke is a type of choke. And I kept getting caught in these triangle chokes. I remember asking, like, 'How do I get out of it'? He says, 'Well, don't let them put you into it'. I'm like, 'Yes, I know. But I already got into it. Now what do I do'? he's like, 'Don't let them put you into it'. And I just wanted—I wanted the cure, and I was like, 'Yes, but I want it' and there are, there's some things you can do. But the real answer is...  Lisa: Prevention Daryl: ...prevention is so much better than cure. Like, well it's good... Lisa: Great principle. Daryl: You're in it, like, you gotta panic, you got two or three options, you got to panic, you're gonna spend a lot of energy, you're gonna flail and struggle, it's gonna be close. We can talk about how to do it. But really, the best solution is, don't let them do it to you in the first place. Note and recognise the signs and protect yourself before it happens. Lisa: That is a great law for the whole of the health paradigm that I live under. Daryl: Yes. How do I deal with heart problems?  Lisa: Prevention, prevention.  Daryl: Prevention. Yes, exactly. And you know proactivity. Lisa: Yes, occasionally,you will still get caught out and you will still and then you want to know those tricks. But in the first line, let's learn prevention and then we'll look at how do we get out of this mess? Daryl: And another really—which kind of ties in and then we can if you want to move on, move on. But this one, I think is also really, really, really important. When I first learned martial arts, I always thought it was about doing things to other people, I'm going to do this too, or I'm going to use your leverage against you. I'm gonna do this to the world. What I've really realised is two things. One, it's not even necessarily about doing things. It's about two things it's about not doing things externally, it's about self-control. It's about boundaries.  So we just talked about 'Don't let him put you into it'. That means that I have to have boundaries around things. Will I let him grab me here? Well I’ll not allow that. Well, I let him grab me there. And I'll be like, 'Okay, whatever. And I'm going to try to do some'. So again, when people start and forgive me, I don't want to go on a huge long rant on this. But when you start, I'm going to do this to you, going to do that to you and I'm trying to do this...  Lisa: You got to be kidding. Daryl: ...and so I don't even care what you're doing to me. When you get—later, it's like what do I accept? What are my boundaries?  Lisa: Wow.  Daryl: What situations do I let myself enter into? And that was—and then the other thing is that a lot of times it's not about what you do. It's not even about winning. It's about who makes the fewest mistakes.  Lisa: Wow.  Daryl: It's really—it's not even about being the best, the smartest, the brightest. It's about making the least mistakes.  Lisa: Wow... Daryl: In this situation, how many doors do I open for my opponent?  Lisa: I totally...  Daryl: These things are great, right?  Lisa: Yes, yes, yes. Daryl: There’s just me posing on the world and more about controlling myself.  Lisa: Yes.  Daryl: And am I allowing myself to be manipulated this way? Am I allowing myself to be grabbed here? Am I allowing his energy to mess with my mindset? Lisa: Wow, that is gold. Daryl: In a tournament, I've seen them lose the match before it even begins. Get you two guys step up, and the rest get in there, and they like their eyeballing on each other.  Lisa: Yes. Daryl: You see one guy like and he's just kind of coward. Like he lost before we even get started. So... Lisa: I haven’t seen that in ultramarathons are—another sporting analogy, but I've seen when people start bargaining with themselves and you do during an ultra. You start saying, 'Well, if I just get to there, I'll be happy with my results’. Or if you start to negotiate with yourself as how far you can get. And when I'm when I see people going, 'Well, I've at least done more than I've ever done before and therefore it's a success'. And when I start to hear talk like that, I know we're in the battle, like we are in the battle. And if they don't change the mindset, they're not going to because they're no longer in that, 'I'm gonna do this, come hell or high water there in the' Well, it's okay to fail and it is okay to fail. But in the battle, you don't want to be in that mindset. You want to be in that mindset, like, 'I'm going for this and I'm giving it everything I have.’  When you start to negotiate with yourself where ‘It would be okay if I got to that point, and therefore this is the longest I've ever run and therefore that's still a success'. When you start doing that type of bargaining with yourself, you're in deep shit basically because you've got to tune your psychology around too because otherwise, you're going to give yourself a way out.  I remember when I was running in the 220k race in the Himalayas that extreme altitude and I had a point where I just completely broke after going up the second path, and it was about—I'd been out there for 40 plus hours in a massive snowstorm. I had hypothermia. I had altitude sickness, asthma. I was just completely good enough reasons to be pulling out. And one of my guys came back to me, and I said, 'I think it's only two kilometres to the top of the mountain because you're calculating in your head'. And he came back and said, 'No, it's six kilometres to go'. And that just completely broke my mentality because six kilometres, I was going out 3k an hour, it was two hours of hell, and I couldn't, and it broke me. And I just fell into a heap and started bawling my eyes out, and everybody was giving me permission to give up. They were like, huddling around, 'You're amazing. We're so proud of you and you did everything you could', and then there was one guy. And he came over, and he shocked me, and he wasn't smiling, and he wasn't patting me on the back, and he was like, ‘Get the F up now’.  Daryl: You're so close. Lisa: ‘You're so close, you're not failing, and I'm not letting you fail and get your ass up off the ground. And I'm going to stay here with you. And I'm going to walk you up top of that mountain’. And that was key because it got me over that psychological break—I broke, but he picked me up, and he got me back on my feet. And I followed his instructions. I just did what he told me to do, put one foot in front of the other, and he got me over that hump, literally. And it's this type of stuff that you learn through sports; it's just so valuable. Daryl: It's just overcoming obstacles and just testing yourself. You don't know what you're capable of until you do it. You can spend all day reading a book about tennis, but until you're out there actually playing it. And there's learning you have to learn, you can learn through reading through lecture through conversation, personal experiences, and through other people's experiences and that's... Lisa: That's what this is about. Daryl: Yes, I mean Alan Watts has this great video called The Dream of Life. Imagine if every night you went to sleep, you could dream, however many years of life that you wished and because it's your dream, you can make them as wonderful as you want it. And so for the first—let's say you're dreaming 100 years of life every night. And maybe you do this for a couple of years, every night for a few years, you're dreaming 100 years of life. And all these lives that you're living, they're all the most filled with all the pleasures and all the wonderful things that you could possibly want. And what do you think would happen? And over time, you would kind of get bored, and you would want some risk and some adversity. And then eventually, you would want to be able to dream and go to sleep, and not know the outcome. ‘I want to go to sleep. I want to have this adventure, but I don't want to know the outcome’.  And that's kind of like that's almost like life. And if you could dream a lifetime every night in your—in a life of eighty years, you could possibly dream the life you're living right now. And that's the whole thing of evolution. Evolution is about growth and challenge and overcoming obstacles and... Lisa: Yes, obstacles like phone calls coming in the middle of your podcast.  Daryl: But, we got—everyone’s with me. Lisa: I think people listening to my podcasts are quite used to interruption. You just cannot stop the world from functioning half the time like somebody's phone is somewhere.  Daryl: Murphy's Law, you just gotta keep on recording. If you wait for perfection, it's never gonna happen.  Lisa: Exactly. You could panic now and start editing for Africa or another way, you could just get it out there and apologise for what happened, which we'll do. So, Daryl, I want to move now because I think there was absolutely brilliant and really insightful.  I want to move into the business side of things. And you've had a really successful business. You've taken lots of businesses to the million-dollar in a plus businesses from scratch, you've done that over and over again. You've helped people scale up and develop these systems and mine the data and work out all this complicated world of online, which is I'd struggle with daily so I want to know from you, how the heck do you do this? And what are some of your greatest secrets from building businesses over a long period of time now? Daryl: That's a great question. There's a lot of different places to start; I think one of the hardest places and where I've had the most failure myself is getting something new going because well, one, it's just not my superpower. But if you've got someone that's got a proven concept, and that's really how in the beginning, I should look it up.  But I got my seven-step rollout system. It's like you always start with a market first. So that means you always have to start with a need and or want so because you can't—the idea of selling ice to Eskimos. It's not about doing mental gymnastics and pushing something on someone that they don't want. That might happen in the world. There might be people that invest a lot of time, energy and resources in that but I have no interest. It's really tough to be like I'm gonna generate this demand. It's not there. The demand already exists. People already want to feel beautiful, people already want to be entertained, people already want to travel and to explore the world. So these needs and wants and that already exists. The idea is that you want to stand in front of it. The demand and want is already there and it's constantly evolving. And every time someone a business comes out, and you create a new product or service to fix a problem there'll be a new problem.  Lisa: Yes.  Daryl: Because now, like before the internet, the issue was how are we going to have these conversations like we can? You’re New Zealand, I'm in Vietnam, how will we do this? Well, now Zoom is created. These companies created tool, and they created tool. And now here's Zoom, but then what's the next issue? And then what's the next problem? So problems are markets, not demographics.  Lisa: Oh, wow. Daryl: Not demographics, the problem is a market. This is the problem that we solve for people. Once you've got that a lot of it—for me, it's like different ways that you can go, but the purpose of business is to locate a prospect, turn that prospect into a customer and then make a customer your friend.  Lisa: Yes. Daryl: It's really a big part of it. It's tough to have a business survive. There are businesses that survive off one-time sales, but the vast majority of businesses need recurring business, recurring freight, ongoing relationships. And a lot of businesses aren't thinking about how to do that. And so, your business is a service to the world. And so the first thing you have to figure out on a small scale, ‘What problem do I solve’? And when you solve a problem, you kind of need to create, I call it a black box. This black box maybe is a mystery to the outside world; we can use a dentist's office people come in crying and in pain on one side, they go through the black box, which is a series of checklists, checklists for this, checklist for that, checklist for next thing, okay, check that we did this, this, this, this is this, boom, they leave smiling and happy on the other side. So that's the black box. That's the problem-solving box. Lisa: Wow.  Daryl: The problem-solving box, all the company is one group of people solving a problem for another group of people via a product or service.  Lisa: Wow.  Daryl: Before that problem is, and you've got it, now you need to design it. Here's some people solve problems really well, but they don't do it in a way that's scalable. So the rule of 10,000. Now I know how to solve the problem. Now I know THE kind of the type of people having that problem. How do I solve 10,000 of these problems for people, think, if I had to bake a pie if I'm trying to bake one pie versus bake 10,000 pies... Lisa: It's going to be more efficient. Daryl: there's a different mindset that you got like, I need a bigger kitchen, I got to do that. You've got like planning in batches, and food storage, it changes the nature of things. And then you got to kind of go out and find those people and that's like a marketing function.  So there's—actually, I can share this. So last year, I actually spent like $40,000 hiring all these research teams to help get down to what are the critical success factors for small and medium-sized businesses?  Lisa: Wow. Daryl: We came up with eight, there's actually nine, but the ninth one is government and economic factors. And it's not realistic that a person is going to influence.  Lisa: No.  Daryl: Not one person.  Lisa: Yes.  Daryl: No, it's not realistic. So the ones that we can influence is things like self-efficacy, which means your ability to be effective with your time, your energy, just yourself and through others. So it's like leadership is part of that, right? Your time management is part of that like mindset might be part of that. But self-efficacy, strategic planning, marketing strategy, market intelligence. So these are different market intelligence is understanding the needs, wants desires, problems of the people of the marketplace, and the competitors, the available options.  So it's market intelligence is like, what's going on out there? And then marketing strategy is how am I going to get my message across. Then you have sales skills and strategies, sales strategy. And then you have money management. You have business operating systems, which is—it could be technology, it could be simple checklists, it could be meeting rhythms, it could be a hiring process, that's the operating systems.  And then you've got business intelligence, and business intelligence is like the awareness of different things. So for example, like you are working with my partner, Kathy. She's helping you with your podcasts, you're getting greater awareness on how many downloads are we getting and how many people are sharing the downloads and how many people are listening and then coming my way—that's all business intelligence stuff.  Daryl: It's the idea of not just doing activities, but to actually measure… Right. But it needs to be aware. It’s like wearing a heart rate monitor, right? Like how's my—that's an intelligence system. How's my heart rate doing? How's my heart rate variability?  Lisa: Yes. I do all of that.  Daryl: What's my sleep pattern?  Lisa: Yes. Daryl:  Am I waking up twenty nights? That's like business intelligence. Those eight factors really are the critical make or break focus points for business.  Lisa: Wow. Daryl: And anything that you would do for a business should back into one of those. So, team building activity. Well, that's kind of self-efficacy, maybe operating systems, it depends. You're going to do a podcast, well, that's a marketing strategy, right? And then the strategic planning is the plan strategically of how you're going to pull the strings together. And like, we know how you plan you develop, how you plan to meet people, is there a thought process and from all this stuff? Lisa: And the hard thing is for the young entrepreneurial. I know we have a lot of people who, in business, starting businesses, or in developed businesses and wanting to scale further. You’re wearing so many hats at the beginning, like you're in charge of all of those departments if you like, and that is the very hard thing at the beginning. Once you get a team around you like we're at a stage now where we have small teams that are helping us with different aspects of what we do, and we're trying to outsource the stuff we're not good at. It's not our specialty, because we don't want to waste... But at the beginning, you have to do it all. And so you're just constantly wearing these multitasking hats and not being very efficient.  Daryl: Right. Lisa: How do people get to that next rung on the ladder? And this is something that where we've been backwards and forwards going on for a long time. How do you get to the next stage? And how do you make an effective team? And how do you outsource certain things, but not the other things? And it's getting to that next level, isn't it?  Daryl: Yes. Lisa: And at the beginning, you just forbought everything.  Daryl: If you've been doing a lot of activity, and you're not really sure what's working, a simple way to think about this is forget Uber and Grab and these other...  Lisa: Yes, this huge...  Daryl: Originally, if you were a cab driver, you would have a car, and your idea first figure out where are the people who need to be driven places and then pay money to do it. Maybe it's taking kids to school, maybe it's picking people up at the train station, or the bus station or the airport, maybe it's doctor's office appointments, right? Like every week for whatever.  But first, if you were the taxi driver, first, you'd have to figure out, how do I keep my schedule full every day? How do I keep myself busy every day? And so first, it's where are the customers? And where do they want to go? Right? Where are the customers and where they want to go? Can I take them there? You get paid in size over the relationship, and the problem you solve. What that means is if I want to get across town, but I have all day to do it, I can walk, right? But if I'm in a hurry, if my child is sick, and they're bleeding, and I got to get in the hospital in half the time, that's a bigger problem. I'll pay whatever, right? I can rent a car, I could bike, right? If I don't want to rent a car, I could pay more to have someone, you get what I'm saying?  Lisa: Yes. Daryl: I could pay someone to drive me. So there's a scale of problems. So first, like, where are the customers? What do they need? Where do they want to go? And then how do you get yourself busy? Now that you're busy what's going to happen is now you have to do is you have to train someone and had it on quality control. How do I deliver this consistently? What is my doing? Because when you do something for someone, why—what's making people really happy? What's making them not happy? Right? How do I make sure I have a consistent good experience for people? Good.  Now, how do I help more people? And then if you're the cab driver, you might have to take a pay cut? Because at some point, you might have to bring someone in and have them drive the car for half the day. Lisa: So you can focus on the business. Yes, yes.  Daryl: You can focus on getting another car and getting that. And so there's this weird period where it's like, 'Hey, I'm busy full time, but I can't be any busier'. So I can charge more money, or I'm going to hire someone, give them some of the work.  Lisa: Yes. Big portion of the money. Daryl: Right. They're gonna take a pint of the money. And now I'm going to get the second part going. And that's actually how Kathy got started. So Kathy is working with you. And one of the beginning she had some clients online, and I was like, 'What do you like doing the most? What's the one thing that you think you can do a lot of? And she really enjoys the writing component', and so we got her really busy. And then she hired someone, and then right? And then she was busy, and they're busy, she hired another person. And she had another person on now she had like a team of six, she's got some, like 26 people now. But in the beginning, she had like four or five, six, 'Hey, now you need a manager'. 'Okay, well, now I need a manager', okay, and that's your manager for the team and the next problem and building that out. And that's a really natural way to grow.  And part of what helps you do that is documentation and training, an edge explained, demonstrate, guide, and power. First, explain how you do it. Let me demonstrate it for you. So you can see it done. And then let me guide you in doing it with you. And then I'm going to empower you to do it on your own, make some mistakes and learn from them, and just repeat that process.  Lisa: Wow. Daryl: So it's an edge thing. And that's creating documentations and systems. But then you've got to actually keep—now you're getting into a different level. How do you communicate a vision? How do you keep a team productive? How do you monitor progress? How do you—because we're talking about self-efficacy, right? If you hire someone that could be brilliant, but if they don't get the work done, and now you're getting into people skills, and how do I communicate? And how do I help them tap into their own internal motivation? So they're not just showing up, clicking on the paycheck, and just clocking out, going home just on their phone all day. So these are different tiers of problems that people fall into. So I don't know if I read a whole of... Lisa: No, these are perfect, Daryl, and it does highlights here. There's always the next level. Daryl: Crazy amounts of entrepreneurship.  Lisa: No, but, like getting out of the startup gates is the hardest part and you dealing also with self-doubt and imposter syndrome often, and can I do this? And people telling you you can’t. Your family members or friends going, 'What the hell are you doing? And you've tucked in your regular job for this'? And you know, that 80% or more of businesses fail. I can't remember what the statistics were, but they're pretty horrific. And you're wearing all these hats. And what you then see is a lot of people starting to burn out. And that's really like part of what we do is all about managing stress and not burning out and how’s the basics of health because you need to do all that in order to be successful because there's no use having millions of dollars in the bank, but you are dead because that isn't going to help anybody. Daryl: I've seen that. I've seen people sacrifice—I see people make money and keep their health at the same time. But I've also seen a lot of people sacrifice their health to make money and then end up spending all that money trying to get their health back. Lisa: To get their health back. And I must admit like I've—not for the—just for the business but saying in rehabilitating mum cost me my health. I ended up nose diving because you're working 18 hour-days sometimes and you just go and helpful either trying to make the mortgage payments at the same time by the hyperbaric chambers, or the whatever she needs and trying to rehabilitate, and running all these juggling balls that we all have in various combinations. And you can't work yourself into the absolute—into the grave if you're not careful. And that's why health and resilience and stress reduction and stuff is what we do. Daryl: Yes, it's always best to have people—one of the biggest—and I've done this before, I've done this a couple of times, unfortunately. Better to collect money first and then develop a product. What I mean is like in my hometown, they're opening up a gym, and they were building, they bought this building, they were kind of doing rentals on the inside, and they set up a trailer outside. And they were actively marketing and were signing up people for the gym that was not yet finished being built...  Lisa: Brilliant  Daryl: ...so they're not yet open. And what happened was at some point, they just closed down the whole operation and left. And what it was is they had a pre-launch goal for themselves. ‘We need to generate this many new members in order to breakeven, or we stop’. And that's a really good thing, and you don't, it's like if you just get pre-orders, Elon Musk did this with, I think, the model three. He made $100 million having people prepay $1,000 on a car. He hadn’t built the factory to make it.  Lisa: Wow. But then it’s Elon Musk. Daryl: Well, no, but, yes, okay, but I mean...  Lisa: Reputation. Daryl: In any way you shape or form it because he built a prototype so he had something he could show people, and they could see and they could—he could articulate what his vision was.  Lisa: Yes.  Daryl: And then he said, 'Hey, if you want to get one and be one of the first you have to make a non refundable $1,000 deposit' and he created $100 million, which is proof of concept.  Lisa: Wow. Daryl: Use that $100 million to build a factory and then charge them the rest of the money for the car.  Lisa: Brilliant. Daryl: And that is of demand. And this is where people go wrong. For example, I like baking pies, my hobby is baking pies. I like baking pies. People praise me all the time for my pies. Man, it would be so great if the whole city just praised me for being such a great pie maker. I'm going to build this business for me and how great my pies are. I'm going to plan this logo, and I'm going to plan the layout. I'm going to plan the menu, and all this stuff. And then I make all these pies. And then what I do is I tell all my friends about my pie shop, and they go, 'Wow, Daryl, your brand color is so nice, and wow what a nice logo and what a nice menu', my friends come in and make an obligatory purchase.  Lisa: Yes.  Daryl: Because they're my friend, but that doesn't last. And then I go through the seesaw where they buy the purchase. They make a purchase. So now I stopped telling people about my pie shop because I'm busy making the pies. But while I'm making the pies, there's no one getting people to come.  Lisa: Wow.  Daryl: I deliver those pies, but they're just my friends. They're buying out of social, like social contract, you're my friend, not because it's something they need. And this business is to fulfill my ego as a business owner, it's not to provide a service to the community.  Lisa: Wow. Daryl: Because to provide a service to the community, I might like making pies, but I need to figure out who needs pies and I might find that there's some office buildings where these people are so busy, they don't have time to cook they're always on the go. And so I would make pies to go, and I would make a custom for their dietary nutrition perhaps. And now it's a symbiotic relationship. It's not a self-serving ego-driven business. It's fulfilling a need. That's something—that's why the market intelligence part is so big of those eight because it's how—you might not have everything else in line, but if you're trying to sell gourmet food to people as they leave in all you can eat buffet... Lisa: And I've done this before I've made a course because I think it's what people want, and then worked out later on that, no, that's not quite what they wanted. They wanted something slightly different. So, we all always do now like questionnaires and polls, and ‘what is it that you need’? And how do you want this?  Daryl: It’s in the phase. Lisa: Yes. And then start—yes because you can think you know what your customer wants and needs, but they will tell you better what they actually want and need. And so always listening to your customers and always seeing what direction are they going in and what do they need next is another good thing. So okay, I've done this part of the thing, but can you actually add on something else another service that will be a benefit to them, that you can provide to them, and create what you call the value ladder so that you have more things ready to go.  And all this is really, really complicated, but you've done this with lots and lots of people and lots of businesses and scaled them up. So, if anybody wants to like—coming to wrapping up the session now, Daryl, if somebody wanted to work with you as a business coach, where do they find you? And what sort of work do you do nowadays? What is your sort of core focus?  Daryl: Yes, good question. So, they go to bestbusinesscoach.ca, that'll redirect them to my main site, they can go check me out there. They can look up Daryl Urbanski on all the social media platforms.  Lisa: Yes, you’re pretty famous. Daryl: Well, we're all famous now. We all have social platforms, so. But I am king in my own universe, that's true. I mean, that's it. And right now, really, what I'm focused on is group coaching. So when I had my martial arts school, I used to love being a part of an environment where people came to get better every day. No one goes to the gym, and they're like, ‘I want to break a leg today’, literally, ‘I want to get sick today’. They come and, ‘I want to get better, I want to fix this part of my jiu jitsu game’, or ‘I want to do squats because I want my butt to be’, whatever it is. But the idea of improving and improvement.  So I'm really focused on my group coaching mastermind, where I'm putting groups of people like that together. So it's a group coaching. And then for people that want more dedicated attention, I have a virtual VP of Marketing Service, where it's like, I can work with them or their team and be present in the meetings, it's a consultation, or I'm a consultant. I'm not necessarily executing or implementing.  So there's a good coaching programme, there's a virtual VP of Marketing. But then I also have a pay for performance model, which is with select people where it's a good fit, win-win-win. There might be an upfront payment just for some setup fees, $1,000, or two, or whatever, depending on the scope of the project. But really, they're only going to pay if they profit because I think that in the B2B space if you want to be a doctor and engineer and architect, you have to pass exams that demonstrate knowledge and capacity. But in the B2B space, anybody can say they're a life coach, anyone can say they're a business coach, anyone can say they're a marketing agency. There's no real way to separate them.  And you can get a certification. But there's not really any real scientific validation of these certification programmes. I just—these companies just create them, and you pay them a thousand bucks and go do a weekend boot camp. And now you're a business coach, and someone should bet their future, their life, their ability to pay medical bills and put their kids in school, on your weekend or dayment of so. I, like, I got away from providing marketing services and being paid a retainer. And I don't think there's anything wrong with people that do that if they provide...  Well, I look for more for partnerships. I'm getting away from clients and more towards partnerships. We're like, ‘Man, I know some things. I've done some stuff, looking for people I can partner with, and it's a win-win’. And yes, so they just sort of… Lisa: If I’m not successful, you're not successful.  Daryl: Right. Lisa: So if you don't make it, you don't make it, that's the end of the partnership and move on to the next thing. Yes. And I think that's a great model. I think that well it works, it's really good.  Well, I think we've bloody covered a whole lot of areas there. Everywhere from use development through to martial arts through to Jiu-jitsu, and building businesses and overcoming obstacles. So it's been a real fascinating ride with you. I'm really stoked to meet you and Kathy. I think you're brilliant people. You're good people.  And I just want to give a plug to your podcast as well. Can you tell everyone where to find you? So you've mentioned your website, which we'll put it obviously in the show notes and stuff, but where can they find you on the podcast? Daryl: Yes, just Google, The Best Business Podcast with Daryl Urbanski. It's not to be egocentric. It's just when I did the keyword research when I launched my podcasts, the most searched word term was best business podcast, so I was like that's gonna be my name. Lisa: I didn’t do that, I wouldn have known to look for an SEO keyword search back in the day. I just went, 'Oh I'm all about pushing the limits, therefore I'm Pushing the Limits'. Daryl: Keywords are fantastic, sorry to interrupt. Keywords are fantastic because in the privacy of my own home while I'm alone, I go into Google and I type in what are my actual thoughts. So keywords can actually be a sign of like mindshare. How many people are thinking this on what sort of ongoing basis. So if you check your keyword search volume, and not all businesses have to use keywords, but it's great from a research and market intelligence point.  I actually call the Google A to Z. A lot can be learned just going to Google and if you're a chiropractor, put in ‘chiropractor space A’ and look at what shows up. And then chiropractor space B, chiropractor space C, and just take note because these are suggested things is; Google's going, this is what people are looking for.  And if you just take an inventory of A to Z around your keyword and what you do, you can learn a lot about where people are, what they're looking for, the results that they want, you go to Google Trends, you put your keyword in there, you can see the trends over years of the search volume. And that doesn't necessarily mean it's going to relate to sales. But if there's 100,000 people that are interested in the topic, you might have greater success, instead if there's only a thousand. It just depends on your ability to reach and get a lot of… Lisa: Google and all of that. Daryl: Keywords are great. The internet is such a powerful tool. You can go on Amazon and look at other products and read the reviews. And you can go on Reddit, put your keyword in Reddit, you can see what people are saying in the forums, you can learn their language, their pain points, their wants and needs. There's a ton of—it's just the world's become so transparent, so well connected. Lisa: I just learned half a dozen things that I didn't know, so… Daryl: Yes. It's so great. It can just really make a difference, where are the customers? What do they want? What problem do I solve for them? And then how do you build a relationship? How do you get them to raise their hand? That's typically the first step.  Who here, who would beat you next? I call it the food court test. So, what I mean is a lot of companies—so think of a mall food court. Let's say I want to sell ice cream. So I could go into the food court, and I could get up on a table, and I could go, 'Baskin Robbins' and look around. A lot of people be like, 'What'? and the people who know me might come over and be like, 'Daryl, what are you doing on the table, man? How are you doing'? Like, 'What's going on? Come on down, how you doing? What's going on'? and be like, ‘Hey, what's going on? I got this nougat ice cream from Baskin', okay, whatever, right? That's one type of marketing. And that's about me, my company, my logo, Baskin Robbins. That doesn't mean anything to anybody. But if you instantly got on a table at a busy food court and I went free ice cream. Totally different things. People come to you, like, what free ice cream? ‘Yes, here we have eight flavours. You can get a free sample if you like. And then it's $3 for a tub of ice cream for $5 for two, which flavour would you like to try first’?  Lisa: Brilliant. Daryl: Totally different analogy. Totally different situation. Totally different, right?  Lisa: Yep.  Daryl: And the flavours that I would make. I can make the flavours that I want. I could be like, 'Ooh, Cheez Whiz and pickles or a bubble—or like nuts and bubblegum' together at last, right? Like, but that's for me, and you can experiment with that. Or I could just go on to Google and go Ice cream, ice cream A, ice cream B, ice cream C, and be like, what are the top—go to Google Trends. What are the top ice cream flavours?  Lisa: Wow. Daryl: Hey, these ice creams are the top. Now I'm delivering something the world wants and needs and is looking for. Lisa: It was such a good analogy, Daryl. It's really good. I'm gonna go on to Google Trends and see. This just so—I think the hard thing for entrepreneurs is that there is so many things you need to be good at, that you don't even know where to start half the time. Is it product development is it...? Daryl: It fails because people put their money down. And it looks—you can even go—look, you just be transparent. Look, I don't even have the product ready yet. This is what I'm thinking of doing. Would you be willing to put a percentage down to save your spot? Would you be willing to get a discounted deal if I give you...?  People like they say the two hardest things to get people to do with you is have sex and give you money. They require the highest level of faith and trust in a relationship. And we all know people who maybe it's not so hard. If I just walked into a stranger on the street and asked him for money, it's going to be they're going to react as if I asked them to just have sex with me like, 'Who are you? I don't know what? I'm just gonna give you my money'. It's gonna be the same sort of reaction. So you have to build that trust. And but you also need to say, 'Hey, if I'm going to build this amazing product. Are you in or not’? like what's going on?  And then after that, it's really those eight categories: self-efficacy, strategic planning, marketing strategy, market intelligence, sales strategy and skills, money management, operating systems of the business and then business intelligence. And again, you need all of them. You need all of them. Those are the eight areas, but the number one thing is, ‘what problem am I solving? And are people proving the demand is there with their wallets’?  Lisa: And it's not just my—what I want for my ego, but what is actually required out there in the world. And I think that's a really—even that answering that first question was a biggie. That pie analogy was a good one.  Hey, Daryl, look, I've taken up enough of your time today. Thank you so much for sharing your wisdom. I highly recommend everyone go and check out The Best Business Podcast and then hop over onto Best Business—what was it .ca?  Daryl: bestbusinesscoach.ca Lisa: bestbusinesscoach.ca, go and see Daryl over there. Thanks very much, Daryl. Daryl: Goodbye, everyone. That's it this week for Pushing The Limits. Be sure to rate, review and share with your friends, and head over and visit Lisa and her team at lisatamati.com. The information contained in this show is not medical advice it is for educational purposes only and the opinions of guests are not the views of the show. Please seed your own medical advice from a registered medical professional.

Aging is a gradual process of cell deterioration, but while it is a natural process, there are ways to hack its biological mechanisms. Certain supplements paired with sirtuin enzymes can lead to better well-being and suppress the effects of aging. In this episode, Dr Elena Seranova talks about the role of sirtuins in maintaining cell health. She also discusses how several supplements, including NMN and resveratrol, work to enhance the beneficial action of sirtuin. Listen to this episode to learn how to promote longevity and overall health.   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition and mind performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join their free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   Consult with Me If you would like to work with me one to one on anything from your mindset, to head injuries,  to biohacking your health, to optimal performance or executive coaching, please book a consultation here: https://shop.lisatamati.com/collections/consultations   Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: Find out how sirtuins play essential roles in promoting longevity. Learn how NAD influences sirtuin activity and how several compounds can increase NAD levels in the body. Discover the best methods for taking resveratrol supplements.   Resources Dr Elena's study on stem cell models of neurodegeneration for studying autophagy Study on NAD supplementation by Dr Elena's collaborator Research paper on the benefits of trehalose by Lisa's supervisor   Episode Highlights [03:24] Elena's Background Originally a psychologist, Elena ventured into neuroscience through her work on a neurofeedback device for patients with psychological and neurological diseases. She eventually pursued a master's degree in translational neuroscience and joined a biotech startup. She continued her studies through a PhD focusing on the molecular pathways of autophagy. [09:41] Sirtuins and Gene Expression Sirtuins are enzymes arising from various genes found across multiple species. They play crucial roles in evolution. Sirtuins assist in epigenetic regulation, where different cells have different active genes. Events such as taking a sauna or engaging in exercise change the environment of your cells. Evoking changes in gene expression helps you adapt to these conditions. [19:09] Longevity Impacts of Sirtuins Sirtuin 1 is heavily involved in repairing DNA damage, while sirtuin 3 contributes towards mitochondrial health. The enzymes coming from both sirtuin genes require the molecule NAD for proper function. With insufficient NAD, sirtuin enzymes might be unable to fix DNA and mitochondrial damage sufficiently. [25:59] NAD Boosters NR and NMN are two promising energy booster supplements that might boost NAD+ levels. NMN shows higher bioavailability and more positive effects on aging mice. Elena herself experienced improved energy levels when she started taking NMN supplements during her PhD years. [37:05] Resveratrol and Sirtuins Resveratrol activates sirtuins, allowing them to function. It works well with NMN — resveratrol handles activation, while NMN provides energy. To increase the bioavailability of resveratrol, consume the supplement with dairy products or food items with oil. [40:01] Apigenin, Sirtuins and NADases Several enzymes compete with sirtuins for NAD. These NADases mean that sirtuins cannot function without a large NAD supply. Apigenin, which is present in parsley, blocks a certain NADase and leads to increased NAD levels.   7 Powerful Quotes from This Episode ‘We'll be having different sets of genes being activated, and this will be in response to different external stimuli, environmental stimuli, amino acids, even availability of nutrients’. ‘What sirtuins do is they upregulate many physiological processes in order to deal with potential danger’. ‘[Sirtuins] do need a molecule called NAD, nicotinamide adenine dinucleotide, and without this molecule, they cannot perform its functions. And what's happening when we age is unfortunately we do have reduced levels of this molecule as we age’. ‘From anecdotal evidence from myself and people that I know that have supplemented themselves with both, everyone just pretty much mentioned to me that they do like NMN much more than NR and they can see the effect and this is the reason why I ended up supplementing with NMN myself’. ‘So within three, four days, I actually felt a different “different”. I felt different energy levels, I felt an increase in my energy levels and I felt an increase in my focus’. ‘Basically what activates the sirtuins is the resveratrol molecule, but in order for them to function properly, you do need the NMN because this is what they consume in order to function, and so this is why it's such a good synergy’. ‘Besides sirtuins, there are different other enzymes called NADases that also consume NAD and if they do that consistently there is not enough NAD for sirtuins to do their job’.   About Dr Elena Dr Elena Seranova started her ventures into medicine through psychology. She established her private practice as a wellness centre, where she encountered neurofeedback therapy and decided to pursue neuroscience studies. She took up her MSc in Translational Neuroscience at the University of Sheffield, followed by a PhD in Stem Cell Biology & Autophagy at the University of Birmingham. Her work focuses on the molecular pathways involved in autophagy. Dr Elena is also a serial entrepreneur. Aside from her wellness centre, she also co-founded a biotech startup before her PhD studies. She is the founder of NMN Bio, a company focused on NMN and other anti-aging supplements. To learn more about Dr Elena and her work, reach out through her website.   Enjoyed This Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so they can include more amino acids in protein in their diet. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript of The Podcast! Welcome to Pushing the Limits, the show that helps you reach your full potential with your host Lisa Tamati, brought to you by lisatamati.com. Lisa Tamati: Well, hello everyone and welcome back to Pushing the Limits. Super excited to have you again with me. Today I have Dr Elena Seranova, who is a molecular biologist to guest on the show. And really exciting. We’re going to be having Dr Elena on regularly to talk different aspects of longevity and anti-aging. And today we're talking about longevity. We're talking about sirtuin genes. You might be thinking, ‘What the hell are sirtuin genes’? but you're about to find out. And why it's important and what you can do to upregulate and support these genes, these anti-aging genes or longevity genes.  So before we get over to the show, just want to remind you. If you are wanting help with any sort of health journey that you're on, if you want some one on one coaching and please reach out to me at lisa@lisatamati.com. If you're looking for help with gene testing, epigenetics, anything of that nature as we've spoken about before on this podcast, you can also reach out to me there, or check out the programme via our website, at lisatamati.com. Everything in health now is about personalizing everything to your genetics. So that's the nutrition, your timings of the day when you eat when you exercise, what parts of your brain you use the most, what your dominant hormones, your personality traits, because of your genetics, all of these aspects are covered in our epigenetics programme. So I'd love you to go and get that.  And for all you runners out there, come and join us at Running Hot Coaching, that's our online run training system. We'd love to coach you. We have personalized customized training plans specifically made for you for your specific goal, along with side video analysis, and you also get a one on one session with me. So go and check that all out at runninghotcoaching.com. That's all for data today.  I am really stoked to have you back. I hope that 2021 is going well for you, that you've had a good break over the last few weeks. And if you're in the southern hemisphere, you're enjoying our beautiful summer. So without further ado, Dr Elena Seranova over in Dubai.  Well, hi everyone and welcome back to Pushing The Limits. I'm super excited. I'm jumping out of my skin. I have an amazing lady with me, Dr Elena Seranova. Hello Dr Elena, how are you doing? Dr Elena Seranova: Hello, hello, it's really nice to be here today. Thank you for the invitation!  Lisa: It is super exciting. So Dr Elena is sitting in Dubai, and we're going to be having a really in depth conversation today. And it will get a little bit scientific but hang in there with us people because this is all about longevity and anti-aging and who isn't into that?  So Dr Elena is a molecular biologist. And she's going to be sharing today some really critical information about the sirtuin genes. you’d be going, ‘What the heck is a sirtuin genes and what do they do? And why do I need to know about them?’ But these are really important things.  But before we get into that, the nitty gritty of the science, Dr Elena, can you give us a little bit of background on you and where you've come from? And what you've done in a nutshell, so to speak?  Dr Elena: Absolutely, yes, so I'm actually an interdisciplinary scientist. So I started my studies in the field of psychology. And then I opened my private practice. So that was my first business that grew into a wellness centre and was in operation for five years. I had two branches. That was back in my home country in Greece.  And I ended up working with a neurofeedback device that was basically retraining the nervous system of different patients with psychological and neurological diseases. And this is how I got interested in neuroscience. And I started studying it myself. I took a couple of those online courses. And I realized that this is such an amazing field.  And in order to understand the symptoms that I see my patients, I actually need to understand the proper science behind it.  And when I started digging deeper, I realized that it's actually the genetic component that is the crucial part that produces all the symptoms. So then I found this amazing master's degree in neuroscience and genetics, and specifically in translational neuroscience in the UK. And back in the days, in 2015, the Greek crisis was bad. So I couldn't grow my business as much as I'd like.  So I decided to move to the UK to do this master's degree. And after this, I ended up, co-founded a biotech start-up that also had to do with the biochemical assays that were aimed at elucidating gene to gene regulatory networks.  And with that, I also realized that I'm even more fascinated by the science, and I really want to stay in biotech. And my co-founders were making fun of me because I was the only person in the office not having a PhD. Yes, that was a traumatic experience. And at the same time, they were surprised when I said that I'm leaving the start-up to do my PhD.  Lisa: They shouldn’t have said so.  Dr Elena: Yes, exactly. So yes, this is how I continued my studies. And my research was focused on the molecular pathway of autophagy. And I was using human physiological cellular platforms of neurodegeneration, utilizing human embryonic stem cells and induced pluripotent stem cells to model neurodegeneration, which was very, very interesting.  And I actually have a review in the Journal of molecular biology that got out a few months ago, in April 2020, on the modelling of neurodegenerative diseases and studying autophagy in those models in human pluripotent stem cells. For anyone interested, you can go check it out. It has an open access.  Lisa: We’ll put the link in. Well done. Congratulations, that’s pretty amazing. And that brings me to a point I'll have to have a separate conversation with you about neurodegeneration and what we can do for the elderly. I've got a vested interest in that one. So we'll definitely put that on our calendar because Dr Elena is going to be coming on the show actually quite regularly in the next few months. So we're going to be doing a bit of a series because I think the information that Dr Elena has is just going to be crucial for you guys out there listening. So really, really excited. But today's subject is all around sirtuin genes. Now these are—I'm going to try and explain it because I've been deep in this research too. So what tipped me down to this path and longevity and anti-aging, obviously, I've been in that space for a while. I listened to Dr David Sinclair on a podcast and subsequently read his book Lifespan, which I recommend everybody go out and buy. It's called Lifespan: How We Age—And Why We Don't Need To.  And Dr David Sinclair is a very, very prominent scientist at Harvard Medical School. And he has his own lab and he’s been studying anti-aging and longevity for decades now. And he was actually the one of the scientists who discovered resveratrol, which we're going to get into today and what resveratrol does, and it's very pertinent to the conversation. But it is also in this book, really giving me an eye opener into what's coming down the pipeline as far as longevity and being able to turn the clock, actually literally back to when you—so, our cells become young.  It sounds almost science fiction-y, some of the stuff that he's talking about that is just around the corner. It is like absolutely amazing stuff that we are going to be able to live longer, healthier lives. And for me, it is about health span, as well as like I obviously want to live long, but most importantly, I want to live healthy till the end. And I think that's probably the priority for everybody. Rather than having the typical degenerative, long, slow, drawn out process.  So anything that I can do to help my friends, my followers, my family live healthier lifespans, I'm into that research. So Doctor Sinclair is an expert on sirtuin genes, this is an area that he studied. And Dr Elena knows all about this. So Dr Elena, can you just tell us, for starters, where do we start on this big subject of longevity genes? And what they do in the body? That might be a good place to start.  Dr Elena: Yes, sure. So sirtuins are enzymes, basically. And it's a group of genes that is quite well conserved across multiple organisms, which means that they play a very important role in evolution and in our biology. And what they basically do is they control the epigenetic regulation in ourselves. And this means that when—in different tissues, there are different genes being activated at a different time. So we'll be having different sets of genes being activated, and this will be in response to different external stimuli, environmental stimuli, amino acids, even availability of nutrients, things like that. And what they really do is they control that all of the important regulatory pathways in the cell are functioning as needed, and they are quite responsive to external stimuli.  So for instance, you mentioned resveratrol, which is a molecule that is found in grapes and in other berries and different plant sources. So, resveratrol is actually found when the plants are stressed. So when there is some sort of either fungal infection in the plants, or there is no water and so on, resveratrol is the molecule that is being secreted. And what's happening is that sirtuins can sense this molecule, and as a result they do get upregulated.  And the reason for this — I guess this evolved from a revolutionary stand point of view is that, so you would have let's say, some small animals running around and consuming different plants, things like that. So the small animals cannot really distinguish consciously between danger, different dangers or lack of foods and things like that. So this process had to somehow be automated. So for this reason, again, resveratrol is like a signal that says to the little animal that there is some sort of danger in the environment. And then what's sirtuins do is they upregulate many physiological processes in order to deal with potential danger.  And there are different stimuli like that in our environment, and we can actually artificially activate sirtuins. So for example, with the use of sauna. We do have this heat shock response, where there is a stress signal from the environment, and then again sirtuins get activated because there is some sort of stressor coming into the body. Another one is exercise. So what happens? And actually not any kind of exercise. But let's say if you're just going for a walk for 20 minutes, you won’t get sirtuin activation. But if you're going for a run, and you start being out of breath, so that your body goes into slight hypoxia. And this is the signal that activates the sirtuin. So for all of the healthy living enthusiasts, don’t just go for a run. Absolutely.  Lisa: So just to recap on that, so this sirtuin genes which code for this enzyme. This enzyme is really important, and we'll get into a little bit more than nuts and bolts of this enzyme, but it does some very important activations on the genome, which is what we want.  Dr Elena: It basically regulates which genes will be switched on and which genes will be switched off. So it allows for a very tight control, for a very tight regulation of the functionality of different genes in the cell. Lisa: Right. And then so sauna, which produces heat shock proteins, I've just bought a sauna recently for that reason. Yes, yes. Well, I heard about heat shock proteins, what sauna can do, how beneficial it is for so many things. I didn't make the connection to that and sirtuin genes. So that's really something I've learned today.  I did know about the exercise, and this is why like high intensity interval training, in moderation people — not like go and do this every day, please, but in moderation. It has a longevity benefit, has an improved actual VO2 max and endurance. And all of these great cardiovascular benefits is partly in relation to the sirtuin genes.  And just going back to the resveratrol, this is a xenohormesis, isn't it? So a stressor that the body goes, ‘Oh, where our environment—is there's something wrong in our environment. So we need to hunker down and get ready for battle’, rather than going forth and multiplying and everything's easy and happy.  So we want to push and pull in regards to all of these things like exercise, like sauna, like resveratrol, you want times of actually pushing things and in times of recovery, so it's not just going in one direction, is it? It is like balance.  Dr Elena: Definitely. Definitely. And then yes. And then another trigger for the sirtuins phase, caloric restriction. And this again comes from what we just described about the animal being hungry, potentially in the near future. So the sirtuins get activated. So it’s the same when you're on a calorie restriction and you're doing intermittent fasting, you will get this reaction again.  And this is tied up to autophagy as well, which has been activated. So you actually need to be fasted for several hours for autophagy to be activated. And research suggests it could be around 18 to 20 hours or more in humans. So I'm personally trying to do this on a daily basis. I'm having a very narrow window where I consume food probably three, four hours a day. I mean, it's not possible, always, especially when you're traveling around like I do at the moment. It might be challenging because I also want to eat high quality food. So I don’t want to be eating junk at the airport. Lisa: Pretty hard, isn’t it?  Dr Elena: Yes. I mean, sometimes this actually pushes me to fasting even longer. Lisa: Great discipline. I can't—I struggle to go over the 16 hour. And I think partly with autophagy—so autophagy, people, this is when the body basically, there is a pathway called mTOR, which we're going to probably do another episode on. And this is a growth regulation pathway where we are actually—if we are activating there's a lot of amino acids, a lot of proteins in the body and a lot of nutrients in the body sort of goes into growth mode. So like bodybuilders want  this growth mode for example.  And when you go hypocaloric for a while and you restrict the calorie intake, then the body goes into a state of autophagy, which is where it's basically eating and recycling it's old cells that actually need to be gotten rid of. And these cells are called senescent cells. So these cells are alive, and they're putting out inflammatory chemicals or cytokines, and then not actually replicating, and that causes problems in the body. And as we get older, we eat more senescent cells.  So you don't want to be in a state of starving all the time. That's not what we're saying here. This is why it's intermittent fasting. And you don't have to do this every day, people. I know, I don't. I'm not as disciplined as Elena. But doing this on, I think something like five days may be normal and a couple of days, where it's sort of a longer fasting period. And just giving your body that change. If you go hypocaloric for weeks on end, you're going to down regulate your metabolism. So that's not where we want to go. And then you're going to have nutrient deficiencies and so on from that point of view. What we're trying to get is this seesaw, the body seems to—like in all of the studies that I've done, it seems to like the seesaw, like cycling. It likes going up and down, up and down. And that actually helps it keep its ideal balance, putting it very bluntly and simply.  So autophagy is something that we want. So fasting, mimicking sauna, exercise, all of these things are going to upregulate the sirtuin genes and these sirtuin genes. Now can you tell us—there are seven sirtuin genes in the human genome, can you just go briefly over what one up to seven does? Dr Elena: Yes, I mean, there are quite a few functions that those genes have. So I don't think we'll have time to go through all of them. The important ones for our subject today for sports and longevity, and so on, is sirtuin 1 for sure, which is a very important protein that can be found both in the nucleus and the cytoplasm. And actually, its expression is different in different kinds of tissues and it also depends on its necessity and its function. And it's actually what we’ve seen is that sirtuin 1 is one of the first genes that would go onto the side of a double stranded DNA break to recover it. So it is heavily involved with DNA repair, very important gene.  And then sirtuin 3 would be the other very important for longevity, which has to do with mitochondrial health and mitochondrial function. So those two, they both are enzymes that in order to function, they do need a molecule called NAD, nicotinamide adenine dinucleotide. And without this molecule, they cannot perform its functions. And what's happening, when we age is unfortunately we do have a reduced levels of this molecule as we age, of NAD. And it just keeps on decreasing and decreasing, basically leading into death but a literal death spiral, where you don't have this beneficial effect of the sirtuin genes repairing your genome, repairing your DNA. And the epigenetic regulation becomes basically loose. So this is what is directing the loss of cellular identity as well. So this is one of the hallmarks of aging, where the cells are losing their identity. And then everything that is happening in the cell, all of the functions, they’re being so tightly regulated. So this is what's happening there.  And then NAD, it's worth mentioning that it exists in two forms and both forms are important. So NAD+, which is the oxidized form and NADH, which is the reduced form. So the reduced form, it's actually something that not many people talk about in the aging space and the supplement space, so they barely know NADH and NAD+. And NADH is actually important for the maintenance of mitochondrial membrane potential. So if you don't have enough NADH, your mitochondrial membrane potential will not be preserved as needed. And this would also lead to decreased mitochondrial function. And decreased mitochondrial function means that you will have a less ATP production and less energy as a result.  And the reason why this is so important for neurodegeneration, as you mentioned previously, because actually, the central nervous system is perhaps the first one that is being affected as we age. So it's very important. And the reason for this is that the postmitotic neurons that we have in the brain, they are heavily relying on massive ATP production in order to function. Lisa: So let's stop there, Elena because your brain is so big. We might have lost a few people on the way there, we might have to backtrack a little bit. So NAD, nicotinamide adenine dinucleotide plus or NADH. So is this a little bit like oxidized, like vitamin C oxidizes and then reduces, oxidizes and reduces. And electrons can be donated backwards and forwards. Is that the same thing, sort of pathways?  Dr Elena: Yes, yes. Yes. That’s right. So NADH gains two electrons.  Lisa: And that is recycled through? Dr Elena: Yes, this is happening through electron transport chain in the mitochondria. And we need both of those molecules in order to maintain proper cellular function. And so this would bring us to our next subject, which is what we can do in order to fix this decline of NAD.   Lisa: Before we go there, let’s just hang on a tiny bit on this NAD, because — so NAD, I know Dr David Sinclair said, arguably the most important molecule. So people, note this name, NAD, NAD+, or NADH. This is the most important molecule in our body next to ATP, and ATP is our energy production. So without energy we’re dead in 30 seconds, and without NAD, we're dead in 30 seconds as well. So either or we're both pretty much up the creek if we don't have either. As we age, the NAD levels go down. And one of the things that regulates the NAD, or needs NAD sorry, is the sirtuin genes to do their job of DNA repair, is one of their jobs. There are many jobs that it does. And if the NAD is being used by the sirtuin genes to repair DNA, then it's not doing its other jobs. And as we get older, like we have something like 2 trillion DNA breaks, it can be wrong, per minute or something ridiculous. Dr Sinclair said, every minute in our body — so, these enzymes are running around trillions of times in our body doing the DNA repair. And also we need to replicate ourselves and do all of this sort of work.  So if the sirtuin enzymes are busy doing one thing, they're not doing another thing. So we want to have more of these enzymes available for all of these jobs. And especially as we get older, and we need more support. So that's just a bit of  how that sort of explained what the NAD is.  Now, we should go on to the next part of the equation. So like there was an NAD salvage pathway, the body needs grams of it every day and we don't necessarily just get it by our food. But there is NAD boosters. What can we do to increase our NAD levels in the body? Dr Elena: Yes, so yes, this is exactly where energy booster supplements come in. And there are various supplements out there. and recent evidence points towards two particular molecules that are being researched. One is an NR, nicotinamide riboside and then the second one is NMN, which is nicotinamide mononucleotide.  So now the NR molecule, in order to boost the NAD levels it needs to be converted into NMN first. And for this reason, scientists are focusing predominantly on NM. And I would say now there is increased interest in the NMN molecule at the moment because it looks like it has increased bioavailability, is being absorbed better. And in tests in mice, it does have a better effect on NR in terms of boosting NAD, but also in terms of the—in terms of improving the phenotype of aging mice with different studies that we've seen that have come out in the past couple of years, from gene expression to energy metabolism, lipid metabolism, insulin sensitivity. A bunch of other markers being improved in my supplemented with NMN. And I have to be honest with you I haven't looked in depth into the research for NR, however the evidence from NMN studies so far is quite overwhelming for me. Lisa: Exactly, wonderful with all the research, too.  Dr Elena: Yes. I mean we would need to have more comparisons but from anecdotal evidence from myself and people that I know that have supplemented themselves with both, everyone just pretty much mentions to me that they do like NMN much more than NR, and they can see the effect. And this is the reason why I ended up supplementing with NMN myself.  So basically, I started studying NAD biology in block during my PhD. And unfortunately, my research paper is not published yet, so I won't be able to share that out. Perhaps next year hopefully I'll be able to share my data with you.  There is a paper from our collaborators lab though that is on bio archive already. And it's from Viktor Korolchuk in Newcastle. And they showed there how basically functional autophagy can maintain NADH pools, which is quite an interesting paper. And it does intertwine a bit with my work. But unfortunately, I can't share right now.  Lisa: Yes, you have to keep zip right now until it's published. So we can link to the bio archive, the one you mentioned there, at least, do some research and also I’ll also link to Dr David Sinclair's work, in his book, obviously. Because it does put it in in a way that people can understand, which is really, really important.  Okay, so NMN, nicotinamide mononucleotide is one of the in NAD boosters, and we need the in NAD to... Dr Elena: Yes. And it's the only direct precursor of NAD. So this is the beauty of it. So from NMN, it converts straight away to NAD. So this is why it has such an enhanced bioavailability. This is why it has those effects because NAD is quite a large molecule by itself. So it's actually hard to—if you supplement orally with NAD. The absorption of the—it will not be high, because of how big the molecule is. So this is why it's called dinucleotide because it has two nucleotides that would need to penetrate the cell. But NMN is a mono nucleotide. And this is why it absorbs better Lisa: It's actually made there—it's put together in the cell. So the nicotinamide mononucleotide enters through the membrane into the cell, from what I'm understanding, and then it becomes a dinucleotide. So it's a phosphorus molecule, I think or something that's added to the NMN. And then it's an NAD.  Dr Elena: So yes, so basically it's NMN is a phosphorylated NR molecule basically.  Lisa: Okay, phosphorylated NR molecule, okay, and then when it goes to NAD... Dr Elena: And that’s the reason why NMN is actually a bit more expensive than other supplements. Because in comparison to other supplements that are just, let's say, plant extracts or something like this, there is quite a lot of biology implicated in the production of NMN. So there are several steps it would need to go through. And it's quite complex and laborious to produce. And this is why it's a bit higher in terms of price.  But from my personal experience again, so I started supplementing with NMN over a year ago, while I was still doing my PhD. And at that point—when I found NMN, I already had a burnout. So, which is something that a lot of PhD students experience and my project was quite, quite challenging. And human embryonic stem cells require quite a lot of cell culture in order to just survive, let alone to expand them and do experiments on them.  So yes, at some point during my PhD, I literally was doing 18 hours, from 6am till midnight. With eight or ten hours of cell culture during that day, let alone the experiments I had to do. So yes, quite challenging. However, it was a priceless experience. I learned a lot. And I think that it was definitely worth it.  So yes, back in the day, so while I was experiencing this burnout, I found out about NMN. And I thought to give it a go. And it was basically amazing the fact because I've been supplementing with different supplements for the past 15 years or so. And I'm a biohacker myself.  Lisa: Yes, yes. Like me. Dr Elena: I transfer with different supplements and stuff. And this was the supplement that I felt the effect of within a few days of taking it and I've never experienced that before with any other supplements. So within three, four days, I actually felt different. I felt the different energy levels. I felt an increase in my energy levels and I felt an increase in my focus. And I remember my partner calling me at some point in the evening at 8 or 9pm, something like that. And we were talking on the phone and he just said ‘Oh, so you're not tired yet’. And I’m like, ‘No, I'm not tired. I actually feel great’. Lisa: ‘This stuff's working’. Dr Elena: Absolutely. Yes. And this is how my current business was born. And this is how NMN Bio was born. And I was so excited to actually have a product in the market that is pure, potent and I know that it is what it is. And because I have been struggling to find a good supplier of NMN for quite some time.  Lisa: Tell me about it.  Dr Elena: Yes, because of its price, I think that there are quite a lot of opportunistic companies out there that just white label the NMN powder, and they don't even have a certificate of analysis and you don't even know what's in there and things like that. And they just totally diluted with niacin or something else. Lisa: Exactly. Yes, this is a danger and this is why having a significant analysis and having it scientifically backed in every batch tested and stuff is really important. I've been on—prior to meeting Dr Elena—I've been on in NMN for maybe five, six months now. And I've had my mom and my brother on it and my husband on it. But I had to go through, jump through all of these loops to get it out of America. Get it sent to someone there. Get it shipped over here and it's not been available down the scene of the world. And finding a reputable source is absolutely key with this molecule.  I remember David Sinclair saying, when you do get your NMN do keep it in a cool, dry place. So don't stick it in a hot place under the sun somewhere. Ideally, probably in the fridge if you can, to give it an extended shelf life and for it to do its job properly.  So you've founded a company NMN Bio, at the UK, and I'm really excited to be working with Dr Elena and I'm going to be importing it down to Australasia. Dr Elena: I'm super excited about this too. Lisa: Yes, me too. Like it's just super exciting for me. Because I'm spending a fortune a month, giving this to my family anyway. And I could never test what I was doing. And now I have a place where I can trust that it's coming from a good source.  So nicotinamide mononucleotide is the one aspect but that's not the end of it all. Is it though? That's not—so resveratrol we mentioned before. This work in combination—and on that point, it should be trans-resveratrol that you take, if you're taking resveratrol with it. Dr Elena: Yes, absolutely. Lisa: And we don't have this yet in the cater of products. But this is in the pipeline, isn't it, Dr Elena?  Dr Elena: Absolutely. Yes, this is coming in 2021. Super excited about it. Hopefully we'll have it on the market in the next few months. Lisa: In the next months.  And but resveratrol, trans-resveratrol you want to be taking that in combination with nicotinamide mononucleotide. So an analogy that Dr Sinclair said was resveratrol is like the accelerator pedal and nicotinamide is the fuel. I think that’s the way around.  Dr Elena: Yes, absolutely. That's correct, because basically what activates the sirtuin is the resveratrol molecule. But in order for them to function properly, you do need the NMN because this is what they consume in order to function. And so this is why it's such a good synergy. And as you said, trans-resveratrol is absorbed much more. And also in order to increase the bioavailability of resveratrol, it's good to take it with some sort of full fat dairy. So for instance, a yogurt. David Sinclair says that he does take it in the morning with a full fat yogurt. Lisa: With some fat, yes.. Dr Elena: In fats, or you could you could do some cheese, probably. I do yogurt as well.  Lisa: Does it have to be dairy? I've been taking it with oil, is that okay?  Dr Elena: Yes, this could work as well. So yes, absolutely. There are a few people doing olive oil for this type. Lisa: So it just needs a fat in order for it to be bioavailable, because it’s a dry powder. And so the oil in the fat helps. Because it's a very insoluble molecule. Dr Elena: And then what I do for my personal anti-aging cocktail... Lisa: Which is obviously working, because Dr Elena is actually 110 years old.  Dr Elena: No, just 32.  Lisa: She’s just 32 but looks like—honestly, I thought, seriously 32? I would have thought you were 22. So something's working. The good diet. It can't be that overworked because you've been definitely overworking for the past few years. And this is obviously helping.  And I'm 52. So I'm old enough to be your mom. And I'm definitely super excited about anything that's coming down the pathway that's going to slow down the degeneration. Because over the years, and after smashing the crap out of my body, I've definitely got some repair work to do. And my mom is 79 years old, she's in the corner over there, taking her NMN as we speak, and her resveratrol, along with their hemp seed oil and all the other supplements and a big green smoothie of broccoli juice. So she's like going, ‘ugh’, it'd be quite funny for you to see her face right now.  Dr Elena: You should also add apigenin to her cocktails. So, this is another molecule which is very interesting. And perhaps in a later podcast, we can also talk about a couple of different things that have to do with raising your NAD levels in different ways. So, basically, what happens, besides sirtuins, there are different other enzymes called NADases that also consume NAD. And if they do that, consistently, there is not enough NAD for sirtuins to do their job. So such enzymes are called parks, which are activated when there are some stress signals in the body. So, for instance, one such signals when let's say your mitochondria are going bad and there is some sort of stress related to mitochondrial function, you will get a secretion of cytochrome c from mitochondria. And then as a result, you will get some sort of activation of the park enzymes and they also consume NAD. Another NADase is CD38. So, this is an enzyme that is activated when there is increased inflammation in the body. So, as we age, CD38 levels increase. And what has been demonstrated very beautifully in a recent study in mice was that CD38 actually controls the functions of sirtuin 3 in an NAD dependent manner. Because they did quite an elegant experiment, where they did have CD38 knockout mice, and the wild type mice or regular mice. And in the CD38 knockout mice the levels of sirtuin are two and a half times higher. And then when they put a saturating amount of NAD in the wild type mice, what happened is basically the function of sirtuin is also increased. And it was similar with the function of surgeries in CD38 knockout mice. So this means that if CD38 is absent, then sirtuin3 in this instance is upregulated and is working much more. But when CD38 is present, it consumes all of NAD and then there is not enough NAD for sirtuins.  Lisa: And this is so this is why we need a bigger pool of NAD, basically for all of these problems as we age.  Dr Elena: So this is one point and then the second point I was going to do there is that apigenin, so the supplement that I mentioned to you, which is actually present in parsley and predominantly in dried parsley. So you can actually get it for cheap.  Lisa: Yes.  Dr Elena: Have a teaspoon of dried parsley every day. So apigenin is a molecule that actually blocks CD38. So this means that it can also increase the levels of your NAD and make it available for your sirtuins. Lisa: Wow. I'm off to get some parsley. I just ripped my parsley plants out of the garden. Bugger. I will get seeds, so I'll have to plant some more. And you do need to dry it in order for it to intensify. Dr Elena: If you dry it, it will have even apigenin. So, the bioavailability increases somehow, I'm not entirely sure of the mechanism. But yes, dried parsley.  Lisa: Yes. Sorry. There's a noise in the background with my mum washing out a broccoli. Dr Elena: No worries. Lisa: Yes, yes, yes, this is my podcast life. Real.  So activated immune cells. So like I've had an infection for the last couple of weeks. So I've been under a hell of a lot of stress in the last year, like really—losing my father and so on, a hell of a lot of stress. And the day before Christmas, I stopped working and I started to relax and my immune system then went, ‘Okay, cortisol levels are now going down. We're going to make you sick. We’re going to do some repair work’.  Dr Elena: That’s how it’s usually done.  Lisa: Yes, yes. That's what happens when you relax. So my whole Christmas period was spent with a head cold and a chest cold. Now, when my immune system is activated like that, I'm going to need a lot more NAD because of this in NADases. You call them, NADases? And the CD38 would have been one of those things that was probably more active when I was sick. Would that be right? Okay, so we need to increase that in order to help our immune system.  So does this—random thought—does this help with other autoimmune diseases as well? Like, does it help deep down regulate some of the inflammatory pathways?  Dr Elena: I don't know, this is not my area of expertise. Wouldn’t be able to comment on top of my head on this. Lisa: Yes, just me connecting the dots going—that would make sense but okay. So all right, so we've covered quite a lot of ground today. And I think we'll probably wrap it up there, Dr Elena. And we'll go on to mTOR and autophagy and other things in subsequent podcasts, and so on.  So we're going to put all the links. If you guys want to get some NMN, and in a few months, we will have resveratrol as well. I'm going to put the links in the show notes to the new website. And we're going to be importing it down to here to New Zealand and Australasia. And I'm really excited about that. Because there is one other company that has it here and it's not got any certificate of analysis, there's no sort of thing. So you want to make sure that you know where you're getting this information from all your supplements from, and you want to know who's behind it.  So I'm really, really excited about working with your Dr Elena. I think this is brilliant. I know we've got a whole lot of products that are in the pipeline that are going to be coming down in the next year or so. Other things—so we will be covering those in future episodes. Things like, I don't know epistane...  Dr Elena: We should definitely talk about senescent cells and what we can do in order to combat them. And then of course, the subject of my PhD, which was around autophagy. So, this is definitely a very nice subject for discussion, because as you mentioned, mTOR is not something that you want to mess with on a regular basis. And actually, the good news are that there is the mTOR- dependent activation of autophagy and mTOR independent activation of autophagy. So my PhD supervisor was the one that discovered during his PhD probably 20 years ago, 15 years ago, the mTOR- independent regulation of autophagy and different molecules that value also can work and activate autophagy in an mTOR-independent manner. So one such molecule is already on the market as a natural sweetener. It's called trehalose.  Lisa: Trehalose.  Dr Elena: If you want to supplement your... Lisa: How do you spell that?  Dr Elena: Trehalose. T-R-E-H-A-L-O-S-E. This is what I use for my coffee. Lisa: Oh, trehalose. So that will help you increase your autophagy?  Dr Elena: Trehalose has been shown to activate autophagy in an mTOR-independent manner. Yes. Lisa: Wow. So I don't need to starve myself in order to activate...  Dr Elena: I mean, there is not that much data in humans yet on this particular molecule, to be honest. I actually don't know what is the dose that you would need to have this effect, but I still prefer it over sugar. Lisa: Yes, absolutely. And anything that supports that pathway anyway and getting rid of these senescent cells. So senescent cells just for those wondering what the hell we're talking about. Senescent cells are basically cells that are still alive, but they're no longer replicating. They're not doing the job properly. And they're sending out inflammatory signals into the body. So they attract cytokines that cause inflammatory responses.  And so what we want to do is we want to knock these cells off them to have their autophagy, meaning their cell death. And when we recycle the parts of the cells for the new job, and that's what we want to happen. As we get older, we get more and more senescent cells and there's actually literally ways our body down and stops and increases inflammation and causes a lot of the effects of aging, if you like. So that's definitely a subject for next time. But Dr Elena, you've been fabulous today. Thank you so much for the work you do, for the patient you bring to the project. I'm super excited about our collaboration and helping lots of people stay younger for longer. I think that will be. Dr Elena: Absolutely, that’s the goal. Lisa: Yes, absolutely. Have a wonderful evening because it’s around midnight in Dubai. So thank you very much for staying up late for me over in Dubai. It's probably too much.  Dr Elena: My pleasure. Lisa: And we'll see you again soon. Thanks Dr Elena. Dr Elena: Okay, thank you. Bye bye. That's it this week for Pushing the Limits. Be sure to rate, review, and share with your friends. And head over and visit Lisa and her team at lisatamati.com. The information contained in this show is not medical advice it is for educational purposes only and the opinions of guests are not the views of the show. Please seed your own medical advice from a registered medical professional.

Every day, we spend an average of 20,000 breaths with 11,000 litres of air, primarily made with subconscious effort. If you want better health, changing your breathing technique probably isn’t the first option that comes to mind. We don’t even think about it; we don’t pay attention to how we do it. But it turns out that how you breathe has far-reaching effects on many aspects of human health. Discovering what it means to breathe correctly is crucial for greater wellness. In this episode, author and journalist, James Nestor, joins us in seeking to unlock a person’s full breathing potential. He discusses the myriad of health benefits controlled respiration can provide. You’ll also learn how industrialisation made it harder to breathe correctly and how various exercises can improve your respiration. Listen to this episode to discover simple methods to maximise the benefits of each breath you take.   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition and mind performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join our free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   Consult with Me If you would like to work with me one to one on anything from your mindset, to head injuries, to biohacking your health, to optimal performance or executive coaching, please book a consultation here: https://shop.lisatamati.com/collections/consultations.   Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: Discover how carbon dioxide is necessary for getting enough oxygen in your body. Learn how soft foods and bottle feeding during childhood can impact your health as an adult. Understand how oral exercises and breathing practices can significantly improve your wellbeing.   Resources DEEP: Freediving, Renegade Science, and What the Ocean Tells Us About Ourselves by James Nestor Breath: The New Science of a Lost Art by James Nestor Wim Hof Method James Nestor’s website   Episode Highlights [04:03] How James Got into Breathing  James is a journalist who once covered a world freediving championship in Greece. Despite being a swimmer and bodysurfer himself, he was astounded by participants who can dive 300 to 400 feet in a single breath. Upon returning to San Francisco, James decided to write a book about freediving. His research exposed him to the art of breathing and its importance to wellbeing. He learned that improper breathing is damaging to the body. [10:29] The Physiology of Breathing Contrary to widespread knowledge, it’s possible to have too much oxygen and not enough carbon dioxide in the body. However, it is essential to have a balance between these two. Many standard breathing methods deplete carbon dioxide levels, leading to lower oxygen saturation and more unsatisfactory performance. A study found that by holding their breath comfortably for 25 seconds, 85% of the athletes will not have a breathing dysfunction. Instead of compensating, learning proper breathing techniques can increase your bodily tolerance for carbon dioxide. Listen to the full episode to learn more about the process of breathing! [19:57] Basic Breathing Techniques Most people breathe faster than the optimal rate without realising that many of their health problems come from their breathing rate. The point of breathing exercises is to acclimate your body to breathe through the nose without thinking about it. Slower breaths while maintaining the same volume of air can increase efficiency by 35%. Transitioning to slower breathing will temporarily reduce performance, but you will eventually see improvements as your body acclimates. [27:11] Nasal Breathing Listen to the full episode for James’ points on running and breathing! Nasal breathing leads up to 20% more oxygen absorption compared to mouth breathing, all else being equal. Nitric oxide is a potent vasodilator that increases blood circulation. Nasal breathing increases nitric oxide concentrations six times more than mouth breathing. Breathing through the nose is more effective in defending your body against viruses than any other form of breathing. [38:36] Why Aren’t Breathing Interventions More Popular? There’s not a lot of money that can come from breathing interventions. Hence, the development of this alternative practice isn’t promoted widely. That said, James believes that alternative medicine isn’t always the answer. Conventional Western medicine is still crucial for many health interventions. [41:38] How Modern Diets Changed the Way We Breathe In antiquity, people always had perfectly straight teeth and larger mouths. The introduction of industrialised food removed the need for a larger jaw. Evolution drove the shrinking of the human jaw, so more people have crooked teeth or impacted wisdom teeth. Smaller oral cavities also made breathing more difficult, and the incidence of upper airway resistance syndrome rose. [44:24] Childhood Feeding Improper oral posture can root from habitually breathing through the mouth. When we were younger, chewing was essential. The introduction of baby food prevented infants from performing the right chewing exercises. Breastfeeding changes the face structure and promotes more efficient breathing. Children need to eat hard foods to develop a proper jaw and airway. [48:20] Oral Exercises Even adults can see improvements in their breathing efficiency by doing basic oral exercises. After a year of oral exercises, James was able to improve his airway size by around 15% to 20%. Palate expanders are an option for people who need them. However, oropharyngeal exercises and myofunctional therapy are easier and more effective methods for improving your breathing. [54:33] Relaxation through Breathing Slow, focused breathing activates the parasympathetic nervous system, leading to greater relaxation. Doing breathing exercises several times a day will immensely help you cope better with stress. Listen to the full episode to learn more about how slow light breathing diaphragmatically stimulates the parasympathetic nervous system and the vagus nerve. [59:14] Hormetic Stress The quickest way to reduce stress is to breathe. It is all about working your respiratory system and working out your stress. James suggests starting with the foundations of nasal breathing, slow breathing and awareness. Similar to exercising at the gym, breathing exercises promote hormetic stress. At moderate amounts, hormetic stress is beneficial to human health. Listen to the full episode to learn more about the Wim Hof Breathing Method!   7 Powerful Quotes from this Episode ‘By mastering this sort of breathing, we can not only dive deep, but we can heat ourselves up, heal ourselves, and do so many other things’. ‘Scientific papers were published about this 115 years ago, showing very clearly that you need a balance of carbon dioxide and oxygen to operate effectively and efficiently. When we breathe too much, we can offload too much CO2, which actually makes it harder for us to bring oxygen throughout the body’. ‘That slower breath with that pressure allows us to gain 20% more oxygen breathing through our nose than equivalent breaths through our mouth.” ‘I think our bodies are the most powerful pharmacists on the planet and that’s been shown, so why not try to focus on your body and health a little bit’? ‘By having a smaller mouth, you have less room to breathe. And this is one of the main reasons so many of us struggle to breathe’. ‘Start slow, start low. See what your body can naturally do. If after six months, you’re like, ‘I’m still not, this isn’t working’, go see someone and take it from there’.  ‘I talked to dozens and dozens of people who have fundamentally transformed themselves through nothing more than breathing. I want to mention it again. I’m not promising this is going to work for everyone, for everything, but it needs to be considered as a foundation to health’.   About James James Nestor is a journalist and bestselling author. He has contributed to many newspapers and publications such as The New York Times and Scientific American. His first book, DEEP: Freediving, Renegade Science, and What the Ocean Tells Us about Ourselves, took inspiration from his journalistic coverage of a world freediving championship.  James also authored Breath: The New Science of a Lost Art where he combines thousand-year histories with modern research to shed light on proper breathing. His investigations have revolutionised the conventional understanding of breathing and have helped many people live healthier lives. His other projects include speaking engagements for institutions, radio and television shows, and collaborations for scientific research and communication.  Learn more about James Nestor and his work on diving and breathing by visiting his website.   Enjoyed this Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so they can include more amino acids in protein in their diet. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript Of The Podcast! Welcome to Pushing the Limits, the show that helps you reach your full potential with your host, Lisa Tamati. Brought to you by lisatamati.com. Lisa Tamati: Well, hi, everyone. Welcome back to Pushing the Limits in this new year. I hope you're enjoying yourself. You've had a good break over the holidays, and I have a fantastic guest today. Wow, this guy is insane. So his name is James Nestor, and he is an author, New York Times best selling author, Wall Street Journal best selling author, London Times New York Times bestselling author of a book called Breathe. So it's all about breathing. You might think, how the hell do you write a book on breathing. But I tell you, this is going to be a really exciting interview, and you're going to learn so much that you wish you'd been taught years ago. He's also the author of Deep, another best selling book that he did on freediving. And he's a filmmaker and science writer for many of the science magazines. Now in this book Breathe. He explores the million year long history of how the human species has lost the ability to breathe properly. And why we're suffering from a laundry list of maladies from snoring to sleep apnea to asthma to autoimmune diseases and allergies. And in this, on this journey in this book, which was absolutely fascinating. He travels the world and spends a decade in the attempt to figure out what went wrong and how do—we fix it. And, you know, the links that the sky week two—for his research has just absolutely next level. I really enjoyed doing this interview with James. He's an incredible person. And just so very, very interesting. So I hope you enjoy the show. Before we head over to speak with James in San Francisco, just like to remind you to do a rating and review if you came for the show. This is a labour of love. And it really really helps the show get out there if you can give us a rating and review, either on iTunes or wherever you're listening to this podcast. Or if you can't work it out, just send me an email with it. And we'll gladly receive those as well. And if you want to reach out to me if you've got any ideas for podcasts, or people that you would like to see on here, or if you have a question, health question, if you want help with health journey, health optimisation, epigenetics, run coaching, that's our day job. That's what we do for a living. And that's what we are passionate about. And that's what we love. So if you're having trouble with a tricky health issue, if you wanting high-performance, if you're wanting to do that next ultramarathon or first run your first five-kilometer race, whatever the case may be, please reach out to us, lisa@lisatamati.com. And you can find all our programs also on that website, as well as this podcast and lots of other goodies. So I hope you enjoy this interview with James Nestor. Over to the show now and thanks for listening. Lisa: Well, hi everyone and welcome back to Pushing the Limits. It's fantastic to have you with me and I am jumping out of my skin for excitement today because I have someone that I've been just so looking forward to interviewing. An amazing author, James Nestor, who is going to be sharing his research and his book, which is really a game-changer. Breathe is the name of the book. And James is coming to us all the way from San Francisco today. So welcome to the show, James. Fabulous to have you. James Nestor: Thank you for having me. Lisa: So James, can you just give us a bit of a background into your—who you are in your background? And how the heck did you end up writing a book about breathing? And why do we need to know about it? James: So I'm a journalist, and I write for science magazines and outdoor magazines. I've been doing that for years and years and years. And I think the real jumping off point for me was when I was sent out to go to Greece to write about the world freediving championship. And even though I've spent my life near the ocean, I'm a surfer. I'm a swimmer and body surfer, all that, I had never really spent too much time under the ocean. And I had never seen anyone freedive before because the water is very cloudy here on the West Coast. There's not a lot of places to do this. So I remember going out in this boat, it was the first day of the competition and just watching these people take a single breath and go down 300, 400 feet on a single dive there. And come back four minutes later and—just it was like they we're answering emails just like. Okay, next up, back for lunch. It was what the hell is going on here? I had understood that this was absolutely impossible. And yet here these people vary sizes, various forms - big, tall, large, small, all that - that had mastered this thing. And I got to be friends with a few of them who took me into this other side of freediving outside of the competitive freediving, which I just thought was pretty insane. And they allowed me to understand free diving as this meditation. And of course, breathing is at the core of this meditation. And by mastering the sort of breathing we can not only dive deep, but we can heat ourselves up, heal ourselves and do so many other things. Lisa: Wow, so that was the jumping off point in, for those interested. Yeah, I've taken an interest in freediving too. And my gosh, what they do is pretty next level, insane. I don't think I'm crazy enough to really have a go at it. To be fair, but absolute admiration for what they do and how they do it, in—the everything that they have to overcome. But okay, so if we just jump in now, the into—how does we know? What can we learn from these free divers and other traditional breathing techniques? And why is it important for the everyday person to be understanding how the breath works in the physiology, which we'll get into which I found absolutely mind blowing and thought, why is nobody told me this? And why did—why does, why should someone listening to this actually be interested? James: So the free divers told me that the only way to hold your breath is to master this art of breathing. And it was also something interesting to see all of these different people. And they all had these enormous chest, they had expanded their lung capacity. Some people double the average adult lung capacity by forcing. Well, they were not born this way. So it made me think about how malleable the body is depending on what inputs we give to it. And so I got back to San Francisco, and I wrote another book that featured freedivers. But in the back of my mind, that book was called Deep. And it looks at the human connection from the very surface to the very bottom of the deepest sea, magnetoreception echolocation all that. But as I was researching that book, and writing, I just kept finding more and more information about breathing, about how so many of us in the West, including in the medical world view breathing as just this binary thing. As long as we were breathing, we're healthy, and we're alive. When you're not breathing, that's bad, your dad or you have a serious problem. But that is such the wrong way of looking at this. It's like saying, as long as you are eating, you're getting food, you're getting nutrients. But it's what you eat. That's so important. And it's how you breathe. That's so important. So I was lucky enough to then meet a bunch of leading experts in this field who have been studying this stuff for decades, even publishing in these weird scientific journals. No one's been reading their stuff. I thought, why the hell hasn't anyone told me this? Like, I'm middle aged, I've been mouth breathing, through most of my life. I've been whenever I was working out or surfing, I'm just thinking I'm getting more oxygen in. And this is so damaging to the body, and no one was talking about it.    So this book took me so long, because I couldn't understand why some researchers on one side were saying how you breathe has no effect on your asthma, has no effect on your body, on your brain. And this other side was saying they're 100% wrong. Here's all the data. So it was going through all that and weeding through all that that took me a while. But I think at the end, I finally found the truth behind all of this. Lisa: He certainly did. And the book is such a deep deep dive like you know, and I've been talking to some friends about you know, reading this book and, and everything. How can you have a whole book on breathing? And I'm like, you have no idea. You could probably write 10 books on breathing and it's so powerful. And as an athlete I've, you know, I was just saying to you prior to the recording, I've spent my entire life as an asthmatic since I was two years old. I have a very small lung capacity. I have a low VO2 max, despite that I decided to become an endurance athlete. Go figure that one out, got some mental issues, obviously. But I'd spent my entire athletic career breathing in my mouth in places like Death Valley, in the Sahara, in the Himalayas, and altitude, and you know, freezing cold temperatures. And all of the problems that that brought and so this book has been a life-changing thing for me personally. Unfortunately, I'm no longer a competitive athlete bagger. You know, like I didn't get the memo back then. But now training hundreds of athletes. Wow, I can start to influence them and change them and are already started to adopt some of the information into the programs that we're using. So super powerful information, and in really important. So, okay, now let's go into a little bit—the physiology of breath because we sort of think if I take deep breaths, and breathe often in faster, if I'm running, then I'm going along. I'm getting as much oxygen as my body can get. Why is that completely upside down? James: That is upside down. And it's so counterintuitive. It took me months to get my head around this, even though we've known these scientific papers were published on this 115 years ago, showing very clearly that you need a balance of carbon dioxide and oxygen to operate effectively and efficiently. And when we breathe too much, we can offload too much CO2, which actually makes it harder for us to bring oxygen throughout the body. If you don't believe me right now, you can breathe 20 or 30, heavy breaths. You might feel some tingling in your fingers or some lightness in your head. This is not from an increase of oxygen to these areas, but a decrease of circulation. Lisa: Wow. James: Because you need a balance of CO2, for circulation, for vasodilation. This is—it is integral to providing blood and nutrients to our body. And for some reason, as Westerners we just think more is better, more is always more. That is not the way of the proper way of thinking about this when you talk about breathing, you want to breathe as closely in line with your metabolic needs as possible. Why would you? It's like being in a car. Why would you be revving the motor? Everywhere you're going, I had a stop sign just revving the motor. When you were over breathing. That's exactly what you're doing. You're causing a bunch of wear and tear on your heart on your vascular system. And you're sending stress in those—to your mind. People like you are very strong willed and we'll fight through it right you'll just keep going you're in pain, I don't care. I'm gonna finish this race. I'm gonna make it happen. Compensation is different than health. Oh, and and so this is why so many professional athletes, they'll be really good for a few years. The minute they stopped, diabetes, chronic health problems. Our body.. Lisa: Thyroid, diabetes, metabolic problems. Yeah, like no hell, you've spent your life being a disciplined athlete. I'm struggling with hypothyroid, for example, and high blood sugars. And I'm lean and I'm, you know, it's like what the heck. Like, wow. And I hope through the breathing in some of the other stuff that I'm doing that I can remove some of the damage because you're because it is so counterintuitive. So that carbon dioxide there was a real mind bender for me, because I've always understood carbon dioxide as a negative thing. You know, we want to breathe it out. We want to get it out of the system. That's the end result of you know, what do you call it the electron chain in the ATP production, and we're producing this carbon dioxide, we're gonna give it out. And that's not the case, isn't it? It's a controller of the acidity in the blood is something that we want to train, our chemoreceptors need to be trained in order to be able to tolerate more carbon dioxide. So this just dive into the winds a little bit on the actual physiology that I've just touched on the air so that we can actually get to the bottom of this carbon dioxide, your mind bender, really. James: So when we take breath in, it enters into our lungs and the bronchioles, to these little air sacs, the alveoli, and from there it goes through various layers and enters into red blood cells. The vast majority of oxygen enters into red blood. So there's some free floating but not much. So in those red blood cells or something like 270 million hemoglobin, and so then it enters into this hemoglobin. And it's, you know, it's funny, why would when we're working out, why would we get more oxygen in one area than another? So CO2 is the signaling molecule. So where oxygen is going to detach is an areas where there is CO2, and oxygen isn't going to attach otherwise. So you need this healthy balance of CO2, we have 100 times more CO2 in our bodies than we do oxygen.  Lisa: Wow. James: Okay, so this is this very carefully controlled system that needs to be in balance, and our bodies are so wonderful at keeping us alive. So when we become imbalanced, all these other things happen. If we become too acidic, we'll learn to breathe more, right? We’ll trigger that if we become too alkaline, our kidneys will release bicarbonate. So all of this is incredible and so important. Compensation, different than health. We can compensate for a very long time. Imagine you can live maybe 40 years eating garbage crap food eating Fritos. That doesn't mean you're healthy. No offense to Fritos. Delicious, absolutely delicious. But, you know, it doesn't mean you're healthy. So… Lisa: Yeah. James: ...the reason why you have to understand this balance of CO2 and oxygen is because you can't just understand CO2 as a waste product. It's still considered this a medical school. Yeah, you don't need it. But people who study this know that is—it's absolutely essential to have that balance, you don't want too much. But you don't want too little. You want your body to be able to operate at peak efficiency without having to go through all those compensations, right? To keep you there.   Lisa: Exactly. So when we breathe in, we.. When I say, we don't hold our breath, and I'm holding my breath for a long time, as long as I can. And then that's horrible urgency that comes up and you start to—your diaphragm starts to make that sort of hiccup thing. And this is actually the chemoreceptors in the brain, which is the area that is what I understand, correct me if I'm wrong, that is measuring the CO2 levels more than anything in the blood, not the oxygen levels. And it's so, the CO2 going up, and then the body's going “Oop, time to breathe,” and it makes you do that, you know, hiccup thing in order to make you breathe. And when I'm doing my breathing exercises that I've learned from you, I let that reflex go for a while while I'm training my body and to be able to accept more carbon dioxide. And that will help me be a better athlete with a bit of a EO2 mix hopefully, and make me faster and so on. But it's the CO2, that's actually pushing the oxygen into the cells as well, isn't it? And that was another, a mind bender as well. James: It's an exchange. So you can think about those red blood cells as this cruise ship, right? So and they're full of oxygen. And they cruise to areas where there are other passengers that want to get on this is CO2, and they exchange. The CO2 hops on as oxygen hops off. And this is just how it works. So that need to breathe, you're 100% right. A lot of people think, gonna exhale, hold my breath. “Oh, I don't have enough oxygen, I need to breathe.” No, that is dictated by rising carbon dioxide levels. And so many of us are so sensitised to CO2, that we can't hold our breath more than 10 seconds without going. But they've done a study with athletes. And they found that to very comfortably hold your breath, over 25 seconds, 89% of those athletes will not have any breathing dysfunction. So this is a great practice to do. And this is why this is used in so many different breathing techniques for so long. The ancient Chinese were doing breath holds. Pranayama ancient Hindus were doing breath holds for thousands of years—is to exhale softly. And to hold your breath calmly. You don't want to be struggling and feeling your diaphragm moving. Just calmly, when you feel a little teaspoon of discomfort. You breathe and you calculate how long that is. Don't look at this as a competition. I know that there's a lot of people out here. No, you can compete later. So what you want to do is to get your CO2 tolerance higher, because by having a higher amount of CO2, which is really a normal amount of CO2, your body can operate better. You will have more circulation. Oxygen will detach more easily. And when you're doing endurance sports, this is what you want. You don't want to use energy for things you don't have to use energy for. You want to be burning clean and tight. And that's what this allows you to do. Lisa: This is about efficiency isn't and maybe you're saying that the average person is breathing 12 to 18 times a minute, on average. And ideally, we should be around the five and a half or six times a minute would be ideal. “So breathe light to breathe right” was one of the catchphrases that stuck in my head. And that's my trigger for all over breathing again. And so it's actually slowing down our breathing rate and not increasing the volume so much as diaphragmatic breathing. So using the deep, lower lobes of our lungs to actually get the breath end and doing it a lot slower. And why are we all you know, doing it 12 to 18 times a minute and overbreathing? Which is yeah. It is... James: Sometimes a lot more than that. I mean, I've talked to clinicians who see people breathing 25, 30 times a minute just and they've been doing this for decades, and their bodies are just destroyed. So it's, these things become a habit after a while and our body gets used to that cycle of compensation. And we start acknowledging this is normal. We started thinking having migraines is normal, having cold toes and cold fingers all the time is normal, being exhausted all the time is normal. None of this is normal. And especially if you look at modern populations of what's considered normal now, I mean, what 15% of Americans have diabetes, 25% have sleep apnea, 10% have autoimmune like, what is going on here? And that this is just accepted that, “Oh, just you know, I've my diabetes...” Lisa: Aging. James: ...my drugs. So anyway, I'm getting off track here. You when this becomes a habit, again, compensation different than health. And a wonderful practice to try is to breathe in at a rate of about five to six seconds, and breathe out at around that same rate. I put in the book 5.5 yet, but then people have been writing me, saying, 'I'm a half a second off'. Oh, my God. So now I'm saying anything in that range. And if that's too difficult for you, slow it down, go three seconds in three seconds out. It's perfect. This is not a competition. This is about acclimating your body. So we can't breed this way all the time, that's going to be impossible. But whenever you become aware of your breath, that you're breathing too much, you can bring your breath back by breathing this way and recondition it. And the point of all these exercises is not to think about them. You want to do them often enough, that you're always breathing through your notes that you're always breathing lightly and slowly. And that range of diaphragmatic movement, especially for athletes, I cannot tell you how essential this is, when you're breathing too much. Okay, here's what's happening, you're breathing up into your chest, which is extremely inefficient. There's more blood further down in your lungs, so can participate much more, much better in gas exchange. But you're also doing something else. You're taking air into your mouth, your throat, your bronchi, bronchioles, none of which participate in gas exchange yet do you bring it in? You go? I'm using maybe 50% of that breath. If you slow down with the same volume, six laters a minute, to about six or seven breaths, right? Per minute, your efficiency goes up 35%. 35%. And if you're not gonna make a difference, you're running for five hour days. You're crazy. If you look at Kipchoge, check out how he's breathing, you know, an hour and a half, extremely light. He's completely in control, you can hardly see his chest. And he is in the zone. Sanya Richards-Ross was the top female sprinter in the world for 10 years, check out how she's breathing through the nose in control, destroying everyone else and all of our competitors. So it takes us a while, which is why people don't, you're going to see a decrease in performance when you switch. Okay, guaranteed that it's gonna to go down. If you stick with it, it's gonna go up. I don't want to say that it's true for everyone. But I would say 95% and the breathing experts, the elite trainers I've worked with have told me 100% of the people they've converted, their performance goes up and the recovery is cut by half. Lisa: Wow. And then I mean, who the hell doesn't want that as an athlete, you're fighting for 1%. So when we're talking, no such mess of possible changes that don't rely on your genetics and don't rely on you know, things that you can't control anyway. And like, for me, transitioning has been hard. I'll be honest, because I was completely congested all the time. And that's why I'd heard that nasal breathing because that’s the next thing we'll discuss that nasal breathing was very, very important for a number of reasons. I didn't really understand why. But I was like, well, I can't breathe through my nose is just blocked the whole time. And I don't have a show on hell of doing that. So well. Well, I'll carry on doing my breathing. And then when I learn how to decongest my nose and sometimes it will take me two or three breaths. And the first time the first couple of weeks when I was doing it, my nose was running and I wasn't getting anywhere and I'm like, this is not working. But I pushed through that phase. And now I can run for like a team case at a fairly good pace, completely nasal breathing, if I do the warm up phase properly, if I go out the door and just try and do it straight out, the gate won't work, I need to do the walking, holding my breath, and get that cleared first, and then I can get into my training. And then I can hold it in the first 10 minutes, I'm still finding it a little bit like I want to breathe with my mouth, but that instinct is there. But I'm slowly training myself into that system. And saying, I can actually, you know, I can actually run for a good hour just through my nose without any problems. And I've also not done the high-intensity. So I backed off the super high-intensity, because I know I'm automatically going to open my mouth when it gets to that. So while I'm in this transition phase, I'm not doing anything beyond that sort of aerobic capacity level. And I think I need this just to adapt. So these are huge types of people listening out there, if you are congested, and you think, well, this is all well and good guys, but there's no way in hell that I'm going to be able to breathe through my nose. Think again, there is, it's just a matter of being taught how to do it. And that's a pretty simple couple of exercises that were, you know, that's in the book. It can really, really help us if you persevere through it. And then I expect to see improvements and my VO2 max and all the rest of it. Now, let's talk a little bit about the reason why it has to be nasal breathing. And so it's not just about breathing slowly. We've talked about breathing slowly, we've talked about diaphragmatic breathing. We've talked about CO2 and the role that we don't want our CO2 levels too low in the body. Let's talk now about the whole. Where was I going James? Help me out. I've just hit a.. James: You wanted to talk about breathing, you want to talk about fitness, you want to talk about nasal breathing. Lisa: I hit a moment. So nasal. So we want to understand the physiology of the nose and why the nose is what we want to be breathing with rather than our mouth. James: So I want to mention a few things. A few more things about running. This may seem overkill, but just a couple of points. So what I've heard from various instructors, Patrick McKeown is a world renowned breathing therapist, top got Brian Mackenzie the same thing. Never work out harder than you can breathe correctly. So if you're entering the zone, your mouth is open, slow it down and build your base and work up from there. Sometimes it took Dr John Douillard took him six months to fully acclimate. But once you get there, you are going to find a power in yourself that you did not know existed. And this has been proven time and time again. When Carl Style was working with the Yale running team and the US Olympic running team. He said that these people suffered way more sicknesses, respiratory problems, asthma, COPD than anyone else. And he said, “They push through it because they're competitors. They're gonna push through it.” A complete mess. So there has to be a slight shift and thinking of like, you have to accept your performance is going to go down for a little bit. Right now's a good time to do that. We're still in a pandemic. So you know, once things open up, you'll be kicking everyone's ass. And that's not a bad thing. But just know that this is a wave. This is a process. So the reason why you want to be doing this, we'll get to nasal breathing now is I will bring on my guest. He's been waiting over here patiently. Steve, for the people who aren't watching this, I'm holding up a cross section of a human skull. You can see the nose right here. When you breathe through the nose, you're forcing air through this labyrinth. It's so similar to a seashell. It's called the nasal concha. So seashells have their shells this way to keep invaders out to keep pathogens out. Right? Our noses serve the exact same function. This is our first line of defence. So when we breathe through our nose, we're heating air which is important in cold climates where humidifying it, which is very important in dry climates. We're pressurizing it, we're conditioning it, we're removing particulate which is important, if you live in a city or basically anywhere else now. We're helping to fight more viruses. So there will be a smaller viral load breathing through the nose. And we condition this air so by the time it enters our lungs, it is properly conditioned to be more easily absorbed. When you're breathing through your mouth. You can consider the lungs as an external organ. Yeah, because they're just exposed to everything in your environment. So not only that, not only is this the most effective filter we have is it forces us to breathe more slowly. This is a self-regulating device. Yeah. How long did it take me to take that breath took a while? How long does this take? Yeah, nothing. So that's slower breath with that pressure allows us to gain 20% more oxygen breathing through our nose than equivalent breaths through our mouth. Again, if you think this is gonna make no difference to, you you're absolutely crazy. And this is simple science. You know, this isn't controversial stuff. Lisa: No, this is simple science, but not well, knowing until your book came out and became a worldwide best selling book. Thank goodness because this stuff needs to be out there. And I'm called silly because I'm deep in the waves and in researching all the time. And by hacking and the latest longevity, and the goodness knows what I'm just always into the latest and greatest. And I'm constantly surprised at how you know that some fantastic information never sees the light of day, because of the systems that are in place, or traditions and laws and stuff. And it's like, wow, we have to get this information out there. And this is one of those times when I'm thinking thank goodness, someone has put this into a book that's readable for people to understand the science without having to do such a deep dive themselves. And I think that that's really important. And that nasal, you know, nasal breathing. Also, it does another thing that I found really, really interesting was all about the nitric oxide. Can you explain what nitric oxide is and what it does in the body and why the nose is so important in that regard? James: Nitric oxide is this amazing molecule that our bodies produce that plays a central role in vasodilation. Having more nitric oxide will decrease your chances of having a stroke, will decrease your chances of having a heart attack. It will increase circulation to your brain. I mean, I can go on and on here. It's no coincidence that the drugs Sildenafil also known as viagra, guess what it does, it releases nitric oxide in your body. That's how it cleans. Yeah, we get six times. One study showed that we get six times more nitric oxide breathing through our nose than we do through our mouth. And if we hum we get 15 times more nitric oxide. So this has an incredible effect on the body and especially now there are 11 clinical trials right now where they're giving patients with COVID. Guess what? Nitric oxide. And apparently, according to Nobel Laureate, Louis Ignarro, oh, it's working wonderfully well in these. Studies are going to be out soon. I heard something. My brother in law's an ER doctor, my father in law's a pulmonologist. So we talk all about this stuff. And the vast majority of the people suffering the worst symptoms of COVID are people with chronic inflammation. And as an opposite, very observational study. There are also mouth breathers. Yeah. And this was known 100 years ago, they were saying 75 to 80% of the people with tuberculosis are mouth breathers, chronic mouth breather. So there's been no official study on this just this is just observational stuff. Don't go write me about this, that your nasal breathing got COVID. It can happen. Lisa: Can happen still, we're not saying that.  James: It's to me, but we know that can happen. But we also know something else. That breathing through the nose will help you defend your bodies so much more effectively, against viruses. And this is what Louis Ignarro again, he won a Nobel Prize. So listen to that guy, if you're not gonna listen... Lisa: Yes and I've actually I've heard Dr Ignarro speak a number of times, and I'm hoping I can get him on my podcast to actually just to talk a whole session on nitric oxide and what he discovered, because he he won a prize for discovering this, this gas if you like in the body, because nobody really understood what it was or how it operated. And it is being used for Viagra. And the reason it works for that is that it expands and dilates the blood vessels, but that's what's actually doing it and all parts of our body. And therefore when we're doing this nasal breathing, and we're getting more of that nitric oxide and I mean, a lot of the athletic supplements that you can get now in your corner supplement store are about, you know, drinking beetroot juice or whatever increases your nitric oxide. So this is another way to get at an info for you athletes out there. You want better performance, you know, a lot of my athletes are on beetroot juice and things like that. Just nasal breathing is another way of doing that. You know, so that's a really big piece of the puzzle, I think. James: And those don't work. They certainly work but the key was so much of this just like with a key with oxygen. You don't like, go and get a bunch of oxygen for five minutes, then walk away so I'll fix them. You want to constantly be producing this stuff. So beet juice, you know what we'll work for a short amount of time. But to me, it seems like a much better idea to use something that we're naturally gifted with to use our nose. And to constantly be having a body that can constantly produce a healthy healthy level of nitric oxide. I drink beet juice. I'm a big fan of that, the nitrates and other vegetables can help release more nitric oxide. Great stuff, right? But nasal how often can you be drinking beet juice, you don't want to be drinking that 10 times sugar in it. Lisa: No. There's a lot of sugar in it. James: There’s a lot of sugar in it and you know, occasionally is great, but there's other ways of doing this. And you know, I think our bodies are the most powerful pharmacists on the planet and that's been shown so why not try to focus on your body and health a little bit? Well last thing I want to mention that I just find, is so frustrating here in the US is all this talk of COVID all this talk of you know wear a mask, which I'm a believer in that stay at home. I'm a believer in that. Zero talk about not eating four double cheeseburgers a day.  Lisa: Hey, mean. James: Ola, like getting your health and breathing through your nose. like where's that conversation? Getting vitamin D, getting vitamin C. And so anyway, we've seen what the government's you guys have a much more progressive government, let me tell you, we're so jealous of it. But now we have the whole... Lisa: We’ll be a medical society, though there's nothing. It's not that late. But yeah, and I've had a number of episodes, I've just done a five part series on vitamin C, and intravenous vitamin C, and cancer, and sepsis. And, you know, the whole gamut in the problems there. In this, every single doctor has said to me too, when it comes to COVID, why aren't we building up our immune system so that we don't get people in our ICU on ventilators? You know, so that we don't get to that point, or we have less people and, you know, that just seems like a no brainer to me, but we're still promoting eating crap and drinking crap. And, you know, and not taking into account. It's, yes, I mean, the vaccines and all that, but how about we just take a little bit of self-responsibility we might not have as bad if we do get it. You know, like I've got a mum. I've just written a book called Relentless that my listeners know about and it was about rehabilitating my mum back from an aneurysm four and a half years ago, where she hit massive aneurysm. Hardly any higher function, I was told, like, should never do anything. Again, I spent four and a half years rehabilitating her and she's completely normal. Again, she's driving the car, she's walking, jogging, everything's fine. And this is why I've ended up doing what I do, because I'm very passionate, because none. And I mean, none of this was offered in the standard medical system that we were in. They were great at the surgeries, they were great in the crisis. But when it came to rehabilitation, there was just nothing there, and so I discovered all of these things. And one of the passions I have is just staying one step ahead of here and giving her the next thing now she's 79 years old, I want to keep her healthy. So when COVID threatened us, you know, I've, you know, got over there in the corner, my hyperbaric oxygen chamber, my ozone over the air, and, you know, you name it. I've got it so that if it does come, we prepared as prepared as we can be. And that is a good approach, I think prevention, rather than waiting for the disaster, and then trying to pick up the pieces at the end of the day. You know? James: Yeah, and I just want to be clear, and I know that you're saying the same thing here. There's, doctors in my family that practice Western medicine who've helped people, when I get a car accident, last thing I want is acupuncture. I want to go to the ER and have somebody say, “Sir, I break a bone. I'm not doing pranayama breath work, I'm going to go and get a cast.” But about rehabilitation. This is 100% true, because it costs a lot of money. There's no way a system can support full rehabilitation. And one thing that I've heard from almost every expert in the field, whether it's a professor at a university, or an MD, or a nutritionist, or whatever is they believe, this isn't my view. This is their view. I want to be objective here but they believe that there's a reason people aren't talking about breathing again. It's, there's no money in it. There's a money. Oh, why the US government isn't saying “Don't go to McDonald's today.” That's going to shut the economy down. So the good news about this is people who are interested want to take control of their health. There are now other means of getting information from people who have studied this stuff, people who are into scientific references, who are looking at science in a real objective way. And so I view this thing, hopefully, this is going to be a lesson we can all learn then that we can acknowledge how incredible the human body is, how we become susceptible to illness, and how to better defend ourselves in the future. Lisa: I'm just so on board with all of that. And I think it's our right and this is a problem we do. You know, we love Western medicine, they do some brilliant things. I love naturopathic medicine, I love alternative, complementary, whatever you integrate, or whatever you want to call it.   We've all got deficits, and we've all got blind spots, and every single piece of this. And it's about bringing the whole lot together, and not letting money rule the world. I think is, if we can ever get to that point, that would be fantastic because it is at the moment. And there's a lot of things that are being hindered, like things, simple things like breath work, like stress reduction, like intravenous vitamin C's, like things that don't, nobody can make money at, or hyperbaric oxygen is not going to make millions for anybody. So it's not getting out there, that information is not getting out there. And it needs to be out there. We got I reckon we could talk for days, the job's because we were obviously on the same track. But I wanted to touch on a couple of areas. One was the whole skeletal muscle record of our ancestors and our facial, you know, our whole facial development and why that's part of the problem and the food problem, the mushy food that we eat today. And then remind me to talk briefly about the immune system and all this inveigled the vagus nerve and stuff. So let's start with though, with the skeletal record, and the difference between our ancestors and how we are today. James: So early on in my research, I started hearing these stories about how humans used to have perfectly straight teeth and I don't know if you're like me. I had extractions, braces, headgear, you name it, every single person I knew had the same thing. It was never if it was just went this is what how it was done. At wisdom teeth removed. If you think about how weird that is, you're like, why are we removing teeth? From our mouths? Why are teeth so crooked? Where if you look at any other animal in the wild, they all have perfectly straight teeth. And what I learned was that all of our ancestors, before industrialisation, before farming, any hunter-gatherer all had perfectly straight teeth. So I went to a museum and looked at hundreds of skulls, and they all stared back at me, these perfectly straight teeth. Completely freaked me out. They had these very broad jaws, wide nasal apertures forward, growing powerful faces. So if you have a face that grows this way, and you have a mouth that's wide enough for your teeth, you have a wider airway. Having a smaller mouth, you have less room to breathe. And this is one of the main reasons so many of us struggle to breathe, we have upper airway resistance syndrome, sleep apnea, snoring, and so many other respiratory issues is because there's less room in there. And what happened is this came on, in a blink of an eye with industrialised food in a single generation. People went from having perfectly straight teeth, wider nasal apertures, to having crooked teeth and smaller mouths and a different facial profile. And this has been documented time and time again. Yet I had learned in school, which for me, it was zillion years ago that this was evolution-meant progress we're getting we're always getting younger, you're getting taller, we're getting better, look around the day and ask yourself if that's true, it's complete garbage. And then I went back and looked at the real definition of what evolution means. All it means is change and you can change for the better, or for the worse. And humans, as far as our breathing concern is concerned, are changing very much for the worse. Lisa: Wow. And so we're, I mean, I'm saying I grew up have had so many extractions and teeth completely crooked and a tiny little mouth and all of those sort of problems that you're describing. So what was it that their ancestors did differently? So it was just the food being not we not chewing as much was that basically? Yes, like that's that was a real chain game changer for us when the industrialisation happened and we got mushy food. James: There were many inputs, chewing is the main one. So when you live in an extremely polluted environment, sometimes your nose can get plugged, right? You start breathing through your mouth, that can create respiratory problems, but if you breathe through your mouth long enough, your face grows that way actually changes the skeletal picture of your face. So that's another input improper oral posture is what that is called, but it's for when you're younger chewing is so essential and it starts with breastfeeding. There were no Gerbers food. I don't know if you have that out there, but there were no, like, soft foods. Just a few 100 years ago. So if you think about it, so now we're eating the soft processed foods right out of the gates. We're going, we're being fed on a bottle, soft processes. All of our mouths are too small and too crooked. So this chewing stress starts at birth. They've done various studies looking at kids who were bottle fed versus those who are breastfed. When you're breastfed, your face pulls out your mouth, gets wider because it takes a lot of stress to do. Two hours a day, like every day, every two hours, you're doing it. And literally, and I've talked to parents who had twins, I just talked to a lady yesterday who bottle fed one did love not want to be breast fed breast fed the other. They look totally different. One has crooked teeth, one has autoimmune problems. One has swollen tonsils, the other doesn’t. So that is anecdotal. But there's been studies in the 1930s they did tons of studies into this. So I'm a dude, I'm not going to sit here and tell everyone they breastfed people for that is not my point yet. But some people just can't. But I think it's important to acknowledge that the physics of how this works. And after that, if you have bottle fed a kid that's fine. But they need to start eating hard foods baby led weaning, this is what needs to happen to develop that proper jaw to develop that proper airway. And even if you don't do that, if you then go to soft foods, and your kid is two to three years old, and it's snoring or sleep apnea, which is so common now it's so tragic, because that leads to neurological disorders, ADHD, again. This isn't crazy New Agey. This was at Stanford, there's 50 years of research on this from the top institution here. So there are direct links between those things, but luckily we have technologies now that can help restore to the mouth to the way it was supposed to have been before industrialisation. They actually widened the mouth of these small little kids, and open their airways, and it drastically improves their health. Lisa: Today so it's palatal expanders that you you tried out and actually isn't even as an adult was you developed I remember it was at eight coins worth of new bone in your in your face and in a year or something crazy so we can still so if you've missed about if you've not received your kids or your you didn't get that yourself or whatever, it's not all over there is things that you can start doing even starting just to chew now like that to eat some carrots and whatever you know, whatever hard foods you can find to actually use those that powerful joy in order to make it stronger. It's just like every other muscle in the body isn't it? And when we're mouth breathing to our remember you saying or the muscles here get lax and flattered and just like any other muscle that we're not training, if we're if we're going to mouth open all night and we're you know, then we're causing those muscles to be lax and over time that that leads into sleep apnea and things as well can do. So yeah, so this is something that we can practically get a hold on now even if it's a bit late for you and I think. James: Yeah, I talked to my mum I was bottle fed after like six months my mum was like six months is a long time when I was growing up bottle fed soft foods industrialized crap my off intel I was you know 25 and it discovered these things called vegetables. But you know, so so this isn't pointing the finger at anyone we were sold this story by our governments that said you shouldn't eat mostly refined grains, eat your Cheerios, eat your bread, or crema wheat eat your oatmeal like that this is eat your sugar, that's good. Eat your chocolate milk, you know, so we have knowledge now we know the folly of our ways. But the one thing that was inspiring to me this is easier to do, when you've got a developing kid quickly growing it, you can set the foundation and their face will grow around like their faces grow different. It's just, it's beautiful to see how the body forms to its inputs. So I, you know, youth was several decades ago for me, for far too long. I was a child of the 70s and 80s. Right? Yeah, we thought I thought once you're in middle age, you're completely screwed. What can you do, but that is just a convenient excuse for people to say, “Oh, it's genetics. Oh, I inherited this.”  Like genes turn on but they can also be turned off and so I wanted to see what how I could improve my airway health in a year and so I took a CAT scan, and I did proper oral posture, you're 100% right when, when you're just eating soft, mushy food in your mouth is open. All of those tissues can grow really flabby just like anywhere else on your body. But if you exercise them if you exercise the jaw, the strongest muscle in the body, you know, for its size, the tongue, extremely powerful muscle, you exercise these things, they get tone like anything else. And this can help open your airways. So this is just an anecdote, this was my experience, it'll probably be different for other people. But I did a number of these things. And a year later to the week, I took another CAT scan, and the results were analysed by the Mayo Clinic, which is one of the top hospitals here. And they found that I increased my airway size about 15 to 20%. In some areas, and I can't tell you just as a personal story, it has absolutely transformed my life because I can breathe so much more easily through my nose. At night. I am silent. I didn't snore before but I was knowing that my wife would always tell me, totally silent now. And of course I am because I have a larger airway, things are more toned air can enter more easily. Lisa: Is it easy to find palace expanders are these like any a couple of dentists in the world doing this sort of stuff? James: Not everyone needs palatal expansion. I've gotten so many hundreds of emails of people, you know how we are, it's like, what's the latest thing, oh, there's a new pill, there's a new device. Oh, I get it, that's gonna solve all my problems. So they can really help people who need it just like surgical interventions. For people who have severe problems in their nose are a huge help. They're transformative. What I found is a lot of people don't need that. And what I firmly believe is start slow, start low, see what your body can naturally do. If after six months, you're like, ‘I'm still not this isn't working,’ go see someone you know, and take it from there. But palatal expansion absolutely works for people who really need it, but you would be amazed by just doing something called oral-pharyngeal exercises. There was a study out in chest, which is one of the top medical journals, you know, they found this significantly cut down on snoring, not lightly, significantly. And all it is, is exercising the tongue, roof of the mouth, proper oral posture, just working out this area. Toning it, of course, that's gonna help you if this is flabby and hasn't been to.. Lisa: The gym for your mouth. James: That's what it is. And I view that world, there's a whole separate school called myofunctional therapy that is helping people do this, which is so beneficial. They focus mostly on kids, but they also work with adults. And this is what they do. They are the instructors, the gym instructors, for your mouth and for your airwaves. And I strongly recommend people looking that up, there's a bunch of instructionals for free on YouTube, you can go that route as well. Lisa: Oh, brilliant, we'll link to some of those on your website. And, you know, I get people those resources. It's just, it's just amazing and fascinating stuff. And who would have thought this conversation would go so deep and wide, I wanted to just finish up then with talking about the immune system and stress reduction and vagus nerves and all of us area too, because, you know, me included in this and most people are dealing with, you know, massive levels of stress, and breathing can I've, since I've read your book, and I was really, you know, quite aware of how to bring my stress levels down and movements and the importance of you know, yoga and all those sorts of things. I've had that piece of the puzzle sort of dialed in, if you like, but the breathing exercises and actually calming the nervous system down within minutes. Now I can fall asleep in seconds. And you know, what seconds is a bit exaggerated but minutes, and I can I can take myself from being in this emotionally, my god and i tend to be like that because I'm like, you know, busy, busy, busy. And then go, “Hey, I'm spinning out of control. I've lost control of my breath. And I hear myself and I pick myself up on it now.”  And I go and do two minutes of breathing exercises. That's you know if that's all I can afford to do, and I can switch into parasympathetic now, that's been gold. Can you just explain why the heck does doing this slow light breathing diaphragmatically stimulate the parasympathetic nervous system and the vagus nerve from what's actually going on there? James: Sure. So what people can do now is take a hand and you can place it on your heart. And you can breathe into rate of about three seconds and try to breathe out to about six to eight seconds, just whatever's comfortable. Now, breathe in again. 123 and exhale. And as you're exhaling out very softly, you're going to feel your heart rate, get lower and lower. And lower. So when you are exhaling, you're stimulating that parasympathetic side of your nervous system, our breath can actually hack our nervous system function. And by exhaling more, and taking these long and fluid breaths, you can trigger all of those wonderful things that happen when you're parasympathetic. You reduce inflammation very quickly. You send signals to your brain to calm down. You actually change how your brain is operating the connectivity before the between the prefrontal cortex and the emotional centers of the brain changes when you slow your breathing.  So throughout the day, if you want to remain balanced, you take those soft and easy light, low breaths, to account of whatever's comfortable, three, four, even up to six, and six out. But if at some times you feel “My stress levels are starting to increase. I'm feeling my mind slip. I'm making rash decisions.” Start extending the exhale. An exercise I like to do is inhale to about four, exhale to six, you don't have to do it that long. Inhale, two, three, exhale to five, whatever's comfortable, as long as that exhale is longer, you're gonna feel your body slowing down. And if you don't believe me, all you need to do is get your heart rate variability, monitor your pulse oximeter and take a look at what happens after 30 seconds of slow, focused breathing. And you will see this transformation occur in your body, if that can happen in a couple minutes, what's going to happen to you after a couple of hours of taking control of your breathing, or a couple of days, or a couple of months.  I'll tell you what's going to happen. I talked to dozens and dozens of people who have fundamentally transformed themselves through nothing more than breathing. I want to mention again, I'm not promising this is going to work for everyone for everything. But it needs to be considered as a foundation to health. Lisa: And you need to stick at it for a little bit. And you know, I do my HIV monitoring every morning before I get out of bed and do my breath holding exercises and look at my boat score from Patrick McKeown. And you know, all that sort of stuff. Before I even put my feet on the floor, and I yeah, I can control my heart rate to a degree just through my birth weight. So I know this works. And I know that when I do a longer exhale from that, and compared to the inhale, immediately, I just feel a bit more calmer, and a bit more in control. And it's reminding myself and this is the trick because we, when we're in the middle of work, and we've got meetings and phones are going and emails are coming at us, and it's like the “Lions are chasing me.” And it's been trying to remember to breathe in. Bring yourself down and calm yourself down. And just take that couple of minutes many times a day, you know, depending on how stressful Your life is. And in doing that on a regular basis, over time will have massive implications. Because we're talking here, your digestion. You digest food better if you're in a parasympathetic state versus a sympathetic, your immune system. Again, coming back to COVID in that conversation, you're going to be improved, you know, your hormone balance. Yeah, just to fix everything, the way your, the brain waves, all of these things are going to be affected by your stress levels. And what is the easiest quickest way to reduce your stress? You breathe. So I think you know, that's a that's a really, really top tip. This just before we wind up and I've taken enough of your time, James but I you did in the, towards the end of the book, you went into some extreme super breathing practices, which because I was like, wow, okay, because I you know, read all about Wim Hof and looked at his breathing techniques. And I was like, wow, how how does that work, then? Because I'm over breathing when I'm doing that. How does that work? What is there a specific time when that type of breathing or the extreme breathing one pops just one of them? But you know, is there a reason to be doing that type of extreme breathing stuff? Or can it help? Or is it just for crazy like good, crazy, but crazy. James: Seems so counterintuitive, after learning about all these benefits of breathing less and breathing lightly, to then practice something where you're breathing like this. Yeah, and I was like, What is going on here? These are two completely opposite things. But think about those breathing practices like going to the gym. You're not going to go to the gym for 24 hours a day you're going to destroy your body, but going to the gym for half an hour and working out going to the gym for an hour and working out says huge benefits to so these breathing practices are all about working out the body and working out the respiratory system and working out your stress. Okay? So they purposely stress you out. A lot of people think “I don't want to stress that, why do I want to do something that stresses you out?” The point is, they teach you to control your stress, you consciously bring stress on, and then you consciously turn it off. And this hormetic stress, these short bursts of stress are so beneficial to our bodies, because we are not meant to be sitting on soft sofas and soft beds, eating soft foods, watching soft TV programming all day, we're meant to work out sometimes. And that's what these are so effective for doing. Some people find them jarring if they haven't done any breath work. So I suggest people start with that foundation of nasal breathing, breathing, awareness, breathing slowly and all that. But for some people for whom nothing else's work, no other drug has worked. I'm talking about people with autoimmune diseases, rheumatoid arthritis, even amass of psoriasis. I mean, the list goes on and on. I've seen this time and time again. And the science is very clear that this hormetic stress, doing this in a controlled way, allows you to decrease inflammation for the other 23 and a half hours of the day, which is exactly what the parasympathetic state does. So I love what you call Wim Hof Method, he's the first person to say I talked to Wim semi often I love what he's doing. He's such a cheerleader, he changed people's lives. Love the guy. He knows this isn't his method. This is 1000 year old stuff, you can call it Sudarshan Kriya, you can call it pranayama. Whatever all these methods are so similar, because they do the same thing. They have you breathe very intensely. And then they have you hold your breath or not breathe at all. And then they have to breathe very intensely. So this is the interval training, you see what's going on here. So this is HIT training for the respiratory system. I'm a huge fan of it. I use it as much as I can. I've seen big benefits to it. And it so happens to be right down the stream from me at University of California, San Francisco, Dr. Alyssa Apple, who is the expert in telomeres, had a famous book out a couple years ago. She's now studying this stuff, breathing and arthritis. And her study is coming out next month. I'm talking to her next, next week. So this stuff in, in my view, especially with athletes, the people getting the calls now are people that are focusing on breathing Brian Mackenzie elite in stride, length is Brian. He's doing this is all he's doing now. Lisa: Yeah, these guys are just on the next level. And when I first read the book, and I you know, read Patrick's too. And I was like, hang on, I don't get this because I was into the Wim Hof stuff. And I was like, yeah, I'm doing that sort of stuff. And but, you've just really clarified that for me, actually put that into sort of mistake, that part of it. That it is, like the intense interval training. So you don't want to be doing this 24 seven, you know, you want to do this with a specific purpose for a specific short period of time to create a stress just like you do when you go in train your backside off, and then you come back and you recover from that and it just that push and pull. And on you're so right, like, we and this is an issue in our, in our world now we are so comfortable. We are so warm all the time and cozy, you know, in our clothes, clothes and their cozy houses and our cozy cars and now we never get outside and we need as human beings to be pushed and pulled and out in up and down and have challenge, you know, challenge both mentally and physically. I think to keep ourselves strong and we don't, that's when we you know, fade away and have problems and get sick and all those sorts of things. So I'm a big, you know, mean, pushing the limits is the name of my podcast for crying out loud. You know. James: I actually talked to Patrick quite often, we correspond all the time. He and Anders Olsson told me at the beginning they're like, Oh, this heavy braid. This is bad. This is bad. Yeah, Patrick's come around now. Worst wins book. He's like, Wow, this is great stuff. So he's starting to incorporate this stuff. Because again, it's Westerners, it's we always think, it's needs to be one or the other. You're the slow breather, you're the fast breather, your paleo or your vegan, your kid. These things all have benefits to me. They're more tools in the toolbox to use at different times. And we're showing this these short periods of intense breathing can really be this pressure release valve for stress. And I'd be surprised if someone does the Wim Hof Method or Tummo. I'd be surprised if anyone is feeling more stressed after that. I mean to me, I find this is a very powerful tool. I use it before sleep sometimes, man the second my head hits the pillow. I'm gone in about eight hours. And that's what you want. That's brilliant. And it's good to Yeah, that Patrick's saying that, that Toby and Patrick's coming on the show in a few weeks time, so I'll ask him about it. Because I, you know, like I've been fooled do I, you know, because I've been doing the Wim Hof stuff previously, and now I've like, all backed off of it. But now I might have another crack at it again, and go a little bit deeper and just see if I can, you know, get to the next level. Because I mean, there's slow breathing for most of the time and certainly controlled in the in the training, and then there in the running and so on, is what you want to be doing most of the time, but we want these little stressors, these are medic stressors in order to improve and… James: Guess how one breathes the rest of the time. He rolls through his nose. Yeah, really slowly. And he hums a lot. Increase nitric oxide. So this is everyone sees him as the maniac screaming at you to breathe, and they don't see him the other 23 and a half hours a day where he's very chill, you know? So this is again, it's not one or the other. It's able to look at the benefits of all these things, just like the benefits of all these different foods that pick out the ones that work for you and to use them. Lisa: Excellent. I think that's a beautiful place to wrap it up. James, thank you so much for writing this incredible book, and for sharing your knowledge and spending so many years because I know this was a lot of years of research that went into this. Please everybody go out there and buy this book. Get the word out there, share it with your friends and family the links will be in the show notes. But James, where can people find you and in your book and where they best to get it? James: My website is a good place to start. I've listed all of the scientific references because I know this stuff sounds completely wacko. You can see videos, you can see expert Q and A's with a Harvard professors. There's exercises from Johns Hopkins. All of this is free. And it's at mrjamesnestor.com. There's links to the book too, because the how of breathing is the easy part. It's to me I found the more interesting story was the, what does it do? Where does this come from? You know? In what ways can it help benefit us and that's what I focused on. I'm also on Instagram trying to get better at this social media crap. And I'm posting things related to only breathing there. Lisa: Yeah, Instagram, you probably need to do a bit of Wim Hof before you jump on it because all the social media has drives me nuts too. But we have to do it. We live in this world. We do James, thank you so much. It's been an absolute honour to meet you. And I'm really, really grateful to you. James: You have to promise in six months after continuing to nasal breathe and work out. I want to hear a full report on where your endurance levels are and your performance levels.  Lisa: You got it, maybe I'll be competing again with Lenovo. That's great. Thanks a lot for having me. That's it this week for Pushing the Limits. Be sure to rate, review, and share with your friends and head over and visit Lisa and her team at lisatamati.com. The information contained in this show is not medical advice it is for educational purposes only and the opinions of guests are not the views of the show. Please seed your own medical advice from a registered medical professional.

No one is exempted from exposure to environmental pollutants. While this may sound worrying, there are steps, backed with scientific and empirical evidence, to rid our bodies of these harmful pollutants. However, there is still a lot of misinformation about detoxification that we need to uncover. In this episode, Dr Bryan Walsh discusses the common perception about detoxification and explains the actual science behind it. He talks about the different phases of detoxification and its complexity. Dr Walsh also tackles the importance of excretion as a widely ignored aspect of detoxification in diets and weight loss programs. Detoxification may seem challenging to start, but it begins with getting to know your body and blood chemistry. If you want to know more about the science behind detoxification, then this episode is for you!   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition and mind performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join our free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   Consult with Me If you would like to work with me one to one on anything from your mindset, to head injuries, to biohacking your health, to optimal performance or executive coaching, please book a consultation here: https://shop.lisatamati.com/collections/consultations.   Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: Learn about the phases of detoxification. What is the assessment criteria for detoxification? What is the importance of context in detoxification?   Resources Try out a Metabolic Detoxification Questionnaire here. Alternatively, you can look for other questionnaires by searching for ‘metabolic detoxification questionnaire’. Detoxify or Die by Sherry A. Rogers Fasting Mimicking Diet Program by Dr Valter Longo Metabolic Fitness Curious to start your detoxification? Try out the Walsh Detox Program!     Episode Highlights [04:47] How Dr Walsh Started Studying Detoxification Dr Walsh was interested in health and fitness from a young age. He eventually ventured into massage therapy and became a fitness professional. He took a postgraduate degree to become a naturopathic physician. After his education, he felt that he had to study more to serve his patients better. His goal is to connect conventional Western medicine and alternative medicine. [09:56] Views on ‘Toxin’ and Detoxification Dr Walsh cites some ridiculous notions surrounding detoxification. In the 80s, it used to be rehabilitation for addiction to alcohol and drugs until everybody started hopping on the ‘detox bandwagon’. Xenobiotic or commonly known as ‘toxins’ is something foreign to the body that can cause damage in excess. When water leaves the body in any form, water-soluble toxins leave as well. Meanwhile, the body still needs to turn fat-soluble toxins into water-soluble toxins to get rid of it. Our bodies are naturally built to detoxify pollutants through biotransformation. Listen to the full episode for an in-depth discussion on toxins! [16:11] Categories of Pollutants First is heavy metals. This category includes aluminium, arsenic and mercury, among others. Second is persistent organic pollutants, which include phenol, dioxins and pesticides.  The last category is volatile organic chemicals (VOCs) that are usually inhaled.  In essence, pollutants are everywhere. [17:41] Everyone Is Exposed While everyone is exposed to pollutants, the levels may vary due to location and lifestyle. For instance, Dr Walsh believes that athletes may be less toxic due to sweating during exercise. Listen to the full episode to know the body’s pathways for getting rid of environmental pollutants. [23:04] The Difficulty in Assessment Criteria There are a lot of variables and testing methods to consider in assessing toxin exposure. The fat biopsy is regarded as the gold standard test. However, because different body areas store different amounts of fat, there’s no consistency in the body. Taking these tests can guide you to make different lifestyle changes. However, keep in mind that they cannot determine your body’s toxicity level quantitatively by an absolute number. Listen to the full episode to learn more about the complexity of detox questionnaires.  [30:00] Nature of Pollutants Toxin gets stored in a cell or area with low concentration. This is called the concentration gradient.  If there’s more toxin in the blood and less in the cell, it will get stored in the cell. When fasting, you go into a catabolic state. Studies have shown that xenobiotics in the blood increase in this state.  All detoxes are cellular detox. [33:43] The Phases of Detoxification Phase 0 starts with the fat-soluble toxin entering the cell. Phase 1 is the reaction with the addition of a hydroxyl group. Phase 2 concerns conjugation reaction of adding methylation, sulphation and the like.  Finally, phase 3 is when excretion happens.   Tune in to the full episode for Dr Walsh’s analogies and a detailed explanation of each phase! [42:06] The Three Pillars of Detoxification The keys of detoxification are mobilisation, biotransformation and excretion.  Mobilisation is getting pollutants out of storage. Biotransformation encompasses phases 1 to 3.  Excretion should take the toxin out of your body. [47:34] Effects of Dieting Dr Walsh recommends doing a weight loss program in conjunction with a detoxification program. During periods of weight loss or catabolism, xenobiotic levels increase. The problem with rapid weight loss and yo-yo dieting is the redistribution of toxins in the body without excretion. [53:22] Nutrients and Detoxification Being nutrient sufficient is enough to support phase 1. Phase 2 is driven by amino acids. Phase 3 can be blocked by three inhibitors: milk thistle, curcumin and green tea. However, note that the effects of these three inhibitors are based on its dosage and the context. One protocol will not work for everyone; you have to look at the totality. Listen to the full episode for more details about nutrients and botanicals!  [1:05:00] The Nature of Symptoms For Dr Walsh, thyroid dysfunction may be secondary to another issue. Once symptoms show, you should consider if it is a protective reaction. [1:11:32] Advice for Detoxification Dr Walsh shares details about his detox course, including a practitioner-based programme and The Walsh Detox for the general public.  Your blood chemistry is essential in determining your detoxification programme.   7 Powerful Quotes from This Episode ‘I’ll be the first to tell you that science will never prove some of the things in life that are the most important things — relationships and love and how we try to study how the brain works — and I don’t think we have any idea’. ‘This is part of my problem with the industry is we can’t even decide on what a toxin is. . . So what I would suggest, the one that people are most talking about, that’s why I think environmental pollutant or environmental toxins make more sense because usually what people are talking about are things that are outside of us that get inside of us and cause damage of some kind’. ‘They will test their blood, their urine and their sweat for a specific xenobiotic or environmental pollutant. And they will find in many cases, it’s not in the blood, it’s not in the urine, but it is in the sweat’. ‘Everybody’s toxic. Everybody needs to detoxify. . . It’s not necessarily exposure; it’s we all have some degree of storage. The question is, when somebody is not feeling optimal, is it because of that or not? And so you can’t run around screaming everybody’s toxic because I don’t know that they are’. ‘And so it’s [toxins are] concentration gradient-based, which also means so that’s how it gets stored. If there’s more in the blood and less in the cell, then it will tend to go into the cell. And that’s when it gets stored’. ‘There’s some ridiculous stories out there that will say, ‘The body won’t release toxins if it’s not healthy enough, and it doesn’t think it can deal with them’. That’s not true’. ‘I’m against protocols; because one protocol will be brilliant for one and harmful for another same protocol’.   About Dr Walsh Dr Bryan Walsh has been studying human physiology and nutrition for over 25 years and has been educating others in health for 20 of those years. When he isn’t teaching, he spends his time poring over the latest research and synthesising his findings into practical information for health practitioners to use with their clients. He has given lectures to members of the health care industry around the world and consistently receives positive feedback in his seminars and courses. His online educational platform, Metabolic Fitness, helps health professionals to stop guessing and start knowing what to do with their patients. Dr Walsh is best known for challenging traditional dogma in health and nutrition concepts, such as questioning current models of adrenal fatigue, glucose regulation, detoxification, mitochondrial dysfunction and more. As such, he has been sought out to consult with multiple companies, academic institutions and wellness organisations. Dr Walsh is also a board-certified Naturopathic Doctor and has been seeing patients throughout the U.S. for over a decade. Outside of his professional endeavors, you can find him spending time and having incredible amounts of fun with his wife, Dr Julie Walsh, and five children.   Enjoyed This Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so they can learn more about the science behind detoxification. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript Of The Podcast! Welcome to Pushing the Limits, the show that helps you reach your full potential with your host Lisa Tamati, brought to you by lisatamati.com. Lisa Tamati: Hi, everyone, and welcome back to Pushing the Limits. And today I have just a super superstar for you, Dr. Brian Walsh, who's sitting in Maryland in the USA. Dr. Walsh is someone that I've followed for a long time and learned from. He is one of the great teachers in biochemistry and physiology. And today we are discussing detoxing very relevant to this time of the year. And this is all really next level information. Because it's all about detoxing, like what are the actual physiological steps of a detox process? And what is the latest and current research. This is not something you read in a two page magazine article detox type of thing. But this is the real deal with someone who really, really knows his stuff.  Now, Dr. Brian Walsh has been studying human physiology and nutrition for many, many years. And he spends his time sort of poring over the latest research and synthesizing all of that information for the layperson to be able to understand. And he also lectures at Western States University in biochemistry. And as a healthcare professional, he's a doctor of naturopathic medicine. And he has an online educational platform called metabolicfitnesspro.com, where he helps other health professionals like myself, and many, many others, as well as lay people with his programmes and courses. And we're going to be discussing today, as I said, detoxing, how to do it properly, when not to do it, what to be aware of if you are doing it. And he's you know—Dr. Walsh is someone who's really known for challenging traditional dogma in health. And he actually goes and does all the research, does deep deep dives into all of the clinical studies into PubMed, and then brings us the latest and information. So he's really someone that you want to have on your radar, someone that you want to know, if you want the latest and greatest in information.  I hope you're enjoying your Christmas time, by the time this episode comes out, Christmas will have been passed. And we're into the new year. And hopefully the world is on a new trajectory and that 2021 is going to be a hell of a lot better. And what better way to start the year than with a discussion around detoxing and getting your body in good shape for the year ahead. So without further ado, I'll be heading over to Dr. Brian Walsh.  And just a reminder too. If you want help with any health issues, if you are dealing with anything, please reach out to us lisa@lisatamati.com. You can reach me on email. If you're wanting information about our online run training programmes at Running Hot Coaching, want personalized run training, please do reach out to us as well. We just launched a new package that will be coming out in the next few weeks. So keep an eye out for that where we're going to be offering video analysis, as well as fully customized programmes and a session with me—all included in there in a package price. It's really really a no brainer. So if you want to find out about that, please reach out to us at lisa@lisatamati.com.  Of course our epigenetics programme is still open, if anyone wants to know and understand the genes—understanding everything to do with your genes, eliminating the trial and error for your body, understanding what foods to eat exactly, which areas you're predisposed to have problems with, how your brain functions, what your dominant hormones are all of this sort of great information. Please also reach out to us and we can put you in the right direction. We've done a few webinars already on our epigenetics programme. And in the coming weeks, we're also going to be having Dr. Ken McDonald on from PH-316, who's going to be going a little bit more deeper into this. So I hope you enjoy the session though for now with Dr. Brian Walsh. And we'll head over to him right now. Lisa Tamati: Well, hi everyone and welcome back to the Pushing The Limits. This week, I am super excited. I'm jumping out of my skin. I have a man who I really, really admire. I love his work. He's got an incredible brain. Just absolutely mind-mind conversation we were going to have today. I have Dr. Bryan Walsh with me. Welcome to the show, Dr. Walsh. Dr. Bryan Walsh: Thank you so much for being here. Lisa: It's a really, really an honour to have you on. Dr. Walsh, you’re still in Maryland, in the States? Can you give us a bit of a background just on who you are and sort of a quick synopsis and your background as a physician, etc.?  Dr. Bryan: Well, yes, I guess I should say it all started out, I was very much into health and fitness, even at a young age, quite honestly. I became a fitness professional—that’s how I started. And then I did a lot of orthopaedic work, so that led me to massage therapy. So I did massage and I was a fitness professional. And the problem is my clients would ask me health advice. And here in the States—I'm a law-abiding citizen—I could have talked to them about nutrition and supplements, but I wasn't allowed to with those things that I did.  So then I looked—and there's something in the States, it's a naturopathic physician, naturopathic doctor. I know you guys have naturopathic there. They're a little bit different. It's a four year postgraduate degree. So you go to four years of university, and the traditional four years. And then you have your doctorate. That sounded really good to me because I was already into alternative health. I was devouring books, on health, on herbs, on homeopathy, everything in the health. And that was the umbrella for all these things that I was interested. And I thought, wow, that's great, perfect.  So I went through four years of that. Spent way too much money. But it's also where I met my wife. So that is money rally well spent. Yes. Although we both went to school there. So we doubled our debt, essentially, by marrying each other. But what we quickly realized is that it didn't really prepare us to do what we wanted to do. And it didn't take long. I was sitting in front of patients, and I honestly—I didn't think I know what I was doing. I didn't feel qualified. I spent all that money over the four years of school with great classes, but it sounded like all these great topics but...  And so that started me—and this is all to tell you this story— where I realized I had to teach myself everything, that I had to reteach myself physiology. I know we're going to talk about detox today. But how I stumbled upon that what I'll call is the truth about detox. And so where I am today is I believe in old medicine, I believe in the body heals itself. But Western science and Western medicine is incredible. I mean, we owe much of what we know about the human body, in terms of mechanisms and pathways and how herbs even work in the first place, to Western science.  So what I tried to do is bridge the best of both, is to take the alternative nutritional functional health world, which is great for some things but horrible in others, and combine that with conventional Western medicine, which is great in some things, but horrible in others, and I try to connect the two. So I hope that gives you much of... Lisa: That’s brilliant.  Dr. Bryan: I love science. Lisa: And I love the way you sort of combine the traditional or the alternative with the allopathic sort of model because they do both have good things, and they do both have problems.  Dr. Bryan: Absolutely. And I can tell you, I love science. But I'll be the first to tell you that science will never prove some of the things in life—of the most important things, in relationships, in love, in health. We try to study how the brain works and I don't think we have any idea. We try to—we're doing genetic testing now, I don’t think… We talked about the microbiome, I don't think we know much of anything when it comes to these things. So, science is fascinating. It's so fun. It can occupy you for hours upon hours upon hours of reading and the rabbit hole of PubMed, but I don't think it will ever offer some of the answers.  So that's kind of where I live is that we live in this expansive universe full of all sorts of possibilities. But here on Earth, science really helps us a lot understand certain things, but it doesn't contain all the answers. Lisa: It's a very humble approach. And I think a really good place to start because we know a lot, we don't know a lot more. But we have to sort of work with what we've got and the best knowledge. And this is something that I've really enjoyed out of like, I think I've devoured everything I could find on the internet of yours. And I must say sometimes, I'm like my brain is spinning, trying to keep up and it's fantastic. And I was talking to a colleague who's also really into you and he's got a master's in physiology and he said, ‘Well, I struggled, too, so don't feel bad’. But you do have a way of putting things into analogies that I have just found absolutely fascinating. And today we're going to go into detoxing. And there is an analogy in this story that I've heard you speak of a couple of times that really went, ‘Aha, I get it now’. So definitely want to delve into that analogy. But so just to start with, with detoxing. Let's look at what detoxing in the public realm—if you like—in the popular—the magazines. People talk about detoxing a lot. And I think that we don't understand what detoxing is. So let's start there. What is a proper detox? Dr. Bryan: So what you just described, that's the problem. It's a mess. I was just in the checkout line at the grocery store, two days ago. I even took a picture of my phone to send my wife and it was like, ‘A faster way to do a liver detox’, and it was some medical doctor. I thought, ‘I'm not even going to open that magazine. It's going to be garbage’.  You’re right. People say, ‘drink a little bit of lemon juice in the morning, and that's a great way to detoxify the body’. And then I was in the airport one day, and I saw these foot pads that you put on your feet to help pull toxins out of your feet. And then there's the foot pads, and there's colonics. And there's all these different things, and that's why conventional medicine doesn't believe any of this because you have these people saying, ‘Well, when you skin brush, then you're detoxifying yourself’, maybe, maybe not. But no wonder they think that we're a bunch of quacks because if you stand back and look at all that nonsense, it does look like quackery.  In the 80s, detox, the only detox there—unless you were like a hippie—in the 80s, was like a celebrity going through some kind of rehab for some kind of addiction, alcohol or drug addiction, then they would go through some kind of rehabilitation, so that was a detox. That was the only detox there was. And then all of a sudden everybody started getting on this detox bandwagon. And the thought is that we are bombarded with—we’re basically these toxic waste cesspools of disgusting that’s inside of our bodies, and the only way to get rid of it is to do these to detoxify.  Now, there's some truth to that, some truth. But our body is designed to—a better way to say detoxification is biotransformation, first of all. So there are two different types of we'll call—I don't even like the word toxins, quite honestly. You can call them xenobiotics, starting with it with an ‘x’. Xenobiotic means it's something foreign to the body. You can also call them environmental pollutants, environmental toxins, whatever you’re going to call it. Some people say synthetic, but that's not true because Mercury is toxic to the body in high amounts. So, for lack of better terms, we can call them toxins, xenobiotics or whatever. But they're things that are foreign to the body that in excess can cause damage.  There's essentially, for simplicity sake, two forms, there's water soluble, and there's fat soluble. Water soluble, by and large, I don't think we have to deal with too much, because our body is really good at getting rid of it. Our body is so much water already, we don't have to do anything to it. If we have access to something that's toxic, and it's water soluble, our body's pretty good at getting rid of it.  And when you look at the ways of getting rid of something, it's anywhere that water goes. So sweating, obviously, urinating, it's quite a bit of quite a water. In faeces, there's a small amount of water that gets expelled there. And even technically—and people have measured this but in tears or saliva, you can get rid of toxins too. So anything where water is leaving the body, then water soluble toxins are leaving as well. And I personally believe that those aren't much of a concern to us because our body... It's kind of like if you take a whole bunch of B vitamins. Technically, those can be toxic in high amounts but they're water soluble in your urine turns glow in the dark yellow if you take too much of that because your body is getting rid of it. Same with vitamin C or any of the water-soluble vitamins.  Interestingly—and I hadn't thought of this as a way of describing this, but the vitamins that they say to be careful with are the fat-soluble ones like vitamin A, D, and K because they can accumulate and then those are the toxic ‘vitamins’ if you look at conventional medicine. So fat soluble toxins, those ones are more of concern because they can get stored and the body has to work a little bit harder in order to get rid of them. In other words, you have to take something that's fat soluble, turn it into something that's water soluble, and then the body can get rid of it and all those pathways that we talked about.  So the body has built in detoxification or bio transformation processes—everybody says it's the liver but it's not. The enzymes and steps necessary for this are found in a number of tissues and in quite a bit. So, things that have exposure to the outside world, the skin has this disability, the liver does, the kidneys do, the lungs incidentally do, the testes in a guy does when we consider the location as exposure to the outside world more so than some of the internal organs. And we can go into the details of this but basically this fat-soluble toxin that can cause damage to the body gets metabolized or bio transformed, turned into a water-soluble toxin, if you will, a compound. And then is easily excretable in—again sweat, tears, saliva, urine, or a little bit in faeces. So yes, that's kind of a nutshell version of it, I think. Lisa: Okay, so. So let's look quickly at what are toxins and what sort of a fix they have in the body? So we're talking things like your heavy metals, your Mercury's that you mentioned, your pesticides, your preservatives in your food, there's chemicals that were exposed to. Dr. Bryan: So that's honestly—this is part of my problem with the industry is we can't even decide on what a toxin is because the toxin if you think about it, a toxin is something that could cause damage to the body. Right? So then you could say a reactive oxygen species or oxidative stress is a toxin, technically. Hormones, if you have too much of a hormone, can that cause damage to the body? It absolutely can. So, then all of a sudden is a hormone a toxin.  And so that's where we start to run into problems, is that we just throw out these terms like toxins. Well, what is that something that? Something that damages the body? Well, a hammer, if you hit me on the head is going to damage my body. Is that a toxin? Let's say, oh, it's internally. All right, well, so how about lipid polysaccharides from a gram-negative bacteria? That's an infection. Is that a toxin? Yes, it is. So that's our—aflatoxin, you have mould in your house. And so, it ends up being this really broad term that people have a hard time describing.  Now, so what I would suggest. The one that people are most talking about, that's why I think environmental pollutant, or environmental toxins, make more sense because usually what people are talking about are things that are outside of us that get inside of us and cause damage of some kind. And there's three, let's just say major categories of that there's actually more. One would be things off the periodic table. So that's the heavy metals, by and large, so aluminium, arsenic, mercury, all those types. Even copper, copper is toxic. Iron is toxic.  Then there's—loosely the category that you can call persistent organic pollutants. And that's all the ones that get all the press, like this phenol and phthalates and dioxins and all those different things, pesticides. And then there's the ones that you could call them volatile organic chemicals, or VOCs, those ones are usually inhaled. So, you paint, you’re repainting your house, or your apartment and the smell that you get, or cosmetics or toiletries, cleaning products. If you buy a brand new piece of furniture and that off gassing, carpets. So those are the— mean, there's more, but those are the three major categories that I consider so... But then you consider where those come from, in the food that we eat, in the water that we drink, in the air that we breathe, it literally is everywhere. Lisa: Yes. So we are toxic.  Dr. Bryan: Well, yes. We are. And I long time ago would say that we're all toxic, and everybody needs to detoxify. And I've tempered that a little bit because like for example, there's one published paper that suggests—well, okay, I should take a step back—everybody is exposed, everybody is exposed, period, end of story. To prove otherwise, I would need to see that proof.  Now, it's going to be different considerably, however, based on your location, where you live. In New Zealand versus America. Here in America, I'm in Maryland, but that's going to be a lot different. I'm near farmland. So, we might have exposure to pesticides, but not so much some of the other things that might have been more of an urban area. In New Zealand there’s other different things.  So also that depends on one's lifestyle. So me and my family largely eat organic food as much as possible. We use—I don't say green cleaning products, but we use better cleaning products than just the standard things. And so we probably have less exposure than somebody following a standard diet using standard toiletries, cosmetics, yes, and all those different things too. So, we all have exposure. Yes, that's it. I think I believe that's irrefutable.  Is it stored in all of us? And I'm going to go ahead and say yes, but to different degrees. For example, you said you're a professional athlete. You have sweat a lot more than the majority of people. There's also some really interesting evidence showing that exercise actually upregulates certain detoxification or bio transformation enzymes. So you might actually be more adapted to that. Lisa: Another good reason to do it.  Dr. Bryan: Absolutely. You know what? It’s so funny, like, you know you're supposed to, but then you just see more and more reasons. And it does, it absolutely has been shown in papers, to upregulate certain detoxification enzymes. In addition to the fact that you're sweating more so than somebody who's sedentary. So, I haven't seen any literature on this, but I believe that most athletes are probably less toxic than the general public.  Lisa:  The sweat is also a preferred pathway for some of the toxins to leave the body.  Dr. Bryan: If used badly, yes. The skin has been called the third kidney before, which is kind of a cute thing to call it. I mean, is it or is it not? I mean, it's not like you're urinating out of your skin. So that should be gross. Next time you sweat, think of that. No, but it's a major excretory organ.  And I will add this, there's some really interesting, really interesting scientific papers — small, unfortunately, not a lot of money in this industry to test this stuff. But they will take a group of people, and they will test their blood, their urine, and their sweat for a specific xenobiotic or environmental pollutant. And they will find in many cases, it's not in the blood, it's not in the urine, but it is in the sweat. Lisa: Exactly. Yes. The preferred pathway, yes.  Dr. Bryan: That's an indication that a) it's being stored and b)... Yes, whether it's a preferred pathway or not, what that means to me is that it's probably stored in the tissues. Because you think about the blood, the blood is circulatory and it's bringing things around. The kidneys are filtering the blood. So, if it's not in the blood, that makes sense, it's not in the urine. What that means is it's stored. It's if it's not coming out in the urine, that means it's not in the blood, that means it's stored in tissues. And so, it isn’t going out. So whether it's preferred by the body or not, I don't know. But that just means that it's right there, right close to the tissues.  Lisa: Yes, In coming out.  Dr. Bryan: Right close to the periphery, and it's coming out via the interstitial fluid and stuff surrounding itself. But here's another thing to consider, too, when you talked about the demographic of the population that listens to this is, while most athletes probably have less—I mean, when it gets a broad state, you can't say yes, might have less because of exercising, because of firing. But are they exposed to something more than might somebody else be?  So for example, if they're drinking out of plastic bottles that have been warmed up sitting in the sun all day, like might they have more excess pollutants...  Lisa: More BPA... Dr. Bryan: ….these people are outside exercising in polluted area.  Lisa: Exhaust fumes.  Dr. Bryan: Exhaust fumes. I mean, you think about your respiratory rate when you're exercising, your respiratory rate is quite a bit higher than somebody who's sedentary. So then all of a sudden all those... Lisa: And oxidative stress Dr. Bryan: Yes, absolutely. So there's a lot of factors to consider for sure. Lisa: Yes. So we've looked at—these are the broad categories of toxins. And yes, we're probably all toxic, and we need to be doing or thinking about doing a detox—I don't want to say protocol—but to thinking about it constantly detoxing. And you touched on the couple of studies here where they measure the sweat, they measure the urine, and so on, and they got different measurements for different things. That's one of the problems, isn’t it?  The assessment criteria. Because obviously, if we're doing a detox, we want to be able to assess, are we actually getting—and when you dived into the literature of assessments in defining out which is the best—how do I see if I'm toxic? What did you find in the literature around all the assessments? Dr. Bryan: So in the functional medicine world, there's no shortage of—well just tests in general and really attractive, good looking tests that when you look at them, you want to run them. Like, ‘Well, I would like to run this on myself. forget my patients or clients I want to run these tests’. The scientific validity on a lot of these tests is not there at all, despite what people might say or think.  Yes, so I'm not opposed to testing for toxins. But there's so many variables to consider, and the practitioners that are running them, I don't think are considering these. So I think a lot of people are using them—they're wasting their money on them because they're not considering all these variables. So, for example, the first question to ask is, ‘what tissue do you test’? Do you test the blood? Do you test the urine? There are hair tests. Technically, in the literature, they test fingernails for toxin exposure. There's so many different ways of testing–fat biopsy, you want to take a needle into your fats, take some of it out and test that.  And actually—I'll say since I said that—fat biopsies are considered to be the gold standard for internal toxic burden, and that would make sense if that's where they're stored. But the problem is, according to research—and this is done on humans, mind you—that different fat depots in the body store differing amounts of things. So, you might inject it into your, your, your butt fat, and find a whole bunch of one thing, and then you do it to your abdominal fat, and you come up with a higher amount of something else. So, if that's the gold standard, and you can't even have any consistency in the human body, then that's not going to be accurate, either. And if that's the gold standard, then that's not accurate, then none of them are going to be accurate. So, the short version is there are some—I guess I'll say, like validated as much as you can questionnaire—subjective questionnaires that one can take and get an idea of how toxic they may or may not be. Now, it's not quantitative. It's quantitative in the sense that you get a numerical value for the score. But it's not quantitative, in terms of like, This is how toxic I am. I am 80% toxic out of 100’. It's just a subjective questionnaire. But if somebody were to take a questionnaire like this, and scores high... Lisa: We've got a problem Dr. Bryan: ...and then does a few detox rounds or whatever, for a few months, six months, nine months, whatever it is, and then does it again and their scores are lower, that's good enough to suggest that they're doing better. And what's interesting about some of these questionnaires, is they not only asks things like, ‘do you live around industry? Do you have exposure to petrol or to gas’? But your symptoms as well. And so it takes all of these considerations, like, ‘Yes, I live and work around a lot of chemicals, but I don't have symptoms’ versus somebody that has a whole bunch of symptoms that are associated with toxic exposure, but they don't live around them. So, it does—they really are comprehensive. Lisa: I’d like to get a couple of the links to those if we could possibly see.  Dr. Bryan: And listen, it's free. That's the very nice thing. You don't have to spend 300 US dollars on some blood tests that may or not be accurate. And what people are really interested in is, ‘how toxic are you’? Well, if my surroundings and my symptoms suggest that I am, based on these questionnaires, that's good enough for me. And as opposed to test, if you do it six months later, and it's approved, then I think you're probably doing a little bit better. Lisa: It's a little bit like your cell blueprint, which I found brilliant, by the way, and if anyone wants to check out that we can put the links. That questionnaire that you've developed there gives the practitioner the direction to go and we don't have a specific, ‘This isn’t definitely but hey, you might want to check your thyroid. Hey, you might want to go and check if you've got a parasitic infection, or whatever the case may be’. And I find that a brilliant system really. Dr. Bryan: But isn't that what a practitioner wants to do? I mean, the patients come in, and they want to know, ‘Well, where should I head first’? And detox questionnaire—and again, so everybody is exposed period, everybody's exposed. Everybody has some degree of storage. Now, I don't know how much. They might be really toxic. They might be cut. Who knows? But everybody has some degree of storage. The question is, then, is, ‘Are your symptoms—because of xenobiotic exposure—are in storage or not’?  And that's where these questionnaires come in handy. If you take a questionnaire like that, and I mean, because there's people out there, believe me, there's plenty of them. Everybody's toxic, everybody needs to detoxify. There's an old book called Detoxify or Die. I mean, if that's not scary enough. It’s a good book, but I mean, it's not necessary. So we all have exposure, it's we all have some degree of storage. The question is, when somebody is not feeling optimal, Is it because of that or not?  And so you can't run around screaming ‘everybody's toxic’ because I don't know that they are. But if you score high on one of those questionnaires, then that's the direction you'd want to look into. And if you score low, I mean, listen, people will still argue it, ‘Well. We're still all toxic’. I wouldn't go down that road. It wouldn't be the first thing that I’ll thought about.  Lisa: It’s not your first protocol Dr. Bryan: Oh, no. The questionnaires... Absolutely.  Lisa: Yes, I think that's what I do as a practitioner too, as epigenetics practitioner, and a health coach, is go for the low hanging fruit first. Because we can go in 100 directions and I can confuse the hell out of my clients and they can be like, ‘what the hell am I doing’? But if you are going for the ones late tackle, best piece of the puzzle, and then work your way up the food chain is so to speak—and actually find out which ones are the most important.  Dr. Walsh, I mean—we're going to put the links in the show notes—you've developed your own detox system if you like, which I'm really keen to share with everybody and for them to check out. But let's go in now to the actual four phases of detox: zero, one, two, and three, and you have four, isn't it? In most people—or some people are at least aware of phase one and two detox within the cell. And when I first heard you talk about this, I was like, ‘Wow, okay, there’s a zero and there’s a three’. Okay, can you explain in a nutshell, what the body does when it gets a toxin? It's in the blood for some reason, it's gotten there. What actually happens next in these detox phases?  Dr. Bryan: All right, well just to make it really comprehensive. I'll tell you, when you said when it gets into the blood, what happens? So when it gets in the blood, it can be detoxified, biotransformed, and excreted. But the best way to describe this is, so if it's in the bloodstream, wish I have something to sort of model this with but so like, so the bloodstream, and then you have you have a cell next to the bloodstream. Now there's—in physiology, there's what's called a concentration gradient. And these membranes… And so let's say we have the bloodstream in a tube—I really wish I had some kind of props here. I’m looking around. I have—my son has a Santa hat, razor blade, I don't know, I don't have much around here. Anyhow, so you have the bloodstream and here you have a cell. Now, if there's more in the blood of this, whatever it is, and less in the cell, it will tend to go into the cell. And it's usually fat cells, because it's fat soluble, it will tend to go into adipocytes or fat cells.  And so it's concentration gradient based, which also means—so that's how it gets stored. If there's more in the blood and less in the cell, then it will tend to go into the cell. And that's when it gets stored. There's a really, really cool paper that discusses how adipocytes used to be considered to be just an energy repository, but then turned out to be an organ because they excrete over a hundred different things. But one of the additional roles they suggest is that it is this. It is to store toxins or xenobiotics, or things that could otherwise damage the body—they're fat soluble, which would make sense.  Now, if that's a concentration grid. Now let's say we're in a fasted state, and we haven't eaten anything and or exposure. If there's less in the blood, and more in the fat cell, then it will leak out. And it's based on a concentration grade, it's based on homeostasis. There’s some ridiculous stories out there that will say, ‘the body won't release toxins if it's not healthy enough, and it doesn't think it can deal with them’. That's not true. What I've seen is that it leaks out from a homeostasis for a concentration gradient if there's less than the blood and more in the cell. So we are constantly leaking this stuff into our blood, if it's stored. Now this gets amplified. And I talked about this in the course, during lipolysis. So in a fasted state, in a catabolic state—not even not even losing fat, but just in a catabolic state which we go through at night. So if you stop eating at 8pm and you're sleeping, you're in a catabolic state, for example.  If you're in a state of fasting, or lipolysis, then that's going to speed up mobilization. So now—and all the studies I've ever seen on mammals or humans show this. In a hypocaloric state, or fasted state levels of xenobiotics go up in your blood. And I'll say it again because that's huge. In a fasted state or a hypocaloric state, like dieting, then if there's stored xenobiotics, it will dump into the bloodstream, and those levels go up. And they always show that every single time because that's a state of lipolysis as a catabolic state.  So then now we're back in the blood. So whether it's at an immediate exposure, or it was just released, the rest of the story remains the same. So then what happens? And I should just say too, I mean, I get frustrated with pieces of the industry. There's some people that will say, ‘Well, it's not a detox if it's not a cellular detox. If you don't detox yourself, then you're not’...  This happens at the cellular level, as all detoxes is a cellular detox. So what I'm about to describe next is the cell.  So let's say we have that xenobiotic it's floating around in the blood, we either just had exposure, or it came out of a fat cell. So in one of the cells, like the liver, the kidneys, the skin that we said has the ability to do this, there are four phases of detox. So if you picture just a cube, all I have is a mug, but I have a cube. Then there needs to be a door coming in and a door coming out, that's going to be two of the phases. And then once it's inside, there's two other things that are going to happen to this.  So here's our cell, we have a fat soluble compound—I'm looking around for some—we have a fat soluble. Lisa: It’s like your room, isn’t it?  Dr. Bryan: Well, that's the way that's why I've said it before. So yes, I mean, you could just use it as that. So in the room that you're in, or even a car quite honestly would work. So if you're in a room, you’re the cell, that's the cell, let's just say it's a liver cell. So when the door opens, that's phase zero detoxification. That's an actual phase. It was recently discovered in the early 2000s. Most people haven't heard of it but it's legitimate, things can block this. So if that happens, then that's a problem, clearly. So phase zero is when the door opens and the fat soluble compound comes into your room, into where you were.  Lisa: Into the cell. Dr. Bryan: Into the cell, right. And once it's there, it has to go through two phases of detox. And you said I use analogies—quite honestly, I kind of make them up on the fly. Lisa: That’s awesome.  Dr. Bryan: Well, I mean, I don't even know what I said. But I think in the past, what I've said...  Lisa: It was an angry dude—a person—we make the person a toxin who’s just entered the room.  Dr. Bryan: Oh yes. All right. I make him up on the fly until now. So all right, yes, yes, I can go with that one. So you have the room, the room’s a cell, a person is on the outside of your room, they come in, that's phase zero. And that's all it is in the cell is just a little protein tube. So the person comes in, they're fat soluble person. And they're angry. So what did we say? Lisa: You stick a sticky note on the head.  Dr. Bryan: Is that what I said?  Lisa: Yes. Dr. Bryan: Let’s make them more mad. That's right. Okay. See, listen, I'm telling you make it up right then and there. All right, you're right. You're right. You're right.  So the person comes in, and they will damage your room. But to incite them and make them even more angry. Yes, that’s right. You put a little sticky note, like what was your little yellow sticky notes, and you put them on the forehead, that makes them really mad. Even more mad than they were in the first place. And now you can calm them down. But if you don't, they're going to start flipping over your desk, and just totally, totally worse than they were in the first place. They were angry when they came in. But now they're even angrier. But you can hand them a $100 bill. And they're going to say, ‘All right, I was angry but now I'm not anymore. I'm good. You just handed me something. So I'll go ahead and quietly leave the room now’. And then when they walk out another door of the room, then that would be phase three.  So to put that—and thanks for reminding me of my analogy. But biochemically speaking, so you have a fat soluble compound, like a phthalate or a dioxin, or whatever it might be. So it literally has to get in the cell in the first place. Now, researchers used to think it was a fat-soluble membrane, fat soluble compound, and would just go right in. And that's not the case. It needs a channel in order to bring it in. That's phase zero, literally it is phase zero. And why is it phase zero? It was because they discovered this after they already knew about phase one and phase two, but they didn't have any numbers before then and they didn't even know it existed. So in the early 2000s, they said, ‘Well, we'll name it phase zero’. So that's the entry of a fat-soluble toxin, let's just say into hepatocyte, liver cell.  Phase one: reactions. There's a few different kinds. They’re like oxidation reduction type of thing, hydrolysis. Basically, what happens is that when in the sticky note what it had on it, it had an OH, hydroxyl group. So you put a hydroxyl group on this person, or you exposed a hydroxyl group that was already present but wasn't fully exposed. Now the problem is after we put that sticky note on their forehead, and they got even more angry is that toxin beforehand could cause damage to the body. It could cause oxidative stress or DNA damage or endocrine disruption or citric acid cycle, mitochondria, whatever was unique to that particular toxin. But now that it has OH exposed or added on to it via phase one, it is water soluble, first of all. It's water soluble, which is cool. Now your body can get rid of it. However, it's considered to be an intermediate metabolite, and is considered to be more damaging than the original xenobiotic.  Now, it's not true of every single time. And that's the thing, there are too many of these compounds to make blanket statements. People will say it's more toxic. No, it's not. It may be more damaging—I'm not going to say more toxic. It may cause more damage now that it's water soluble with this hydroxyl group exposed. But then phase two, when you handle this angry—now really angry person, a $100 bill US dollars. I wouldn't let you guys—you hand them a $100 bill or a bunch of money, they're not angry anymore. They're still water-soluble, they were but now phase two is considered a conjugation reaction and conjugation is adding something to it.  And so people that are familiar with phase two are familiar with things like methylation or sulphation, or glucuronidation, or amino acid conjugation, any of those things but what gets handed is this: so sulfation, you hand them a sulphur group, methylation, it hands them a methyl group, amino acid conjugation, it's usually glycine, glycine will go, glutathione conjugations glutathione, so acetylation and acetyl groups. So the xenobiotic gets handed to it, what's unique to that particular one, if that makes sense. You can make it really easy to talk about hormones like sex hormones, go through the same pathway—the testosterone, the estrogen. They go through the same pathway. Lisa: They do, and neurotransmitters as well. Dr. Bryan: Yes, cytokines, immunoglobulin, antibodies Lisa: And dopamine and all of that?  Dr. Bryan: Yes, by and large, by and large, yes. So then it gets phased two. It gets something handed to. Let's say, it gets a sulphur group and went through sulfation. Now, it's no longer damaging to the body. Now it's relatively benign. It was damaging as its original compound. It came in through phase zero, it was made potentially more damaging by exposing or adding on a hydroxyl group, depending on what the compound was, and depending on the biochemical pathway went through, but then when it gets conjugated, it's still water soluble, but now it's not damaging. And can there—if phase three, that second door is open, can go out of the door.  Now remember, so all that does—and this is a really important part—there's a lot of misunderstandings of what phase three is. Phase three is merely a tube, leaving that cell, which means that, this thing now, in terms of physiology goes into the interstitial fluid surrounding cells.  Lisa: And it’s water-soluble at this point.  Dr. Bryan: It’s water-soluble in the interstitial fluid, and can be excreted in sweat. It can go through the lymphatic system, which is going to pick up some of the junk of the interstitial fluid but that just dumps itself in the bloodstream anyways, which that means it'll probably end up in the kidneys and get excreted out in urine. But a lot of this can end up going in—since it happens in the liver, the liver will get rid of its these...  Lisa: ...products  Dr. Bryan: ...through bile because the route from the liver to the intestines is via bile.  Lisa: Why is this not phase four, then? Like phase three should be the thing leaving the cell. Dr. Bryan: It is, that's phase three. Lisa: Phase four should be like actually the excretion method. Dr. Bryan: You can call it phase—or at some point, you're going to have too many phases. You’ll be like, the 10 phases of detox. It will just confuse everybody. But after it leaves the cell, the most critical piece is excretion. And I mean, we're not talking about this part yet but I'll just say, the three pieces, there's four phases to detox. But the three things that must happen for somebody to actually detoxify, and I say must with a capital MUST, is one is they have to be mobilized. You have to get them out of the storage in first place. Two is you have to go through biotransformation, which is the phase zero, one, two, and three. The third part is they have to be excluded. If they're not excreted—and this is a really important part—if it's not excreted, it can go into another cell. That conjugation reaction that can get undone, there are enzymes that will undo that conjugation. So you handed this sulphur... Lisa: You’re backing in the shot again basically. Dr. Bryan: Well, and then it becomes this damaging thing again, and can get stored in another tissue if it doesn't get excreted, which, incidentally, is why I have a major problem with most fasting programmes. Honestly, most weight loss programmes in sedentary people. I mean, if you take a fitness competitor...  Lisa: An athlete’s all right, they're going to sweat it out.  Dr. Bryan: They'll probably be okay. But if you take somebody who has just been storing their whole life, they've never really exercised, they get to be 45 years old. They wear a certain weight during their wedding. Now, they're 45, they don't feel sexy anymore. Maybe it's a good time to do a real weight loss programme, the chances of them flooding their system with these things is tremendous. And if there is not an active role in, especially that's the mobilization, that's the first part.  But to properly detoxify these, and more importantly, excrete these things, then it's just going to go somewhere else. And I will say there's some evidence. It's weak evidence, unfortunately, there's not a lot of research on this, but midlife weight loss might be associated with an increased risk of things like dementia and certain chronic diseases. Lisa: I want to sit on this topic a little bit and dive into, because I had some questions when I started to understand this whole process, it really rang some alarm bells for me. For people who do like yo-yo dieting, they're losing weight, they're gaining it, they're losing weight, they're gaining it. They're actually doing a lot of damage than somebody who's just lost it. Another thing is if you're losing it slowly over time as compared to just dumping it all because you've done a juice fast that someone told you was a fantastic detox. And then you've dumped all this into the system. And this can have impacts years later, like we just mentioned, like dementia, Parkinson's disease, all of these things.  Because I was listening to one of your biochemistry or blood chemistry lectures, I can't remember which one, something to do with cardiovascular system. And you were talking about the triglyceride molecule, or whatever you call it. And how—if the legs are broken off—it’s free fatty acids get into the system and then this can clog up the system, cause insulin resistance, be a contributing factor to diabetes, all of these things. And I was like, ‘Whoa, whoa, whoa, whoa. So, when I'm losing weight, which I think is a good thing for my body, I'm actually also doing some damaging things because I'm releasing these toxins or these free fatty acids or, or things that are actually causing trouble’.  So when we have a detox programme that's in the latest magazine, and even some of the scientific like Dr. Valter Longo’s Fasting Mimicking Diets, which is a great—lot of research gone into it, but it's looking at the mobilization, the autophagy, the mitophagy, all of these good pieces of the puzzle, but it hasn't actually considered the excretion. It does look at the micronutrients required for phase one and two, which is fantastic.  So you've got three pillars here that you're talking about. First is mobilization, of the fats or the toxins into the bloodstream from stored places, like your fat cells. Then we've got phase one and two, where it's processed, the detox—actual detox situation. And for that, we need a whole lot of micronutrients, which I want to touch on briefly like using your selenium and your B vitamins and goodness knows what. If you don't have those—your sulphur groups. If you don't have those, you're going to have trouble. And then we need to look at how do we get this stuff out. So what can we do to support the body to do binders or I don't know what the sweating protocols or saunas or whatever?  I had one question that for me personally, I've got a mum that had a massive aneurysm four years ago, and my listeners know about my story. I've just written a book about her journey back for massive brain damage. Now she's lost 30 something kilos over this last four and a half years, when I have been rehabilitating her. She does not sweat. And she's 79 years old, she's never really sweated. She doesn't do that very well, naturally. And she also now at 79, can't exercise intensively enough to sweat. I can't put her in a sauna because here temperature regulation has gone with her brain function. I have to be really, really careful, then if I make you lose any more weight, don't I? With brain damage... Dr. Bryan: Well, it’s a hard thing to say for sure. I mean, first of all, with all that weight loss already—I don't want to say the damages—you have no idea.  Lisa: Yes, so hopefully it was not a big dump.  Dr. Bryan: Yes, so there are some interesting human studies, looking at slow versus more rapid weight loss and how much xenobiotic levels go up, and how it affects thyroid hormone, and the basal metabolic rate and all these different things to which is their recommendation is to do slower detox, but like I said, I would recommend how about, I mean start a weight loss, I would support doing detoxification pathways while you're doing the weight loss programme so that you can get rid of these things better, and it doesn't cause damage.  Yes, so in terms of yo-yo dieting, again everybody's a little different. I can't say this happens to everyone. It depends on your diet, your lifestyle, where you live, and how much you've accumulated. I mean, some people don't have a whole lot, I would suspect. But yes, so there in fact, there is at least one study that comes to mind using mice and yo-yo dieting. And what basically it showed with them is that during periods of weight loss or catabolism, that their xenobiotic levels would go up. And then when they stopped in the hypocaloric state, they went back into a more of a hyper caloric state, that the xenobiotics that weren't excreted went somewhere else. And when I mean somewhere else, like a different tissue, so it absolutely can go from one tissue. Absolutely. Absolutely.  In fact, I wanted to tell you this. Anecdotally, I just talked to a guy—I don't know about a month ago—who used to work at a water fast detox clinic in Thailand. And he worked there for a really long time. And he's said that their people would fly to Thailand to go to this water fast detox clinic that had no business to do so. They were not healthy, it's more of a novelty. Like, ‘hey, let's go to Thailand and go to the water fast place for two weeks and do a detox, then we'll go back and live our life normally like we did before, eating a bunch of garbage’. And he said, they had no business doing it, but they would come back once or twice a year. And the same people he said would get worse, that I mean, and horrible, like liver problems or teeth were falling out, and just wrecking them. And it was fascinating to hear that story. He didn't know why. Lisa: Yes, and I can guess why. Dr. Bryan: Well, that's what I mean is to actually have real world experience, possibly. There's no proof of this, but to see these people that would do a one week, two weeks supervised water fast and then come live their life and then come back, and their health was worse. And I think if I had to bet I would say that's probably why. And consider, it's just a water fast. So what were they not doing, is they weren't exceeding, they weren't sweating. They didn't take any binders. They weren't doing anything. All they were doing is just water. And so, to me, they were flooding their system in a very—almost completely fasted state except for water, which is essentially fasting. Flooding their system, potentially with xenobiotics, not excreting them all and then reabsorbing them, putting them in different tissues.   Lisa: Re-depositing them in your brain or something. So you could shift the mercury molecule, for example, from your fat cell where it was pretty safe. Put it into your blood and then it get redeposited in your brain and cause real strife.  Dr. Bryan: And he hasn't contacted me yet. I think he will probably be angry. But Dr. Longo you mentioned, I mean, the guy's brilliant. He's brilliant, he’s great.  Lisa: Oh, yes, no doubt. Dr. Bryan: And it's super, super cool what he's doing, that's a huge concern that I have, though: is that you take an average person and you put them on what's essentially like, what 300 to 500 calorie diet for a period of time, and if you don't support the biochemical—so that's mobilization for sure. If you don't support the second part, which is detoxification pathways, and then the third pick is excretion, then you're potentially making them worse longer. And again, who cares about autophagy and mitophagy if you're just redistributing these xenobiotics somewhere? And it’s a huge concern. It's a legitimate one. And I’m not saying what he's done is bad, I just think it's a piece that is missing.  Lisa: A discussion needs to be had around this. Dr. Bryan: Yes, well, and that's true of... So, take the Gwyneth Paltrow juice test. It's the same thing. You're not binding or excreting anything. You're hypocaloric, yes. Are you improving detoxification? Well, not if you have things like celery and carrots because those might actually inhibit as it turns out. So you're not detoxing. So you're mobilizing, not detoxifying and not excreting—that's bad news, I think, long term. Lisa: Well, let's look—talk about a couple other things that are in the phase one and two, in phase three, actually, more specifically. Some of the compounds that we consider great compounds for a lot of things, like you mentioned celery and carrots. I mean, that's what people juice with. I mean, I know I just had a celery juice for breakfast. I'm not into detox, but celery in itself is not a bad thing. But it can be a mild phase three. I believe inhibitor is in curcumin, milk thistle, some of these things that we consider detox herbs, if you like, and especially in supplement doses versus food doses can actually have the opposite of fate. Can you go into just a little bit of that, what nutrients support phase one and two and three, and which one's actually inhibited? And why is it counter-intuitive?  Dr. Bryan: Well, the counter intuitiveness of it has to do with the dose, turns out. So well, and again, I mean, as humans, good lord, we've been wrong far more times than we've been right. I mean, as a husband, I can tell you, that's true. And father, it's like a daily basis. But so what we did with milk thistle was we say, milk thistle is good for liver liver detox is there for milk thistle is good for detox. And that's not true. And that's fine. I mean, that logical progression of thought makes sense, but it's not how it pans out. So it's dose related.  So, phase one. There's a lot of talk about phase one out there. Phase one are very basic, rudimentary biochemical processes. Oxidation reduction hydrolysis, if those suck in a person, detox is not your problem. They get highlighted a lot—phase one pathways. But in the end, people will say technically you need some B vitamins for this, but you need B vitamins to run most of the basic biochemical processes in the first place. So, honestly, phase one is not a phase I worry about too much in people. As long as they're nutrient sufficient, which basically means taking a good quality multi, they're probably—and I say big probably—they're probably fine with phase one. There are things incidentally, like some of those vegetables that you mentioned.  So this is where it gets crazy. In high doses, things like celery or apples or carrots can inhibit phase one a little bit. And it's dose dependent. And so it's in the concentrated form. Well, what's concentrated form? Lisa: Supplement Dr. Bryan: If you juice a whole bunch of carrots and apples, yes.  I mean, most people will juice more than they would eat the raw fruit or vegetable. So you might juice five or six celery sticks, three carrots, two apples, and, I don’t know, spinach, Well, turns out that all those things will probably inhibit phase one in that concentrated amount. There's nothing wrong with the fruit or the vegetable eating raw. And I will say there's nothing wrong with it, juicing it either but it's all context. I'll get to phase three in a second.  Phase two. Again, these are very basic biochemical pathways that if you can't run them properly, you have bigger problems than just detoxifying. Phase Two are very amino acid driven. So amino acids make glutathione, for example. So you need amino acids just for glutathione, you need the amino acids for the amino acid conjugation pathway. Things like acetylation, you need acetyl groups, those are pretty easy to come by in the body—sulfation, methylation. So you need certain nutrients, usually, amino acids do a pretty good job supporting that.  And problem comes in phase three. So if you consider that analogy of we use the angry guy. So if you want to get rid of the angry guy out of the body, you need to have door zero, and door three wide open. So like I mean, if you consider just like—let's say you have a line of angry people outside, all you need is a sticky note and $100 note to be able to shuffle them through, right? The problem or in the body has a fair bit of sticky notes and $100 notes, not everybody, but as long as they have sufficient micronutrients like vitamins and minerals, and as long as they're sufficient in amino acids, which again, not everybody is, they’re probably okay.  Now, again, it's going to vary with people a little bit. But you need to have those doors open. And the problem really arises, and think about this, where—this is putting our whole story that we've talked about together. If that, if the exit door is closed, you can undo. You can essentially take that $100 note back, and now, it's super angry and super angry again. And so if that third, or I'm sorry, the third phase or that exit door is closed, that's where problems arise.  And so this is where it gets super interesting to me, super interesting. Curcumin, milk thistle, green tea extract, those are extremely potent phase three inhibitors. They close that exit door. And when people question me on this, well I'll show them the papers. But I'll say, ‘Look into the literature’. Because in conventional—and this is what I say Western medicine is brilliant and thank God, they do what they do, because we're learning about things that we need to use for ourselves.  So in cancer therapy, Western medicine is trying to find out how you can keep a chemotherapeutic drug inside of a cell longer, so it can interact with cancer better. And so in medicine, they talk about these pathways, because they don't want these pathways to work because then you need a higher dose. These chemotherapeutic drugs, they don't want them to exit the body. They want them in the body, so they can act against the cancer. And so you know what researchers are using to block that phase three in cancer treatments is milk thistle, and curcumin, and they're even using green tea extract and some of those types of things. They're using those in doses that people would take as a means of keeping the chemotherapeutic drug inside of the cell longer by blocking phase three. Lisa: So this is all about context, isn’t it, Doctor Walsh?  Dr. Walsh: It’s totally context.  Lisa: We're not saying green tea is bad for you. We're saying if you were doing a detox and you're mobilizing all these toxins, don't take green tea at that time, or curcumin, or milk thistle at that time. If you're trying to do something good in the cell, go for it. Dr. Bryan: Well, so milk thistle, I think—and I don't have a list of 10—deserves to be on a top 10 list of herbs. Milk thistle is amazing at what it does. It's so broad and all of its mechanisms. It is truly, truly an amazing botanical.  It turns out, and one of its big roles as people know is it's hepatoprotective. I mean, it can regenerate the liver. But it turns out the reason why, and this is where it really gets cool, the reason why it's so darn hepatoprotective is it blocks its own exit out of the cell. So why can milk thistle be so awesome for liver cell, because it blocks phase three, allowing you to do its other stuff to do inside of the cell longer. So that's why it's so great as a liver herb. It's horrible as a detox herb though, because it blocks phase three. And if you don't let that angry guy out, you're going to take your $100 note back and he's going to be even more angry again.  Lisa: So we need to know what you’re after, what you wanted.  Dr. Bryan: Well, one thing and understand this too. So I came at all this research in the same—where everybody else did. I was, my mind was blown by this. My eyes were open and I thought ‘Holy cow’. And just to give you an example. Well, I'll just make my statement, and then I'll tell you why. Unless proven otherwise, I think most botanicals, most herbs, most stuff don't have a place in the detox programme because people truly don't know what its effects are.  Now I'll qualify what I just said. You can take any nutrient like quercetin been studied with, there's a bunch that have been studied. And here's the problem when it comes to detox, is the same compound like quercetin will increase detoxification in one tissue of the body, like the kidneys. It will decrease detoxification enzymes in another tissue of the body, and I'm making this up, like the liver, and it will have no change on the exact same enzymes, exact same enzymes, same quercetin, same dose, different tissue or cell will have a different effect on the same enzymes.  So what that means is so you can say well, is quercetin a detoxifier or not? You say, well, I don't know because it does in one cell it inhibits at another cell, there's no change in the third. Listen, if someone wants to use quercetin, go for it. But in what I've read, in my understanding of this until proven otherwise, I don't think quercetin deserves a place in the detox programme. And I don't care who says what or shows what, when you look at the dearth of studies in that one area on quercetin, you end up like I have no idea of what a quercetin is, does it detoxify or not? I have no idea. Lisa: So it's analytic, isn’t it? Dr. Bryan: Unless proven, otherwise, you don't take it. So that's true but it turns out, it's dose dependent. And so the amount of quercetin that’s been found in onions, however, is probably beneficial for detox. The amount of curcumin found in turmeric is beneficial. It's helpful. It stimulates phase three, in a high potent dose inhibits phase three. Same with green tea. Like green tea as an extract in a capsule is going to cause problems. A single cup of it, I don't think but it is context. Milk Thistle, curcumin, these things are all amazing. Apples, celery, it's all amazing. But it's all about context. If you're actively detoxifying, I don't think they have a place in a detox programme. Lisa: So quercetin is—for people who are listening, it's basically a senolytic, isn't it? Like, it’s mental health counterpart. Yes, senescent cells and things that might be useful for that. So what we're saying is that these are all great things, but at the right time, in the right context for the right person is the key. And this is the good part. Dr. Bryan: Quercetin is step further. So quercetin blocks histamine release from a mast cell, it also inhibits the thyroid. So... Lisa: Wow. I got—oh my god.  Dr. Bryan:  You have to look at the totality. No, that's it. So, that's fine. So somebody who has hypothyroid with allergies, maybe quercing is not the best idea. But somebody with normal thyroid and allergies and possibly it will work. And well I mean, this is if you followed my work, you know I'm against protocols, but that's why. Because like one protocol will be brilliant for one and harmful for another, they're the same protocol. Lisa: Yes. And that's why it was so great with all their blood chemistry stuff was like trying to understand the actual physiology rather than just going one plus two equals three, and therefore this person has XYZ. And to be honest, as a health coach, it’s a lot of work trying to get that into your head. It's harder than working from protocols.  Dr. Bryan: It's a pain in the butt. Lisa: It's giving me more work to do. Dr Bryan: That's horrible. No, it sucks. It's horrible. But I mean, listen, no. And here's the thing: as a practitioner, you can either decide—and I don't judge, I don't care what somebody does—if you want to go down the easy route and just use protocols on people and not think much, that's totally fine. For me, it's integrity. I mean, if people come to me and want me to try to help them, I will do my due diligence in trying to do so. And  knowing that I can't just give out protocols, which sucks because then you bang your head against the wall for every single patient sometimes, and it's not easy, but it's good medicine. Lisa: Can we just touch on—before, and I know we nearly have to wrap up shortly, but thyroid? How does all of this affect the thyroid? And if you need a suggestion for the next thing that you want to bring out, I need help with thyroid. The thyroid is an epidemic sort of problem and... Dr. Bryan: And it's not easy to fix in nutrition.  Lisa: And trying to do it without, just taking levothyroxine or eltroxin or whatever isn't fixing it for most people. A lot of people are subclinical and the toxins that we’re having and the state of our hormones, estrogenic, if we’re dominant estrogen or testosterone, it's all having effect on our thyroid and our thyroid is just so important. Have you got any words of wisdom in regards to the thyroid in all of us? Dr. Bryan: Okay, so as it pertains to toxins, I can briefly discuss that. Here's my take on thyroid. Thyroid dysfunction is very downstream. Meaning, in my opinion, it's not usually primary, it's usually secondary to something else, whether it's inflammation—I mean, who knows what. Another thing that the practitioners must ask themselves, so they have to ask themselves this is I mean, if people don't remember anything else, just remember this, is when you observe something in the body is to ask if it's on purpose.  So for example, I did a workshop on adrenal fatigue. Maybe it's low cortisol because the body wants low cortisol, and maybe low cortisol is protecting the body, and I have a lot of evidence to suggest that it is. Maybe low thyroid… So this is a thing, is it a thyroid issue? Is it something that's causing the thyroid issue? Or is it an organic thyroid issue? And if it's organic, does the body want it to be that way? Hypertension is protective in some cases, I will tell you. Insulin resistance is beneficial from an evolutionary perspective, as is PCOS. So, these are areas that I think that medicine has wrong, but...  So when you think about quickly the physiology of the thyroid. So there's the hypothalamus, it makes TRH and then the pituitary makes TSH and thyroid makes T3, T4, and there's a conversion of T3 to T4, there's binding and there's receptors and all that. So there's probably about 10 different spots. Xenobiotics, in the literature, scientifically proven, has been shown to affect every single aspect of thyroid physiology, from the stimulation of production in the hypothalamus, TRH, TSH, thyroid hormone production inside the liver, thyroid hormone release, thyroid conversion, thyroid binding, and then eventually thyroid binding on the thyroid receptors inside of itself. Every single, every single aspect of thyroid physiology is and as I say this, because it's a potent effect of xenobiotics.  So to make it clinical, if somebody is having thyroid dysfunction, subclinical thyroid symptoms, or it's showing up in a lab, what do you do? You have to be willing to be subjective and do the questionnaire. And if they score high, say, ‘Listen, I don't know if this is going to fix it or not, but you've scored high on this, it's worth a shot’. And so then you do a few rounds of a detoxification programme over the course of a few months, six months, whatever they have, however high their score was. And then have them retested. If their thyroid rebounds, then yes. I've seen some pretty crazy things with that detox. In fact, this is more of a male thing.  But I have a patient right now that reached out. Long story, really chronic guy, probably Lyme disease, just wrecked him, like neurological wrecked him so so bad. I feel so bad for him. But because of that he developed low testosterone, low testosterone symptoms, erectile dysfunction. And it's just—he's an awesome guy. I say he's awesome because he had accepted these things well. This is in his upper 30 years old, he's not even that old. But he kind of accepted it, he’ll be like, ‘This is my life. A certain amount of erectile dysfunction is going to be my life’. And he did my detox. 10 days, for the month afterwards, totally normal. He was on fire in that area. He retested his testosterone, his testosterone went up. So I'm not saying my detox does this. But what did he do during that 10 days that was able to—he  had such an amazing effect. Was it the calories? Was it the food he was eating? Was it detoxification? I don't know.  So I say all that because if somebody has symptoms, do one of these symptomatic—I'm sorry, subjective questionnaires. If you score relatively high, that's the best assessment that you can do. And I would try a few rounds of doing a detox programme. If it wasn't high, I wouldn't bark up that tree. I would consider something else, some subclinical infections or micronutrient deficiency, or genes. A lot of people like to jump on the genetic train but that's a possibility as to why, too and mental emotional.  Lisa: And how we process these things.  Dr. Bryan: Yes, mental-emotional issues, absolutely. All those things. Lisa: Yes, and the genetic some right into the whole functional genomic stuff. And that definitely plays a part in how we process things out of the body, good or not for good or whatever, and it’s part of this thing. So okay, so if we’re looking at—so the thyroid in this case, look upstream, have you got toxin exposure? If you have, well, let's look at avoidance for starters, how can we avoid some of these, clean up your house, clean up our personal hygiene products, clean up your food, organic when possible—all of these things, then we'll look at a detox.  Now, your detox programme is a 10 day programme that you can do on—regular depending on how toxic you are. And the first—sort of six days—I think it is six days is sort of based around the fasting mimicking. So a low a low calorie diet with a good mix of macronutrients to make sure that you've got all the stuff in the body to do the phase one and phase two. And what is the second part of your detox? And how do people get this protocol if they want to do it for themselves, or practitioners listening out there, how can they get this to help with the clients? Dr. Bryan: Yes, so our main website right now is metabolicfitnesspro.com, that has all of our courses, including the detox course, there's a practitioner based one, which, I mean, that's the one I like I will say, but that that has all the science of all the paths because it goes deep into the science, basically, for practitioners. So they have a better understanding when they're talking to their patients, and they just know how the processes work. We have a more watered down version of it, The Walsh detox, that's available to the general public. Practitioners can buy that one, too, but it doesn't have as much science, it's a lot more watered down. But it's the same protocol, essentially. So yes, those are available metabolicfitnesspro.com.  Lisa: We’ll put the link in the show notes. Dr. Bryan: So the second part of it—I mean, since recording that, I might do an updated version of it soon here. That whole 10 days was for somebody who has never done the detox type thing, any kind of dietary modification. So just consider the average person, you know who they are, who’s never really done much with their diet, minus trying to lose weight at some point.  For people that are more experienced with dietary modifications, that are probably a little bit healthier, going into something like this, like yourself. What I have been doing with people is we will do instead of one 10-day detox and a month, we'll do two of the latter half. So two 4 to 5 day, if that makes sense. So it's really just fasting mimicking diet. So it's five day the more intense version, but we'll do those. So first week, and third week in a month, we might do five days of that. And that's arguably the more... Lisa: Practical  Dr. Bryan: Well, a potent part of it, too. Yes, it's more potent than the ones with the mung beans and all of the things in the protein. So there's a couple ways of doing it, but it just—again, it depends on where somebody is. We've had people with multiple chemical sensitivity, that didn't feel real well, and they had to modify their program, more binders, more foods, so they weren't as hyper caloric, longer saunas at a lower intensity. So it's not a protocol, it's principles, if that makes sense. They are modifiable depending on somebody. So somebody like yourself, I wouldn't bother doing those first six days, I would just do the last four days a couple of few times a month, if you wanted to. Lisa: Yes, and keep processing the stuff and it really is just final on the binding. How can we help our bile, like bind up our bile, and some of the things that we can excrete, the sauna you mentioned is a great thing. Exercise and sweating and sauna. What about laxatives and diuretics and things? Are they bad? Because to help once you've got the stuff out to get it out or binders like activated charcoal, chitosan. Dr. Bryan: So those are on the programme. Well, and here's the other thing, there's so many, I think garbage detox programmes out there that I wanted to try to make what I thought was the first truly evidence based one looking at the scientific literature. So there are binders that exist that I didn't include, because I couldn't find any literature on them like zeolite or bentonite clay. I love them. I think they're great but I couldn't find literature on it.  Things like charcoal, chitosan or ketosan, however, you want to pronounce that, fibre, soluble insoluble fibres, modified citrus, pectin, they all have some evidence behind them that they actually either increase bile excretion, or when they increase bile excretion, increase xenobiotic excretion as well, which is faster, that's what we're after.  So you ask a really good question. What, somebody’s liver health going into this? What is their bile production going into this? What is their bile going into this? Yes, all that stuff. So I've been meaning to do sort of a follow up to that programme because I have like a phase two of that where you can modify some of these things.  Lisa: For difficult patients.  Dr. Bryan: Well, yes. So kind of—I mean, it eventually puts all this stuff together. So you're doing the blood chemistry stuff you said. So like, if you determine that somebody has fatty liver, they probably don't have very good bile flow, and they may need some additional nutrients to do a detox that you don't or I don't know, or probably most of your listeners don't. There's pH comes into this as well, which is kind of a big piece when it comes to the kidneys and whether they reabsorb things or not. But just the fundamental principles, is designed to help somebody who's relatively healthy do a good detoxification programme and see results. If somebody is particularly unhealthy then there are some modifications that would need to be made. Lisa: That would be a great update to the whole thing. Yes. For people like in mum's case, no gallbladder, liver enzymes. Not too bad, but they're not the greatest, all of those sorts of aspects. But I mean, it's going beyond today's discussion.  Dr. Walsh, thank you so much for all the work that you do in this area. It’s absolutely mind blowing. It's opened my eyes to a lot of things. I really hope people go to metabolicfitnesspro.com. Check out Dr. Walsh's detox programme, but not just his detox programme. If you are a practitioner, there is a whole lot of education stuff that you can—I have a lot of colleagues who I talk with and Dr. Walsh is a hot topic. He is a hot topic. Everybody's learning from Dr. Walsh. So people out there listening, if you want to get it from the best, if you want to know what's really in the literature, and you don't want to sift through PubMed for months on end, and do it yourself, which I really don't have time to do. Then, I'd rather get it from someone like Dr. Walsh.  So, thank you so much for your time, Dr. Walsh, Dr. Bryan: My pleasure. Thank you. Lisa: Thank you very much.  Dr. Bryan: You, too.  That's it this week for Pushing the Limits. Be sure to rate, review, and share with your friends. And head over and visit Lisa and her team at lisatamati.com. The information contained in this show is not medical advice it is for educational purposes only and the opinions of guests are not the views of the show. Please seed your own medical advice from a registered medical professional.

Have you ever done something without knowing why you connect to it so much? That was how it happened for Tiffanee Cook. Coming into the world of boxing and fitness, a world full of people who have stories and reasons behind their drive, she felt like she was the only one who didn’t have a ‘story’. Tiffanee soon discovered, however, that finding yourself, developing self-awareness and confronting your past can all happen in the boxing ring. In this episode, Tiffanee joins me to share her journey from the corporate world to the fitness industry. She recounts how a traumatic past allowed her to connect with boxing and being in the ring. Tiffanee also talks about how her experiences changed her outlook and helped her learn how to set boundaries. If you struggle with developing self-awareness and finding yourself, this episode is perfect for you.   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition, and mind performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join their free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   Consult with Me If you would like to work with me one to one on anything from your mindset, to head injuries,  to biohacking your health, to optimal performance or executive coaching, please book a consultation here: https://shop.lisatamati.com/collections/consultations   Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce,’ go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: Gain valuable insights from Tiffanee’s journey into boxing and fitness. Discover how finding yourself and developing self-awareness despite the odds is possible. How can you let go of your conditioned responses?   Resources Connect with Tiffanee: Facebook | Instagram Tiffanee & Co. Fitness: Website | Facebook Roll with the Punches Podcast Roll with the Punches on Instagram   Episode Highlights [04:45] How It All Started Tiffanee is from Tasmania, but she moved to Melbourne when she was around 20 years old. She’s been in Melbourne for almost 17 years now and has worked in the corporate world for the majority of those years. She watched a talk on resilience by former British Royal Navy Aircrew Officer, Paul Taylor. Paul showed her around his gym, where she saw a poster about a 12-week corporate boxing challenge. Tiffanee was riddled with anxiety the day before the fight. Despite the odds, she won. [09:14] Finding Her Way in the Fitness and Boxing World Tiffanee ended up buying a Certificate of Fitness from Personal Training Academy at the fundraising event during the first fight. As she was finishing her fitness training qualification, a friend trained with her. The next thing she knew, other friends also started training with her. While initially not interested, Tiffanee felt like she needed to give it a go and grow in that career path. Looking back, Tiffanee can see her transformation from a disengaged employee to an engaged employee, to a coach, to a business owner. She launched an online coaching program three years ago. While it fell away quickly, she loved how people opened up to her and shared their stories. [15:16] Confronting Your Emotions and Finding Yourself The boxing ring is the one place where Tiffanee trusts who she is. She developed more self-awareness. In the boxing ring, you react before your conscious mind catches up. When she was younger, Tiffanee was a victim of sexual abuse. Confronting her doubts and fear in the boxing ring also gave her the opportunity to look back and think about how her childhood experience changed her. [25:42] The Connection Between Her Past and Boxing Through the boxing ring, Tiffanee saw her inability to connect with her emotions at the moment. She copes by compartmentalising, only accommodating what is happening. She resonated with how there was support on the outside but none that could step in the boxing ring to help her. In the ring, she can come out on top and handle what’s happening. It took a lot of reflecting and writing to see how past experience allowed her to connect with boxing. Listen to the full podcast as Tiffanee shares more about taking a break, training and learning more about herself and her emotions. [34:26] Changes in Tiffanee’s Outlook Her story allows Tiffanee to meet and connect with people in the boxing ring. We all yearn for a resolution on some level, especially if we are not happy in all areas of our lives. Boxing has an opinion-based judging system. As a boxer, you are essentially putting your self-worth and identity in the hands of other people. We all want to win. But at the end of the day and in the years and months to come, you’re just the same you. What you do is not who you are. [43:33] Helping and Finding a Connection with Paramedics Tiffanee met a paramedic in one of Craig Harper’s camps. When COVID hit, they started an online fitness program to help other paramedics who are single and need to go in isolation. The project eventually evolved into her podcast. She found herself connecting with the paramedics. To be a great paramedic, you have to learn to suppress your emotions, and she knew how that felt and its repercussions. First responders experience a lot of horrific situations and are working under a lot of stress. This can take a toll on them physically, mentally and emotionally. [51:21] Epigenetics and Your Physical and Mental Health There is no divide between mental and physical health.  Epigenetics allows you to look at the various aspects of your health to get the best out of your body — from improving your performance to finding ways to prevent health problems. For Tiffanee, one of her conditioned responses to signs of conflict is to be accommodating. Now, she has learned to set boundaries. Having boundaries is vital to avoid burning yourself out and depleting your resources.   7 Powerful Quotes ‘The one thing I did love about online coaching was people would just open and bare their soul in a way that you don’t get when they walk in person in the boxing environment’. ‘The boxing ring is the only place where I feel that even for myself I am unmasked. It’s the one place where I can trust who I am’. ‘I resonated with standing inside a boxing ring with somebody standing in front of me that was there as an opponent to inflict pain. I resonated, that there was all of this support on the outside but none that could step inside and help me’. ‘It crossed my mind, “If I touch this area of myself, I'm changing who I am as a boxer”. So how much does it mean to be this boxer? How much of my identity revolves around that’? ‘If things have changed, but that in itself was beautiful. I went back to boxing not for boxing’s sake also, and I box not for boxing’s sake, for the sport, but for getting a handle on who I am’. ‘So it’s like what do we fight for? You’re putting your body on the line. And this one fight, this one result, this means the world to you. But guess what? … At the end of the day, in two month’s time, you’re just the same you’. ‘What you do is not who you are’.   About Tiffanee ‘Everyone has a plan until they get punched in the face’. Tiffanee Cook has learned this as a businesswoman, performance coach and boxer. The comfort, predictability and safety provided by the corporate world, to the lessons and let-downs in and out of the boxing ring. Coming to the realisation that to have one’s hand raised in triumph, adversity, discomfort and combat must be navigated. In the face of the messiness of life, do we fight or do we flee?  Tiffanee speaks openly of her own personal experiences (good and bad) and how those experiences have enabled her to develop self-awareness, resilience, courage, independence and the skill to maximise passion, possibilities, and potential. She talks about getting knocked down (literally and metaphorically) and what it is that makes some of us get back up and some stay down. Working in business, sport, high performance and personal development, Tiffanee explores a range of ideas, tools, skills, resources, philosophies and strategies to empower individuals, teams and organisations to improve everything from productivity, efficiency, culture and communication to physical, mental, emotional and social health.   Enjoyed This Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so that they can learn as much as you did about self-perception and finding yourself despite the odds. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram, and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript of the Podcast Welcome to Pushing The Limits, the show that helps you reach your full potential with your host Lisa Tamati, brought to you by lisatamati.com. Lisa Tamati: Well, hi, everyone, and welcome back to Pushing The Limits with your host Lisa Tamati. And this week, I have an exciting interview with a young lady Tiffanee Cook, all the way from Melbourne in Australia. And I came across Tiffanee because she's a fellow epigenetics coach, and we bonded and enjoyed over that topic.  And I was just really fascinated with her story. She's an incredible athlete. She's a personal trainer in Australia, has her own podcast, called Roll With The Punches for obvious reasons. She's into her boxing and really incredible. I love watching her on Instagram and doing her thing. She's extremely fit, extremely strong minded and a really intuitive young lady. It was just a fascinating conversation over what it takes to be in the ring. And how it transformed her life from being a non-athlete, at the age of 29, going into the corporate boxing scene for the first time and then completely that revolutionising her life.  And how going into boxing actually opened up a lot of old wounds from her childhood. She had been through some traumatic events in her childhood, which she shares about, which was very nice of her to share, and some reflections on that and some learnings from that. So a really interesting interview ahead for you. Before we head over to the show, though, if you can give us a rating and review, if you enjoyed this content, please do share it with your friends and your family. I do really appreciate you doing that. Slowly, one by one we're trying to build a community of people who love good content, who find value and good content, who want to listen to experts in different areas. And I have some fascinating interviews coming up in the very near future with some really heavy hitters, some big names, and some really extraordinary experts in the field. So make sure you stay tuned for that.  Just a reminder, too, as we head over into the crazy, silly season. I hope you've all survived okay this year 2020. Come out the other end of it. Let's hope that 2021 brings something a little bit better. It's been the toughest year of my life for sure. And I know many, many others have had horrific challenges to face both personally with businesses, with loved ones, with health issues, and fear. There's a lot of fear around in this last 12 months. So I hope you've survived that, okay.   If you are wanting some help with any issues, whether you're dealing with health problems, if you have come to the end of your tether with the sort of standard medical and if you want to get some alternative—looking at some alternative approaches to things and you want some help navigating a health journey, health optimisation, whether you want gene testing epigenetics, whether you just want some help in reaching a huge goal, some mindset support and some mental toughness training, then please reach out to me, lisa@lisatamati.com. You can send me your emails on there. And we can have a conversation and see whether working with us would be something that would be of benefit to you. We also have our standard—other programs that we're running. Our epigenetics coaching programs, which looks at your genes and how to optimise every aspect of your life according to your genes and how they are expressing right now. I know Tiffanee's right into that as well. So it is next level information to help you be the best that you can be.  We also have our online run training system, Running Hot Coaching. We'd love you to come and join our family. We've got over 700 athletes now from all over the world, that we train for various events, whether you're starting from absolute beginning, don't know where to start, want to make sure you do it in a proper structured manner, then come and see us. Or even if you've run hundred hundred miles and you still just want to optimise and reach the next level of performance, Neil and I and our team would love to help you with that. So please reach out to us at that. lisa@lisatamati.com or head on over to lisatamati.com, or our running website which is runninghotcoaching.com. Right. Without further ado, over to Tiffanee Cook. Lisa Tamati: Well, welcome back, everybody. I'm so glad to have you with me. I have Tiffanee Cook with me, and I'm super excited for this conversation. Wow, what an amazing young lady. Tiffanee, welcome to the show. Tiffanee Cook: Hey, Lisa. Thank you. Lisa: It's just so exciting. We connected through our mutual love of ph360 in epigenetics. Tiffanee is also an epigenetics coach and fan. And we have a few mutual friends. So we connected through that. And then I sort of delved into Tiffanee's website and what she was doing and a podcast and thought, ‘Wow, what a What an amazing young lady’. So I wanted to get her on the show.  So, Tiffanee, can you give us a little bit of a background in who you are, and what you do, and all about what you're up to now, that's what we really want to get into the weeds on. Tiffanee: Yes, awesome. Oh, thanks for the intro. So I'm from Tassie. I'm a young Tassie lass Tasmania, that's this, we sit down at the very bottom of Australia floating around. I grew up there, and I screwed it over to Melbourne when I was almost around 20 years old, mainly because I just felt like I was twiddling my thumbs in Tassie. It just wasn't enough air to keep me occupied.  I’ve been in Melbourne for the last 17 years. And I've worked in corporate for the majority of that. At 29 years old, I was at a talk for resilience. Actually, I went and watched a talk on resilience by a former Navy Seal. Actually, he's been on my podcast, Paul Taylor and that was fascinating. And after the talk, we went downstairs to have a look at—he had this gym called Acumotum, and it was all based on human movement. It was quite a forward thinking gym, and associated with PTA global to be honest.  And we went downstairs to the boxing gym. And there's this big poster on the wall with dudes in suits and boxing gloves on and it said, Executive Fight Club. And I looked at that, and I was like, ‘Oh, there's something that gets attention. I’m in’. So on the spur of the moment, I decided to enter corporate boxing challenge, which was kind of crazy, because I certainly was not someone that knew how to throw punches all too well. And so that experience took me in the ring for a 12-week challenge. And then we were to fight on stage, on cameras, on Foxtail, in front of a thousand people and you know all the bells and whistles that you can hear in a professional boxing fight. Needless to say it was an enormous experience—enormous experience. And it brought with it a huge amount of growth. So I can remember my fast forward to the day before and I did not sleep until 6am in the morning. I got to sleep. I had to wake up at 7:30 to go to the airport to pick my mom up, who's coming to watch the fight. So I remember texting my trainer, ‘6am, going home soon. Still no sleep, this is not good’. And he was, ‘Yes’. And then I was just socially useless for the day. Mom went out for lunch and then I was just riddled with anxiety. It hit me all in the last hours, riddled with anxiety. ‘What the hell am I doing’? We get to the fight night and I'm sitting there and I'm watching my best friend. She was the first fight of the night and I watched her. And she won and of course that was amazing. And I was like ‘Yes right we're on the winning team’. Then they handed me the microphone. I remember this second bout of panic hitting me because I thought well, ‘I don't want to win because I can't. What am I going to do’? Now I’m about to get in the ring to win a fight that I don't want to win because I don’t want to speak to people. But long story short I did and I won that fight and you could not get the microphone out of my hand.  After saying before the fight I will never ever ever ever do something like this again because whatever's on the other side could not be worth what I've been through the last 24 hours—that dissipated. And the feeling on the other side of that, the feeling having done it anyway was 10 times stronger. It was amazing. Lisa: So cool. Tiffanee: Yes so continued on. Fought with amateurs, had a great experience, ended up over the next couple years becoming a boxing coach, getting into health and fitness, and the evolution just keeps rolling on. I won't talk about it, it’s two or four o'clock here and we'll have to wrap it up. Lisa: Oh and you've got a couple of titles and some image titles and you've—Victoria titles I think. And yes you came right into the boxing from then on and then dived into this world of fitness and coaching and more or less. So have you left the corporate job? Tiffanee: I have left the corporate job. It was funny when I was doing the qualifications for fitness because in that first fight, we held a fundraiser that went to the Australian Save the Children trick. So held a fundraiser and Personal Training Academy donated a certificate of fitness to be auctioned off. And on the day, no one bid for it. So I purchased it for $500 which was super cheap. Yes, super cheap.  So I ended up doing my qualifications. And as I was finishing them, it took me forever, because I never planned to use them. It was out of interest. And as I was finishing, it was a couple years later I finally realised, ‘I should finish this course’. One of my good friends and a friend that I network with sort of said, ‘Oh when did you finish that course’? And I said, ‘Sunday’. ‘Thank God, because—all right. Well, as of next week, I'm training with you, you just tell me how much and how often’, and I was like... Lisa: Oh my gosh, you're gonna be a trainer. Tiffanee: Yes. And I was like, ‘Oh, okay’. And then a couple of friends did that. And then next minute, within six months, I was like, ‘Something has to give. I have to start saying no’. But I just  looked around and went, ‘There's people that choose this career path that want to be where I am, and grow this quickly’, and I just feel like, ‘I have to give this a go’. I have to feel like I have the right to not throw in the job and give this career path for yes, I've never looked back. Lisa: Wow, that's amazing. And, you know, when I go to your website and what you do, and the videos of you doing boxing, it's like you are a machine. Girl you are a machine. Your one tough nut. And so who wouldn't want to be trained by you? You mean? Yes, I was looking at you doing your boxing exercises that when you jump and go into the band there. Wow, that's really cool. You know I might finally want to get better at boxing. Tiffanee: Oh, yes. It's an amazing sport.  Lisa: Yes it is, I mean, I only dabbled in it when I was looking. I nearly did a corporate fight. And then I didn't end up doing it in the end. But the training was great. It was a great thing. So from the fitness side of it, absolutely love it, absolutely get it. It's really, really awesome. And to say, a kick ass girl like you just doing what you're doing. It's like, ‘Wow, that's so cool’. It's like, ‘Oh’. And diving into the hole, this is now my new passion where I need to be hitting. Obviously, the universe is sort of telling, ‘Here. Go here’. And having the net, the courage to jump out of your corporate job was at a big scary moment. Tiffanee: Yes, look at what it was huge. It was huge on a couple of levels. So there's level number one, where I looked back over a couple of years of doing the corporate fights. And what I saw, when I glanced back was this girl who went from a disengaged employee that just did this job in this industry that she did. And if you ask me now why I did it, I loved it. I always loved my job. And everyone always thought that I was always really passionate and happy at my job, because that's the sort of—whatever I do, I'm pretty into it.  But why I was working at the print industry, just because I fell into it out of school. And so that was my thing. But I looked back and saw this disengaged employee that had over the last couple of years, turned into an engaged employee that turned into a coach and a business owner and an entrepreneur for lack of a better word. I went, ‘Wow’. That wasn't deliberate that happened hand in hand with this stuff that happened in the boxing ring. And I always call the boxing ring walk my metaphor for life.  So my passion when it came to coaching people was understanding. The cool thing was, it gets you super ripped to get you super fit. So people will come to that. They want your energy, and they want your enthusiasm. They want your empowerment and they want your abs. No, that's all this side repercussions. I was like, ‘What I love is that I know that you as a person are changing when I teach you this stuff in the boxing ring, I know what's happening. And you don't even have to know what’s happening’. Lisa: You’ll look back... Tiffanee: Yes. But one day, you'll look back and realize your whole life has changed. Lisa: Very insightful. very insightful. It's really weird, because it isn't about the abs. I mean, like, right. Tiffanee: Yes, it was funny. I did online coaching—I launched online coaching nearly three years ago, super successful. I launched it. And within the first two months, I'd sold $10,000. And I was like, ‘Wow, I don't have a huge following to be selling it like this’. Lisa: That's cool. Tiffanee: But it fell away really quickly, because I found so many people coming to me. I guess I wasn't equipped with my messaging and getting it out there and how to cope with things. But yes, people came to me wanting carbs and counting macros and counting whatever they ate. ‘Wait, we're not counting calories. We're not counting this. That's not my jam. I don't care. Like, yes, you have abs, yes right at the end of this. We're not doing it by measuring stuff and counting things’. So, a passion for that side of things really dissipated.  But one thing I did love about the online coaching was, people would just open up and bare their soul in a way that you don't get when they walk in-person in a boxing environment. You get right to the crux of why am I here. People sitting in front of you saying—you know that they're beautiful, they're not overweight, they're super fit looking, they're gorgeous, and they're saying, ‘Well, I'm fat and when sometimes I don't go out for lunch with my friends, because I'm having a fat day’. I’d be like ‘Wow. I've seen you in the boxing gym for three years. You're so fit and gorgeous. And you’re still sitting there telling me this story’. That's getting stories out of people.  Lisa: And you know, you write them in the online training space. I mean, we have an online run training system and stuff. It’s been through hundred iterations. And it's super powerful in one way, because you can connect with people all over the world, and you can help people... But having their—it's a real struggle to create that energy that you have when you're live in a room with somebody. And so there's this problem between you're only one person and you want to reach a lot of people. You want to help have a massive impact. And then you're struggling with the systems that are available today and the way—and then you're having to learn a whole new language and technology and my God, what. All these marble black things that you have to know what you're doing in the space. And we sort of persevere because we've frickin stubborn.  Neil and I, my business partner and I, had huge learning curves. And by no means have we got it all sussed by any stretch of the imagination. And now we do both. We do the combination of things. And because you need to have one-on-one because you have a high touch and you also hone your skills when you're working one-on-one with people. And when you're in the online space, then you can reach a broader audience. It's more affordable for people. So you want a bit of both. Because when it’s high touch, it costs more, it's just the way it is. And so having that combination of things is really powerful, too. I wanted to dive down a little bit into—we got talking before we started the recording—a little bit about some challenges that you had as a young person, and how that sort of came out in the ring. Are you happy to share a little about that Tiffanee? Tiffanee: Yes, absolutely. Absolutely. I spoke to this—just recently shared it for the first time on my podcast. Roll With The Punches. Lisa: Roll With The Punches, by the way people.   Tiffanee: Roll With The Punches. Lisa: Roll With The Punches is a podcast. Tiffanee: Yes, so I guess I found myself at 29, I was inside the boxing ring and I had some really strong traits. And I had a really strong idea around who I was as a person and my identity. And like I mentioned to you before I had all these strengths. And at points inside that boxing ring—the boxing ring is the only place where I feel that even for myself I am unmasked. It's the one place where I can trust who I am. Because we build this identity. And I think sometimes that that identity is so strong that even we… Lisa: Big believer, aren’t you? Tiffanee: Yes. I can be the master of having stories and reasons that I believe. So what I see in the boxing ring and it’s this developing a self-awareness, is this raw honesty of how you react before your conscious mind can catch up. So if you're scared, you react before you can pretend anything. You see, if you're aggressive, if you're scared, if you have self-love, if you see all of these things. And it's quite confronting.  I found that within two years of the sport, and I'm now questioning—I'd start to go for walks around town and I would have these memories, I would start thinking of memories of when I was a child. And when I was a child for quite a quite a few years, I was at the hands of sexual abuse from a person, a neighbor, a family friend. And it was something that I'd pushed down and I'd never ever spoken of for so long that I guess it really felt like it never even happened. Lisa: You thought you’re over it. Tiffanee: Yes. So here I am strolling along and all of a sudden, that would pop in my head. And I think about running into this person, I'd start to get angry, bad. And I start to think that ‘Why is this coming up. This is weird’. I start to Google it. ‘What are the repercussions of an adult who has experienced childhood sexual abuse’? I had a best friend at the time, who was a clinical psychologist, and we were on a walk and I was like, ‘Oh, so what…’ I explained the question to her, and I remember her answer was like, ‘Ah, no, I haven't dealt with anything’. And I was like, ‘All right’. And then a couple weeks later, we’re there speaking about so and so. And I was like ‘Nah just speaking about myself’?  All these frames feel differently.  But yes, basically, I questioned why am I in this boxing ring? Something is drawing me in on a level, because I'm not someone who keeps coming back. I find the next shiny object pretty quickly. I said to you before, when I was at school I was not—I was smoking when I was 14 like smoking cigarettes. I wasn't turning up to do fitness and things. But when it came to sprinting, I'd come first in that 100, 200, 400 meters and anything jumping and I loved it because I was good at it.  The boxing, I never felt I was good at it. It was a skill I didn't have that I had to work hard for. I'd work hard and consistently and self doubt and fear and all of those hard-to-cope-with, confronting emotions and I was doing it. So, I started writing why, what's going on here. And these emotional breakdowns were coming up. And it really just started peeling back that hard shell and making me look at how that experience as a child had changed me. And it really gave me the opportunity to face that. Lisa: Wow, that's amazing. Because you were digging so deep in some really confronting stuff in the ring. It's sort of opening up your personal—because like you say, you can't run anywhere when you're in the ring, or your boxing, or in your training, and you're pushing your limits and you're feeling fear, and you're feeling anxiety, and you're outside of your comfort zone pretty much the whole freaking time. And that makes you start to think, ‘Well, who the hell am I and what am I doing? And where have I come from? And what am I’?  I mean, for me, and I use ultramarathoning as my metaphor for everything, for obvious reasons. So as you in the boxing ring. I was running. When I started doing ultra marathon, I was running from the pain. And the pain that I felt physically was a metaphor for the pain that I was in internally. For me that's the masochistic side of really pushing my body to the absolute limit in the early days, was about listening in the pain that I was experiencing in my soul, in my heart, in my mind, and the talks of incessant negativity that was in my mind.  I found when I pushed my body and was in pain, and suffering, and pushing to the limits, and achieving things as well, that changed the conversations that I was having with myself, and it opened up avenues for me to let that pain out and to start to work through it and start to heal from it. And then of course, you're surrounded by amazing, incredible people in the sport.  And you're doing incredible things. And then people are starting to say, ‘Hey, that's pretty amazing what you're doing’. And slowly over time, you start to build—rebuild, what's broken inside, and people don't see this on the outside. They don't see the broken heart that's on the inside. When I was young, I had no self esteem, no confidence. I'd never been doing this sort of stuff. Like for God's sake. I was like a timid, very broken person. I hadn't experienced sexual abuse, like you, thank God, in my childhood, but I had been in abusive relationships. And been through that experience, and had some other stuff in my youth, again, through sport, and being pushed too hard, too early in my sport, and things.So I was dealing with a whole lot of crap. In other words, and this was my outlet.  And as time went on, running, rebuilt, who I was and what I thought I could achieve. And when I started to open those doors, just like you've been through in the last few years, it's like, ‘Holy shoot. I can do a heck of a lot of things that I didn't think I could possibly do. And if I can do that, maybe I can do this’. And your horizon starts to open up as to who and what you are and what you're capable of. And in that time, your things are changing as to how you're dealing with stuff because that's the other great thing with sport and training and discipline and perseverance is you start to develop a toolbox of ways of thinking, of skills, of ways of managing your emotions, and you learn all these tricks.  And then when you dive into the whole world of epigenetics and you start to understand your own genes, that's the next level stuff. You start to realize, ‘Hey, I’m on this chemical bomb and I've got to move and I've got to do my breathing and calm myself down. And I know when to turn myself on. When to push and when to pull back’. And you know, come 52. So I'm starting to slowly work stuff out, not touch wood. I can still have breakdowns quite regularly. Don't get me wrong. But you know what I mean? And you start to feel as if like, ‘Ah, this is sort of making sense’. And then you know, as you get older, life’s even more shitty. So you've got stuff to look forward Tiffanee: Yes. I can’t wait. I can’t wait. Lisa: But you know, you've got some—at least some coping mechanisms or some ways of dealing with it. So what started to come out? So how did the sexual abuse as a child? I mean, a lot of people have been through this. And it's so cool that you're willing to share it because it is about how is it affecting you today as an adult, what happened to you back then. Because it's this stuff, that programs your subconscious, and you don't even know it? Tiffanee: Oh, big time, big time. I'm taking it back into the boxing ring. What I saw in there, and it was a real strength in the boxing ring. So what I saw in there was this inability to connect with emotions in the moment. So I was a very technical boxer. I was inside. And I wasn't—definitely wasn't talented. In fact, in that first fight, I think everyone with myself and everyone around me was like, ‘Oh shit, look at this chick. How are we gonna fix this in 12 weeks’? We only sparred once or twice before the fight. And the time that we jumped in and sparred, the trainer came over and he said, ‘Is that the first time you've sparred’? Then he goes, ‘Wow, you did really well’. So you can't tell what you're gonna be like in any situation. So I did really well.  But what made me do really well was this inability to connect and feel and deal with emotion. So I had built this coping mechanism that I guess it was: accommodate what's happening. Accommodate what's happening. Emotions will come back in three days later.  Lisa: Yes, yes. That’s called compartmentalising. And there can be a real strength, compartmentalising, being able to not be emotional in the moment. Tiffanee: Yes. And in most of my early fights, I'll walk back to meet the enemy like, ‘What happened’? Really, my awareness in there was, I was just on full fight or flight. Go. I couldn't feel the punch. It’s winning and losing felt was ours. My defenses weren't great. But I was strong. And I was resilient. And I would just walk in and I would go. I knew I was there for a job and I'd do it.  Over there, what I found really interesting—so I guess let me talk about what connected with me there, was that idea of: I resonated with standing inside a boxing ring with somebody that was standing in front of me that was there as an opponent to inflict pain. I resonated, that there was all of this support on the outside, but none that could step inside and help me. I resonated with the fact though in this ring, they could see, I got a chance to show them that this is happening to me. And I'm going to come out on top and I can handle this. Lisa: Wow. Tiffanee: It was all this stuff. It took a lot of looking at that and writing it out and seeing how it felt to say and think like that, to know whether it connected. Lisa:  Very intuitive. Tiffanee: Yes. So, in 2015, I left work and became a coach. So I stopped competing for a little bit just to adjust and get in three years passed before I hopped back in the boxing ring. And when I did and that was only last year in 2019 or 2018. Sorry. I jumped back in the ring, and simultaneously as I opened two gyms. But mind you, so I don't know who whatsoever. Does it all at once. On that person, whoever it is.  So I jump back and walk through. And my biggest curiosity—I don't say fear, I say curiosity—was in that time, I've done a lot of work. I've done a lot of therapy. I'd sought out help. I knew what I needed to resolve in relationships—and we can touch on that later. You wish but I knew that my biggest strength is inability to connect with emotions had now been tampered with a lot and that I'd worked on that. And I thought—to be honest in working on it, it crossed my mind. ‘If I touch this area of myself, I'm changing who I am as a boxer. So how much does it mean to be this boxer’? Yes. Oh, yeah. ‘How much of my identity revolves around that because of it. Because I don't play in this space’... Lisa: You may not be the boxer that you were prior when you were emotionlessly be. Tiffanee: Exactly. Lisa: Yes. Can resonate with one. Tiffanee: Yes. So I went back and I went to training and I remember I had a hard trainer. I've had a few trainers over time. He was my first amateur trainer, really loved his style of training. But you know, I think million dollar baby. He was brutal. He was… Yes, he did not come without the work.  So I went down and trained with him. And at this gym down in Dandenong. A lot of—mostly male boxers there. Quite an intimidating space, really. I hadn't sparred or done anything for a couple of years. Aside from the—I had to throw the gloves on, hit the bag occasionally.  And I remember jumping in the ring with one of his fighters, and he was a southpaw. He is a heavy hitter, he has a—without even trying he lands these punches that are like a freight train. Hitting like a really strong lad. And I hopped in the ring. And I wore an [31:08 unintelligible] that I thought broke my nose. So I've never had a broken nose. Lisa: Pretty pretty nose. Tiffanee: I know I always thought I've got quite a—for the listeners, I've got quite a sharp pointy straight nose that you just wouldn't think that a boxer could hate this nose. Basically the amount of punches are away. Anyway, he lives in Africa. And I thought, ‘For sure that’s broken nose in it’, quite a lot. I felt anxious. And it was the first time three minutes felt like three years in there. And I remember being hyper aware that my heart was—I felt naked. ‘I knew that you can all see my emotion. I'm feeling it. And I don't want to be here’. And I feel like for the first time I don't even want to finish this round. I felt so exposed. And yes and it told me you know, all I needed to know was ‘Yep, things have changed’, but that in itself was beautiful. I went back to boxing not for boxing sake. Also I boxed not for boxing sake for the sport but for getting a handle on who I am. And saying that—it's like my… Like I said it’s like... Lisa: Like your measuring stick? Tiffanee: Yes, yes, absolutely. Lisa: So, are you competing now. Or are just back from the competitive side so that you can focus on all this sort of stuff? Tiffanee: COVID certainly—well, by the end of last year, I'd burned myself out again because I was the head of all the gyms and all the training. I was doing way too much. Now that I know my about my health side, I understand what has always pushed me to the break point, into that zone. Lisa:  Yes. People, so sorry. We're talking about the language. So we are very similar health type. So we tend to—just for the listeners, we have a lot of adrenaline so we go, go, go until we go bang, and then we’d crash. And recognizing that pattern and because we're both very similar—similar place in the wheel, and is a really important thing so that we don't burn out so that we learn to back off before we have the crash. It’s not great Tiffanee: Yes, as an activator. So I would get up at 4:30 and I would do a five hour shift holding pads in my gyms. Then I'd drive down for an hour and I'd gonna do a two—usually a two hour boxing session but we're talking three minute rounds and probably sometimes up to an hour straight of sparring. So it was two hours of high intensity brutal work yet five nights a week. So I look at that and I'm like, ‘Okay, well activators aren’t built for to last in. It's no wonder’. But before knowing about epigenetics, I was just like, ‘I don't know why I'm burning out’. Lisa: Pretty obvious now. Tiffanee: I mean, it should have been obvious anyway. Lisa: It’s also not born for running for days on end either. As I found that quite later to piece through. Tiffanee: The Crusader coming through. Lisa: The Crusaders a little bit more. But... Tiffanee: Yes, it's kind of nice to be on the cusp of both. Lisa: You get to have the best of both. Tiffanee: Yes. Lisa: You mucked up both ways. But did you see—did it change? Doing this emotional work, and she—and I've never seen this before. But, I often get asked, ‘Why are you not doing ultra marathons now’? And one of the reasons was obvious. My mom got sick and my whole life focus changed. And then you know, life's come at me with a full throttle and I haven't been able to do that. I can't dedicate 20 hours a week to my sport anymore. It's just impossible.  But on the other side of that equation is that I've now spent so long studying the body and human physiology and epigenetics and all the rest of the stuff that I actually don't want to do that to myself anymore because I want longevity and I want health and I am 52. And I did it for 25 years and my body isn't the same. And I've taken some health hits from it. I also have been in a place in my life where I feel like in the early, long part of my career, I felt like I had to prove something to somebody. And I was doing it to be something, prove something that I was tough, that I was strong, that I was able, because I've always been told, ‘You’re useless and weak, and you can't do this’. So that was my reaction to try to prove that I now no longer have that desire, and therefore the hunger is gone. If that makes sense. So I no longer have that absolute desire to go through whatever it takes to the finish line, and you need it in that sport. if that's what you—if you want to reach the top.  And that played with my identity for a long time. ‘Then who am I if I'm not that tough, you know ultramarathon running girl’? And now I'm like, ‘No, actually I've got bigger, different’, or should I say, ‘different things to do on this earth. And that was a great time. I've taken these great experiences that I can now share. And it's okay to be doing—being a badass in other ways’. And that's okay.  And I think a lot of athletes have this real difficult time when they shift from their active career into something else and feeling like you are nobody now. And that is not true. You now have a huge amount of things. You're not starting from scratch, you're starting from a place of wisdom and you've got these experiences that now you can move forward and—just pushing, repeating. I've seen some of this in a few other athletes—really top level athletes, who I've had conversations with and they've said to me, privately, ‘I don't want to be doing this anymore. But I don't know who I am if I'm not doing this’. And that's not a good place to be.  It's time to do something different. We've got a short life, we want to do some—we can move on without feeling like we're losing ourselves. It’s as surprising that as a change in the transition. Does that make sense? Tiffanee: Yes, I love that you asked this question because in my early podcast, I've tried—a couple of times attempted approaching this question. But I felt like I hadn't quite landed where I wanted it to with the people. So my question, because boxing is one... Because of my experience when I say boxers, when I walk into a boxing ring and somebody walks into the boxing club, especially a female. Through the first fight, we got to know everybody so you know everyone that you're training with. And I remember saying—I hadn't said this before—I remember saying in the early days, to like my parents, ‘I'm the only one there without a story. Ah, people have had marriage breakdowns, oh they're on drugs, oh they've got this, oh they've got that. They've got this big story and I'm just there like, this is me little not—no self-awareness me going’. Obviously I have a great time because I'm awesome. You know, like, did I not know what was coming. Lisa: You did have a story. Everyone has a story. Everyone. Tiffanee: Yes. And that's why I really connect with people in the boxing ring and people that walk in all boxing gym. You know that there's this deep story, don't know whether they know it or not. And I asked that question a couple of times to various people in this space, ‘If, do you think that the reason—so we have this we all have this drive to success, but what is the reason that’... The only thing that makes us succeed in one thing is this yearning desire for a resolution on some level.  Lisa: Yes. Tiffanee: And we're either aware of it, or we're not. If we weren't totally fulfilled in all areas of our life, we wouldn't—especially when it comes to things like boxing or ultra marathons where it's attacks on your bollock. I have a friend and she's a really good friend of mine and we both started boxing, Judith Courtney I spoke to her on the first fight. For a couple of years, her life really revolved around boxing, again someone with a story and a metaphor and it was strong. But boxing meant so much it was her identity at that time on such a level.  But when you break it down, especially for boxing, especially for females, especially for Australia, you know like it's sport where the decision is based on a couple of factors sitting around the ring saying whether you want to last. You know, it's an opinion based judging system. And it's often tampered with whoever decides. ‘What are you scoring? And well I like this style of fight, so I’m gonna score it this way.’ So you’re putting your head, your self worth and your identity, and your win right into the hands of other people.  And boxing is a sport, especially for females, especially in Australia, where if you're not in, if you don't have a passion for it, nobody knows anything. If you walk out and say some of the top boxers in Australia's names to 90% of the population, they'll go ‘What? Who’? They take someone in just doing amateurs. You know, I know some of the top amateurs in this space. But if I say their name to most people, they'll go, Lisa: ‘No idea’. You know, famous... Tiffanee: Yes, exactly. So it's like, ‘What do we fight for’? You’re putting your body on the line. Yes, and this one fight this one result? This means the world to you. But guess what? We all want you to win, you might want you to win. Yes, the accolades are all waiting for you. But at the end of the day, too much time, you’re just saying you. Lisa: They don't believe the hype and that's a really good point. Sometimes, when you get even into podcasting, or you're in the public eye, and you get people telling you, ‘you're doing great, and you're amazing, and you're awesome’. Never believe that shit. Totally, they go to your head, because this is real. And you want to take your cues from the people that you love and respect and that are close to you at all times. Never take your cues from people— and this is not to—it's fantastic, having people love what you do and things like that. I’m not saying that. But what I'm saying is don't ever let that stuff get to you because it will change you. Tiffanee: Because what you’re doing is not who you are. And if people are loving you for what you do, you stop doing it and they drop away. Lisa: They drop away, and then all of a sudden you think... So in other words, just like in the boxing ring with the dudes in the corner are judging you and they have control over how you feel about yourself. If you lose, you're nobody you know. And if you don't finish that ultra marathon or you failed, not in my camp, that's not the way I operate it. That's not the way I coach. People who put in the hard work, do the discipline, go through the life-changing training, start on the startline, those are the people that I'm stoked about.  What happens on the actual day, and you're going through the race, that's all up to the gods really. Hopefully, you give it your all. And if you gave it your all, then that's all you had to do. You gave it everything, you prepared your body right, you did that... Whether you won last, didn't finish, whatever, that's all about the learning curve. And then it's about standing back up again. So don't like—failure is— people say, ‘Oh, you know, you learn the most in failure’. Well, it's damn true. You do. And it's not pleasant always. But the journey in other words, the journey as we are doing the changing and developing and stuff. It's not all about race day or boxing day in the ring. It's all about the rest of the stuff. So, Tiffanee, you've done a project recently, and you're talking about on your recent podcast. You've sort of wanted to help people with paramedics. You were talking to—the trauma that they go through and or first responders in general. What was the correlation there between what you do and how you've been helping in that arena? Tiffanee: Yes, cool story. So when COVID hit— so, a couple years ago I did a camp with Craig Harper. I was on Craig Harper's podcast quite a bit. And he does a camp once a year for people to go down and spend three days, bit of luck, self-development camp, it's amazing. And I met one of the paramedics there two years ago. And from that, I'd done some boot camps and things a couple years ago with them. Now when COVID hit, Ryan had put a message in the Facebook group of support to the paramedics who was single, who will go into isolation, and it was gonna be a shitty time.  And I commented on that, and I was like, ‘You're amazing. You're such a good soul’. And so she rang me up, she said, ‘I've got this idea. And she goes, ‘I'm going to get some funding together and give you a gig helping us stay fit online. So we're going to create a wellness hub’. Yes, so I put together this training program. And with that, I said, ‘Let's get together on Friday afternoon and feel good Friday, and we'll have a drink or whatever I have... Honey, soda water or just get together so people don't have to be alone’. And that quickly evolved into getting speakers on which involved into—evolved into this podcast.  But, I found myself connect really strongly with paramedics and it was around this boxing analogy in my experience. But what I connected with is I look at these people, and they've chosen a career where they where they walk into trauma. And into walking into that trauma, in order to be a great paramedical first responder or a law enforcement officer or firefighter, you have to train yourself the ability to suppress emotions.  So the first thing I saw was all you guys suppressing emotions. And I saw what that did to me. And I saw how that played out and the negative repercussions that I had to deal with. So I realized that this connection, there’s curiosity around these people and why do they deal with it, and what are their levels of self awareness? And how is it playing out for them? Is it playing out for them? Is it the same thing? Or am I on the wrong track? I'm still asking that question. And I've had so many conversations around it. And it's funny because I'm like, ‘Oh my god, you just these Tasmanian chicks sitting in front of my phone, zero qualifications in this area, but a huge amount of curiosity’. Lisa: Would you let that stop you Tiffanee? Tiffanee: Well, that's it. And I've sort of gone. I just—from any of the research that I've done, I haven't come across anyone asking these questions. Sometimes you find out great answers from a place of complete ignorance. And that's definitely where I come from in this space. Lisa: You ended up making conversations, and you're living here. Our first responders—I come from a—as I was saying before a family, firefighters, my dad, my brother, my husband, all firefighters. And they are exposed to inordinate amounts of horrific situations, let's just be honest, and the trauma that they go through, and that they see is a very big impact. Without getting into any details, like my husband's lost a few friends over the last few years to suicide. And to say it's not job-related, and we don't know all the details and so on, but it can be bloody well, bet your bottom dollar. A lot of it is what they've seen, what they've been through, and the lack of support around them.  And especially I think, for me, they're expected to be tough and handle the gentle. And when you are—you have to be able to function in these sorts of traumatic situations, which is super, super important. You also need to not suppress our emotions and to realize we're humans that have emotional responses to what we're seeing. And that needs to be dealt with some freaky now, and I don't—you don't have the answers. I don't have all the answers, but we need to shine a light on it. And say, ‘Hey, people in all of these really caring professions—doctors, nurses, first responders, all of these people. We want these people to be compassionate, we want them to have a high level of humanity. And we need to support them in what they're doing and what they're facing and what they're seeing in the aftermath of that’. I don't think I could cope with it. Day in and day out. It's pretty phenomenal the job that they do, Tiffanee: Oh, it's huge, it's huge on an emotional level. And then on top of that, after looking at them, that these guys are—they're working under those conditions. But then just the conditions of shiftwork and which affects their diet, their exercise, their everything that creates a being that is resilient, is getting sorted out the walkthrough. It’s getting poked and prodded in every direction and then put into such a high-performance environment. I sat down with a friend of mine who has just recently joined the police force, and obviously he was getting into the academy and I was like, ‘Oh, no, whoa’. Lisa: What are you doing? Tiffanee: I said to him, ‘We want to have you on a podcast’. He says, ‘Give me a few years in the force’. I'm like, ‘No, right. because this may seem with you having breakfast asking you in your first year of becoming a police officer’, because he said, ‘Uh, yeah, I've become hyper vigilant from day one is now when I walk into a restaurant I check the exits I check the things’. That doesn't happen without your body... Lisa: Responding. Tiffanee: Yes, exactly. Exactly. Your amygdala switched on. You're having these physiological responses. You're putting yourself into hyper awareness all the time. You can hear. When you start responding to things like you said, you hear a certain language or something in a background conversation and you become aware of it like that you switched on, switched on, switched on. Lisa: I can see it on my mind, my husband. you know, like, if I put the smoothie blender on, without telling him, his cortisol is up like that. He's very sensitive to loud sounds. In their job, they're exposed to the sirens and tones going off all the time. And so he's hyper responsive to those noises, the phone going. That in every single time it sends his body into a fight or flight, and trying to help him sort of bring that down really quickly, but that’s what they’re programmed. 23 years of responding to tones.  And in the middle of the night when you're in a deep sleep phase, and then, whatever the case may be, that stuff has an effect on your—you just constantly—and you think about it, like a bus will go past and lead out to your brakes. Immediately the—’what's happening’? It's just because they're good at their job, they're good at responding really quickly. And it keeps them in a state of—for the next couple of hours, the body's got a whole lot of cortisol running around, and that puts up your blood sugar levels, and that causes insulin resistance, and that causes weight gain. And all of these knock on effects. Tiffanee: Yes. A conversation I always have is, there's no divide between your physical and your mental health. I'm a different person mentally, when I'm underslept, undernourished, and your physical body creates the chemicals that give you mental balance and equanimity.  Lisa: Yes. And this is why I think like, why I love epigenetics is in the programs that we both do, because we can help people look at the chemistry and the hormones, it's because they all want to know about the food and the exercise. But actually understanding your hormones, your personality type, what part of your brain you use the most, how you respond in different situations, and from a genetic perspective, really helps you understand how to get the best out of your body and not to play into your problem.  So we both been very close to being very similar body types. We know we need movement. If you stick me at this desk all day, I'm going to be one angry person. I need regular movement breaks, I need little bits of food. I need, throughout the day, I'm burning very high. And I need them to shut down at night. I know all these things. So I'm called constantly aware of those, and that helps me balance out. And I wouldn't say, I've got the site's down because, gee sometimes I still have big meltdowns. But I'm watching myself—even when I have a meltdown, and I lose control whether I'm crying or I'm angry, or whatever the case may be, I'm watching myself, and I'm observing my behavior. And I'm thinking, ‘How did I do that? And why did I do that? And how do I bring myself back down’? So we're really on bringing awareness to the problem, even when I haven't mastered it, if it makes sense. Tiffanee: Hmm. We're talking about conditioning. And you asked earlier how some of this conditioning plays out from the abuses. And what I noticed over the last few years was this accommodating—like my first response to things is to accommodate. So what I would find is I'd have constant—I remember having a conversation. I can't remember conversations. I remember being at work, I was a trainer and the owner of the gym and said, ‘Oh, can we do blah, blah’? And almost before people finished speaking, I'm like, ‘Yes, yes. Yes, cool, cool’. I just—I don't want conflict, I just want to be everything for you. Whatever you need Lisa: Whatever you want me to be Tiffanee: Yes. And then I'd find myself laying around a bit like, ‘Did I just agree to that’? You know and it took me a long time to realize that, ‘Ah, this is a conditioned response that you will accommodate the other person and it doesn't matter what you think or feel because you don't think or feel right now. You just accommodate and deal with it later’.  And so what I've learned to do, which is hard for activators because we like to react and to respond. What I've learned to do is listen, try, and think and feel in the moment and then say, ‘Can you give me a day or so before I commit to that’? So this new setting boundaries. I don't have boundaries before, zero boundaries. So it was kind of a—I used to just dodged through life trying to keep massive distance between people because I didn't know how to set boundaries. So it just would avoid it and avoid conflict. And yes, so that was my way of keeping myself safe then. But now it is, I just say, ‘Hey, I think that that sounds good. But do you mind if I just commit and get back to you’... Lisa: And that though, is a perfect answer. I really, really struggle with this. I'm still struggling with this one as my business partner Neil is like, ‘Just stop doing stuff for people and saving everybody in the planet. You've got to make a living’. And I’m like, ‘I know, but that other situation, that situation, excuse, excuse, excuse’. And I'm like, ‘Listen to yourself. You’re burning yourself out. You can't put your resources into our things. You're not helping them’. But you know, I'm like, ‘I know, I know. I know. But’... It's something I struggle with on a day to day basis, because I just want to heal the world, fix everything. I have to make a living. I have to have money in my bank. Now. I can't just do what I want. And I really struggle with it. I really struggle with saying no. And that no is a perfect answer. And that's definitely a work in progress. You know, on the other hand, it's like, ‘Okay, well, deal with things that you know that you can be’. But it's hitting boundaries because I do burn out because I'm doing too many things with too many people and trying to help, too. And  spreading yourself too thin and then you don't do a good job. That's the other thing Tiffanee: Yes. And maybe beat yourself up over it. Lisa: Yes, then you fail. It’s an ongoing problem. Hey, look, Tiffanee, I've taken up so much of your time already. It's been absolutely fabulous to have you on the show firstly. And to get to know you. I think we'll be doing things in the future together, I hope because you're a pretty cool young lady. I think you're amazing. I want people to go and listen to Roll With The Punches with Tiffanee Cook. And Tiffanee, where else can people can find you if they want to reach out to you after hearing your amazing story and what you do? Tiffanee: They can find me on Facebook, Tiffanee Cook, Tiffanee, with a double E. Or @tiffaneeandco Instagram. More @rollwiththepunches_podcast on Instagram. Yes, all the usual places. Lisa: Okay, we'll grab all those links on getting seen them all over to me and we'll share them in the show notes. Tiffanee, thank you so much for being on the show today. It's been absolutely fabulous. Tiffanee: Lisa, I have loved it. Thank you. That's it this week for Pushing The Limits. Be sure to rate review and share with your friends and head over and visit Lisa and her team at lisatamati.com The information contained in this show is not medical advice it is for educational purposes only and the opinions of guests are not the views of the show. Please seed your own medical advice from a registered medical professional.

In this fast-paced world, it seems the only way to move forward is to push harder and harder. But where is this relentless rat’s race taking us? Never has there been a higher prevalence of chronic disease and mental health disorders globally. If we want to change this dynamic, we must understand that rest, recovery and effective stress management are equally important in driving results. Neil Wagstaff joins me in this episode where he explains the science behind stress. He outlines the various stages in the stress curve to help you identify where you might be in the spectrum. We also talk about the importance of awareness. With a better understanding of stress, it’s possible to make small lifestyle changes to reduce its toll on you and take greater ownership of your health. Don’t miss this episode if you want to develop your resilience and learn effective stress management!   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition and mind performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join our free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   Consult with Me If you would like to work with me one to one on anything from your mindset, to head injuries,  to biohacking your health, to optimal performance or executive coaching, please book a consultation here: https://shop.lisatamati.com/collections/consultations   Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: Understand stress better by learning about its symptoms. What is homeostasis, and what are the stages of stress? Discover the importance of awareness in stress management.   Episode Highlights [03:15] Defining Stress Stress is a normal part of life. It can be good if it’s used in the right amount. Picture stress as a bucket. When the bucket is filled in too quickly, it can overflow. With proper balance, stress can be managed, and you can avoid the bucket from tipping over. The Goldilocks Principle shows that the amount of load or stress we put on our body should be well-balanced to get a positive result out of it. Stress should be balanced with recovery to get optimal results. [11:59] Symptoms of Stress Feelings of depression, anxiety and anger start to rise in times of distress. A weak immune system reflects stress in your body. Stress happens when there is a lack of balance between work and recovery, when there is a lack of resilience. Take the time out, time to reflect and to show gratitude so you can move forward. [20:13] Health and Homeostasis The goal is to maintain homeostasis, when the body is well-balanced and stable. The alarm stage usually comes after experiencing homeostasis, especially when you’re anticipating something new or big in your life.  This can bring about an arousal of emotions, which can be overthrown using stress management techniques. Being always on the go can lead to chronic mental health problems like anxiety and depression. The key to maintaining homeostasis is giving yourself time to recover. [24:16] The Resistance Stage of Stress After the alarm stage comes the resistance stage, where you actually put stress on your body. It is when you can feel really stuck. This stage can result in a chronic state of exhaustion. This puts you in the position to address the stressors by changing habits, perceptions and behaviours to bring back homeostasis. [26:41] The Exhaustion Stage of Stress This stage happens when your stress peaks and things get out of control. We want to prevent reaching this stage as much as possible. Stress can activate the body’s fight or flight response, which can have a negative spiral effect on the body, both physically and mentally. It is crucial to bring awareness to your behaviour and decisions when in the exhaustion stage to avoid spiraling down further. [31:41] On Awareness Increasing our awareness around stress and personal wellness has made a big difference on the things we do. Individuals with lower awareness tend to externalise their problems and not have control of their lives. The greater your awareness, the more likely you are able to take ownership of your problems and control your mood, health and how you look at the world. Awareness is also vital for teams. It allows you to help your teammates and prevent things from spiraling out of control. It starts with being aware, but you don’t have to tackle your problems all at once. There is no instant fix, not even coaching. [36:16] 7 Questions to Increase Awareness What is the biggest stress you have at the moment, and how is it expressing in your body? What normally causes stress for your body? How is stress showing up — does it come in certain environments? When is stress showing up? What can be done immediately to alleviate the feeling and support your biology? What can you do to manage your stress response better? Finally, what are the long-term strategies you can implement to lower your residual stress? [42:36] Stress Management: Start with the Small Things Look after your stress like you look out for your body. Do any mobility work (or breathing work) that is right for your biology. Spend time with nature. Perform habit stacking or the art of doing simple things to get complex things done every day. Start doing things in practice to increase your awareness.   7 Powerful Quotes from This Episode ‘...the resilience is found in rest. But society will say to us that resilience is found in pushing harder, pushing, doing more, doing more and doing more, but it's found in rest’. ‘So this is why it’s important to remember, in daily life and business, you need the recovery aspect in there. It should be like a training program’. ‘Finding joy in something is the real key to my mental balance. I’m not being selfish when I take half an hour to paint a picture. I’m not being selfish — I’m being sensible, and I’m looking after my own health, and therefore, the health of my loved ones’. ‘Sometimes the answer isn’t actually just addressing what’s under your nose and addressing your work. It could be addressing your food, your movement, how you’re looking after your mind and all those things. And then change your perception of work totally so you can manage it a whole lot more effectively’. ‘It's really important for corporate teams or sports teams to start recognising signs and others. And if you are more aware than the other person, then you can help them more… so that you can actually prevent things from spiraling out of control’. ‘If you find yourself blaming everybody else for the situation, then you're probably not very aware of things that are going on because you're just externalising. If you're moaning a lot… Then you might want to have a look at the way that you're actually processing things and understanding things and take more ownership’. ‘You don't have to tackle the whole thing at once. But it's being more aware. Am I a person who goes through life blaming everybody else, blaming the system, blaming that? Or am I someone who does something about it, takes ownership, starts to make a change in [my] own life’?   Enjoyed This Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so they can learn more about effective stress management. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript Of The Podcast! Welcome to Pushing the Limits, the show that helps you reach your full potential with your host Lisa Tamati. Brought to you by lisatamati.com. Lisa Tamati: Welcome back to Pushing the Limits this week everyone. I hope you're having a fantastic December. Can't believe we're already here, Christmas is just around the corner.  I have an interview today with Neil Wagstaff.  He's a repeat offender on this show. And I love having my business partner and my coach, exercise, science men, Neil Wagstaff with me. And we're going to be talking resilience and stress, how to control stress, how to understand what it's doing to your body, and some of the techniques and things that you can do to cope with stress. And I really hope you get benefit from this episode.  It's an ongoing theme. We have lots of stress in our lives generally. We live in stressful environments, we've got families and financials and sicknesses and illnesses, and all sorts of things that we have to deal with on a daily basis. So here's some really good advice and tips around managing stress and being resilient.  Just before we head over to the show, please give the show a rating and review if you enjoy it. And make sure you share it with your friends and family. And if you're looking for stocking fellows, make sure you head over to my shop on lisatamati.com, my website. You can check out my fierce jewelry collection, there you can check out my books.  And of course, if you are having trouble with any sort of health issues, or you've got a big goal, or you want to deal with some mindset issues, I am taking on a very, very small number. I've pretty much meet the quota. But I've got a couple more spots left. If you want to work one on one with me reach out to lisa@lisatamati.com. And I can send you information about my health optimization coaching.  Okay, now over to the show with Neil Wagstaff.  Lisa: Well, hi everyone, and welcome back to Pushing the Limits this week. Today I have my wingman Neil Wagstaff, with us again. My gosh, you're coming on the show a lot, now, Neil.  Neil Wagstaff: Like you make me feel really popular, man. I love it. Lisa: It's really good to have you here because you just got so much knowledge. And it's just fantastic being able to share all your knowledge with everyone out in podcast land. So if you're a new listener to the show, thanks for dropping by. And if you're returning listener, thanks very much for coming back again and please don't forget to give us a rating and review. We love hearing from you guys and you reaching out.  Now today, the subject is stress and how it affects your body and health. A big topic for so many people, especially given 2020, it's been a disastrous year on many, many fronts for many, many people. Certainly been the worst one of my life. So we're going to talk about how to deal with stress, how to recognize the signs and symptoms of when you're getting overstressed, how to just to manage your physiology so that you can get the best out of your life without tipping yourself over the edge. So Niel, over to you. More to say what’s it all about.  Neil: Firstly, it is a normal part of life, it is definitely a normal part of life. And it can be good. It's often given a very negative, negative sort of press and people see it as a negative thing. It can be that definitely, but it's also something we need in our daily life. And something we want—you and I personally we thrive off it and love having things to do, we love being busy and love getting things done. So that's good.  For some of the good stresses that people be aware of when just understanding they're putting them into that stress category is these things will have an impact on our body and can put load on it. And therefore they're putting load on it they can cause inflammation and effectively cause stress of some sort. So exercise is a stress and it's a very good stress if it's used in the right amount. Okay? It can also be bad stress.  Lisa: Dosage. Neil: Yes, exactly the right dosage. Food can be a stress and it puts a load on our body. Again, use well, it's a good one. Work, again, manage well with good balance is a great stress to have and we all should enjoy doing it. Mental challenge can be a good stress. You like being pushed to our limits, you're definitely a great example of someone who loves pushing the limits, Lisa.  Lisa: Yes, mentally and physically.  Neil: So there are good things in that. New environments, new experiences. They're all great stresses that you can put on your body. General ones on the bad list would be things like poor sleep, and lack of exercise, social stress, prolonged challenge—the stuff that goes on for too long without rest and recovery. And then significant physical or mental trauma as well.  Now if you manage those two buckets. We often talk about the bucket of stress and you have heard us discuss that on previous podcasts as well. But these things, if they're thrown in the bucket, and the bucket gets too full too quickly, then some things on the good list can actually be the things that actually cause the overflow and cause too much stress. But manage well, manage those lists well, and you're going to be in a position that is part of normal life, it should be good. Stress needs to be there. The key thing is that you've got balance with it. And that's what we'll go on to talk about a little bit more, a little bit more today. Lisa: Yes, so I think things like exercise people don't often recognize as a stress and it can be added into that same bucket. And we have talked about that principle before on the show, where, that can be the stressor that tips it over, if you've already got a very full bucket. So even though you think, ‘Oh, doing my training today is a good thing’. It is, if your body's ready for it, for example. And if you've had a lack of sleep and lack of social interactions and your food was crappy, then that extra stress of exercise, or doing it too hard on that day might not be a good thing. So it's about balancing it. And it's about recognising when your body is in a state of excessive stress.  So now we're going to talk about the Goldilocks principle. And I love the Goldilocks principle, it's pretty much a metaphor for everything in life. The more I study biology and chemistry, the more I start to understand that everything in the entire world is all about the Goldilocks principle. Not too hot, not too cold, not too much, not too little. Just getting it right. So how do we get it right, and what is the Goldilocks principle in regards to stress, Neil? Neil: What you said, is so true, Lisa. It is so appropriate to so many aspects of life, it really is. One of the examples we often use is quite an easy way to look at it, it is looking from a training perspective, and especially from my background, that's what I understand well.  So when someone goes through a training program, or an exercise program, goes through rigorous exercise classes, you don't want to create a training stimulus in the body. You want to create a effect on the body under load. So you're going to cause some stress, it's going to break it down, so you'll get a response. And it comes up after a period of time and it could be sort of that four or six week period. We then start to get some great results. Otherwise what’s known as super compensation, where your body compensates and responds really well.  Now the reason it does that is because you've put the right load on it. So you put the right amount of stress from an exercise point of view, therefore, you're going to get the nice result at the other side. Now if we do put too much—or sorry—too little stimulus on the body, then the result is going to be smaller, and we won't have such a great result at the other side and four to six weeks time. If we put too much stimulus on, which we see a lot of people doing in our work, and not enough recovery, and you don't get any results at all.  Now stress works in a similar way. And what we're looking at in this example is we want to put stress as in the exercise load on a body to get the result. But in our daily life, should be a similar process. The amount of load we put on our body each day should be enough that we get a great result at the other end.  And we had a, Lisa and I were away doing a court presentation about a week or so ago. And we had a great discussion there with one of the one of the team we're working with. And he gave the example of in sport like I've just given, you've got the chance to recover. Now in business and daily life, you don't often get the chance to recover. So you have these periods which becomes longer and longer and longer, where you're putting yourself under excessive load to get a result. But you missed that super compensation because the amount of load you're putting on means there's no recovery and that means that the result you get it, but you get it it's such a hopper that after a long period of time you end up burning out, and that's what we want to avoid. So this is why it's important to remember there in daily life and business you need the recovery aspect in there, it should be like a training program. Lisa: And there was a really good example last week. High end executives really pushing the limits on a business point of view and in doing that day in day out, year in, year out and leading—but leading to problems. And this is a societal problem where we all under the pump all the time, or a lot of us are. And that does lead and it's trying to manage your—the physiology because our physiology is still old. And the fact that it’s ancient, our DNA hasn't necessarily evolved to our current lifestyle and so trying to manage this as best we can to get the best results. Now talk about super compensation, I did a really hard CrossFit workout yesterday, and I've got very sore ass cheeks today. So I'm not going to go and smash myself again today, and that because I want that super compensation. The fact that I have sore muscles, sore glutes, and sore legs means and I caused a training stimulus. So right now my body is weaker and I need to give it a bit of recovery, and recovery might mean doing a bit of yoga today and a gentle walk and maybe a light jog. But it doesn't mean going and smashing myself again today because that will likely lead to a negative adaptation. And I want to get the most out of that painful workout yesterday. So I know to back off a little bit today.  And that's what hold training plans are about—getting that combination right and that periodisation right for your particular goal. And that's what we do with Running Hot, with all our athletes that we're training is periodisation. So that they peak at the right time, and they get the most super compensation and not the negative adaptations that can happen when you start to go into that overtraining. And it's quite counterintuitive, isn't it? Because as athletes, you just want to go hard and go hard again the next day and then go home. You've had a sleep, you've had some food, you should be good to go again. But you do need that recovery time, both on a 24 hour hourly basis, as on a monthly basis, as on a yearly basis. So we're going to talk a little bit about that as we go through the session. These are micro and macro cycles we're talking about. So let's talk a little bit about this and what it is to get this just right? And how important the accumulation of stress can lead to your downfall? And why resilience is really found in race? So what are some of the symptoms for somebody, either as an athlete, or as a corporate athlete, or someone who's got three kids and two day jobs, what are some of the signs that that stress is starting to take a toll on their physiology and on their psychology as well? Neil: For mental health point of view, we've got people on too much load and too much stress is where depression will start to come in—anxiety, anger. And those feelings, the risk of chronic disease goes through the roof that just jumps up, jumps up massively and puts more load on the body, and then the immune system just starts to drop as well because that additional load, there's no rest on the body.  On the flip side, if you've got the balance just right. So we're talking about that super compensation, you're getting the balance, right, so you're getting that result, then you're going to feel calm, you're going to feel more proactive. There'd be lots of growth and recovery. And from a health point of view, your health is optimised, and your immune system’s strong.  Now, a lot of people we're speaking to in the trap of going hard, going hard, going hard, it’s going hard. And then we get those feelings of anxiety, anger, depression, and more disease issues. As we work through people's blood with them, we're seeing higher risk of disease when we're looking at bloods now than what we have done in the past, which has a bigger impact, obviously, on immune system and future chronic disease as well.  So taking in those and listening, you will have found those times in life where you felt that productivity was good, you felt calm, there was good growth, and you feel on point. I guarantee you, when you look at those times, you'd have had good balance, and you've had enough rest and recovery in the day, in the week, the month, the year. It means that you're getting those benefits you should from a stress management point of view. And some of you listening as well will have experienced the others and most of us—Lisa and I have at some different points in life, where you experienced the anxiety, the anger, because you've got the balance wrong. And that's an easy—easy is the wrong word to use. But once you understand that, it is an easy fix to make.It's just understanding the how to make the fix so you get the resilience. And as you said earlier in the exercise example, it's counterintuitive because the resilience is found in rest. But society will say to us that resilience is found in pushing harder, in doing more, doing more and doing more, but it's found in rest. And that's where a lot of the happy feelings and emotions are found as well, by taking time out, time to reflect time to show gratitude, and to allow you to move forward. And at the end of the day it's in—you've used this example recently as well, if you haven't been healthy.  Lisa: You got nothing. You have zero. Neil: Exactly. So you need it. Lisa: Yes, and I think like that depression, anxiety and anger part of the puzzle. So these are all your neurotransmitters that are at play here. So your dopamine, your GABA, your serotonin, your adrenaline, your cortisol, all of these things that are actual chemical things in your body causing you to feel a certain way.  So when you see yourself—and I mean this is definitely talking to me here. When I see myself getting irritable and angry and snapping and being anxious about the future, then I know, “Hang on.” And Neil will say to me, or my husband will say to me, ‘Hey, you're getting out of control again’. And I’m like, ‘Well, okay, I need to take more time out’. And just sometimes like taking a couple of hours out for yourself is not being selfish. And I really, really struggle with this one because it's for me, it's like a guilt, ‘But I should be doing this’, and ‘I should be doing that’. And I've got a billion things on my to do list. And so I hear the people when they say, ‘But I haven't got time for that’. It's like, yes, but do you want to be an asshole to your friends and family?  Like, if we get down to it, that's what happens, and depressed and miserable and losing the joy of life. When you don't have enough GABA, which is one of your neurotransmitters, and you don't have enough serotonin in your body, that's what you're going to feel. You're going to have lose the love for life, you're going to lose the love for your passions, that your hobbies, you're going to like—not be interested in them anymore, you're not going to have that dopamine hit where you want to get up and go and you're motivated to drive towards something.  So when you feel that those neurotransmitters are off, by just backing off the accelerator pedal, having some time out to do some health and self care, like I love getting into a sauna, or going for a walk, or doing some stretching, or doing some meditation, or breath work for me is huge. All these things help me manage my emotional state and help my body recover. And we often think that, ‘Ugh, I've just got to get over it. And I'll have a good sleep tonight, and I'll be good’. But if you're not giving your body, the right ingredients, the right nutrients, the right time out and play, then you're not going to have the right combination of neurotransmitters running around in your body. And no matter how much willpower you have, you're probably not going to have a positive outlook on life. And it's something I've really had to learn the hard way.  Now, after going through a very stressful few months that I've been through with losing my Dad, I've had to prioritize just doing something I love. And for me that might be—I'm into painting at the moment, following my dad's footsteps, and that gives me joy. And finding joy in something is a real key to my mental balance. I'm not being selfish when I take half an hour to paint a picture. I'm not being selfish. I'm being sensible, and I'm looking after my own health and therefore the health of my loved ones. And that does have an effect on our people around us. And none of us want to be that horrible person that's grumpy all the time. It's not much fun. So.  Neil: Definitely, it’s a great, great example. And thing as well, as people are listening is understanding that what is worked for you won't necessarily work for everyone and vice versa. So it's finding your thing, and your rest and relaxation, self care, it's going to be different for each person. And if you try things, and they're not working for you, resonate with you, then try something else. And once you find your sweet spot, like you described the painting, then you will find those feelings. So, I wouldn't necessarily get it from painting, just because I can't paint.  Lisa: Neither can I. Neil: There’s other things I definitely get it from. So it’s understanding that you find what's your sweet spot, and what's going to have that impact on your body. Once you understand that, then it becomes a lot easier to do. Lisa: And don't think you're being selfish because you're doing it. That's the real key message and trying to prioritize us because it's like where the corporate executives last week. You have to perform. Yes, but underpinning your performance is health. So if you don't have health, it shouldn't be something that you optionally do on the side, it’s one of the things you get around to, it underpins everything.  So this is part of your health, regime, your practice. And if you see health and looking after yourself, and that's nutrition, that's fitness, that’s all of those things. If you see that as the foundation on which to build your house, that's a different approach, than to seeing it as a pillar on the side that you want to get around to, that you never do get around to.  For Neil and I, it is fundamental. It is our priority. It is also our business in our case. And we can't be good examples to you guys if we're not performing the best that we can and looking after ourselves. And just reprioritising—having those conversations in your own head is about, ‘it's not being selfish, this is being sensible’.  So now, I'm going to talk a little bit about the stress curves and the phases that you go through from good health and homeostasis, right through the exhaustion stage. Neil, can you explain this concept a little bit? Neil: Yes, so we look at different stages as we go through the stress curve. So if we're looking at homeostasis, as you saying good health, this is when the body's in balance, and it's stable and hasn't been pushed, there's no stress on it. And we've got in a calm, there's nothing that changes, changing the environment. So that'd be a nice place to be all the time. But most of us would get bored quite quickly, and would generally get anything done. So good space to be for your body but that's the sweet spot. So we want to spend some time in that. And we want to spend ideally some time in that each day, each week, each month, each year, so we manage those peaks and troughs.  The alarm stage, which comes next is where we start thinking, readying ourselves for the future. So this is where we've got heightened awareness, increased speed of thinking, higher attention, and generally a higher state of arousal. Nothing's happening yet, but we're readying ourselves for this. So this one of Lisa’s example, could be getting ready for a marathon, or a race, or a running event. It could be getting ready for a big, big meeting, or big presentation where you're preparing yourself for it. You've been going through the process, your body starts, the blood pressure will go up, heart rate will go up. You get a physiological response going on in your body to prepare yourself to what's to come.  Now that's healthy, if you're not in it all the time. Okay, so that's healthy, it’s good if you're in all the time, we want to be able to ready ourselves for that. Where we're seeing quite a lot of problems at the moment, as people aren't coming out this, they're always on.  Lisa: Staying on the alarm stage.  Neil:  They’re always on, they’re always switched on, they're lively. They're always twitchy and ready to go. And if you don't come out of that, then your body's not going to have the chance to recover and you're going to start to get—from a physiological point of view, those stress hormones flying through your body at a great speed. And that's what starts to put more problems on the body and problems with health. And that's where we see more issues with chronic disease and where we see bigger issues and those feelings of anger, anxiety, depression, and mental health.  Lisa: Mental health. I mean, I've got like an example there with just being open about my life with going through the drama with my dad and losing him. And being in that alarm phase, where we're fighting for his life for a couple of weeks in hospital and going harder, harder, in that absolute. I was in the alarm stage, and then the next stage, which is the resistance stage, where you're actually in the doing. And now we lost the battle, in that case.  And now, the anxiety that comes with being in that state for a few months, means that my body needs a massive amount of recovery right now. It doesn't need to be smashed and smashed with really high intensity workouts constantly and I'm slowly—but rebuilding, but it's the understanding that that's had a trauma on your life. And that has led to a very bad state of affairs, as far as all your exhaustion, all your stress hormones were concerned. And if I don't do something about that now, what that could lead to as real big health issues.  And I saw this when I went through it with my mom, four and a half years ago with her journey. I went hard out for the first 10, 11 months like to the point of like, absolutely blind myself to pieces, and I had to because she needed that. But then my body shut down, and then I was in and out of hospital. And I was in shit creek basically for the next year because my body was in that exhaustion stage, which is what we're going to talk about next. And so it's understanding—just as that's an example of my life, but we are going in and out of these stages on a daily basis, but also on a weekly basis and on a monthly and yearly basis.  So we just talked about the alarm stage where you're ready for action, but nothing's actually happened yet. So you're all anticipating and then you're in the actual resistance stage, which is the doing part of putting stress on your body. So you're taking action, you're making your body adjust and cope with the environment and you're in the fight. You're using the fuel and your body is resisting the stress. So this could be doing a workout. It could be situations like I was in, this is where you're going under slipped, maybe you're tired, you're pushing through, your stress hormones are very, very high. And this is a stage you can also get really stuck, isn’t that Neil? Neil: Yes, it's spending too long here as well. A good example where we see too many people doing it is—I was having this conversation, someone today is just not getting enough sleep. We've all done it where we've had deadline at work or lots going on, but so many people are pushing it further and further and further now. So even though you're tired, you push through, using your stress hormones to stay on it, and there comes a point where your body will just stop producing the stress hormones as it should. And then you're really into the neutral phase. And that's when you start to get the risk of the chronic disease and the other feelings that we talked about—anxiety, depression, and the mental health side of things.  Lisa: There is a reason why chronic disease is just going up exponentially in society today, I mean that and toxins and environment and all that sort of jazz and food chains. But one of the big problems is this chronic state of exhaustion all the time I think, so that actually... Neil: To add to your point earlier, you shouldn’t add the other things in it like poor food. You then add pollution, you add in toxins we've got around us.  Lisa: Heavy metals. Neil: All of those things have all increased, and they've increased massively over previous years. And we're looking after our bodies less than we ever have done. So now we're in a position that they add those other things on top, and all of a sudden, the load just comes more and more and more.  So it's been where as well—where your stress is coming from, like we spoke about the start. It could be that simply by changing your eating habits, or the time of day you're eating, and what you're eating, and when you're eating, all of a sudden, that actually takes a load off your body. So you manage your work a whole lot more effectively. Sometimes the answer isn't actually just addressing what's under your nose and addressing your work, it could be addressing your food, your movement, how you're looking after your mind and all those things and then change your perception of work totally. So you can manage it a whole lot more effectively.  Lisa: Yes, absolutely. So the last stage that we wanted to talk about is going into the exhaustion stage, which is what we just explained, Neil, where you're absolutely been on the go for—God knows how many weeks, months, years, and your body is starting to shut down. And this is where you are starting to get chronic problems, and serious ones.  And this is the phase you don't want to get into because this is where you're going to be set on your ass, whether you like it or not, where your health is going to go down like mine did. And you will be forced to take a break. But we want to prevent that whenever possible. I mean, sometimes life is just going to throw a curveball at you. But if you understand this process, and you can perhaps stop getting to that exhaustion stage and understand that those stress hormones, I think most people think, ‘I've heard stress is bad for me. But how is it bad for me’?  Well, if we just go back, and I have talked about this a couple of times, but your parasympathetic and your sympathetic nervous systems, you've got these two systems, your rest and recovery and your sort of go-go-go state of affairs. And that sure is sympathetic, and most of us are sympathetic dominant. We're not having enough time for that rest and recovery, and our ancient biology is just really not keeping up.  And when you are in that fight or flight state, and you've got lots of cortisol and you've got lots of adrenal and you're taking energy away from your immune system, you are taking energy away from your digestive system, you're taking blood flow away from different parts of your brain, so you're not unable to make good decisions. You're unable to digest your food, and then you're affect your absorption. And that can affect your thyroid and it can affect your immune system, and on and on it goes.  So this is how stress actually has a physical effect on the body. It's not just a mental thing. I think people think often it's just a mental—under stress as a mental—no, it's very much a physical reaction of the body about where the body is putting the resources. You have a limited finite amount of money in the bank, or energy in the body, and their body is going to prioritise the areas that are most important.  So if it thinks that you're running away from the lion, it's going to put all the energy into making stress hormones, to making sure your blood is in your muscles so that you can run and you can fight. It's not going to be—in helping your immune system repair. It's not going to be in fighting infection. It's not going to be digesting and this is where the resources are being put. So it's like you spending all the money that you earn from your job in one particular area of your life and not paying the mortgage. That's what's happening. And you need to be paying that mortgage otherwise you're going to lose the house. That's a really good analogy, actually isn't Neil?  Neil: Yes, it’s a great comparison. And it brings us back to where we were talking about the start is where you're allocating your time to. In that example where you're allocating your money to, but if you're allocating all of your funds, all your time to one particular area, then something else is going to suffer. Lisa: It's going to crash. We like to think we're superheroes and Neil you’re very, very close to being a superhero. But we're not really, we’re not really both. Neil: Thanks. For me, I’m a little bit of one. Lisa: Yes, for your kids. Neil: And understanding as well that these different phases that we've just been talking about. You can go through these levels in one day, which was what we call a micro cycle, or you can over a longer period of time, months, years—go through them as a macro cycle, so a bigger cycle.  So we've talked about what happens if we stay in these phases, each of these phases too long. And Lisa has given some real good examples from her life is what does actually happen, from a mental and physical point of view, as well. So the fact that you can go through them each day, the exciting thing about that is you can put yourself in a position that you can control them each day. So you might feel like it's a big mountain to climb. And you've got to do a lot before you can get a grip of it. But you can actually make some quite significant easy changes each day to mean that you can start going in and out of these.   And sometimes just little micro rests, small rests, small windows opportunity where you actually can switch off the body, switch off the mind. And again, different things work for different people. But once you find your thing, start doing more of it because this will get you longer results in work, family, and sport as well. It applies to every aspect of the puzzle.  We talk a lot as well with getting people become more aware of themselves. So when we talk about awareness, we will look at the load that’s going to put on people's body. And I know that this has made a big difference that hasn't at least just been increasing our awareness around stress and our own personal wellness. And as we've increased that, it's made a big difference to what we're doing. And generally, we've seen those with lower awareness will generally tend to externalize their problems more, lose control more, the factors influencing their mood in life, and often will blame others more—it's someone else's fault, someone else's problem.  The greater awareness is, you’re more likely to take ownership of our problems, more likely to deal with them, and control our mood or health and how we look at the world. So it puts us in a much better position. Generally as well, we've seen that awareness will increase with age, although this isn't always the case.  Lisa: Not always.  Neil: Not always the case, the increase in experience. So as we've dug deeper into the science of what we do, how we do it, is definitely increased our awareness to the point that as we've experienced more things, coach more people through these things, our perspectives changed and as well, the way we self-reflect. And that's all led to low levels of stress because we've now got a better understanding of what's going on, why it's going on, and what load is having on our body so we can do something about it.  Lisa: And we can look after each other better, just as business partners, right?  Neil: Great point. Great point.  Lisa: It’s really important for corporate teams or sports teams to start recognizing signs and others And if you are more aware than the other person is then you can help them more and that is your responsibility then to be aware of other people and their needs around you. So that you can actually prevent things from spiralling out of control, and support each other a little bit better. And back off when things are getting tough for somebody and push a bit harder when someone needs a kick up the jacksy. So it's all about helping others and being more aware.  So if you find yourself blaming everybody else for the situation, then you're probably not very aware of things that are going on because you're just externalizing. If you're moaning a lot, ‘Well this is shit and that is shit. And my boss's this and my things that’, then you might want to have a look at the way that you're actually processing things and understanding things and take more ownership.  I'll give you an example of this with some of the people that come to ask for health problems and health consulting and health optimisation. I can sort of pretty much tell in the first 10 minutes whether this person is taking ownership of the situation, or whether they're just blaming everybody else and they're angry about it, but they want a magic bullet. And the ones who want an instant fix in blaming everyone else and not taking ownership over the situation are very difficult to work with from a coaching perspective and also very unlikely to get great results. And will likely blame you in six week’s time because they didn't get the result.  And they will go through 10 coaches and they'll go through 20 coaches and they will still have no results at the end of it. And it’s not necessarily the coaches’ problems, or the health professional problem, it is often the fact that they are not taking ownership about the things that they can take ownership on, in educating themselves and working on it.  So you can start to work on pieces of the puzzle. You may have a big health issue, for example, and now we work with some people with some pretty serious freaking health issues. And when you can work on a piece of it today and this piece of it, and we can work like a detective, and we can work through problems, you don't have to tackle the whole thing at once. But it's being more aware, ‘Am I a person who goes through life blaming everybody else, blaming the system, blaming that? Or am I someone who does something about it? Takes ownership, start to make change in your own life, and affect what you can as well as trying to influence the world around you’? Does it make sense? Neil: It makes perfect sense, Lisa. It really does. It's a great, great takeaway for the listeners, as well, just ask yourself that question, ‘Where am I at from a self-awareness perspective with regards to my own personal wellness’? And you can use those examples you just went through there, put a scale on it.  But we've got a great list of questions, Lisa. We can start to get the listeners to use to increase their awareness around their own stress. The thing we wanted to point out as well as we start to wrap things up is that everyone will respond to stress in a different way. So therefore, the way we respond to stress is going to be different. So therefore, the way we manage it is going to be different as well.  So as you're going through these questions, there's no right answer, there's no correct answer. It's an answer that should be individual to you and should be personal to you. So ask the question, What is the biggest stress you've got at the moment? And how is it expressing? What is the stress you're expressing in your body?  Number two, what normally causes stress for your body? So you'll be very aware how your body reacts and feels in different situations. So take time to listen to what it's saying, where you feel stress increasing, you feel your anxiety levels climb, and just feel your body tensing? If you start to get signs and symptoms—and again, it's going to be different for everybody and take note of them and do something about them. We work with so many people that get the signs and symptoms, but don't take note of them and don't do anything about them.  How's the stress showing up? Is it coming in certain environments? Is it around certain people? Is it around certain conversations? So again, ask that question, when is it showing up? When is it arriving? Can you change anything there to make sure it doesn't show up? And what can be done immediately to alleviate the feeling and to support your biology? You made the great reference earlier in the conversation about painting and what that does for you. For me going and moving and I know this works for you as well, Lisa, but going in and moving, getting something, going rhythmical is great for my mind. That could be walking, swimming, running, cycling doesn't have to be anything high intensity, but just movement helps massively. Rhythmical movement will help calm my body, calm my mind.  And what can those around you do to support you? Now as we've been throughout our career as coach and athlete, and now in business, we're very aware of how we can support each other. But that's taken time to have the conversations and work through it and talk to each other about it. I know you do with Haisley, and I do it with my wife, Sam. Once you understand those things, and we've set it up with the people we work with around us as well, it makes a massive difference. If people understand how to support you, and are aware that there's different ways that different people are going to get stressed—what stresses you is going to be different for me. So if I don't take the time to understand that, I'm going to be going through thinking, ‘Now it doesn't worry me, it's not going to worry Lisa’, and that work in both directions.  And number six, what can I do to manage my stress response better? So again, just asking the question would increase awareness. The fact that we're drawing attention to it increases awareness, which means we're more likely to do something about it. Then finally, what are the long-term strategies that I can implement to lower my residual stress? So once I work out the answers to the previous questions, then what can I do long term? And it could be as simple as we're big fans, as we always say, of what's the low hanging fruit? Is it simple now that I go to question five and go, right, ‘What can others do to support me? Am going to make those around me—my family, my friends, my close work colleagues—am I going to make them aware of what's causing me stress, so that they can help me and pull me up’?  Like we do with each other will often pull each other up and go, ‘Right. This is clearly getting a bit much’. Going this direction, we'll do this differently, or you give me time to do things and process things because you know that helps keep me calm. And when you're going fast and hard, I say well, ‘Time to slow down. It's great but you’re getting too excited, come back’. And that works for us. So increasing awareness really does help you get results rather than just accepting that, ‘I'm going to carry on with the back pain. I'm going to carry on the inflammation in my body. I'm going to carry on with the upset stomach. And not connect them back to something external that’s causing it.  Lisa: That’s a really good one because like I had a conversation with someone today and I've got repeated inflammation in the body, repeated pains in the neck, and then not connecting the dots. They connected one dot today that I went, ‘Hah, finally something is starting to drop’. When you are having pains every which way in the body, if your initial thing was to go, ‘Well, I've tweaked my back’. Instead of going, ‘Hang on, why am I having ongoing injuries? Or why am I having a stack of things happening to me? Or why am I getting pains here, and then I'm getting pains there, there's something underlying going on’.  And what we're saying is often that underlying thing is an inflammatory response is related to stress, very often you'll find a component at least of stress. And then it can you know, as we see, it can be from a food stress or toxins, through a psychological stress, from lack of movement, stress, or lack of sleep, dehydration, but these are all forms of stress. And so understanding what is the trigger and trying to connect the dots and this is where that self-awareness.  And in using these simple tools that we've been talking about on this podcast and other podcasts that we've done—the breath work stuff, the meditation stuff, and the movement stuff, the routines for habits, the healthy habits that you develop over time, and you start to stack one on another. And these little things that help you manage your biology, and help you manage your dopamine levels and your serotonin, all your good neurotransmitters, and your hormones and all these things. And it is about tweak, tweak, tweak, tweak, until your life starts to look better, feel better, and be better. And then it will be a constant thing. It's not like you're going to do this once and you're good to go.  Neil and I have a whole lot of tools in our kit that we can pull out in times of stress to help us get through. However, we're still going to have times when we tip out of balance, and then we need each other and their family members and other—my friends to put us back in the balance again, and just make us aware. It's not a one and done thing. It's a constant tweaking, learning, growing process, about trying to keep yourself in a good, a good state, both physically and mentally.  Neil: A lot more and more, Lisa. I'm asking people, it should be like with some of these things that you do to look after your body. It should be like brushing your teeth. I ask the people I'm working with one on one, I say, ‘Right, did you brush your teeth today’? Now know what I mean? I've asked two or three people, really say, ‘We brushed our teeth’. And what I meant was, ‘Have you done any mobility work? Have you done the breathing work and what's right for their biology? Have you been out, spent time in nature, and I might get responses like their response that they're actually a bit fluffy today.  But we do those things every day. And you talk about habit stacking. And it's exactly that. If you can brush your teeth every day, then you can do the other things that will control and maximize your health and do them as well, the simple little things, it’s not just about brushing your teeth. So let's start putting some other things in practice that do that crucial awareness. We don’t do it, isn’t it? Lisa: We think we have to have the most expensive piece of equipment or the best supplement or the greatest course or—actually if we just did the basics right, often that will give us a good foundation. Yes, we can get fancy fancy stuff later and get more into it if you want to really tweak your biology which we love doing and testing and trialing and experimenting, but just getting those basics right. And yes, making it the underlying underpinning philosophy of your whole life, that has to be at the core of it. Health, looking after yourself has to be at the core of it, and it is not being selfish.  Again, I had someone else today, very stressful life, a lot going on. I’m telling them the same thing we can week out, they're coming back with this problem and that problem, and they're not hearing what's going on, and they're not willing to invest in the right things, or to buy the right foods, or to sit down and actually go through the process of actually making the small changes. Because they want the quick answer and you have to look after yourself and they also don't prioritise themselves. Everybody else comes before them.  And therefore they are going to be unhealthy ongoing until they can come to that point of self awareness that they have to be doing these small changes and getting the micronutrients and avoiding certain things and changing just little behaviors so that they can actually be a good father, a good husband, a good wife, a good friend, a good colleague, whatever the case may be, put your own oxygen mask on first before you help somebody else. It's not being selfish. So I think that's a pretty good place to wrap it up for today, isn't it Niel? Neil: I agree. Agree. As always good chatting mate, good chatting.  Lisa: Good chatting. And if you enjoyed this, please let us know. We'd love to get here. You know what you thought about the shows that we're putting out, the information that we're putting out. We'd love to get comments and feedbacks, of course rating and reviews are always appreciated. But just yes, if it's helped you let us know.  If you want more information, and of course, we'd love to work with you. Reach out to us as we have our epigenetics program, which is all about understanding your genes and how they interact with the environment and how to optimise and getting rid of trial and error, and knowing what to do for your body. Then we also have our online run training programs, of course, which we love, training athletes, going and doing amazing things all around the place again, or a holistic approach to everything that we do.  So reach out to us, support@listamati.com. We'll find both new life and thanks for listening today. We really appreciate your time and attention. Any last comments, mate?  Neil: I’d like to say good chatting. We're looking forward to another conversation soon. Lisa: Right. I'm going to go and do some movement in nature. Brilliant. We'll see you next week, everybody.  That's it this week for Pushing the Limits. Be sure to rate, review, and share with your friends and head over and visit Lisa and her team at lisatamati.com.  The information contained in this show is not medical advice it is for educational purposes only and the opinions of guests are not the views of the show. Please seed your own medical advice from a registered medical professional.

Whether you are a beginner or experienced ultramarathon runner, you need to be well-prepared for every run you do. Ultra running has its bright side — the uplifting community, the sense of accomplishment, and the goals of becoming stronger. However, there are certain risks involved in the sport, and as an athlete, you need to keep yourself informed. In this episode, Eugene Bingham joins me to explain the dangers of extreme sports and marathons. We share personal stories about the damage it could do to the body — experiences that should serve as a warning to runners. Eugene also discusses things to be aware of before and during races that can endanger us, giving us five specific tips for preparation and self-management. Don’t miss this episode and learn more about the risks of and preparations for ultra running and other extreme sports!   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition, and mental performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join our free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   One-on-One Health Optimization Coaching  If you would like to work with me one to one on anything from your mindset, to head injuries,  to biohacking your health, to optimal performance or executive coaching, please book a consultation here.    Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research, and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: Learn about the risks and dangers of extreme sports and ultra running. Gain valuable insight into the things you need to be aware of before and during marathons. Understand the importance of listening to your body.   Resources Death of a runner: The rare condition that tragically claimed a life by Eugene Bingham Desert Runners on TVNZ   Episode Highlights [04:01] The Dangers of Extreme Sports and Ultramarathons Eugene participated in the 2020 Tarawera 100-mile race where an experienced runner died. The runner’s death certificate showed that he had a multi-organ failure, acute respiratory distress syndrome, and rhabdomyolysis. However, it was difficult to pinpoint the true cause of death since it can be a result of accumulated health conditions. [09:50] What Is Rhabdomyolysis? Rhabdomyolysis, or muscle breakdown, is quite common for runners. As the muscle breaks down, myoglobin from the muscle is released into the bloodstream, clogging the kidneys. It can be difficult to tell when this happens since symptoms can be easily mistaken for simple muscle soreness. This can happen to everyone, not just those who do extreme sports and ultra running. [16:27] Importance of Self-Management At some point, we have to ask ourselves if the damage we’re doing to our body is worth it. There are risks, and you have to be prepared for them.  There is a culture of not quitting unless you’re taken by the ambulance. However, we have to listen to our body before it gets to that point. [20:19] Mental Toughness and Listening to Your Body As we grow, our physical abilities and mental maturity changes. Accept that the body may not be able to take what it could years ago. The goal of pushing your limits is good but keep in mind that you also need to train and prepare yourself. Being mentally tough also means knowing when to stop and rest. [22:53] Ultra Running: 5 Tips to Remember Do not take drugs like ibuprofen and Voltaire.  Drink when you’re thirsty and do not over drink.  Be prepared for a range of weather conditions. The race does not end at the finish line. Replenish yourself after every race. Look out for each other. [28:08] Always Have Support Eugene shares his experience of having hallucinations but was kept safe by his companions. Form connections and friendships with the people you meet in races. They are bonds that last forever. Listen to the full episode to hear Eugene and Lisa share more stories about how people have helped them during races! [38:33] Conditions to Be Aware of We need to be careful about dehydration. Symptoms of hyponatremia (having low sodium levels in your blood) are swelling, nausea, and lightheadedness. Low levels of potassium and electrolyte imbalance can result in tetany seizures. Electrolyte tablets are beneficial — make sure they have all the nutrients you need. Having no appetite after a race is dangerous. We need to replenish our bodies straight away.  [47:10] Risks Are Exponential When you exponentially increase the distance you run, you exponentially increase our risks as well. All races are relative to pace. Never underestimate a race by distance. Take every race like a big deal and don’t become complacent. Recovery after a race is also crucial. Don’t succumb to peer pressure and sign up for a race immediately after. [51:53] Quick Checklist Do not expect that you can do it just because you’ve done it once before. Be aware of conditions such as rhabdomyolysis, heat stroke, hyponatremia, dehydration, seizures, electrolyte imbalances, and breaking ankles. Plan well — note altitudes and paths. Running is just like driving. Driving is considered dangerous but we don’t avoid it; we just take extra measures and precautions to make sure that we are safe.   7 Powerful Quotes from This Episode ‘People need to be really conscious of the risks — they need to be prepared to put the time in. You've got to prepare your body and you've got to know your body’. ‘Having lined up at the start line with someone who didn't make it home — that really reinforces that these are real risks and you have to be prepared for them’. ‘The race doesn't end at the finish. Some of the most dangerous time is after that: when people get to the finish line and drive home, they're tired — you can crash easily’. ‘Sometimes there's a bit of competition, isn't there. But, number one, you've got to look out for each other. You are comrades — you've got to have each other's backs’. ‘It is incredible, those connections you make. Even if you don't see each other again, but yes, you've got that bond. That's forever’. ‘Take those precautions. Just be a bit careful. We want to push ourselves. Yes, we want to be out there. Yes, we want to find new limits, but we also want to get back home’. ‘Respect the distance. You cannot run something like this without respecting it’.   About Eugene Bingham Eugene Bingham is a senior journalist at Stuff, co-host of the Dirt Church Radio trail running podcast with his mate Matt Rayment and an ultramarathon runner. In a career of almost 30 years, he’s reported and produced news and current affairs, winning multiple awards as an investigative journalist. His work has taken him to three Olympic Games, and a number of countries including Afghanistan, the Philippines and the Pacific. No matter where he goes, he always packs his running shoes. He has a marathon PB of 2h 43m and his longest event is the Tarawera Ultra 100-mile race which he ran in February 2020. Eugene is married to journalist Suzanne McFadden and they have two grown-up boys. You can listen to their podcast on Dirt Church Radio. You can also follow and support them on Patreon, Instagram, and Twitter.  Have questions you’d like to ask? You can reach Eugene at his email.   Enjoyed This Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so they can be aware of the dangers of extreme sports and ultra running. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram, and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript For The Podcast! Welcome to Pushing the Limits, the show that helps you reach your full potential, with your host, Lisa Tamati. Brought to you by lisatamati.com.  Lisa Tamati: Well, hi, everyone, and welcome back to this week's episode of Pushing the Limits. Today, I have journalist and ultramarathon running legend, Eugene Bingham, to guest. And Eugene is the host of the podcast, Dirt Church Radio, which I hope you guys are listening to. It's a really fascinating insight into the world of running and trail running. And he has a really unique style, him and his friend, Matt Raymond, run their podcast. So I hope you enjoy this interview.  Today we're talking about the dangers of extreme sports, not just ultramarathon running, but doing—pushing your body to the limits. While, you know I'm definitely a proponent of going hard and mental toughness and pushing the body and all that sort of good stuff. We also need to know about the downside. We also need to know about the risks. And recently there was a death, unfortunately, at the Tarawera Ultramarathon of a very experienced ultramarathon runner. And so we're going to dive into some of the dangers and some of the things that need to be aware of when it comes to pushing the body to the limits. And so you have an informed consent and an understanding of what you're getting into when you're doing these sorts of things.  Before we head over to the show, though, please give them a rating, review to the show if you enjoy the content. Really, really appreciate the comments and the reviews and if you can do that on iTunes, or wherever you're listening, that would be really, really appreciated. And if you haven't sold your Christmas stocking yet, please head over to my shop and check out my books, Running Hot, which is chronicling all my running adventures in my early days, Running to Extremes. Both of those books bestsellers, and my new book, Relentless - How A Mother And Daughter Defied The Odds, which is really a book about overcoming incredible obstacles, the mindset that's required, the stuff that I learned while I was running and how it helped in this very real world situation, facing a very dire situation within the family. I hope you enjoy those books and if you have read them, please reach out to me, give me a review. Again, if you can, I'd really appreciate that you can reach me at lisa@lisatamati.com.  And just a reminder too, we are still taking on a few people, on one on one health optimization coaching, if you're wanting to optimise your health, whether it be with a difficult health challenge, that you're not getting answers to mainstream health and you're wanting some help navigating the difficult waters that can sometimes be, please reach out to us. And we deal with some very intricate cases. And I have a huge network of people that I work with that we can also refer you out to. I am not a doctor, but I am a health optimisation coach and an epigenetics coach. And we use all of the things that we've spent years studying to help people navigate and advocate for them, and connect them to the right places. And this is a very different type of health service if you like and it's quite high touch and it's quite getting into the nitty gritty and being a detective basically. And I'm really enjoying this type of work and helping people whether it be with head injuries, with strokes, with cancer journeys, thyroid problems, or all these types of issues. Not that we have it or every answer there is under the sun. But we're very good at being detectives working out what's going on and referring you to the right places where required. So if you're interested in that, please reach out to us lisa@lisatamati.com. Right, now over to the show with Eugene Bingham.  Well, hi, everyone, and welcome back to the show. I have Eugene Bingham. I know he's so famous, he actually sit down with me to record this session. So fantastic to have you here. Right? How are you doing?  Eugene Bingham: I'm very well, thank you. And thank you for having me on. Such an honour.  Lisa: Fantastic. Yes. Well, I was lucky to be on your show. And you've been on mine, and we just really connected. So I wanted to get you back on because you've just written an article, which was very, I thought was an important one to discuss. And it was about the tragic death of an ultrarunner last year or this year in the Tarawera Ultramarathon. And while we don't want to go too deep into the specifics of that particular case or we'd like to know what you know about it... Eugene: Sure.  Lisa: ...but wanted to have a discussion around the dangers of extreme sport or ultramarathon running and some of the things we just need to be aware of. So, obviously Eugene and I—neither of us are doctors or any of this should be construed as medical advice, but just as—have to give them out there...  Eugene: Absolutely.  Lisa: But as runners and people who have experienced quite a lot in the running scene, and I've certainly experienced enough drama, that it is something that we need to talk about. So Eugene, tell us a little bit about what happened? And what are you happy to share  Eugene: Sure.  Lisa: ...and what you wrote about in your article, which we will link to in the show notes, by the way. Eugene: Yes. Thank you. Sure. Yes, so I was a competitor in the Tarawera hundred mile race in February, which as you said—when you said last year, it does feel like last year, doesn't it? Oh gosh, it feels like it was five years ago. But it was February 2020, all those years ago. And in that race was sort of about 260 of us lined up. And then that race was a runner an older—oh, he’s 52. So from Japan, a very experienced runner, had run Tarawera previously, had run lots of other miles, and ultraraces. And unfortunately, about a kilometre or so from the finish, he collapsed, and about 34 hours into the race. And although people rushed to help them, and he was taken to retro hospital, and eventually to Auckland City Hospital, he died. And I remember, I remember the afternoon we heard about it, and Tarawera put it up on its Facebook page to let us all know that one of our fellow runners had died and I stopped. It was a shock.  Lisa: Yes. Eugene: You know we do this thing, because we love it.  Lisa: Yes. Eugene: And because we get enjoyment from it. And he was someone who paid the ultimate price.  Lisa: Yes.  Eugene: So I—we're a couple of hats, and one of them is a journalist, and so I—but really, what first kicked in was, I really want to know what happened. I really wanted to know what happened. I've had health issues myself, had a few scares and so on. A few wobbles and races, and I thought—just from my point of view, I was really curious to find out. But I also thought it was important to find out for other runners... Lisa: Yes, absolutely. Eugene: ...or say, I listen for others. And so I started to see if I could find out. COVID got the way a little bit and distracted me. But eventually I did manage to track down what happened there. Yes. Lisa: And what was the result of the findings in this particular case? I mean, we're gonna want to discuss a few.  Eugene: Sure. Lisa: I think, in this case, it was a couple of things, wasn't it? But this is without picking—and we're certainly not picking on anybody or any, not race, or anything or saying this is bad or anything. But what was it that you discovered in it?  Eugene: Yes. Lisa: So with that, research.  Eugene: Sure. So initially, I remember the talk was that he might have had a stroke, or there might have been some sort of underlying condition.  Lisa: Yes.  Eugene: But I got a hold of his death certificate and it shows that he had multiorgan failure, and acute respiratory distress syndrome, which are both conditions that they can be in multiple causes of those sorts of things. But the one that jumped out to me was Rhabdo. You're gonna make me say that? The proper name for it. Lisa: Rhabdomyolysis Eugene: Thank you. Lisa: I'm an expert in rhabdo. Eugene: So yes, that was the third one on the list. And that was the one that really jumped out at me.  Lisa: Yes.  Eugene: Months earlier, I'd spoken to Dr Marty Hoffman, who's in a University of California Davis in the States, and he's sort of recognised around the world. Basically, if there's an ultra—there's a paper about medicine involving ultrarunning, you'll find Marty Hoffman's name on it, he knows this stuff.  So I'd run to him months ago, at the suggestion of a friend, Dr John Onate, and I had a good chat with him. And he sort of ran through the list of what we could be looking at here, but he was really—it was a stab in the dark at that point. But he told me then that they’re hipping no deaths from rhabdo, knowing deaths from rhabdo from ultrarunners.  Lisa: Yes. Eugene: Yes. And no knowing deaths from ultrarunners of the AH, exhausted and just talking it, ‘How can I train you’?  Lisa: Yes.  Eugene: So we were kind of that, like, ‘What could it be’? Yes. So when rhabdo appeared on the desk fit, I rang him back and said—I actually emailed him and said, ‘Hey, this is what it says’. And he was very surprised because he keeps track of deaths of ultrarunners around the world. And as he said, there hadn't been one recorded before, doesn't mean there hasn't been one, of course.  Lisa: Yes, it doesn't mean. Eugene: It's just no one, yes, no one knows what causes.  Lisa: And I think a lot of these things will have contributing factors in—completely unrelated but going through the journey with my dad recently it was at the end, he had multiple organ failure.  Eugene: Yes.  Lisa: He had sepsis however, and before that he had an abdominal aneurysm.  Eugene: Yes. Lisa: So it shows the progression like it. What did he actually die off?  Eugene: Yes. Yes.  Lisa: He was born with the failure probably, or zips as chicken or eek scenario. Eugene: Yes. Lisa: So these things, one leads to an acute respiratory syndrome  Eugene: Yes. Lisa: And they all lead on from one to the other when the body starts to shut down, basically.  Eugene: It's a cascade isn’t it?  Lisa: It’s a cascade. That is a very good way of putting it. So rhabdo—and while there is perhaps no documented case of a death from rhabdomyolysis, I don't know if they—I know in my life, I've had rhabdo. I can't even remember the number of times I've had rhabdo.  Eugene: Yes. Lisa: I took away kidney damage from it and the last few years, I've been trying to unravel that damage and undo that.  Eugene: Yes.  Lisa: I'm getting there slowly.  Eugene: Yes, yes.  Lisa: So it is a very as if quite a common thing. Eugene: Yes. Lisa: So we don't know whether in this case that was actual final, what actually did it? It certainly would have been a major contributing factor.  Eugene: Yes.  Lisa: Well, what is rhabdo? I suppose we better explain what rhabdos are. Eugene: Yes. So I mean, well, from your experience, you will know better than me. But I spoke to Dr Hoffman and to Dr Tom Reynolds, who's the race doctor for—one of the race doctors for Tarawera.  Lisa: Yes. Eugene: And they explained it as the muscle started to break down and the myoglobin from the muscle being released into the bloodstream. And then it basically just starts clogging up the kidneys and just causing real damage in your kidneys. The problem with it is the symptoms for sort of sound like a lot of other things and also can just sound like what you might expect running an ultramarathon. Lisa: Yes, the kind of that also. Eugene: Yes, tenderness of muscles, a bit of confusion, and so on. And then even some of the blood tests that you can do to pick it up. So they look for CK—you're much more proficient in the medical world than me. Lisa: Not more. Eugene: But the thing that they test for—it basically there was an experiment at Western States a number of years ago, where they tested bloods of people in Western states and they tested something like 160 runners, all of them had elevated CK levels.  Lisa: Yes.  Eugene: So in part, it's just a function of ultrarunning, your muscles are gonna break down to some extent. So that makes it very, very tricky to find out, to discover it. And Dr Hoffman said, ‘Sometimes the first sign that you get that someone's got rhabdo, is they have a seizure’.  Lisa: Yes.  Eugene: So it can be a tricky, tricky condition to pick up. Yes, that's really—it's hard, isn't it? It's really hard. Lisa: It is hard and—but when you are going for—and some of these races are 24, 36, 50 something hours, you're going to have some breakdown of muscle and you… Eugene: You are. Lisa: I mean, keeping an eye on the colour of your urine or if you are not producing… Eugene: Yes, that’s an important one. Yes. Lisa: It is probably the easiest thing to think about. Because like you say, the nausea and headaches and confusion and fatigue are all very general parts about running anyway. So keeping an eye on it, like getting a pouch of fluid. What I would find is that in the lower abdomen, and I don't know if whether this is an actual medical symptom or not. But in the lower abdomen, I've developed this pot gap running and, it wasn't fat, obviously.  Eugene: Yes.  Lisa: ...within a couple of hours. It was fluid, and would usually coincide with my kidneys—they’re not producing or producing very little output. So I think there might be a sign that something's going on there.  Eugene: Right.  Lisa: In rhabdo, like, we're talking ultramarathons, but I have seen a case of rhabdo in a half marathon in summer.  Eugene: Yes.  Lisa: Yes. So a mild case, but enough to be taken to hospital. So it's not even just people doing the extreme extreme stuff.  Eugene: Yes.  Lisa: But it is a very—and you have to ask yourself, how much damage are we doing every time we do and I often asked, ‘Why are you not running anymore’? ‘Why are you not doing it anymore’? And apart from life's gotten a bit crazy. Am I? Indeed yes.  Eugene: Yes, yes.  Lisa: Should I have not got the time to be doing offers? I want longevity and while I love ultras, and I love the culture. And I love what I got to do. And I'm certainly not, I mean, I train lots of ultrarunners. I for myself, don't want to put myself at that risk anymore. Now that I'm also 50 and I want longevity. And therefore my health comes before my sporting ambitions now. It didn't when I was younger, but now with—unfortunately, one of the side effects of studying medical stuff for the last five years, is that I'm now a little bit more cautious.  Eugene: Yes.  Lisa: Because ignorance is bliss.  Eugene: Yes.  Lisa: What you don't know, you just go and do.  Eugene: Yes.  Lisa: You don’t actually know the implications and sometimes, you don't actually know the implications until well down the track, like, you use to check. Eugene: Yes. yes, sure. Lisa: That's where I'm sitting at the moment, as far as the sort of the dangers and the risks. I mean, how did you feel as a runner, who—you were in the same race doing the same distance? You're a little bit north of 25 now. Eugene: Jump 47. Lisa: You're 47?  Eugene: Yes. 47, yes.  Lisa: And did this make you stop and think about, ‘Do I want to keep doing this stuff? How do I feel about it’? Eugene: Yes, it sure does. It sure does make your family think of that, doesn't that? I think it reinforces that you need to have really good self management. You need to be well prepared. I spoke to—when I spoke to Dr Reynolds, and I said to him, ‘We had this big conversation about all the cold coloured urine and all that sort of stuff’. That sounds a bit odd, and a little different other conditions that can come about. Yes, and so on. And I said to him, ‘Boy listen to all of that. Do you recommend people run ultramarathons’? And he said, ‘Look. At three o'clock when the medical team is full. And I've got my hands full, I look around, and I go, What the hell have we been doing this for’? But he says, ‘But it's a small proportion that gets badly affected. And as long as you manage your risks, and you're aware of it’, he said one of the things that he's really concerned about is people jumping up the distance too quickly. Lisa: Yes.  Eugene: Or the runner suddenly, ‘Wow, I'm gonna run 100 miler’, because it has become, I think it's… Lisa: The new marathon.  Eugene: I told him, I spent more time trying to talk people out of doing milers than I do in trying to talk them into doing milers. I don't think I talk to any other or talked anyone into doing a miler. It's a very personal choice. I spend a lot of time talking to people out of it, makes me so again. But again, I don't know if that's a good idea, mate.  Lisa: Me too.  Eugene: Yes. And it sounds bad.  Lisa: Yes.  Eugene: Try running podcasts. Lisa: I know. You know, my buddy out running. Eugene: Yes. But I just think people need to be really conscious of the risks.  Lisa: Yes.  Eugene: And they need to be prepared to put the time in. And that's one of the things that you've identified. You've got to prepare your body. And you've got to know your body. I mean, I took—I've been running my whole life. And I didn't take the decision to enter the miler, lightly, certainly would now knowing what I do know now. And when I say no, I mean, I'd always heard of rhabdo. I'd heard of AIH, I'd heard of dehydrational systems.    And you sort of think about you sort of like, ‘Yes, yes, yes’. But having lined up at the start line with someone who didn't make it home that really reinforces that these are real risks, and you have to be prepared for them. You have to be ready for them. So, I'm not gonna stop ultrarunning, I don't think. But I'm certainly going to be a hell of a lot more careful. And listen to my body.  Lisa: Exactly.  Eugene: Sometimes you can get that. I find one side of ultra running that I struggle with a little bit is the whole kind of ‘You're not going to quit unless the ambulance takes you off the course’ kind of thing. I don't like that. I don’t really like that. Lisa: I totally agree. Eugene: You know, I agree. I love the whole mental toughness thing out of it. Don't get me wrong. That's one of the things that I enjoy about it. But you have to listen to your body. You have to listen to your body. I've pulled out of a 100k race, where I could have pushed on. You know. Looking back, it's like, ‘Yes, I could have pushed on, at what cost’? You know?  Lisa: Yes.  Eugene: Yes, it just wasn't worth it. Could I push through and be out there for another hours and hours and hours and hours? Putting myself...  Lisa: Yes.  Eugene: Yes, sure. I could have but what was the risk? What could have happened? And what do I get out of it? Instead I actually came away from that race having learned a hell of a lot of lessons. And they prepared me for the miler, actually. Lisa: Yes. And I think that’s some beautiful attitude and in a very wise mind. Some of the things that I did in my younger years or even—I’m talking 40s. Eugene: Yes, yes. Lisa: We're stupid. There is no other word for it. And especially in the 30s, my 30s, I thought I was bulletproof and I could push and I had that mentality, you're going to have to drag me away, framing and I have seen lots of others. And I have nearly pushed my body on a number of occasions to the point of death and I've been very, very lucky not to have died.  I've had tetany seizures, which is where your potassium level and your electrolytes are so out of whack that the whole body cramps and so I'm having a heart attack. I was luckily at that at the point that I head out, I was in Alaska, and I'd been for six weeks out in Yukon with poor nutrition and so on and pushing the body every day. I just come off a mountain when this tetany seizure hit. Luckily, I was two minutes from a hospital, and they saved my life.  Eugene: Wow. Lisa: But that would have been deadly very quickly. I've experienced extreme levels of dehydration in the Libyan desert where we only had like one and a half to two litres of water a day in 40 plus temperatures. And gone to the point where I no longer was in control of my body, and my—not only just hallucinations but the central nervous system starting to shut down. Massive kidney damage, and taking nearly two years to recover from that.  I’ve had food poisoning while running across Niger, and again bleeding at both ends pushing it to the absolute limit I did pull out of that race at 64 hours after 222Ks but that was way too late. I've gotten away by the skin of my teeth. Not to mention going through war zones or military body areas Eugene: Yes. Lisa: Or being in really dangerous situations and that's a whole podcast in itself. But it wasn't worth it. Now I think I was just so afraid of failure I was so afraid of not achieving that, which I'd set out to do that. And I have to think about it now and go I wasn't in—people who are in war scenarios or some survival situation where you have to freakin go to the limit alive. Eugene: Yes. Lisa: But I wasn't in there. This is a—well, Libyan desert ended up like that, but you know what I mean? Eugene: Midnight summer bitches.  Lisa: Oh yes, it’s some stupid shit. It really was. But at what costs? Now, I've had a lot of health issues in the last five to six years and a lot of that comes from—I haven't been able to have children you know and so on and so forth. And these are the contributing factors  Eugene: Sure enough. Lisa: That's the only reason for certain things, but now as a coach and as an older wiser woman, I don't want to see people pushing their bodies to that point where they actually close to dying or causing major damage to the body.  Eugene: Yes, yes.  Lisa: It really is not worth it. Eugene: I mean this pushing the limits isn't there. And mentally, I think there's a lot to be said for having a goal that's going to stretch you when you are going to go for it. But the key is to be prepared, isn’t it? To actually have done the training...  Lisa: The training  Eugene: ...to prepare your body. To test—so that you know when your body's screaming at you, you know it’s saying, ‘Okay, you know what, you know to pull the pen or you know to stop and rest or whatever’. I think there was some good—Tom Reynolds had some five tips which are really good.  Lisa: Yes. Let’s hear them  Eugene: To prepare yourself for an ultra especially ultras but even marathons I suppose  Lisa: Absolutely. Eugene: Number one on his list, and I think he would make this number 1, 2, 3, 4, 5 is don't take drugs like Ibuprofen and Voltaren and those sorts of things.  Lisa: Super important. Eugene: Do not take them. Yes, super important. The second one is drink to thirst. You know that you can have problems—your own problems if you have too much liquid.  Lisa: Yes, which we’re talking about in a sec. Eugene: Yes. Be prepared for the conditions. Have a plan for a range of conditions. So make sure you've got thermals. Make sure you've got your jackets and sawn and layers that you can take on and take off especially if you're going to some of these remote areas that we go to as ultrarunners.  Number four, the race doesn't end at the finish. Pack warm clothes, get some food ready that you can eat, some liquids. And another thing that he pointed out to me is actually some of the most dangerous times is after that finish line. When people get to the finish line, and drive hard, and they're tired. Lisa: It's so true. Eugene: You can crash easily for a second crash.  Lisa: Yes.  Eugene: And number five is look out for each other. and I think that's so important. Sometimes there's a bit of competition isn't there? But number one, you've got to look out for each other Lisa: Yes.  Eugene: You are comrades in this together and you've got to have each other's backs. And there's little relationships that you build up with someone you've never met before. I still remember having a good chat to a farmer from Jordan. I spent a lot of hours with him at Tarawera. Haven't spoken up since, never met him before in my life, but there we were together at Bizmates on the trail. Lisa: Awesome. Eugene: Keeping an eye on each other. Looking out for each other. You make sure they've got their bottles filled at the aid station. You make sure that they're not getting confused or anything like that—just looking out for each other. Simple isn’t it? Lisa: That’s gold. Eugene: And that was the five tips that he gave. Actually, they're pretty good tips. Lisa: They are very good tips, and a couple other ones to pick out like the training. In my early days as a coach, I remember taking an athlete who went from half marathon to running the Big Red Run 250Ks. Eugene: Wow. Lisa: Inside a month.  Eugene: Oh. Lisa: Now on a red mat, that was stupid.  Eugene: YeS.  Lisa: He came over to do 100k to be fair, and he was doing so well. He just decided to carry on and to do the whole thing. And it was an incredible achievement.  Eugene: Oh, yes.  Lisa: However, broken my butt. Like, it never was quite the same afterwards. And he wasn't ready. He wasn't, like, his body wasn't ready. So when you prepare your body, when you're training, you doing these long runs, and you're doing back to back running, and you're doing strength training, you're doing mobility work, all these things are preparing the muscles so that they don't break down so quickly and they don't need—you don't need about rhabdo.  And another big piece of the puzzle is the experience side of things. Because then you can actually start to feel when your body's doing a chick or not. As I run, I used to do like little chickens every half hour or an hour I'd go right I'm doing a control like a pilot would before he flies the airplane. ‘How is everything? How am I feeling? Have I ever drunk in the last 10 minutes? Have I eaten anything? When was the last time I weighed? When was the last time’... Just doing a mental checklist as often as you can.  Now one of the hard things with ultra though is that you start to lose your brain function, so all the blood flow is going away from your executive function up here and you become like a bit of a moron. You’re like, ‘Oh, oh’. Eugene: Absolutely. Solving maths? Impossible. Lisa: Impossible. Or maybe doing a 24 hour race, the one at the Millennium Stadium, and there was some guys they’re testing us just for a laugh, doing Noughts and Crosses as we run around the track and our brain function is a day and night wore on just we weren't even able to add up one plus one anymore. We just completely like, ‘Eh’? He’s got low blood and my brain is not functioning. So what that does mean is that your ability to make good decisions is also impaired. I remember saying to one of my friends who was a paramedic and she was with me in Death Valley, in the second time I did Death Valley. And she says, I said to her, ‘You are responsible for my health’. I was lucky I had a crew in that situation. If you pull me out, you pull me out. I know that you won't pull me prematurely because you know what, it's taken me to get here. But my life is in your hands and I respect that. I respect you. I respect your knowledge as paramedic. If you tell me it's over, it's over. And she will be able to make that decision because I knew from my personality and from my matter that cost me to get there wasn't going to be pulling out anytime soon. So sometimes if you can have in the case where you have a crew have somebody say, ‘This is now getting dangerous’. And it's a fine line. Like I pulled my husband out of a race once, Northburn, a race that I co-founded a few years ago in the South Island. And he was doing the 100k and he actually rang me on the cellphone, and it seem the case, we had a massive storm up in the mountains. It was wild. It was his first 100k, he was in the mountains. He was scared shirtless. He was hypothermic. And I was like, ‘Oh my god, darling, just come home’. You know? So that was—and he could have pushed on.  Eugene: Yes. Lisa: And mentally that cost him a lot because he pulled out, and he didn't push over that hub. So there's this fine line between it should’ve been ours... Eugene: But he lives to tell the story.  Lisa: Exactly, and he's done that, so it wasn’t... Eugene: Exactly, that doesn't matter, you know? We love those stories. I love reading your books. I love reading the things that you've been through. But, my gosh, when you think about the risks as you say and the cost, and that's a common story. You're not alone in there, That's the sport we’re in.  Lisa: Yes. Eugene: It's ridiculous to me. But you know, it's a tough one. And it's, I think that's a really good idea. Having someone who's who's got your back. Someone who you can trust, like you say, they're not going to pull you out you know just because you stub your toe. Oh gosh... Lisa: Just because you’re... Eugene: Exactly. Exactly. Who hasn't? But you can trust them so that when you've gone to that thin line, bang!  Lisa: Yes.  Eugene: Come on my area.  Lisa: Yes.  Eugene: And I was lucky to have a really good mate who phased me. I went through some hallucinations. Nothing major. But he thought it was—I had my mate. And he was looking out for me. In fact, he laughed at me. Lisa: What did you see in your hallucination? Eugene: Oh, I hit home. So we were running around on an unfamiliar course. We were coming around the back of Blue Lake. Up towards the Blue Lake aid station. So about 120km. And it was just before sunrise. So, you get that funny light.  Lisa: Yes.  Eugene: It's still dark, but the light is changing. And I swore coming up to the aid station, I swore I saw a robot sitting off to the side of the trail. And in my photo frame mind, I justified it as ‘Oh, it must be like reading, it must be scanning us telling the aid section that we're coming’. And so I saw it. And said to my mate, ‘James, there’s a robot. It's pretty cool’. And he's like, ‘The what’? ‘The robot there’. And he's like, ‘There’s nothing, man’. And I think it was a tree or something. I don't know what it was. But it's funny how I justified it to myself. So it was fine. And then after the light changed, I got a couple of situations where it's quite unlikely to cause hallucination or is vision going. But I—the ground was just like liquid glass. Lisa: Wow, that’s cool. Eugene: I was like, ‘Oh, should I put my foot down or not’? And James said, ‘What are you doing? Come on’! It was like, ‘What's going on with the ground’?  Lisa: [32:58] inaudible the glass. Well. Eugene: So that was but—people have some great hallucinations, don't know. But the point of that was, I had my mate there. It was never unsafe. And I'm grateful for that. So I think that's a really good tip, Lisa, to have a crew with you. Lisa: I think hooking up. Or if you're in a race where you don't have crew—which most of them are. And that you do hook up with somebody. If you can try and not too many people because then your pacing will be all out. But if you can just hook up with one person or maybe two at the max. I remember running the Gobi Desert in the Sahara with same gash who was in the desert runners movie together and this is great footage and desert runners is playing at the moment on TVNZ if anyone wants to check it out, it’s a cool movie. And yes we're running along holding each other's hands, bawling our eyes out, and but we got each other through both of those messiest days, both in the Sahara, and in the Gobi. And we ran together in India as well but with crews in that case. But that comradeship that we have there was just gold. It just helped.  When you [34:17] escaped shirtless you hit someone the and we did get lost and we did fold our paces and we did have all sorts of dramas and we kept each other going through all those hard times and I think that's one of the beautiful memories for me that I take away from that. And there were other people I've done the things with... And the depth of connection that you have with a human being when you've gone through something like that it's just next level. And that's one of the beautiful things because we’re talking about all our negatives here but it is just like—she’s a very amazing woman that one. She’s done incredible things. Eugene: It is incredible, isn’t it. Those connections you make.  Lisa: Yes.  Eugene: The friendships you forge. Even if you don't see each other again, but you've got that bond. That's forever.  Lisa: Yes.  Eugene: Those moments that you shared when you're vulnerable. Lisa: When you're up [35:11] Creek and literally. Guys who didn't even speak the same language or a woman I remember running in the Sahara at one point with a—I was crying, she was crying. She was from South America somewhere, didn't speak a word of English, or another French guy picked me up in Jordan when I was running across there and I'd passed out and he came along, picked me up, got me into the next checkpoint. The French guy and Niger, it's just like, ‘Wow’. The stuff that you help each other through. It's gold, but does this do happen, you know?  Eugene: They do. They do. Yes. Lisa: We have one in the Gobi Desert. We had a young man, Nicholas Kruse was only like 30 or 31, I think. And he was first time doing it. And he wasn't trained enough, I don't think. And he—I think he underestimated the thing. And he unfortunately probably paid the ultimate price. And then you've got also the dangers. I mean, you got cases like with Turia Pitt, the forest fires in Australia, or there are things that could go wrong. Eugene: Yes, absolutely. Lisa: Even in these organisers' races. You have falls where you've hit your head and concussions and... Just because you're in an organised event, do not think that there isn't an element of danger, or that you're going to have to be self-reliant, you cannot. And inside these countries is beyond the abilities of the organisers actually to cover every base. Eugene: Absolutely. Well, even in races in New Zealand, we go to some remote places, and races route is difficult to get. You're not just going to be able to ring up 111 and get an ambulance there.  Lisa: No. Eugene: It's not like that. I've been in a 100k race where—because there have been lots of runners going through this. It was a narrow bit of the trail. And it was really dry there. And runners have been going over this bit of land. And basically, as the day wore on, it sort of started to break down a little bit. And I was just the unlucky one stick on the trail in a way. And I slid down this bank...  Lisa: Oh my god. Eugene: ...and down, down, down, down down, thinking, ‘Uh-oh, when's this going to stop’? Luckily, I hit, I came to a stop on a tree, not badly. And then basically had to scrape my way back up. Now, I was fine. But you know, those sorts of things can happen if I stumbled in a wrong way as I came off the trail and hit my head, whatever. So you are—yes, you will, I mean, it’s not... Well, I mean, when we've been out on a run in a cotton wool, so [37:57] do we. But we don't want to go everybody. But you don't need to be conscious. Lisa: I'll be conscious of it. I think... Eugene: And even when you're training too, when you're training, when you are going out in remote areas. Make sure you tell someone where you're going. Preferably run with some other mates. Maybe think about taking a locator beacon with you if you're going somewhere really remote.  Lisa: Absolutely. Eugene: Have a phone with you, do those sorts of things. Take those precautions. Just be a bit careful. Yes, we want to push ourselves. Yes, we want to be out there. Yes, we want to find new limits. But we also want to get back home.  Lisa: Yes, we want to come home to our families and not die on the way.  Eugene: Yes. Lisa: If we can. I mean, people can take it to the level that they want to go to, but just don't want people going and thinking that everything's safe because it's an organised event or because hundreds of other people have done it, means absolutely nothing. Eugene: Absolutely.  Lisa: I’ll tell you, like how many thousands of people have climbed Mount Everest, but it's still a frickin dangerous thing to do. Eugene: Absolutely.  Lisa: Doesn't mean it's safe just because lots of people have done it. I think like—if we just went through a bit of a list now of some of your things that you'd like from a medical perspective, that you should gone this research on and find out about.  One of them, so we've talked about rhabdomyolysis. Dehydration is the opposite, is well known, dehydration is what we think about more, and that's certainly something that can then can lead to troubles. And you've got hyponatraemia or EAH, so hyponatraemia let's just talk about that one briefly because it's a biggie. Hyponatraemia is a low sodium level in the body. I've had it. Lots of people give this. And it's again, a hard one to diagnose because it is very similar to the opposite problem, which is dehydration. So hyponatraemia you've actually got too much water on board.  One of the signs of this I'm even doing was 100k, one of those Oxfam ones. And because we'd been walking for so long, it was a walking running situation thing. And I got really bad hyponatraemia in that one. I was drinking a lot. I wasn't having my electrolytes, right. And my hands were like elephant hands.  Eugene: Wow.  Lisa: So that's an indication that there's something going on. So look for signs like that, look for swelling, edema. And yes, that could like...  Eugene: Nausea, lightheadedness, those sorts of things as well. Lisa: Coordination, going haywire. And the problem with hyponatraemia is you don't want to just be thinking it's dehydration and then drinking more. So it's an—it's a low sodium. So, your potassium and your sodium are having antagonistic relationships in your body. And you have, for every three bits of sodium that gets pushed out of the cells, three bits of potassium come into the cells. And it's like, it acts like a pump. And it's actually what helps your muscles contract.  So if you get that sodium, potassium, ainger, other electrolytes out of whack, there's a whole lot of things that can happen. hyponatraemia being one of them. In another one being a tetany seizure, which is what I mentioned what I had in Alaska.  Eugene: Yes, so what's that? Lisa: So this is where—in my case, it was a potassium that was really, really low in the body at 1.4. Like it’s deadly... Eugene: Wow.  Lisa: Deadly low. And I'd had in the couple of weeks building up to this actual seizure. My hands were doing this, and I was cramping all the time. And that was so—if you ever start doing that, like this weird thing where your hands are starting to spin. Eugene: So, like dinosaur hands on. Lisa: Yes, so your fingers—for those listening can't see me do my funny thing here. It's the muscles contracting and your fingers are pulling in. So I remember, swimming at some point, and the lead up to this with this was happening to me. I was like, ‘What the hell's that’? And then it would go off again. But there was a sign that I didn't have enough potassium as I found out later. Eugene: All right. Lisa: So then I had, a couple of weeks later, this tetany seizure, and it started with the whole body. Just like every muscle in the body cramping all at the same time, the most painful thing you can ever—like really bad pain, including your face muscles, including your heart, which is the problem.  And in there, the pain was horrific. I thought I was dying, I was. Luckily I just come off a mountain, or was taking shelter in a public library because it was pouring with rain and freezing cold. And this happened in the library. And there was a paramedic in the library who just happened to be fixing a light bulb. He saw me go down.  Eugene: That’s one of the 43:10 [inaudible] moments. Lisa: Yes, that was very lucky. He put a gel straight into my mouth. He just happened to have a gel on him. And that gave a little bit of glucose and stuff too, and managed to release the seizure for a couple of minutes before it happened again. But by then he got me into the ambulance and around to the hospital pretty quick, smart. And they were able to save me. But that could have been deadly. That could have been a massive heart attack on the way out. I've seen that also happen and we were in the outback of Australia with friend Chris Ord. And he had a seizure at mile, coming in at 90 sort, and we've been running in 40 odd degrees heat and he'd been taking electrolyte tablets. So people electrolyte tablets are absolutely crucial. You've got to have them. The ones he was taking didn't have potassium. They had everything else in them but their ratios weren't right. And he ended up—we had to—again incredible pain, whole body seizing, racing him into the hospital Alice Springs.  What I did do and what you can do in a case like that is give him three cans of Redbull—not advertising for Redbull or because generally that’s a shit thing to be drinking. And this case, with what it's got in it and the sugars and stuff that helped. So yes, but that's just a potassium sodium balance.  Eugene: Yes .That's the thing, isn't it? We're missing with our chemistry. We're missing with the body's chemistry. I don't know what it was but I had one race where I just finished and as soon as I finished, I started shaking.  Lisa: Oh, yes. Eugene: Shaking and shaking. I couldn't stop for hours. And it wasn't cold. I wasn't cold. Lisa: Oh, I know what it is. Eugene: Well, what is it? Because... Lisa: I don't know the name of it. But I've had that many times. It's basically where you've just got nothing left in the body.  Eugene: Yes, somebody said to me, glycogen. Yes, just the glycogen is gone.  Lisa: You just got nothing, you got nothing to heat because you know we heating ourselves all the time with our glycogen supplies and our glucose is running out of their body. And you were just on absolute zero basically, taking your blood sugar, I bet you’re in a really, really low  Eugene: Right.  Lisa: And so like, in Death—I’m telling my bloody stories, but...  Eugene: Why not? Lisa: A member in Death Valley. We be head like 55 degrees during the day, I’ve had heat stroke and had all that. And then at nighttime, it was 40 degrees. And I got shivers. I was doing that. I was like this and it was 40 degrees.And I was like, ‘Really, what the hell is going on? It's 40 degrees’. It was a lot colder than it had been, but I just had nothing left in the tank and therefore I was shaking.  And that can be a real danger when you say in the Himalayas, which I've also done and that's where you just cannot warm up. You can't keep your heat going. And these can run into other problems where you just stuck—your blood sugar just keep dropping, and you can end up when—going into a coma just because your blood sugar is too low, and you got hypothermia. Eugene: The other problem that happens. And I've had this a couple of times after ultras is I just have zero appetite, I can't, I just can't face the thought of food. You got to get something into you, you go start replenishing your body, you got to look at soups or something to get some nutrition back into it. Because like you say, it can be dangerous. Lisa: And that's a recovery too, like, if you can get something in it will help you recover a heck of a lot faster even like just generally fully training runs, if you can get something in within an hour. But usually within an hour, you just do not feel, you just feel like vomiting if you eat too much. So you just have to take a little, little, little nibble, nibble, nibble. And something that you're really—usually savoury salty things that you will get have a taste for. So soup or things or something like that. Just trying to eat something in. My gosh, there's a lot to be worried about. Eugene: And that's the thing, that's the thing. These are all things that you need to be conscious of. But you manage your rests, don't you? You can manage them. And what one of the other things that Dr Reynold said, and I think is pertinent today, what just what we're dwelling on the bad things is that these risks are exponential. So he says, ‘Don't think that you run 100k all year, well, then 160Ks, that's only another 60k’. It's an exponential increase, and an exponential increase in those risks as well. So conscious of those things as well.  Lisa: So watch when you're jumping up in this.  Eugene: Yes.  Lisa: And also don't fall into the trap of thinking, ‘Oh, I did it once. Therefore, it's a piece of cake. I could do it either’. I've run into this where I came off the back of a Himalayan one. I just done 222Ks. I thought it was the bee's knees. And then I went and did it just a couple of weeks later and I hadn't recovered properly a 50k in Australia. And the wheels freakin came off at 25k. It wasn't the—I had to be risky for some beer drinking Ausies in the middle of the bush. I'll tell you your ego suddenly deflated.  Eugene: Yes, absolutely, Lisa and it's—I learned that lesson even just with the map just for the marathon.  Lisa: Don’t say that. Eugene: But just for the marathon. I ran my first marathon when I was 21 and I trained for it. And so I found it actually quite easy. I don't mean that—I wasn't fast but but it was I got to the end of it. I can't keep waiting for the wall. The wall never came. I got—I thought, ‘Ah’! So I made the mistake thinking marathon is easy. A piece of cake. Yes, run up on the next one. [49:13] ecruzi hardly did any training.  Lisa: Oh.  Eugene: My bad, so bad. And it was like it was just the marathon telling me, ‘Sunshine’...  Lisa: Respect. Eugene: ‘Respect the distance’. You cannot run something like this without respecting it. And it was a good listen.  Lisa: Good listen. Eugene: Good listen, I'll let my listen. But I let my listen.  Lisa: And in by that token, respect any distance. People often say to me, I'm just doing it, I'm just doing half marathons, or I'm just doing marathons and because I've done lots of ultramarathons they think, ‘Oh, that would be nothing for you’. And I'm like, ‘Hell no’. Eugene: Hell no. Absolutely. Lisa: Every distance has to respect because it’s sort of basic thing for starters. 100 metres is a long way when you're going at Usain Bolt and 5k is really fast when you're going at your maximum. And a team K is an attunity. It's all relative to pace for status. And the second thing is never think because you did it once. Next time, it's going to be sweet. And Eugene has given us an absolute good example of that. And it is. It’s like take every race is that first is a big deal. And you have to prepare your body for it.  And don't—oh, another mistake I made this was awesome. Another embarrassing thing. So you know. Done 25 years of stupid stuff and then when my mum got sick I didn't train obviously properly for 10 months and then I ran across the north on and raising money for charity a friend who’ve died, Samuel Gibson a wonderful man that we lost. And I was so moved. I decided I'm going to run anyway. And I have not been training for 10 months because I've been looking after my mum and I sort of thought out, this sweet, have done this backwards and upside down. I can do this. Oh my God, my ass got handed to me. And I got through it. But oh, hell, it was hell. It was not funny. So prepare. And even though you've done it a100 times doesn't mean you still got it. Eugene: That's right. That's right. Lisa: I assume I don't got it now. Eugene: And that point you made earlier about recovery, too. I did a 100k race and then you had this plan to recover, to take weeks off, got peer pressure. Mates we're doing a 50k. ‘Come on. Come on, man. I don't want peer pressure. Peer pressure’. ‘Okay. You’re already lined up to this 50k race’. Oh boy. And it just set me backwards. It set me back so far, you know?  Lisa: Mentaly too. Eugene: Yes. Absolutely. Absolutely. Yes. Yes. Yes. So, yes, respect things. Lisa: We've got to respect things. We've got to not expect that our bodies got it just because we've done it once before. Be aware of things like rhabdomyolysis, heatstroke, hyponatraemia, altitude if you're doing altitude, podcasts in itself, be aware of burnout...  Eugene: Hypothermia. Lisa: ...hypothermia, dehydration. All of these things are things that we can and do happen to be seizures, electrolyte imbalances, getting lost, going through dangerous places, breaking ankles, and all that sort of thing. So part, it is, can happen. So, be aware of that. And we're not saying don't go out and have adventures, because that'd be really critical. But prepare for those adventures. Get proper training. Get proper coaching. Know what you're in for. Eugene: It's like driving a car. One of the most dangerous things we do. But we make sure we wear our seatbelts, we make sure our cars have got a Warrant of Fitness and the service, and everything. We make sure there's air in the tires, we make sure there's fuel in the tank, and our bodies have got to be like that as well.  Lisa: Exactly. Eugene: That driving is so so dangerous. You know, so many people a year die on our roads.  Lisa: Yes, more than ultras.  Eugene: Yes, so we don't not drive. We just make sure that when we drive we are prepared and our cars are prepared. Well, that's the same as running. There are risks, not as much as driving. But there are risks, but we just make sure we've got air in the tires, we've got fuel in the tank, that we're serviced, and ready to go when we line up for races. Lisa: Brilliant. Eugene, you've been fantastic today. And now you've got another thing to get to. So I want to thank you for writing that article. And thank you for your honesty and openness about this because it's really important that we do talk about it in our running community and to share the good, the bad and the ugly. So I think it's important. And keep up the great work. Of course, people should go and listen to Dirt Church Radio. It's a fantastic podcast that  Eugene: We have great gear that’s wireless.  Lisa: Honoured to be on your show, mate. And I love talking to you and I love what you do. So thanks very much, mate for being on the show today.  Eugene: Anytime. Thanks, Lisa. That's it this week for Pushing the Limits. Be sure to rate, review, and share with your friends and head over and visit Lisa and her team at lisatamati.com The information contained in this show is not medical advice it is for educational purposes only and the opinions of guests are not the views of the show. Please seed your own medical advice from a registered medical professional.

Exercise gives our body a physical and mental boost. It’s good stress, but it’s stress nonetheless. Thus, doing a running warm-up before an interval run or training is integral to get the most benefits out of running.  Neil joins me in this episode to explain the steps in preparing for a running workout. We emphasise the importance of setting your mindset before training. We also cite different examples of run-specific movements, drills and breathing exercises. If you are a runner wanting to do a running warm-up right, then this episode is for you.   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition and mind performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join their free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   Consult with Me If you would like to work with me one to one on anything from your mindset, to head injuries,  to biohacking your health, to optimal performance or executive coaching, please book a consultation here: https://shop.lisatamati.com/collections/consultations.   Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: You will learn about the role of stress levels and mindset when preparing for training. Know more about running warm-up and breathing exercises. Discover the importance of run-specific movements.    Resources Email lisa@lisatamati.com to know more about my health optimisation consulting. Visit my YouTube channel to watch warm-up, workout and training videos for runners.   Episode Highlights [03:47] Understanding Your Bucket of Stress The bucket of stress is filled with things going on in your daily life. You layer exercise on top of it. Having an overflowing bucket and doing high-intensity interval running will cause more stress to the body, causing injuries and pain.  Conduct a wellness check to assess your current state. The checklist includes sleep, nutrition, hydration, movement, energy, body, and stress. Listen to the full episode to learn more about computing your wellness score! Change your warm-up and training to suit how you are feeling. [12:13] Shifting Your Mindset Neil is a father of three. He works out because he wants to be a superhero for his kids.  Figure out what training means for you. Mindset is essential when doing a workout. You need to shift from work mode to training mode. Incorporate diaphragmatic breathing exercises to activate your body’s parasympathetic state. [18:47] Activating Your Muscles Spiky balls, rolling sticks and foam rollers are some of the tools you can use to activate your muscles. Expose your feet to neural stimulation to get them to move freely. Because the feet are connected to other parts of the body, activating it will start to relax the muscles and tissues above it. Activation may vary from person to person. Some people have a lot of tension in their bodies, while others are hypermobile. [22:11] Static vs Dynamic Stretching Static stretching is holding a single stretch in one position for 30 seconds or longer. Doing a static stretch lengthens and switches off the muscles, making them too relaxed. The body thus becomes too floppy. Static stretching has its benefits after a run or during a yoga session but not before a run. Dynamic movements allow the body to move more freely. [25:48] Warm-Ups and Fascia The fascia connects the different parts of our body from our head to toes. Fascia lines run across the body. Warm-ups should help open, lengthen and move the fascia. Stretching and moving the fascia allow you to move better and run more freely. [31:47] Doing Drills It is best to do run-specific movements and drills. Ball of foot hops and carioca are some of the drills to help you warm up. Listen to the full episode to learn how Neil does his warm-ups! Listening to music helps to have cadence. You may create playlists for before and after you run. If you’re doing a recovery run, you can use calmer music.   7 Powerful Quotes from This Episode ‘That's what training is about. It's not about the actual run where you actually get the results. It’s in the recovery phase’. ‘How you prepare your mind is going to be key when you understand your “why” before you warm up’. ‘A lot of people find their toes are bunched together and tight. If we can get some movement through those, we start to get more benefit from our running as well’. ‘Gone are the days of static stretching and standing on the doorstep during your quad stretch, holding. All you're doing there is switching the nervous system off and increasing your likelihood of injury and discomfort’. ‘You take which bits of the tools you want out of the toolbox, and then you start using them from your perspective’. ‘Looking at what you're currently doing, who you are and how much in a warm-up — what percentage you use each tool for will be quite different for each person’. ‘You will have — and I promise you this — a much more fun run, and you'll enjoy it more if you've put the time into this warm-up piece of the puzzle’.   Enjoy the Podcast? If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so they can optimise their running warm-up. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript Welcome to Pushing The Limits, the show that helps you reach your full potential, with your host Lisa Tamati, brought to you by lisatamati.com. Lisa Tamati: Hi, everyone, and welcome back to this week's episode of Pushing The Limits. Today, I have Neil Wagstaff, who is my wingman at Running Hot Coaching, and we're going to be talking everything about running and preparation for a good training session — how to tell if you're ready for that session that's on your list today. We're talking about stress levels. We're talking sympathetic and parasympathetic nervous systems. We're talking activating muscles. We're talking lymph and circulation and a whole lot of great info that you don't want to miss if you're into exercising, fitness or running. Before we go over to the show, though, I just want to remind you please give a rating and review to the show if you enjoy it. Share it with your family and friends.  We've been going now for five and a half years, and we've been in the top 200 globally ranked shows in health and fitness genre, and we really appreciate your support. And every one of those reviews and ratings really helps the show get seen by more people, heard by more people, so that they can get this great information that we're getting out. Just want to also let you know, we are taking on a small number of clients on one-on-one health optimisation consulting. If you got a really tricky health situation, if you're not getting the results that you want in the normal world, if you are needing help navigating some complicated situations, then we'd love to help you. We only work with a very, very few people at a time. And that requires quite a commitment from us, from the research side of things in helping people optimise their health or navigate their way back to health. So if it sounds like something like you would like to know about, please email me lisa@lisatamati.com. We only work with a very few people at a time at that level. So just letting you know that that's available.  Now over to the show with Neil Wagstaff in Havelock North. And I hope you enjoy this fantastic interview. Lisa: Hi, everyone, and welcome back to Pushing The Limits. This week, I have my wingman, Neil Wagstaff. Neil, how are you doing? Neil: I'm good. Thanks, mate. I'm very good. How are you? Lisa: It's very hot here. I'm sweating as well. Neil: Here as well. Lisa: Very humid! Right, people. Today, we have a really good webinar for you, podcast episode for you, all around the importance of — this one’s for runners, really — and it's all around runners warm-ups. Why do you need to do one, what's included, why you need to incorporate breathing into that warm-up routine. It's more than just running warm-ups, believe me, you'll get some great value, if you're a runner in this one, or if you're into fitness. And we're going to be talking about the importance of running specific movements to prepare for your run. And we're going to be going over some of our top drills to activate your body and get you ready. So, Neil, we did a fabulous session yesterday on this, and it was so valuable we decided we got to record this for the podcast, so… Over to you, mate. Neil: Thanks, mate. Thanks, and as you say, it is a lot more than just the runners warm-up, but it's… Gone are the days we just lace up your shoes and run out the door. That's what many, you know, we definitely did in the older days. And a lot of our clients we work with do, a lot of people, as you said in the introduction, as well, it’s not just the runners. It's in an exercise environment as well. So we put a lot of emphasis on this in the gym environment. So important, there should be some good nuggets for everyone. So the first thing first before you even think about the warm-up is understanding about what we call your bucket of stress. So the bucket of stress, if you will imagine you've got that bucket sitting in front of you. And within that bucket, there's things that will fill it up. Now some of those things are going to be what's going on in your daily life. They're going to be your kids. They're going to be your work. They're going to be family. They're going to be other stresses that are happening, and then you layer exercise on the top of it. So with the bucket stress, it’s understanding how full yours is. If you're going to go out and do a high-intensity interval run, where you're doing 1K intervals at 80, 90% of your max effort, and your bucket is already overflowing, then that run, those interval runs on top are just going to cause your body more stress or more loads, which will give you a pretty harsh response, which will then result in injuries, niggles and pain. Lisa: Yeah. Neil: On days where your bucket is full, what you want to be doing is really changing your workout or changing your routine to suit how you're feeling. Okay, you know, I've had massive conversations over the years about the bucket. What's your— give us your perspective of it and how you manage your routine a little bit differently now. Lisa: Yeah, and I'm still probably a bad example some days. Neil: You’re a good work in progress. You’re a good work in progress. Lisa: Do what I say not what I preach sometimes. But it's really, I have really adopted the fact that it is important to do a warm-up when you're preparing for a run. And also to understand what we're trying to get across here is that just because stress is good for your body— I mean, sorry, running is good for your body or exercise is a good stressor, if you like, it is still adding to your total stress load. So the level that Neil used to run it when he was not a dad of three little children and had a bit more time and didn't have a massive German, a couple of businesses to run, he could dedicate more intense time to training without breaking himself, if it makes sense. Now, because his energies are split in every which way, he has to be a little bit more careful how he prepares for an event, the time that he takes for it, and the time that he prepares his body.  So if your training plan says today, you should be going out and smashing a really long run or a really intense run, but you haven't got the resources because you had a really shitty night sleep, and you didn't drink enough yesterday, and you didn't eat properly, and the kids have been up all night, and goodness knows what else — you've got a lot of stress and a lot of worries on your mind — then you're probably not going to get to that adaption— adaptation, sorry, when you do that training, which is what you're actually doing it for. It's not just about ticking the box because my coach said or my plan said that I had to do that today. And I've ticked the box, therefore I am good to go. It is about saying, 'Is my body going to respond to this training session today’? Yes or no? Or, ‘Would I be permitted to postpone that really intense workout to a little bit later, maybe tomorrow? And I'll get to bed early tonight. And I’ll drink well, and I’ll hydrate well. An I’ll do all the other bits and pieces as well. And then I might be a bit more prepared for that'. Does it make sense? So you’re not doing things when your body is not going to get the adaptations because that's what training is about. It's not about the actual run where you actually get the results; it’s in the recovery phase. So understanding where your body is at, which is a really good segue into our wellness checklist. Isn't that, Neil? Neil: Yeah. So yes, you go through as well as, just asking yourself each day, where you're at a number of different things and things we get with our wellness checklist. And you can all do it at home as you listen to this. It’s a simple scale of 1 to 10. So 1 to 10 on these things we're going to talk about. How well did you sleep? That's the first one. How well have you eaten, and where you're at from nutrition point of view? Lisa's already mentioned hydration, number three. So how well have you hydrated? How well have you moved? What sort of exercise movement have you done in the past day? On a scale of 1 to 10. And then energy wise, where's your energy score at? 1 being the toilet, 10 being at rock and roll levels, you’re ready to party. And body, any niggles, any injuries? And your stress score, so 1 with the stress will be low and 10 will be good. That gives you a total score. If you've got a score up over 50, and it'd be a good indication that you're ready to go and do a warmup that relates to what's in your program. If it’s saying that, we're doing the example, the 1K, then that puts us in a position that we should be ready to do it. If my score is lower, which some days it is, then I'll look at my program and go right, I've got intervals. But I mean, my score’s down at 40. So those two workouts don't match up then. So what I then do is go, ‘I can still go train, but my training may be a recovery run instead so I feel my energy levels back up’. If you are continuously having low scores with this full stress bucket, it's not a runner's warm-up you want to be considering. It's about— it's really another strategy, which is how am I going to empty some of my stresses out of my bucket? Because your bucket should be managed on a daily basis. So that you, you know, 80, 90% of the time you're doing what your program says, it's just having the confidence and understanding that some days when things don't go perfectly you can tweak it. Okay, so just to recap: sleep, nutrition, hydration, movement, energy, body, and stress, scale of one to 10. 1 being in the toilet, 10 being rock and roll. And we can send the, or add the… Lisa: Yeah, we’ll put this in the show notes, actually, the checklist. Neil: Wellness check to the show notes. Yeah, so that's understanding again really helps you manage your bucket. So before you've even warmed up, you're asking, what's my session I'm going to do? Now, I know what type of warm-up to do. The other bit to consider as well is really, really a little bit about your why. If you are… Many programs out there, what we've looked at over the years, designed by ex-professional runners, often male, without giving them a hard time, and often by men. And in our business, we work with a lot of ladies. Over 70% of our business is working with females. And a lot of our athletes we're working with, mums or dads, and they have got busy work lives, busy family lives. So those programs are running five, six days a week just doesn't work. So ask the question as well, what's your why? And who are you? So for me, personally, as Lisa knows, my three little ones, Ellen, Cameron, Annie, I love the idea of getting dressed up as Superman. Okay, and we shared a couple of pictures of me dressed up as Superman. So it's understanding what your why is and why you're doing it. I want to be a superhero for my kids. Therefore, the type of workout is different now, as Lisa said earlier, than I was doing in my… pre-kids. And when I was back in my 30s, then I was thinking more like a professional parkour athlete and wanted it to be doing. So therefore, the warm-up is going to be different. So what we're trying to do, and the big thing especially from Lisa's perspective as well, is how important mindset is. We're really big on that with what we do as well. So understanding what mindset you're going into this workout in. So for me, I'm going in as a superhero, wanting to be a superhero, for my kids. Some people who are listening will be going in with a professional athlete mentality. So how you prepare your mind is going to be key when you understand your ‘why’ before you warm up. There's no need for me to warm up like a professional athlete if I'm wanting to go and warm up like a superhero. It’s a different mindset as I do that. Does that make sense? Lisa: Yeah, it does make sense. And I mean, like, I'll give you an example out of my sort of, you know, day. So if I'm, like, full on busy with the business all day, and I'm sitting a lot at the computer and meetings, and blah, blah, blah. And then comes five o'clock and I go right, I'm shutting the computer, I'm out the door. And if I go out without any preparation, and we've had arguments with people, they said, ‘Well, I've just slowly increased my pace. Isn't that a warm-up’? No, it's not a warm up. And I'm still guilty of this on occasion when because you're like, you've got half an hour, and you got to get out the door. And you don't want to do a warm-up, and so… But there's a couple of pieces missing out of that puzzle. One, there's a really important reason why you— firstly, you want to shift your mind, you've been in work mode all day. And now you got to, ‘Oh my gosh, I got to go and train’. And the last thing you feel like when you've been sitting for hours in a static position is to go and do a full on workout. So you have to change your mindset because you can fail before you get out the door. And a lot of people have this argument with themselves every single day. It's like, ‘That’s on my list, but I’m knackered from work, and I don't feel like going out the door. And I just want to go home and eat a packet of chips and sit on the couch’. And so there's a couple of tricks that I use to get myself out of that thought process. So the couple of rituals that I do. So when I go and I go, ‘Right, I'm going to get into my training gear, regardless of whether I'm going out the door or not because I'm just going to do that’. And when I just go and do that, I put my training gear on, that is a ritual for me that I am… My body starts to go, ‘Oh, when we're heading for training. We better get ready’. And it gives you enough, a couple of minutes, just to get your mind in that new space. You've been in the work space or the driving space or whatever you've been in, and now you're entering a new phase, and you're bringing yourself into the present moment. You're getting your gear on, and for me, putting my running gear on as always, for me, like putting on my armor, and I'm getting ready for a battle of sorts. It doesn't always have to be a hardcore workout, but I'm getting ready for action. Then the next thing I do once my gear is on, it's like, well, ‘I might as well just do a little bit of a warm-up and see how I go’. Like this is when I'm having those days when I don't want to train, you know, you know those ones. These are the tricks that I do to get myself out the door. So then I start to activate my muscles. And we're going to go through a whole list of things with Neil, right now. But just from a mindset point of view, when I start doing my dynamic stretches and my activation and my thing, and I'm getting my heart rate up. And then by the time I've done that for a few minutes, my mind is ready for the actually going out and then my body is also woken up. So that's just a little bit of a mindset tip to get yourself out the door and bring yourself into the present moment. We also like to incorporate in that some breathing exercises, just, we could talk for hours on breathing. There is so much to learn about breathing. But just to give you just a simple quick exercise that you can do before you go out. So you've just come from work. You're going to do a box breathing exercise, where you're breathing in for four in the inhale, holding it for four, out for four with the exhale — a nice strong exhale — and then holding it for four. And you just do that box rhythm for maybe three, maybe four breaths. And in that time, close your eyes, seem to yourself into your body, start to feel your heart pumping, start to feel how do my arms and my legs feel, and you're just pulling your focus in, and then you'll be ready. Once the time you've opened your eyes, you'll be ready to get underway or get your warm-up sorted. So those are just a couple of little quick mindset tips to help you over that hump, whether it's in the morning and you get out of bed and you're going training or after work or whatever the case may be. Neil: Perfect, Lisa. Let’s go with the breathing just to add in as well, it’s the… often, when you've not just flipping the mindset, you're also flipping things like the diaphragm. A lot of the time, if people have been in a sympathetic state throughout the day, which a lot of us are throughout the day now. Then if we go to, we're breathing through our upper chest and breathing through our shoulders, a lot of people will get massive results, just by them realizing that they can breathe properly into their lungs, and they're actually going out with not having enough energy to run because their breathing patterns, off. So getting that breath going, and as Lisa said, with the nasal breathing is a great thing to add in, a very simple thing to add in as well. As we go through this, this already, we haven't even got to the moving part yet, we've already had quite a long discussion, we want people to realise is we're creating a toolbox for you. That's a toolbox of things that you'll be able to pull out when you need them. Some of you won't need the breathing as much as others, depending on what else has happened in your day already. It's a great thing to do. But some of you may find you've had quite a relaxing afternoon before you go run, and you're already breathing very nicely. So you don't need to use the breathing as much as someone that's been in a stressful situation for the afternoon or is in a very sympathetic state before they head out.  Lisa: Just briefly on the sympathetic and I think I've covered this in a couple of podcasts. But just to recap.. Sorry, took the computer over. You have a parasympathetic and sympathetic nervous system. So you, when you're in a sympathetic state, what we're meaning by that is that you're in a hypervigilant, alert, stressed out state, where you are producing quite a lot of stress hormones. Your cortisol levels might be up. Your adrenaline might be up. And your heart rate might be up, and your breathing, very often, is in the upper third of the chest. And this is telling your body, 'I'm in fight or flight mode. There’s dangerous things happening to me’, even if those dangerous things are just emails and a shitty telephone call from the boss. Yeah, that isn't necessarily a lion or a tiger that, you know, used to be chasing us when we were back in the caveman days. But it's the same response in the body. And so what we’re wanting to do with this breathing exercise is to doing some diaphragmatic breathing, so that's breathing into the belly, and we're going to do sessions on breathing because honestly, that's a couple of bucks worth.  But it's all about flipping it, getting that sympathetic nervous system activated. So you have nerves in the bottom of your lungs. And when you do very good strong exhales are really important in breathing in with the diaphragm, you're actually activating those nerves at the bottom of the lungs and tuning on that parasympathetic state. Now that parasympathetic state is all about rest and digest and recovery and immunity and all those repair processes. Now, we are going into an exercise situation, but to start off in a place of not being stressed is a good place to start. So flipping your mind and flipping your body over from one thing into the next thing. So that's just a very brief touch on sympathetic versus parasympathetic states. Neil: The next piece in the… or the next tool in the toolbox is going to be our rolling or myofascial release. So the tools we use for this are spiky balls, one of our favourites, rolling stick, which like rolling pin and a foam roller. Easy wins and low hanging fruit are always going to be your feet because they spend most of the day wrapped up in a shoe. And generally, our feet don't move as well as they should. Our feet should ideally move like our hands do, and our toes should move like our fingers. For most of us they don't so getting them out, getting them exposed to more neural stimulation and releasing any tight bits in the feet and getting them moving more freely makes a massive difference. You got... Lisa: Can you explain the neural stimulation? I think that's— it’s really why they're activating those fibers in the feet is the connection to the brain and the coordination and… Neil: Connection to the brain. One thing it does, it's like waking your feet up. So if I spent all day with my hand, for example, in a big glove and deprived it of senses and deprived it of being able to feel and touch things, I'd lose connection with what was going on around me. So I start to lose connection with understanding what was hot, what was cold and what things should feel like. If I can have that stimulation through my foot, and the great thing with a spiky ball, we're not going to smash it, is it starts to wake the feet up again. So all I'm saying is, wake up, wake up! I'm sending messages from my feet through my nervous system up to my brain going, ‘Ah, that's how I move my big toe’. Ah, that's the big toe, with running real important. But that's how I move it. And that's how my other toes move. A lot of people find their toes are bunched together and tight. If we can get some movement through those, we start to get more benefit from our running as well. Other people are going to have calves that are locked up and feet that are locked up, everything in your body is connected. So if we start to stimulate the feet, we get massive results with people who've got lower back pain or people who have got shoulder pain or neck pain, because the connection with the fascia in the bottom of your foot, it then runs up the back of your body up across your calf, your hamstrings, your hips, starts to relax a tissue above as well. So simply two things that are going to happen as you do that. One is you're going to get some muscles relax that need to be relaxed. Then the other thing, you can actually start waking the feet up. Okay, depending on where, and it's gonna be very much dependent on where you're at as a person. Some people are carrying loads of tension in their body, and some people are hypermobile. So those that are hypermobile aren’t gonna need these tools as much as those that are rigid and stiff. Yeah, do I make sense? Lisa: Yeah. Neil: You need these tools for what you need. And that's the emphasis we want to make is doing this whole thing when we finish talking about it. And its shortest version would be between five and eight minutes or longer version might be 12 to 15 minutes, but some of you are going to use more tools than others. So some of you, what we've discussed already, may use the breathing more than the rolling. But feet is an easy win, calves are an easy win. Rolling around the hip area, the glutes is a very easy win, the quads and getting those areas both, switching off muscles that needs to be switched off. But also starting to wake up muscles that need to be woken up. And it's easy ways to do that with those tools. Gone are the days of static stretching and standing on the doorstep during your quad stretch, holding. All you're doing there is switching the nervous system off and increasing your likelihood of injury and discomfort. Lisa: So just to explain what static and dynamic is for those who perhaps aren't familiar with that term. So static stretching, where you're holding a single stretch in one position for, I don't know, 30 seconds or something or longer. And that's not a good thing to do prior to a run or exercise because you're actually lengthening that muscle, and you're switching it off and making it too relaxed and then you're going to be able to flop it, for lack of a better description when you go out. And so you want to be waking it up, activating it, getting the blood flowing through it, but not turning it off. The static stretching has its value but that comes after the run or if you're doing, say, a yoga session or something like that, then it's a different thing. But you wouldn't go into a yoga class and then go for a run, for example. That would be a recipe for injury, but you're wanting to activate these different areas. The other thing to note with the foam roller was don't smash the crap out of yourself like, it's not go hard or go home. Cause I used to do that, to be fair, you know, when I first started with foam rolling years ago. It was like, ‘Ah, the more it hurts, the more I have to do it’, and, you know, as with everything, yep, you fight through the pain. But actually, the more we've learned about lymph and all the other stuff that we've learned in activating, you don't need to go full ball hard. If it's that painful, you should be around, what, six and seven, right, Neil, for what you're doing with the foam rolling. And you know, we have lots of videos and stuff on our YouTube channel if anybody wants to check it out, or, of course, joining our club and you'll find out all that sort of detailed information. So that's the activation phase. Your hips, your calves, your feet are a good place to start. Neil: It's a good technique, just simple techniques to work with are released with awareness. So we've already talked about breathing. If you find a sensitive spot, you can apply some pressure to that, getting no more than sort of six or seven out of 10. Use your breath, in through your nose, out through your nose to actually release. Your nervous system, we’ve already talked about and your body is fully connected. So by using my mind to tell my brain and to tell my foot or the muscles in my foot to switch off or switch on, I can have that control over my body. I'm using the spiky ball to stimulate it, which gives me something to feel and then I can say, right, wake up or tone down. So use the breath with awareness or release with awareness by using the breath to actually switch things off. If something feels tight, you can imagine the muscle actually switching off, toning down, almost like it's got a volume button on it and you're turning it down. Okay. The next technique, which is a good one, is a pin and stretch. So if you find a niggly spot, thinking about rolling the calves. I'm sitting on the floor with my calf and leg up on a roller. If I find a niggly spot, then I can actually pin it. And then I can move my foot backwards and forwards. So I'm pinning and then stretching. I'm moving my foot in and out of plantar and dorsiflexion. Okay, and then actually flushing the muscles as well is another great technique. We're rolling up and down and across the muscle and a great way to… almost like imagining like your muscle’s like a sponge, where you're you're wringing it out and then putting it back in a bucket of water so it can absorb again, and wring it out. So you’re flushing out and getting fluid moving backwards and forwards. Lisa: Yep. And so on. Yeah, that's absolutely, that’s key. Neil: Right So next on our list. So now we've breathed, we've worked out where we're at, if we come back from the top, we've worked out more from mindset, breathing, rolling. And now we're going to look at our — the body is all connected — so we're going to look at our fascia. So the body is connected, again, like static stretching — gone are the days where we should be looking at the body in isolation, and looking at warming up or moving specific muscles like our chest on its own, or biceps or triceps on their own, or our thighs on their own. The body is connected from toes to head. So the fact that it’s connected from toes to head, and there is myofascial lines that are running right across our bodies — front, side, back. We want to be in a position that the movements we're doing in our warm-up should help open, lengthen, move. Imagine your fascia like a superhero suit. I love talking about superheroes and the superhero suit. And you can— that superhero suit should move easily; you should be able to move easily in it. So what we're doing with these big fascia movements, is you want to be in a position where you're getting that superhero suit just to fit a little bit better or fit a bit more comfortably. And if you do that, then it fits more comfortably when you start running. You're running more freely, we haven't got any sticky bits. Okay. Lisa: So like, just explain a little bit, you know, in two seconds, it's like the chicken skin is. I know. It's like each of these subjects we could do an hour on that seriously, but the fascia, so we all know we've got ligaments, we've got tendons, we've got muscles, but a lot of people really have a struggle. What the hell is fascia then? And what do you mean it's all over my body? And you get that? Like, you know, that…  Neil: Connects absolutely everything. In two seconds, fascia connects everything. It will connect the tissue, like you described the chicken skin on chicken. It's on the superficial level. It connects muscles, it connects bone, it connects your vital organs. So if there's anything locked up in any of that fascia, it's almost like a, like a web, if you look at it. Lisa: That’s a good analogy. Neil: And have a look at it. And depending on what parts your body you're looking at will depend on how dense that web is. Lisa: Like a spider cobweb’s like. Neil: Exactly, exactly that. You move that to the… To move freely, if I've got something as locked up and my fascia’s sticky, or it's not moving as well as it could, then it could be that I've got a shoulder pain on my left shoulder. And that's actually my right foot. So it’s looking at, and all we're doing with these big fascia movements and looking at myofascial lines, and very simply speaking of the anterior, posterior and downside of the body as well, you’re starting to get that suit to fit more comfortably. We're starting to iron out any of those sticky spots. Now, if you find that as you're moving through some of these movements, that you find that you are stickier in some areas and others, it starts to let you know that you've got some imbalances there. Now on top of that, as part of dynamic movement, you then want to add in some run-specific movements. So if I'm going to run, I'm going to be spending time on a single leg. I want to, at some point in my warm-up, I want to be doing something that ideally is on a single leg and is involving opposite arm and opposite leg, like running will. So the warm-ups and dynamic movements we include as part of our warm-up will include stuff that resembles running, gets blood flow and heart rate up, gets tissue open and ready to move and work and gets me ready for the run. So when I get into the run, I'm not spending the first 2 or 3K trying to iron myself out. Open up my fascia, I'm actually running comfy, my body is now awake; my blood pressure, heart rate, breathing rate and tissue are all up and warmer. And I'm in a position where I can move more freely. Yeah, do I make sense? Lisa: Yep. So without having been able to show you visually here how to do the exercises, what we are working on is giving a little, some sample runner’s warm-ups to do that will show you some of the dynamic movements that we're talking about here to open up and get that fascia going. We haven't got that organised yet, have we, Neil. Hopefully, by the time this comes out, we might have something or coming soon. To give you a bit of an example of the types of things that we're talking about here. So just to recap from the top once again because it sounds like a hell of a lot to do before every single run. But actually, we're talking five to eight minutes. Or if you're doing a really— that's the other thing, if you're doing a super intense workout, you need to warm up longer. Like today I did an interval session, so I spent more time on the rolling and the activating and the getting the heart rate up and doing the drills, which we'll cover in a second. And before I actually went hard, because I don't want an injury. And the harder the training session is, the more I'm going to be engaging all my muscles to sprint, then I need to have everything at operating temperature. If you think about a car on a winter's morning, if you turn the motor off and then jam your foot on the accelerator and tear off, what's going to happen? Your car's not going to be very happy with you because it hasn't been able to warm up, get the blood going or the petrol going or whatever it is in a car, and get it up to warmth, get it up to speed, before you go flat tech if it makes sense. So we've done the mindset, changing your mindset, putting your gear on, getting your head in a good space, tricking yourself into just getting out the blumming door for starters. Then we've covered off some breathing. We've covered off some activation exercises — rolling the feet, rolling the calves, rolling around the hips with the foam rollers and the balls. Then we've gone and looked at some warm-up exercises, which is activating all your fascia or getting your heart rate up and so on. And the last piece of the puzzle — and this should all take you five to eight minutes, 10 minutes if you're doing a hard session — the last part of the puzzle, Neil, what's it? Neil: It’s the drills. So we do some run-specific drills that are same with the dynamic movement. And this becomes part of the dynamic movements, there's quite a lot of crossover here anyways. It's part of that movement. So things like we were talking about — opposite arm, opposite leg movement. So things like, some of our favourite ones are simple things like ball of foot hops, which is like a skipping movement, where we're just bouncing, landing on the ball of the foot with the heel kissing the floor. So warming the body up, starting to get the elasticity and the muscle doing the job it should and getting ourselves ready to roll. We use some other run-specific movements like forward land, which is simple opposite arm, opposite leg movement, where we're starting to really work on the pull of the leg and the action of running. And then another good one that we get some great results with is our carioca, which is a crisscross of the legs. And you can do carioca and have a look, and you'll see that all, we've got videos of these drills, if anyone wants them. Lisa: Yeah, email us. Neil: Please let us know. And the whole idea of these is that, again, everything — hips are open, heart rate’s up, blood pressure's up, we're ready to move. And we've done some movements that are run-specific, so when we go run, we're actually ready to run. So to break it down and give you an example of what my normal warm-up would look like — I'll always run my feet. Okay, I will always go through my breathing, sort of goes from my breathing start and then go through and roll my feet, and I roll my calves, and I roll across the top of my hips and up either side of my back. So they’re my go-tos. From there, I will do three usually big fascia movements, one for the front of the body, one for the solid body, one for the back of the body. And then I go through two or three drills. I’ll go and run. On a recovery run that will take me about five minutes. Okay, on a higher intensity run, as Lisa was saying before, on interval run, that might take me sort of 12 to 15 minutes. But it's you… You take which bits of the tools you want out of the toolbox, and then you start using them from your perspective. The other bit to throw in, just throw the mix, finally, is just looking as well, I'm a big fan of using music. We've talked about this quite a lot before as well as. So music helps me have a cadence. So if I'm doing an interval run, I find music really helps me with cadence to help me keep my cadence up. I'm doing a recovery run, then I don't enjoy using music as much because I'd rather you know, hang out and make it more of a meditative state and chill out from there. So thinking as well about what's in your playlist. Does music motivate you and help add to the mindset? Or does silence help add to the mindset? Working out what you need for each run and should it be part of that session; I use music often in my warm-up. And the music I choose for recovery run is significantly different than one I use when I'm warming up for an interval run. One's going to be really lifting me intensit-wise and mindset wise, the other is going to be letting me know that this is going to be cruising, it's going to be laid back, it's going to be about recovery. Using music as well can make quite a significant difference. Lisa: Because it's… Sorry. It's all about the mind part of the puzzle really. You know, you put, I don't know, Thunderstruck on when you're trying to do an interval session. And you're like, yeah! And you going for it, and the cadence helps you and so on. And that's using your body to activate those that, again, in that case, you're activating some adrenaline and getting that going, which you need for that session. And then you know, you want to calmer ones with you if you're just doing a recovery where you don't want to be smashing yourself and you just want to be cruising, then you want a more cruising music. But just on that note, though, just be aware, if you're in traffic, you know, it can be really dangerous. And I've been hit by a car because I had bloody things in my ears, and I was unaware of the traffic around me. So just being a little bit cautious if you are out running on roads and crossing streets, especially when you come to intersections, and you can’t hear that car coming around the corner. Neil: Pick what you're doing and where you're doing it. Lisa: Be aware, be aware of your environment. Neil: Looking, then you should have that toolbox in place now. Looking at what you're currently doing, who you are and how much of a warm-up — what percentage you use each tool for will be quite different for each person. So as we said at the start, some people will need to spend more time breathing. Some people will need to spend more time rolling. Others might need to spend more time with the dynamic warm-up. You'll all do a little bit of each but it's going to be, the percentage will be different. And when you use each tool, it’s going to depend on what you're doing and what's on your program. Lisa: And one other point here is that you will have — and I promise you this — a much more fun run, and you'll enjoy it more if you've put the time into this warm-up piece of the puzzle. Because I know a lot of us are under time pressure and stress. And we've got like, ‘I've got 30 minutes, I've got to get my running today. That's all I've got, I don't want to spend 10 minutes warming up’. Okay, negotiate with yourself and try to do at least five minutes, because it's better to get that five minutes because that other 25 is going to bring you more than that extra five minutes of running, if that makes sense. Because you— if you talk to runners, most people and if you're a beginner, you might not be aware of this, but the first 20 to 25 minutes are absolute crap for everybody all the time. You know, it's very rare, where you just run out the door, if you haven't warmed up, that you'll be enjoying yourself and your body will be stiff, it'll be sore, it'll be not activated, you won't have a good posture, you'll feel like your heart and your cardiovascular system isn't woken up. All of that can be avoided if you do all of this in the preparation. It's like laying the foundation of a house. If you do it on quicksand, you're not going to have a very stable house. If you do it on concrete and you put your foundations and your poles in properly, you're gonna have a house that stands for a long time. You're going to enjoy your run a lot more. You know, today's session was was a classic example of that, you know, interval session full on, hardcore, big good workout, warm-up prior and the session wasn't nearly so difficult than if I just jumped out the door and done it. So don't underestimate that. Neil: Good polling, Lis. I liked it. Lisa: Don't underestimate a good warm-up. So people, if you've enjoyed this content, please share this with your friends and family. Share it, get it out there, get it out in the world, we really appreciate you doing that. And if you, you know, want to come and join us at Running Hot Coaching, this is what we do. And what we love is to help people with their running journeys and inform people. And as you can see, we take a very holistic approach to our running into our health programs and to all of the programs that we do. Because we look at people as whole people and not as runners or not  as ‘You've got a health issue or specific health issue’. We look at the whole person the whole time so that you can actually get the best performance because there's no optimal performance without optimal health. That's probably a good place to leave it, actually. Neil: I like it. Lisa: Well, thanks for joining us today. Thanks, Neil, for your wisdom as always — epic. Really appreciate you, right. And we'll see you again next week. Thanks, guys! That's it this week for Pushing The Limits. Be sure to rate, review and share with your friends. And head over and visit Lisa and her team at lisatamati.com. The information contained in this show is not medical advice it is for educational purposes only and the opinions of guests are not the views of the show. Please seed your own medical advice from a registered medical professional.

Sepsis is a massive health issue worldwide. According to WHO, nearly 50 million people get sepsis every year, killing 11 million. Here in New Zealand, one in five ICU patients dies because of it. Thus, raising awareness about the role of vitamin C in sepsis can help save lives. Dr Anitra Carr joins us in this episode to expand our understanding of the role of vitamin C in our body. She also explains how vitamin C functions not only as an antioxidant but also as a cofactor in many different mechanisms, particularly in fighting cancer and sepsis. Everything we share in this episode will be helpful for you should you find yourself or a loved one admitted to a hospital, so tune in.   Get Customised Guidance for Your Genetic Make-Up For our epigenetics health program all about optimising your fitness, lifestyle, nutrition and mind performance to your particular genes, go to  https://www.lisatamati.com/page/epigenetics-and-health-coaching/. You can also join their free live webinar on epigenetics.   Online Coaching for Runners Go to www.runninghotcoaching.com for our online run training coaching.   Consult with Me If you would like to work with me one to one on anything from your mindset, to head injuries,  to biohacking your health, to optimal performance or executive coaching, please book a consultation here: https://shop.lisatamati.com/collections/consultations.   Order My Books My latest book Relentless chronicles the inspiring journey about how my mother and I defied the odds after an aneurysm left my mum Isobel with massive brain damage at age 74. The medical professionals told me there was absolutely no hope of any quality of life again, but I used every mindset tool, years of research and incredible tenacity to prove them wrong and bring my mother back to full health within 3 years. Get your copy here: http://relentlessbook.lisatamati.com/ For my other two best-selling books Running Hot and Running to Extremes chronicling my ultrarunning adventures and expeditions all around the world, go to https://shop.lisatamati.com/collections/books.   My Jewellery Collection For my gorgeous and inspiring sports jewellery collection ‘Fierce’, go to https://shop.lisatamati.com/collections/lisa-tamati-bespoke-jewellery-collection.   Here are three reasons why you should listen to the full episode: Learn more about vitamin C’s antioxidant properties. Discover how vitamin C helps patients with pneumonia and sepsis. Learn about vitamin C’s role as a cofactor and how it ensures the proper functioning of different body processes.   Resources Read more about Dr Carr's study on vitamin C levels in patients with pneumonia. Access Dr Carr's review on recommended doses of vitamin C. Health and Immune Function Benefits of Kiwifruit-derived Vitamin C by Dr Anitra Carr Read more about Dr Carr's ongoing clinical trial on vitamin C and its effect on COVID-19 patients. Learn more about Dr Paul Marik's protocol for sepsis using vitamin C and steroids. Learn more about Dr Fowler's Phase 1 safety trial of IV vitamin C in patients with severe sepsis. Watch Professor Margreet Vissers' lecture on her work on vitamin C.   Episode Highlights [04:40] How Dr Carr’s Research on Vitamin C Started Dr Carr’s research began in 1998, where she studied how reactive oxygen species (ROS) produced by white blood cells react with our tissues. White blood cells produce ROS to help kill bacteria. However, they can also react with the tissues and create inflammation. Dr Carr then began investigating how vitamin C’s antioxidant properties help decrease inflammation. She also studied the benefits of vitamin C in preventing atherosclerotic plaques and the development of cardiovascular diseases (CVD). [09:42] Vitamin C as an Antioxidant Vitamin C has real antioxidant properties. Metal ions produce oxidants in the body; vitamin C donates electrons to these ions, converting them to the reduced state. The recommended daily dose to benefit from the antioxidant potential of vitamin C is 60 to 90 milligrammes in men and 75 milligrammes in women. You need a higher dose (120 milligrammes) of the vitamin to protect yourself from CVD and cancer. [17:57] Vitamin C in Food vs. Vitamin C Tablet Dr Carr conducted a comparative dosing study between kiwi fruit and vitamin C tablets. She found no difference in the vitamin C obtained from food and tablets. The body recognises the same molecule and takes up the same amount. [21:36] Vitamin C in Sepsis and Pneumonia Patients with pneumonia can develop sepsis, resulting in multi-organ failure, septic shock and, eventually, death. In observational studies in patients with pneumonia, Dr Carr found that the lower the vitamin C levels, the higher the oxidative stress. The body's requirement for vitamin C goes up by at least 30-fold when you get pneumonia and sepsis; it is hard to get those amounts orally. ICU patients need a vitamin C dose of 100 milligrammes per day. In these patients, the actual levels of vitamin C measured in the blood is lower compared to the amount they are receiving. [25:25] Why Is Vitamin C Testing Not a Protocol in Hospitals? Doctors are not familiar with the importance, recent research and mode of action of vitamin C because it is not taught in medical schools. The hospital system is not set up to routinely measure vitamin C. In trials, vitamin C is treated as a drug rather than a vitamin. We need to know how vitamin C works to create proper and adequate study designs. [32:27] What Are Some of the Future Vitamin C Studies We Can Conduct? We need studies about the frequency, dosing and timing of its administration.  We need to learn about the finer details of the vitamin rather than doing the same study designs. It is tough to obtain research funding due to the misinformation surrounding vitamin C. We also need to educate doctors and patients alike about the science behind vitamin C. [43:16] Vitamin C as a Cofactor Our cells rely on enzymes to carry out chemical reactions. A cofactor helps enzyme function. Vitamin C functions as a cofactor for the enzyme that synthesises noradrenaline and vasopressin. These hormones help in blood pressure regulation. It’s better to give ICU patients vitamin C than giving them vasopressin drugs. This allows the body to naturally produce the hormone, preventing the side effects of getting vasopressin externally. Vitamin C is also a cofactor of collagen, which plays a role in stopping cancer metastasis and wound healing. [54:30] Vitamin C in Epigenetics The expression of DNA may be regulated by adding or removing methyl groups. Vitamin C is a cofactor for enzymes that modify DNA methylation. It controls the switching on and off of genes, playing a possible role in personalised medicine.   7 Powerful Quotes from This Episode ‘I’m much more interested in the whole person and how they're feeling, not what's happening inside a single cell’. ‘Don't wait until they're at death's door and at septic shock. It's hard for a vitamin to do something at this stage, even a really high-dose vitamin’. ‘A lot of these studies were designed to reproduce the first studies that came out to see if they could reproduce it also. That's why they’re using similar regimes. But now that we know more about it, each study adds another piece to the puzzle’. ‘There’s bigger issues at play with the whole pharmacological model that our whole system is built upon, and that nutrients and nutrition isn't taught in medical school. So, we're up against this big sort of brick wall’. ‘People go into a hospital setting or something, and they expect to have the latest and greatest information available, that the doctors know all that. And unfortunately, that's not always the case’. ‘Every person's life that is saved is a family that's not grieving’. ‘It’s the reason I’m doing this podcast, and it's the reason you're doing your research. And hopefully together and with many others, we can move the story along so that people get helped’.   About Dr Anitra Dr Anitra Carr holds a PhD in Clinical Biochemistry/Pathology. She started researching vitamin C when she undertook a postdoctoral research position at the Linus Pauling Institute, Oregon State University, USA, and was also awarded an American Heart Association Postdoctoral Fellowship. Dr Carr produced a number of high-impact publications in the field of vitamin C in human health and disease. Dr Carr is currently a Research Associate Professor at the University of Otago, Christchurch, School of Medicine. She has established her own research group, the Nutrition in Medicine Research Group, and undertakes translational bench-to-bedside research comprising observational studies and clinical trials on the role of oral and intravenous vitamin C in infection, cancer, metabolic health, mood and cognitive health. Dr Carr endeavours to understand the underlying biochemical mechanisms of action as well as improve patient outcomes and quality of life. She also pursues various ways to improve clinician and general public understanding of the roles of vitamin C in human health and disease. You may contact Dr Carr through anitra.carr@otago.ac.nz or call +64 3 364 0649.   Enjoyed This Podcast?  If you did, be sure to subscribe and share it with your friends! Post a review and share it! If you enjoyed tuning in, then leave us a review. You can also share this with your family and friends so they can learn more about the benefits of vitamin C in sepsis and pneumonia. Have any questions? You can contact me through email (support@lisatamati.com) or find me on Facebook, Twitter, Instagram and YouTube. For more episode updates, visit my website. You may also tune in on Apple Podcasts. To pushing the limits, Lisa   Full Transcript Welcome to Pushing the Limits, the show that helps you reach your full potential with your host Lisa Tamati, brought to you by lisatamati.com.  Lisa Tamati: Welcome back to the show! This week, I have another fantastic interview with another amazing scientist. But before we get there, I just want to remind you please give a rating and review to the show if you're enjoying the content and share it with your family and friends. I really appreciate that. And if you haven't already grabbed a copy of my book Relentless, make sure you do, you won't regret it. It's an incredible story that is really about taking control of your own health and being responsible for your own health and thinking outside the box. And it's the story of bringing my mum back to health after a mess of aneurysm. And it will really make you think about those—the way our medical system works and about why you need to be proactive when it comes to health and prevention, preventative health. And it's really just a heart-warming story as well. So, you can grab that on my website at lisatamati.com. Or you can go to any bookshop in New Zealand and order that or get that and it's available also on audiobook for those people who love to listen to books rather than reading them, I know, I certainly do a lot of that.  And just to also remind that if you have any questions around some of the topics that we've discussed on the podcast episodes, please reach out to me lisa@lisatamati.com. And if you want help with one of your health journeys or your performance journeys, or you want to work on some goal setting, on some mindset, please reach out there as well. We'd love to work with you. So today I have the Dr Anitra Carr, who is a scientist at Otago University. She's currently a research associate professor at the University of Otago, Christchurch School of Medicine. She's established her own research group, the Nutrition in Medicine Research Group and undertakes translational bench to bedside research comprising observational studies and clinical trials on the role of oral and intravenous vitamin C in infection, cancer, metabolic health, mood, cognitive health. And she endeavours to understand the underlying biochemical mechanisms of action as well as improve our patient outcomes. So, she's a person who loves to actually not just be in the lab and looking at petri dishes, but to actually help people in human intervention study. She currently has a study underway, which I'm really, really excited and waiting with bated breath to see what comes out. It’s a sepsis study, in the Christchurch hospital with 40 patients. And we talk a little bit about that today.  And we talk about the role of vitamin C  today. Continuing the conversations that we've had with some of the world's best vitamin C researchers. We're looking at the antioxidant properties, we're looking at the pro-oxidant properties, we're looking at vitamin C as a cofactor in so many different mechanisms in the body. We talking about its role in the production of adrenaline and vasopressin, in hypoxia inducible factors, in relation to cancer, and especially in relation to sepsis, which is obviously a very important one for me.  One in five ICU patients in New Zealand dies of sepsis. This is a massive problem. Worldwide, between 30 and 50 million people a year get sepsis. This is something that you really need to know about. You need to understand it and Dr Anitra Carr, also shares why you may not get a doctor in a hospital situation, actually understanding all the information that we're going to be sharing with you today. So, educate yourself, learn from this and enjoy the show with Dr Anitra Carr. Lisa: Well, hi, everybody. And welcome back to the show. Today I have Dr Anitra Carr, and today we're continuing the series around vitamin C. We've had some brilliant doctors and scientists on in the last few weeks and it's been really exciting to share some of the latest research and we have one of our own Kiwi scientists with us today, Dr Anitra Carr from Christchurch. Welcome to the show. Dr Anitra Carr: Hi, Lisa! Lisa: It's fantastic to have you. So, Dr Anitra, can you just tell us a little bit of your background and how you got involved with vitamin C research? Dr Anitra: Well, I first started researching back in the late 90s. So, 1998 and I had just finished a PhD with the University of Otago and I had been studying how reactive oxygen species that are produced by white blood cells react with our own tissues, damage their own tissues because these white blood cells produce these really reactive oxidants, such as hydrogen peroxide, which is hair bleach, and hypochlorous acid, which is household bleach. So very strong oxidants and they produce these to help kill bacteria in our bodies. But these oxidants can also react with their own tissues and that's what contributes to inflammation and the processes of inflammation. And so, I've just been studying how these oxidants react to certain components in our tissues. And when I finished that, I thought it’d be really interesting to investigate how antioxidants, such as vitamin C, which is one of the most potent antioxidants in our body, and help potentially protect against this damage. So, scavenge those oxidants before they react with our tissues, and help decrease the inflammation associated with them and features and conditions. And so, I applied to various people in the United States, I wanted to go to continue my research in the United States. And so I applied to several people over there who are doing research in the area that I was interested in, and they'll write back and say, ‘Yes, we have postdoctoral positions available.’ And so I selected one, on the advice of my PhD supervisor, and this was Professor Balz Frei. He was at the time in Boston. And after I said, ‘Yes, I'd like to work with him.’ He wrote back and said, ‘Oh, by the way, I'm moving to the west coast to Oregon. And I'm going to be the director, the new director of the Linus Pauling Institute.’  Lisa: Oh, wow.  Dr Anitra: Great opportunity it is. I like the West Coast of the United States. I've done a bit of work in California during my PhD. And so, I was quite happy with it. And so Linus Pauling had died just a few years prior to that. And so, the Linus Pauling Institute, which was in California, at the time, kind of needed a new home, I think they're in Palo Alto. And so they ended up going to Oregon State University because that was—for a couple of reasons—that was Linus Pauling alma mater. So, he had done his undergraduate research when he was in a cultural college. And also, because the library there was going to be able to host his papers. And so he has this collection of his writings and papers, thousands and thousands of documents, because as you've stated before, he's one of the only people to have been awarded two unshared Nobel prizes. So one was in chemistry around his work on the nature of the chemical bond. And the other one was a Peace Prize for his anti-nuclear campaign. And so the Oregon State University Library has his complete collection, it's called the Linus Pauling Special Collection. And so I spent a few years at Oregon State University researching how vitamin C can protect against oxidation of low density lipoprotein particles, which are what the body uses to export fat and cholesterol around the body, because the cells need cholesterol. But most people know low density lipoprotein protein as bad cholesterol. I mean, it's not intrinsically bad. But if it becomes oxidized, it can contribute to the development of atherosclerotic plaques and contribute to cardiovascular disease. And so I was looking at how vitamin C can protect against oxidation of this particle, and thereby potentially peak against development of atherosclerosis. And I was... Lisa: What was the outcome of it? That would be really interesting. Dr Anitra: Yes. So, I was particularly interested in the oxidants produced by white blood cells, because these can react with these low density lipoprotein particles and oxidized them. And vitamin C is a great scavenger in particular, and I was interested in how much do you need and how the particulars—is the real biochemical level? And, but also during this time, so late 1990s. We were interested—Professor Balz Frei was interested in the recommended dietary intakes for vitamin C. Because in a lot of countries they are very low—these recommendations, primarily to prevent deficiency diseases, such as scurvy. Whereas, we believe you know, that the recommendations should be high to help reduce the risk of chronic diseases such as cardiovascular disease and cancer and that sort of thing. That's a bit helpful to the outcome. So, in the late 90s, in 1998, the Food and Nutrition board of the Institutes of Medicine was re-examining the recommended dietary intake for the antioxidant vitamins, the A, C, and E in the United States.  And we write a comprehensive review around all the scientific evidence at the time for what sort of doses of vitamin C appear to protect against cardiovascular disease and cancer. And so, we made a recommendation of 120 milligrams a day, which was, at that time twice what the recommended dietary intake in the States, it was 60 milligrams a day at the time. And so we submitted that document, and it was considered by the Food and Nutrition Board. And also another review, I'd written around vitamin C's antioxidant roles in the body versus its pro-oxidant roles. Vitamin C, referred to as pro-oxidant.  Lisa: Yes, I’ve heard that. To get hit around the antioxidant and as a pro-oxidant.  Dr Anitra: Vitamin C is an antioxidant. It's not a not oxidant, pro-oxidant. But what it does is it can reduce—so antioxidants donate electrons, and they reduce oxidized compounds. So, it reduces transition metal ions such as copper and iron. So, these are metals in our body that can read off cycles so they can produce oxidants. Lisa: Yes, and we've talked about redox before in the podcast. Dr Anitra: Yes, so what vitamin C does is it converts these metal ions into a reduced state and metal ions can go on and generate oxidants. Lisa: So it gives ion and copper a longer life, does it? It sort of gives them—ion and copper away to keep going? Dr Anitra: Regenerates them so that these metal ions can keep producing oxidants. But in our body, these metal ions are all sequestered away and protected by proteins, they're not floating around free. In the body, vitamin C doesn't seem to do that, based on the evidence, it seems to just have it’s true antioxidant roles, not this kind of prooxidant by-product, as you might call it. So, this sort of evidence was considered by the Food and Nutrition Board and they decided, ‘Yes, it does have an antioxidant role in the body.’ And, and so they also referred to Mark Levine's seminal work to kind of work out a dose, a daily dose of vitamin C, they thought would be good to help foster this antioxidant potential on the body—potentially protect against these other chronic long-term diseases such as cardiovascular disease and cancer. And so they did end up increasing the RDA for vitamin C instead from 50 to 90 milligrams a day for men, and 75 milligrams a day for women. So that was good, not quite as high as we would have liked to see, but still a step in the right direction. Lisa: A very conservative, aren’t they? They are slow to respond and conservative? Because you think like being the preventative space would be a good thing, if we're trying to... Dr Anitra: It is. Prevention is a lot cheaper, a lot easier to prevent a disease. Lisa: Exactly. But I think New Zealand's even worse, isn't it? I think we're at 45 milligrams, which is I think it is. Dr Anitra: One of the lowest in the world, yes. Lisa: That’s got to change, sorry.  Dr Anitra: So we're trying to generate the evidence to help support them increase in RDA. Lisa: Gosh, so it's also slow, like you've been doing this for what? 20-like years. And still... Dr Anitra: They do say that translation of science into medical research into clinical practice takes 15 to 20 years. Lisa: Wow, that is a really interesting statement. Because this is why I think, like sharing the sort of information direct from the experts, if you like, and I sit this was Professor Margreet Vissers too, that we have to make sort of educated decisions as people in trouble now. Whether you've got cancer or whether like my case who have a dad who had sepsis, you have to make an educated decision now based on you're running out of time. And we're waiting for the research and the research will be great, but it will be another 10 to 20 years down the line before it actually… And then in the medical world, it seems to be a very slow—Doctor Fowler said that beautifully when I had him on last week. It's like trying to shift a supertanker, Critical Care he was referring to is very, very slowly coming around. And I had Dr Ron Hunninghake on as well from the Riordan Institute, another fantastic doctor, and he talked about Medical Mavericks. Dr Hugh Riordan had written three books on people who were really ahead of their time, got in trouble for it and then actually the research and everything caught up with them later.  So that's interesting. So, if you’re listening to this, New Zealand has got 45 milligrams as the RDA, that's just to keep you out of scurvy. Right?  So, okay, so you've done all this antioxidant research and this with RSS and at the Linus Pauling Institute, when did you start to develop an interest in the infectious diseases, sepsis side of that, because I'd really love to... Dr Anitra: Yes, that's, that's more recent.  So, after a few years—three years at the Institute, I decided to have our first child and move back to New Zealand. And I made the decision to quit science and just focus on bringing up our family, ended up having three children. Stayed home for nine years looking out after our children. And I made the decision that they were more important than my career  Lisa: Wonderful. That's an interesting fact, as well as a mom and a scientist, like, an incredibly dedicated career that you'd have spent years getting there and then trying to juggle mum roles with scientist roles, and taking nine years out of your career. Has that hurt your career massively? Or I would have catch up so to speak? Dr Anitra: It hasn't hurt my career. I mean, I'm 10 years behind my contemporaries, my colleagues because I took that time out. But that's the decision I made. And I stand by it because the first three years of a child's life are very important. So I thought I'll dedicate myself to the children in the early years. And after those nine years, right? I've done my time and really can’t get back to work. Lisa: Mum's going to be a working mum from now on.  Dr Anitra: But I just went back to work part time, so, within school hours, so that I'll still be there for them after school hours. And one of the things that drew me back to work—I was recruited back to run a human intervention study. What really excited me because when I was in the lab doing lead-based research, I always felt too removed from the need to be helping. And so I’m much more interested in the whole person and how they're feeling, not what's happening inside a single cell.  Lisa: Yes. Yes, it makes sense.  Dr Anitra: I was really excited and really grateful to be recruited back, especially after taking nine years out for my... Discoveries have been made during that time that I had no idea until I went back and I've got a bit of catching up to do. And... Lisa: So what was that first intervention study, that human...  Dr Anitra: This was a kiwi fruit study. So kiwi fruit is very high in vitamin C. In summary, we're interested in how many kiwi fruit do you need to eat to get adequate and optimal vitamin C level. So it's just kind of a dosing study?  Lisa: Brilliant. Dr Anitra: Then we went on to compare kiwi fruit with tablets. So, animal research had shown our food sources of Vitamin C seemed to be a bit better than tablet sources. And so we would—we thought we'd translate that into a human study. And what we found is there's no difference  Lisa: There's no difference. Uptake of vitamin C from food versus tablets, the body is really good at it. Because we need vitamin C, our body has adapted ways to...   Lisa: Take it wherever it gets it. Dr Anitra: Take it up, regardless of the source. Lisa: Wow, that's... Dr Anitra: The structure of vitamin C's the same in foods as it is in tablets. So the body recognizes it the same, takes up the same amounts. I mean, the benefit of food is that you're also getting all the other vitamins and minerals and fibre. So, we still recommend food. But it is in our daily diets these days, it's very hard to get 200 milligrams a day of vitamin C. Lisa: Just fruits and veggies. Yes. Dr Anitra: That’s just fruit and vegetables. And as you know, different fruits and vegetables have quite different amounts of vitamin C, which a lot of people aren't aware of. Lisa: No. No. Dr Anitra: I mean, people know that kiwi fruit and citrus are high, but they may not realize that apples and bananas are actually quite low in vitamin C. Lisa: Or capsicums are quite high… You wouldn’t think that broccoli… And if you decide to take a supplement, is there a bit of supplement? Like, I have heard concerns about corn-derived vitamin C because of the glyphosate discussion, and that’s a bit hard to track really, the types of vitamin C. But is there any sort of research around—I mean, I've talked previously with a couple of doctors and scientists around liposomal delivery. Have you seen anything in that department or any supplementation method that's better? Dr Anitra: Not convincingly better. I mean, there might be trials that show that’s slightly better than just your normal chewable vitamin C. But I just go for the standard, cheap vitamin. Lisa: Yes, doesn't have to be super special. Like it's a pretty simple molecule, isn't it? Like, the body is pretty, like you say, it needs it, it knows it. Dr Anitra: Liposomal vitamin C kind of wrapped up in lipids, and the body doesn't need it because like you said it’s designed to recognize vitamin C in its natural form, in foods and such like. Lisa: Yes—who was that? I think Dr Thomas Levy was saying it bypasses some of the digestive issues because with vitamin C, you can get digestive stress when you take a bigger... Dr Anitra: When you take a higher dose. Some people, we're talking about more than four grams a day, and some people can get stress, it does but you can use that. Lisa: Okay. So then you've moved into—and forgive me for jumping here—but very keen to talk about the role of sepsis and pneumonia and patients in ICU reasons   Dr Anitra: So, after about five years of doing that research part time, I managed to get at Health Research Council, such as speakers Health Research Fellowship, which allowed me to move into the more clinical arena of studying infection, which was an area I was interested in. And done some observational studies where we have recruited patients who have pneumonia, measured the vitamin C levels, and levels of oxidative stress. And found that they have very low levels of vitamin C and high levels of oxidative stress. And the more severe the condition, the worse it is, the lower the vitamin C levels, and the higher the oxidative stress. So, if those patients with pneumonia are going to develop sepsis, and sepsis is kind of this uncontrolled inflammatory response to a severe infection. And that can develop into multi organ failure and the patient’s taken to the intensive care unit. And it can go on further to develop into septic shock due to failure of the cardiovascular system. And up to half those patients die, it’s the major cause of death in critically ill patients.  Lisa: Yes. And that's what I unfortunately experienced with my dad. And so, with the organs are starting to break down. So, when you get anything like pneumonia or sepsis, the body's requirement just goes up, a hundred-fold or more. Dr Anitra: Yes, at least 30-fold. Yes. So, it's very hard to get those amounts into a patient orally. And so, when the patients are in the intensive care unit, they're generally sedated because they're being mechanically ventilated. And so, they're given nutrition in two different ways because they can't eat. And so, the main way is to drip feed it directly into the stomach, liquid nutrition in the stomach through nasal gastric tube. The other way is to inject it directly into the bloodstream. And so, the recommended amounts of vitamin C by these means is about 100 milligrams a day. Lisa: That’s nothing.  Dr Anitra: But what we did on one of our studies was we looked at how much vitamin C these patients should theoretically have in their blood based on how much vitamin C they're consuming. Because 100 milligrams a day in a healthy person is more than adequate to—provides adequate plasma, what we would consider adequate plasma levels. And so, we mapped out what it would look like in these patients based on how much they were getting. And then we compared it with what we actually measured in their blood, it’s way lower than what theoretically should have been. And so, this, this was an indication that you still need a lot more vitamin C than they're getting in the standard liquid nutrition. And that the body also has these much higher requirements, which has been shown previously by other researchers. Lisa: And so this leading to almost a scurvy-like situation. I mean, some of these severe sepsis people—I mean, seeing one of your [unintelligible 24:53] that sort of normal community cohort of people, young people, middle aged people, and then down into the more severe pneumonia and then sepsis, and severe sepsis. And they are just over the scurvy level. So basically, their bodies are falling apart because of that, as well as the sepsis if you like. and it's... Dr Anitra: And that’s even on top of being given a day of at least 100 milligrams a day, that's still really low. Lisa: That's just not touching the sides.  Dr Anitra: Yes and...  Lisa: Why is this not like—for people going into the hospital, why is it that even though—okay, we may not know the dosages, why is not every hospital testing at least the really sick patients, what their vitamin C levels are, and then treating it the nutrient deficiency only? Even apart from the high dose intravenous stuff, but just actually—with my dad, I was unable to get a vitamin C test done to prove my case. I couldn't prove my case because I couldn't get it tested.  Dr Anitra: Yes, no, it's so true. It's because doctors don't learn about nutrients in medical school, it’s not part of their training.  Lisa: At all, yes.  Dr Anitra: So they're not familiar with how important they are for the body. They're not familiar with all the recent research around all the different functions and mechanisms of action that vitamin C carries out. Over the last 10 years, all these brand-new mechanisms and functions have been discovered, and they think we know everything there is to know about it.  Lisa: Yes, and we don't. Dr Anitra: [unintelligible 26:34] the time. It’s basically exciting. Lisa: Yes, it is.  Dr Anitra: So basically, they don't understand. The hospital system isn't set up to routinely measure it. It is only ever measured if scurvy—if someone comes in with suspected scurvy. And even then, a lot of doctors aren't used to recognizing the symptoms of scurvy. It's not something they're familiar with because it doesn’t... Lisa: They think it no longer exists because it’s what sailors had in the 1800s. Dr Anitra: ...the parents and the wisdom.  Lisa: It’s basically in the sick population. Dr Anitra: It is. But I think... So when I first applied for funding to carry out these studies, in pneumonia and sepsis, there were only a couple of papers have been published at that time looking at vitamin C sepsis, and that was Berry Fowler's safety dosing study.  Lisa: That is phase one trial.  Dr Anitra: And another one, small one in Iran. So, there was very, very little information out there at the time. And so, I put in an application for us to carry out an intervention study in our ICU at Christchurch. So just a small one, 40 people—20 placebo control of vitamin C and 20 getting intravenous vitamin C.  And not long after that, Paul Marik's study came out and that stimulated real explosion and research in this field because of the media interest. So the media picked up on it. And it hit the world. I've been talking about this for years to doctors. I see doctors and they're trying to get to talk about it. But it wasn't until it hit the media, and they heard about it through the media, they thought, ‘Okay, maybe there's something here.’ So that just goes to show how important media can be. Lisa: Exactly why we're doing the show. I have not seen it. But you know what I mean? We've got to get this from the ground up moving.  Dr Anitra: Yes. And so since then, there's been many studies carried out around the world, all of different quality. And so we're learning more and more information, real-time clinical trials, they take a long time to run. Recruitment being the most difficult part.  The other thing is that, a lot of the clinical trials, the clinical researches are used to running drug trials and so they treat vitamin C like a drug, but it's not a drug. It's a nutrient, it’s a vitamin, that the body is specially designed to take up and use very different from drugs. And so they don't always understand how vitamin C works in the body. And it's important to know how it's working in order to design good studies, good quality studies. So a lot of the data that's come out may be impacted by how well the study was done and thought out. So we still don't know all the important essays about the dose, how often should you give it, when should you give it?  I mean, ideally it should be given you know, as early as possible.  Lisa: Early as possible.  Dr Anitra: Don't wait until they're at death's door and septic shock. It's hard for vitamin C to do something at that stage even really high, even a really high dose vitamin. The earlier that you give it, the longer you can get it for digest.  Most of these trials have given it for four days and they stop.  Lisa: Yes, I've wondered that.  Dr Anitra: The whole time, they're in the ICU because once pharmacokinetic study showed that when you stop that vitamin C, some of those patients just drop straight back down to where they were. Now they need to keep that continued input.  Lisa: So why? Why has it been made that it's only—all of those I've seen, I think have been 4-day, 96 hour studies. And occasionally one of them is or for the latest day in ICU, but most of them have been 96 hours and most of them have been very, very conservative dosing. From what I understand conservative dosing. And I know Dr Berry Fowler said where there's some consideration about oxalate in kidney function. And I'm like, ‘Yes, but this is still a very low risk for somebody who's got sepsis.’ Dr Anitra:  If a patient has kidney dysfunction in ICU they put them on haemodialysis anyway, so which clears that excess vitamin C. So it's not such an issue for those patients. But yes, a lot of these studies were designed to reproduce the first studies that came out to see if they are reproducible. so, that's why they’re using similar regimes. But now that we know more about it, each study adds another piece to the puzzle. And so hopefully, future studies will look more into what dose we actually need and it only varies depending on the... Lisa: The severity  Dr Anitra: Severity, etc. How long? And I believe, once they leave the ICU... So patients who survived sepsis, they can go on to have real problems, physical disabilities, cognitive issues, psychological issues, like depression, anxiety. And so, I really believe they keep taking vitamin C when they leave the hospital just orally, that might help with those conditions that hasn't been researched yet. That's a whole area of research that should be carried out to. Lisa: So, if I was to ask you, in your dream world where your resources are unlimited, and you had lots of money, and you had lots of people to help you do all these and you have enough patience to enrol. What are some other things that you would like as a scientist and you understand some of the mechanisms and the cofactors—which I want to get on to as well—what are some of the studies that you would like to see happen? So, we can move this along faster.  What are some of the key things?  So, quality of life afterwards? Yes, like dosages, what?  Dr Anitra: Really practical things that the doctors need to know, I think, what's important, like, how much to give, how often to give it? Most of the studies are done four times a day because that's what was done in the initial studies. Is it better to give it continuously? So, when they're in the ICU, can you just use drugs continuously, rather than this kind of bolus dosing?  So, do more research around that.  So the frequency and dosing and timing like when do you administer it, how long should you administer it for? I mean, there's so many important aspects around that. And we've got the foundational research done now, we can start teasing out the finer details now, I think. Rather than just doing the same study designs over and over again, Lisa: Yes and reproducing.  Dr Anitra: Modify their study designs to start addressing these other issues. And there's some really big studies underway at the moment. One in Canada with 800 people. I mean, they'll give us really good information, those sorts of studies, rather than the little studies. Unless you live in small countries. Lisa: Small countries that can’t afford those things that cost millions and millions of dollars. And is there a trouble with funding because it's not a drug that we're developing here? Does it make it harder to get funding? Dr Anitra: It's extremely hard to get funding because often on the CSUN committee, it's often medical people on these who don't believe in vitamin C. The bad press or the misinformation don't understand the importance, the relevance and so, that's why this outreach is really important. It's just educating people about the science behind it. It's not hocus pocus.  Lisa: Yes, I mean, if I can share—I mean, I've shared a little bit on the past episodes with my case with my dad. I know and I felt they just put me in that, wackery quackery caught and they paid lip service to listening to me. They didn't really and but I’m quite—well in this case, I had to be quite forceful because my dad was dying. And I didn't go away, most people would go away because—and I just wish I knew then what I know now even because I wasn't that deep into the research. And now I am deep into the research and really an advocate for this.  But I was treated like—there was one really good doctor who listened to me, who advocated, he didn't believe in it, he didn't understand the mechanisms of action or any of that sciency stuff. But he did advocate for me at the ethics committee, whereas everyone else would just roll their eyes basically.  And this is why I think it's so important to share this, to come back again and again to the science for science for science, and for them to just open up their eyes just because they didn't learn it in medical school. And it's not in the current textbook for, like you say, because it takes 20 years probably to get it to the textbook. Because it's a vitamin, they just immediately shut down, it’s how I felt. They just immediately, ‘Well, just eat an orange and you're good to go.’ I mean, the surgeon—I had a friend that was going into surgery, and she was like, ‘Should I have intravenous vitamin C, before I go into surgery to prepare my body?’ Very logical thing to do in my eyes. It’s like, ‘You don’t need that, just eat an orange,’ and it's like, ‘Oh, you don't get the whole why and how, and what happens when the body goes through a trauma and a surgery, or a sepsis or any of these things.’And I don't know, like there's a bigger issue at play with the whole pharmacological model that our whole system is built upon. And that nutrients and nutrition isn't taught in medical school. So we're up against this big sort of brick wall.  And when I tell my story to people just, sharing with friends and things, they’ll be going, ‘But where's the downside? He was dying anyway, why couldn't he have it?’ And I said, ‘Well, you're up against machinery, you're up against ethics committees, legal battles, and a system that is just very staid and conservative in its approach.’  And that's not to criticize individual people within the system. I'm not wanting to do that. I'm just trying to make people aware because people go into a hospital setting or something, and they expect to have the latest and greatest information available that the doctors know all that. And unfortunately, that's not always the case. Do you find that frustrating?  Dr Anitra: I mean, it's not the doctors’ fault as such, because they're very busy people, they don't have time to keep up with all the literature, and they're not likely to be going into the nutrition literature in the first place. Which is why we try and publish as much of that stuff and the clinical literature, they're more likely to see it then. And they have the patient's best interests at heart. They've just heard the bad things about vitamin C and the misinformation. And so they don't want to do harm to the patient, I guess. It’s the view that they’re coming from and they don't have time to read all the latest information. And that's why just piece by piece, chip away at theirs, and educate them and hopefully it'll come into the training of the new doctors. And future hopefully, more nutrition courses will be introduced into training because it's not just vitamin C.  The body needs all the vitamins that are all vital to life. That's where the name comes from. You don't hit them, you die. It's as simple as that. So, yes, I think that it is vital that this information gets into the appropriate arenas. Lisa: Yes. And I think that's why I'm passionate about the show is that my sort of outlook on the whole thing is, ‘Yes, I'm not a doctor, but I can give voice to doctors and researchers. And I can curate and I can investigate and I can share.’ And this is a very emotional topic for me or for obvious reasons, but I'm trying to take the emotion out of it because that doesn't help the discussion.  And it’s really hard but I understand the importance—because I know that if I share things in an emotional manner, then I'll get shut down as having mental health problems in a group being a grieving daughter. When actually I’m an intelligent person who's educated herself in this. I've got the best people, and the best researchers, and the best scientists, and the best doctors sharing the latest research. And I hope that by doing that you can get one mind after the other and just get them to understand rather than the emotional side of things. Because what I do want to also share with the story is that every person's life that is saved is a family that's not grieving. These are not statistics.  When Dr Berry Fowler's research, with Dr Merricks research and you see a drop from, I think Dr Merricks was 40%, mortality to 8% and Dr Berry’s was something like 49, down to 29. Don't quote me on the numbers, but big numbers in drops and mortality. And you go, those are just dozens, if not hundreds of lives that are saved. And those families are saved from that grief.  And worldwide, I've heard a couple of estimates between 30 and 50 million people a year who get sepsis. Of those, one in five—I've heard in your research—one in five in New Zealand ICU dies of sepsis. This is a huge problem. This is as big as cancer and actually is one of the complications often of cancer therapies. So, I don't think people understand the enormity of sepsis itself. And then pneumonia, and then we can go into the discussion of COVID, and cancer, and all those other things. It's like we're talking millions of lives every year around the world. So this research is just absolutely crucial. Sorry, I've gotten on my bandwagon a little bit. But I really want to get this information out there. And that I think it's really, really important.  And let’s change track a little bit and just talk a little bit briefly because I haven't covered this subject with the other vitamin C interviews that I've done. Around the cofactor, so vitamin C is a cofactor for so many different areas. So I remember from one of your lectures, it has epigenetic influences and hairs like with collagen synthesis, and that's not just for your skin and your and your nails, but also has implications for cancer. You've got your health, which Professor Margreet Vissers talked about your hypoxia inducible factor, tumor growth. Can you just go and give me a little bit of information around—the vasopressin one would be very good and anything else that pops to mind there. Dr Anitra: Yes, so the cofactor is a compound that helps enzyme function. So everything in our cells relies on the functions of enzymes to carry out reactions in ourselves or the chemical reactions require enzymes. And so a cofactor supports that function.  And so early on when I was just starting in this area of research in the field of sepsis, I was looking at the different cofactor functions of vitamin C, and one of them is a cofactor for the enzyme which synthesizes noradrenaline. And noradrenaline is one of the main drugs, as you might say, that's given to patients who are going into septic shock. So it's given to the patients to try and increase the blood pressure. And it works by making the muscles around the blood vessels contract. Makes the blood vessels a bit smaller, so it increases your blood pressure.  And so vitamin C is a cofactor for the enzyme that naturally synthesizes noradrenaline in our body. And there's another enzyme which synthesizes hormones, one of which is vasopressin.  And this is another drug that's also sometimes given to these patients to help your blood pressure. And it works by increasing the re-uptake of water by the kidney. So, that increases your blood volume and hence, your blood pressure. So, for a lot of ICU patients, they're given noradrenaline and sometimes they're given vasopressin on top of that. Really try and get the blood pressure up. Lisa: Yes, their collapsing cardiovascular system.  Dr Anitra: And I realized, ‘Oh wait a minute vitamin C is also cofactor for this enzyme that synthesizes vasopressin.’ So here it is, a cofactor for two quite different enzymes that synthesize vasopressors naturally in our body. And so, if these patients are coming into the ICU, very low in vitamin C, and going into shock, is one of those reasons because they don't have enough vitamin C in the body to support natural vasopressor function. The doctors have to give them these drugs but if we're able to get them vitamin C, early enough that it can potentially support their own natural synthesis of these vasopressors in the body, which is a much better way to do it. Because if drugs are given from the outside, they're often given in high doses and not regulated, and so can cause side effects. There is a difference being produced in the body, the body knows what it's doing. It regulates how much and how often, all those sort of 46:07 engineering emails and so you don't get the nasty side effects. Lisa: Can I share a bit of a story there? Because both my mom and her case was—she had an aneurysm four years ago, she was on noradrenaline, and could only be given in an ICU. And originally she was in the neurological ward. And they couldn't do it there. And I only realized like she was going into a coma. So she had massive brain damage going into a coma. That when they took her up to ICU, they could give her the noradrenaline that opened up that the vessels in the heat it a little bit, or keep the pressure up, so that the vessels were open to stop the vasospasm in her case, which was killing parts of the brain. But she'd been in the neurological ward where they couldn't give any of that earlier. And so the damage had already been done partly.  And then with the case with my dad, back then I didn't know anything about vitamin C, of course. With the case with my dad in July, this year, I got vitamin C, but it was on day 13 of his 15-day battle, because I had paid to go through ethics committees and all of that sort of jazz. So he was an absolute death's doorstep, should have been dead days ago, according to the doctors. They couldn't believe he was still going but he was one tough man. I don’t know how he was still alive but he was. And the very first infusion that we got a vitamin C, immediately we were able to take him off norad for a period of about eight hours. We needed the vitamin C again, that took me another 18 hours before I could get permission to get the second one. Unfortunately, I couldn't get it in the six-hour bolus, which was ideal.  We gave him initially 15 grams. So this was again, multiple organ failure, fecal matter, and the creatinine, desperate, desperate, desperate straits. His CRP, c-reactive protein dropped from 246 down to 115. His white blood cell count improved and his kidney function went from 27% to 33%. And I was able to take him on vasopressors and noradrenaline for about eight hours. That is incredible for someone who could die at any moment. And we eventually—we failed because I struggled to get the second and I struggled to get the third infusion and it really was too late.  But even at that point, I thought it might be interesting for your research—I have all the medical records by the way, if you want to have a look at the data exactly. But it really was a strong—he doesn't need the noradrenaline, his blood pressure was going up. And that was a really, really good sign. As the dropping of the CRP, which was still very high at 115 but it was way better than where it had been.  So goodness, what would have happened if I'd had him on day one from the surgery? Yes. And, and none of it is understood. So that's one of the cofactors that… And that brings to mind just as someone who's connecting the dots, if you have an HPA axis problem, like your adrenals aren't doing the job well. And your cortisol, vitamin C would probably be a good thing to take to support.  Dr Anitra: And sometimes it’s referred to as a stress hormone because it is involved in the adrenal response. And people who are under stress, or in animal studies who have stress animals they appear, they use more vitamin C, and they generate more vitamin C, the animals they can synthesize it themselves, they generate more vitamin C to compensate for that. We are not there anymore. So we have to take more if we're under stressful conditions. Lisa: Exactly. And that's a really—it's just a funny thing of evolution that we've lost the ability to synthesize more as we like animals, like the goat, especially it can synthesize like a ton more when it needs that. We will give them big brains so that we can make vitamin C so we can take it. What are some of the other cofactors? Just as we start to wrap it up, but just a couple of the other important cofactors.  And collagen? Why is collagen important apart from you want my skin and hair, and your joints? Well, I did hear in one of the lectures about collagen helping stop metastasis of cancers?  Dr Anitra: Right, yes, that's one mechanism. It's also very important in wound healing. And, interestingly, a lot of—a reasonable number of surgeons are aware of this and that they're a lot more open to people taking vitamin C around surgery before and after surgery just to help affect wound healing. Lisa: Oh, wow. Yes.  Dr Anitra: Which is great. And Lisa: And oncologists, are they sort of open to...  Dr Anitra: Least so  Lisa: Least so. Yes. In fact, I've had friends who have told us, if you take intravenous vitamin C, we won't do any treatments. And this is... Dr Anitra: And that is primarily around all the misunderstanding around those early, early trials around intravenous. What I'm seeing is when Linus Pauling showed a feat of vital intravenous vitamin C. The clinicians at the Mayo Clinic who tried to reproduce those studies, they used oral doses, so just small doses over a day.  But back in those days, they weren't aware of the different pharmacokinetics of vitamin C, they thought oral and intravenous, are just the same, like the drug. But it's quite different. Oral uptake is a lot lower, much smaller amounts are taken up versus intravenous, you can get really high doses. And very quickly,  Lisa: Up to 200 times. I heard Professor Gabi Dachs, saying that intravenous is up to 200 times for short periods, but that short periods makes a difference, because you can get that into the tumor cells and to—so that… And this is the problem. Professor Margreet Vissers was saying the original controversy around Linus Pauling’s work and because they didn't have an understanding of how can possibly this mechanism of action been working. They just pursued it, basically. And it caused this big rift, those on the side, and those on that side, and for the next—what are we? 40 something years later—we'll still actually, it's problematic. Dr Anitra: Yes, it wasn't really till Mark Levine did his really detailed pharmacokinetic studies that people realized the big differences between oral and intravenous. And also there’s more recent discoveries of vitamin C's cofactor functions around regulating genes through herbs and through the epigenetic enzymes. These are all mechanisms, which could be involved and its anticancer mechanisms as such. And so the epigenetic area is a very, very exciting, very interesting area of research. And I think it'll enable us to personalize medicine in the future.  Lisa: Oh! I mean, I have an epigenetics program as one of my health programs. And yes, that's looking at okay, how genes being influenced by your environment, and let's optimize your environment to your genes. And the vitamin C helps serve to give people an understanding, so is vitamin C helping produce the enzymes that read the DNA? And then therefore having the reactions. Is that how it works? Dr Anitra: It works as a code. Lisa: the transcription Dr Anitra: Yes, so it helps the function of the enzymes which modify the DNA. So genetics is about the DNA itself. Epigenetics is above the DNA. So it's a way to regulate the DNA as you know. Usually through adding methyl groups to the dynast DNA, adding and subtracting and that affects how the DNA is read by the enzymes that read DNA and transcribe it. Lisa: Turning them on or off, or simplify.  Dr Anitra: So vitamin C, regulates the enzymes which modify the methyl groups and stimulates them coming off or stimulates different mechanisms happening. So switching certain genes on, switching certain genes off, now it can teach you to regulate thousands of genes in our body through stimulation of these enzymes. Lisa: Wow. So yes, I've heard somewhere, I think it was seven or 8000 genes that are possibly affected by this. So we are really at the beginning of the vitamin C journey, as far as the epigenetics mechanisms is concerned. Yes, that's exciting. Dr Anitra: A lot of its functions, not just in cancer, but in all areas of health and disease, these functions could be playing a role. So yes, huge areas of research possible there. Lisa: Yes. Yes. Yes. Is there a—I remember Professor Margaret, talking about Tt? Is that one of the enzymes? The Tt one? Dr Anitra: It is an enzyme, that's right. Lisa: And that's important for cancer in some way? Dr Anitra: Now, the enzyme search modifies the methylated DNA, some regulation that epigenetics. And it's definitely difficult. Lisa: To replicate it in the cancer process. Wow. Okay, we're getting quite technical here.  Doctor Anitra, I just want to say thank you very much for your dedication because I've listened to a couple of interviews with you. And you've actually sacrificed quite a lot to do the research that you're doing because there isn't a heck of a lot of funding and things are out there. So, thank you for doing all that. It's a labour of love, I can imagine. It's a long, slow process, getting the information, getting it to be watertight—scientifically watertight, so that we can actually get people help, who need help. And that at the end of the day it’s the reason I'm doing this podcast. And it's the reason you're doing your research, and hopefully together and with many others, we can move the story along so that people get helped.  Is there anything that we haven't covered that you think would be an important message for people listening today? Dr Anitra: Well, I think—I mean, of course, infection is very relevant these days with COVID. There’s a lot of information and misinformation floating around out there about vitamin C and COVID. And at this stage, the studies are still at the really early, early stages. Americans have done a study which shows that patients with COVID in the ICU do have low vitamin C levels, like other similar conditions. COVID is a severe respiratory infection like pneumonia and sepsis or complications with COVID. And so, I think that the key is to stay healthy, eat a good healthy... Lisa: Boost your immune system, yes.  Dr Anitra: Yes, to support your immune system, it doesn't mean you won't get COVID. But it may decrease the severity and the duration, so it doesn't go on to become the more severe version, the pneumonia and sepsis.  So I think that's an important message and if you do get infection, your requirements, dear God, so you do need to take more vitamin C, you need to take gram amounts, rather than milligram amounts. Want you to prevent getting even more severe. So, I'm all for prevention as much as possible, not leaving it till it's too late. So, I think, yes, just look after yourself, eat well. Lisa: Yes. And get your vitamin C. Come buy some kiwi fruit, and some oranges today, and some lemons, and capsicum. And some supplements maybe. Just as a final thing, you yourself, have a study that's currently underway, which is really, really exciting. And this is based in the Christchurch hospital, I believe, in 40 patients and with sepsis. Can you just tell us a little bit, the parameters of that study and when you think you'll have some results from it? Dr Anitra: So this was patients with septic shock. So once again, at the end. And they were administered either placebo control, so half the patients and the other half were given intravenous vitamin C at a dose of 100 milligrams per kilogram body tissue per day, which equates to about six to seven grams a day. The reason for that, I have wanted to use the high dose, Berry Fowler. But the ethics committee—because when I put this into the ethics committee, there were only the two studies out, which was Berry Fowler's and the small study headed by Iran. And they said, ‘Well, slightly more people have received a lot lower dose versus the higher dose. So we'd rather use the lower dose.’’ Even though there'd be no adverse events at any dose. And subsequently, no adverse events and any studies.  Lisa: No. Dr Anitra: And so, we've used the lower dose, we've only just finished recruiting the last patients. It took a while and we had issues of lockdown. And so now we're in the process of analysing the samples that we've collected analysing the data. And so hopefully, we're about to pull that together, sometime next year and publish the results next year.   Lisa: Brilliant. I can't wait to see that. And yes, that's a little bit frustrating because I would have liked to have seen a study with the 15 to 18. And even that I thought was still very conservative compared to some of the cancer dosages. But I understand from what Dr Berry Fowler said because of the decreased kidney function often in septic patients and so on, but it's just like yes, but the dying often. And it's because that was one of the arguments that was thrown at me, I could damage my dad's kidneys. The sepsis was doing that quite nicely and he was dying anyway. So why the hell?  So, but I think even at those dosages, we’ll hopefully see some fantastic results come out of it. And hopefully, in future we'll be able to do slightly more high-powered dosages. Dr Anitra: Yes. Well, the key is also the size of the study, our study is very small. And we were interested in being a scientist. I'm interested in how it's working in the body because once you understand how it's working, it makes it easier to design better studies and not our future studies.  And so, our study will be too small to show a yes or no, it decreases mortality or not—that we're leaving it up to the large studies to show there. And hopefully, we can put a bit more science behind how it's working, what's happening in the body.  Lisa: And it's such a complicated thing to design a study. People don't probably realize how the parameters and the limitations and the number of variables that you can look at and the primary outcomes and the secondary outcomes and so on.  Dr Anitra: Sepsis is such a complex variable that comes in as unique in this situation. So there's huge variability in the data. And that's where the biggest studies are good, because it helps decrease... Lisa: The statistical...  Dr Anitra: The statistical analyses of those studies. Yes, I'm looking forward to the results of the big studies coming out. Lisa: Yes, but these, these smaller ones are really, really important. So, and it's great that we've got one going in New Zealand. So, thank you very much for your work, Dr Anitra. It’s been absolutely fascinating. And thank you for your dedication to this. I really, really appreciate you. Dr Anitra: Thank you. Thank you for inviting me. That's it this week for Pushing the Limits. Be sure to rate, review, and share with your friends and head over and visit Lisa and her team at lisatamati.com The information contained in this show is not medical advice it is for educational purposes only and the opinions of guests are not the views of the show. Please seed your own medical advice from a registered medical professional