Nourish Balance Thrive

We get a lot of questions from our clients about postprandial fatigue. Never heard of it? Well you’ve certainly familiar with the term “food coma” - and perhaps with the experience of being in one. What causes this phenomenon and why does it affect some people more than others? Is it normal to need a nap after lunch?  On this podcast I’m joined by NBT Scientific Director Megan Hall to talk about postprandial fatigue - the sleepiness, difficulty focusing, and even dizziness or nausea that strikes after consuming a meal. Megan talks about some of the biological processes behind the need for a post-meal snooze, and when to suspect a deeper pathology. She also offers practical tips to help you resolve your own postprandial fatigue. Thank you everyone who so generously supports this podcast on Patreon - without your support, we wouldn’t be able to keep this podcast independent and free of ads. So thank you. And just a reminder - as a Patreon supporter - not only do you have our eternal gratitude, but also... You get some awesome gifts - including 20-35% discounts on all supplements we recommend when working with clients, which saves many of our supporters $50-$100 a month over what they were previously paying on Amazon. So by supporting the podcast, they’re actually spending LESS money each month. In addition to that, you can also get access to our Office Hours, where Megan answers questions twice a week. You can submit all your own questions, as well as listen to all the replays, covering everything from krill oil to mitochondrial support. We’ve worked really hard to make sure that the bonuses you get are actually way more valuable than what you pay whatever level you choose to support us at. So if you’d like to support the podcast and get access to the discounts and Office Hours, just head over to NBT.link and sign up there. Here’s the outline of this interview with Megan Hall: [00:04:25] Common symptoms of postprandial fatigue. [00:05:46] Reactive hypoglycemia; Study: Johnson, Debra D., Kay E. Dorr, and Wendell M. Swenson. "Reactive hypoglycemia." JAMA 243.11 (1980): 1151-1155.  [00:06:35] Diagnosing reactive hypoglycemia; Study: CHALEW, STUART, et al. "Diagnosis of reactive hypoglycemia: pitfalls in the use of the oral glucose tolerance test." Southern Medical Journal 79.3 (1986): 285-287. [00:09:00] Symptoms and causes of hypoglycemia. [00:09:37] Increased insulin sensitivity; Studies: 1. Brun, J. F., et al. "Increased insulin sensitivity and basal insulin effectiveness in postprandial reactive hypoglycaemia." Acta Diabetologica 33.1 (1996): 1-6; 2. Vexiau, P., B. Legoff, and G. Cathelineau. "Insulin and cortisol secretion during OGTT in patients with reactive hypoglycaemia with or without clinical symptoms." Hormone and metabolic research 15.09 (1983): 419-421. [00:09:47] Hypocortisolism; Studies: 1. Meyer, Gesine, et al. "Nocturnal hypoglycemia identified by a continuous glucose monitoring system in patients with primary adrenal insufficiency (Addison's disease)." Diabetes Technology & Therapeutics 14.5 (2012): 386-388; 2. Christiansen, Jens Juel, et al. "Effects of cortisol on carbohydrate, lipid, and protein metabolism: studies of acute cortisol withdrawal in adrenocortical failure." The Journal of Clinical Endocrinology & Metabolism 92.9 (2007): 3553-3559. [00:10:05] Hypothyroidism; Studies: 1. Kalra, Sanjay, Ambika Gopalakrishnan Unnikrishnan, and Rakesh Sahay. "The hypoglycemic side of hypothyroidism." Indian Journal of Endocrinology and Metabolism 18.1 (2014): 1; 2. Yadav, Tek Chand, et al. "Recurrent hypoglycemia: An unusual finding of hypothyroidism." Thyroid Research and Practice 14.3 (2017): 127. [00:10:53] What to do about hypoglycemia. [00:13:09] Accelerated gastric emptying. [00:16:20] Reactive hypoglycemia after exercise. [00:18:51] Postprandial hyperglycemia; Study: Gerich, John E. "Clinical significance, pathogenesis, and management of postprandial hyperglycemia." Archives of internal medicine 163.11 (2003): 1306-1316. [00:20:38] Problems associated with hyperglycemia; Studies: 1. Ceriello, Antonio, et al. "Meal-induced oxidative stress and low-density lipoprotein oxidation in diabetes: the possible role of hyperglycemia." Metabolism 48.12 (1999): 1503-1508; 2. Ceriello, Antonio, et al. "Meal-generated oxidative stress in type 2 diabetic patients." Diabetes care 21.9 (1998): 1529-1533; 3. Cavalot, F. "Do data in the literature indicate that glycaemic variability is a clinical problem? Glycaemic variability and vascular complications of diabetes." Diabetes, Obesity and Metabolism 15.s2 (2013): 3-8; 4. Ceriello, Antonio, et al. "Evidence for an independent and cumulative effect of postprandial hypertriglyceridemia and hyperglycemia on endothelial dysfunction and oxidative stress generation: effects of short-and long-term simvastatin treatment." Circulation 106.10 (2002): 1211-1218; 5. Tibaldi, Joseph. "Importance of postprandial glucose levels as a target for glycemic control in type 2 diabetes." Southern medical journal 102.1 (2009): 60-66. [00:21:24] Insulin resistance. [00:21:39] Video: PAH 2016 - A systems analysis approach to insulin resistance, with Dr. Tommy Wood. [00:23:02] What to do: Look at diet; 1. Krebs, Jeremy D., et al. "Improvements in glucose metabolism and insulin sensitivity with a low-carbohydrate diet in obese patients with type 2 diabetes." Journal of the American College of Nutrition 32.1 (2013): 11-17; 2. Lin, Po-Ju, and Katarina T. Borer. "Third exposure to a reduced carbohydrate meal lowers evening postprandial insulin and GIP responses and HOMA-IR estimate of insulin resistance." PloS one 11.10 (2016): e0165378; 3. MacDonald, Ian A. "A review of recent evidence relating to sugars, insulin resistance and diabetes." European journal of nutrition 55.2 (2016): 17-23; 4. Bradley, Una, et al. "Low-fat versus low-carbohydrate weight reduction diets: effects on weight loss, insulin resistance, and cardiovascular risk: a randomized control trial." Diabetes 58.12 (2009): 2741-2748. [00:28:46] Mediterranean diet; Study: Guasch-Ferré, Marta, et al. "Dietary polyphenols, Mediterranean diet, prediabetes, and type 2 diabetes: a narrative review of the evidence." Oxidative Medicine and Cellular Longevity 2017 (2017). [00:29:56] Endotoxemia and insulin resistance 1. Moreira, AP Boroni, and R. de Cássia Gonçalves Alfenas. "The influence of endotoxemia on the molecular mechanisms of insulin resistance." Nutrición hospitalaria 27.2 (2012): 382-390; 2. Cani, Patrice D., et al. "Metabolic endotoxemia initiates obesity and insulin resistance." Diabetes 56.7 (2007): 1761-1772. [00:30:24] Megan's outline for this podcast.  [00:31:19] When fatigue after a meal might be normal. [00:33:08] Article: Why a pandemic flu shot caused narcolepsy. [00:33:49] Both high fat and high carb meals can cause sleepiness; Study: Wells, Anita S., et al. "Effects of meals on objective and subjective measures of daytime sleepiness." Journal of applied physiology 84.2 (1998): 507-515. [00:33:56] Intestinal stimulation can cause sleepiness; Kukorelli, Tibor, and Gábor Juhász. "Electroencephalographic synchronization induced by stimulation of small intestine and splanchnic nerve in cats." Electroencephalography and clinical neurophysiology 41.5 (1976): 491-500. [00:34:20] Sleepiness after eating vs. just chewing; Study: MJ Harnish, SR Greenleaf, WC Orr, “A comparison of feeding to cephalic stimulation on postprandial sleepiness.” Physiology & behavior 64.1 (1998):93-96. [00:34:38] Cholecystokinin (CCK) may affect the alert centers in the brain; Study: Wells, Anita S., et al. "Influences of fat and carbohydrate on postprandial sleepiness, mood, and hormones." Physiology & behavior 61.5 (1997): 679-686. [00:37:13] Thermogenesis; Study: Zammit, Gary K., et al. "Postprandial sleep and thermogenesis in normal men." Physiology & behavior 52.2 (1992): 251-259. [00:37:40] Summary: How to fix the problem. [00:38:43] Nutrisense for continuous glucose monitoring (CGM). [00:46:29] Timing your walk with glucose peak; Study: Reynolds, Andrew N., and Bernard J. Venn. "The timing of activity after eating affects the glycaemic response of healthy adults: a randomised controlled trial." nutrients 10.11 (2018): 1743. [00:51:01] Support NBT on Patreon to access the forum.  

Trey Suntrup, PhD is a product engineer who earned his doctorate in physics and electrical engineering from the University of California, Santa Barbara in 2015. He is currently the Head of Product at Readout Health, the St. Louis startup that recently launched the Biosense breath ketone meter. Following a successful clinical trial in the autumn of 2019, Biosense has entered the consumer, clinical, and research market as a tool to help those wanting to lose weight or manage blood glucose with a ketogenic diet. On this podcast, Trey discusses breath acetone testing and how it can be used to improve health outcomes. He shares the results of the clinical trial supporting the Biosense meter, including the finding that measurements must be collected multiple times daily to truly evaluate the benefit of a ketogenic or intermittent fasting plan. He also describes some of the advantages of breath testing over blood ketone measurement.  Here’s the outline of this interview with Trey Suntrup: [00:00:15] James McCarter; Podcasts: How to Reverse Insulin Resistant Type Two Diabetes in 100 Million People in Less Than 10 Years and Nutritional Ketosis and Guided Behavior Change to Reverse Type 2 Diabetes.  [00:00:20] Virta Health. [00:00:23] Douglas Hilbert; Podcast: How Busy Realtors Can Avoid Anxiety and Depression Without Prescriptions or the Help of a Doctor. [00:01:02] Trey's background. [00:04:16] NBT Podcasts on ketosis and ketones with Dominic D'Agostino, Ken Ford, Brianna Stubbs 1, 2, 3, 4; Catherine Crofts, Megan Hall. [00:04:29] Megan Hall’s Study: Roberts, Megan N., et al. "A ketogenic diet extends longevity and healthspan in adult mice." Cell metabolism 26.3 (2017): 539-546. [00:04:52] Types of ketones and methods for measuring them. [00:10:03] Study of endurance runners in ketosis: Edwards, Kate H., Bradley T. Elliott, and Cecilia M. Kitic. "Carbohydrate intake and ketosis in self-sufficient multi-stage ultramarathon runners." Journal of Sports Sciences 38.4 (2020): 366-374. [00:11:37] Problems with measuring BHB blood ketones. [00:15:49] Deriving meaning from acetone meter results; The ACEs Unit. [00:21:49] Clinical trial: Suntrup, Donald J., et al. "Characterization of a high-resolution breath acetone meter for ketosis monitoring." medRxiv (2020). Interpretation of trial results. [00:26:15] Ken Ford on the signalling properties of ketones: STEM-Talk Podcast Episode 50: Ken Ford Talks about Ketosis, Optimizing Exercise, and the Future Direction of Science, Technology, and Culture. [00:26:26] Ketogains: Chase results, not ketones. [00:29:29] Early Time-Restricted Eating, Intermittent Fasting. Review: Mattson, Mark P., Valter D. Longo, and Michelle Harvie. "Impact of intermittent fasting on health and disease processes." Ageing research reviews 39 (2017): 46-58. [00:32:43] Biosense blog post: The Effects and Impact of Ketones and Fasting. [00:33:13] Marty Kendall’s blog post: Is the acetone:glucose ratio the Holy Grail of tracking optimal ketosis levels? [00:33:56] Continuous glucose monitors (CGM). [00:35:16] Integration with Cronometer. [00:35:48] Heads up Health; NBT podcast w/ founder David Korsunsky: How to Use Data to Take Control of Your Health. [00:38:25] Senza app. [00:40:52] Getting the biosense meter: Biosense website. [00:42:10] Upcoming clinical trials. [00:46:45] Find Trey on LinkedIn. 

T. K. Coleman is the Director of Entrepreneurial Education at the Foundation for Economic Education (FEE) and the host of The Revolution of One podcast. As a member of the FEE faculty, he is a prolific writer and speaker and leads workshops on themes related to entrepreneurship, economics, and education. I met T.K. through our friends at The Minimalists podcast, where T.K. is a regular guest. On this podcast, T.K. and I are talking about race relations in America. This topic has made headlines recently, but the stress of being black in the US is nothing new for people who cope every day with a society that refuses to fully accept them. T.K. is one of the best speakers I’ve ever heard describe the struggles facing young people of colour in a system that is biased to favour some over others. He discusses the fundamental fears that keep us divided, the reasons COVID-19 disproportionately affects African Americans and some of the key factors that can help us overcome our differences. Here’s the outline of this interview with T.K. Coleman: [00:00:32] The Minimalists podcast. [00:01:08] The fall of CrossFit founder and CEO Greg Glassman. [00:03:38] Peter Gray; Podcast: Free to Learn: Unleashing the Instinct to Play; Book: Free to Learn. [00:04:19] Foundation for Economic Education (FEE). [00:05:27] Cofounded the Praxis apprenticeship program with Isaac Morehouse. Praxis introductory video. [00:09:11] Nicholas Taleb. [00:12:12] Race relations. [00:17:25] Video: Sapolsky on Depression in U.S. [00:18:22] Struggles: white students vs black students. [00:23:18] Book: Nonviolent Communication: A Language of Life: Life-Changing Tools for Healthy Relationships, by Marshall Rosenberg. [00:23:53] Book: Language and the Pursuit of Happiness, by Chalmers Brothers. [00:24:43] Book: How to Win Friends and Influence People, by Dale Carnegie. [00:27:57] How to know yourself. [00:28:58] Article: Taking a Walk as a Revolutionary Act by T.K. Coleman and Isaac Morehouse. [00:29:28] Book: Journey of Awakening by Ram Dass. [00:31:06] Acceptance and Commitment Therapy (ACT); Russell Harris article on ACT: Embracing Your Demons: An Overview of Acceptance and Commitment Therapy. [00:31:16] Book: The Righteous Mind: Why Good People Are Divided by Politics and Religion, by Jonathan Haidt. [00:32:58] Article: The coronavirus is infecting and killing black Americans at an alarmingly high rate. [00:34:19] Economic, educational, and cultural factors. [00:39:51] The West Memphis Three. [00:42:26] Video: Heartland Future Talks 2019: Robert Sapolsky & Lone Frank. [00:42:35] Book: Why Zebras Don't Get Ulcers, Third Edition, by Robert Sapolsky. [00:44:16] The war on drugs. [00:46:17] A16Z podcast: What We Can’t Reveal We Can’t Heal. [00:57:33] Book: Behave: The Biology of Humans at Our Best and Worst; Video: Robert Sapolsky. [01:08:26] Exposing kids to diversity. [01:13:05] Increasing opportunity rather than giving preferential treatment based on demographic. [01:18:28] Book: The Evolution of Everything: How New Ideas Emerge by Matt Ridley. [01:18:33] Video: Nassim Nicholas Taleb: "Localism and its Application to Lebanon". [01:18:51] The rich always fear the poor. [01:20:02] Follow T.K.’s work.

Jodi Flaws is a Professor of Comparative Biosciences and the Principal Investigator at the Reproductive Toxicology Laboratory in the College of Veterinary Medicine at the University of Illinois. Her lab studies the effects of environmental pollutants on the development and function of the human body, specifically relating to endocrine and reproductive health. Joining her is Karen Chiu, a PhD student whose work focuses on the impact and mechanism of various chemicals on the gut microbiome. On the podcast today Dr. Flaws and Karen Chiu discuss some of the health-damaging chemicals that have become ubiquitous in our food supply, personal care items, and even our carpeting and mattresses. They describe some of the physiological effects of these pollutants, including potentially deleterious changes to the gut microbiota and early reproductive aging. They also share tips for reducing and mitigating exposure to these compounds. After recording this podcast Karen talked with me a bit about organic foods - are they worth the additional cost to avoid some of these toxic chemicals? It turns out that while they are exposed to fewer pesticides, hormones, and antibiotics than conventional foods, it’s not true that organic foods are totally free of these contaminants. If you see the "USDA Organic" label, you can assume the food is at least 95% organic, while a product that claims to be “made with” organic ingredients is at least 70% organic. In her opinion, organic foods and products are the way to go when possible, given their lighter chemical load. It’s always a good idea to wash your produce to get as much of the pesticide residues off whether it be organic or conventional. Here’s the outline of this interview with Jodi Flaws and Karen Chiu: [00:00:30] Paper: Chiu, Karen, et al. "The Impact of Environmental Chemicals on the Gut Microbiome." Toxicological Sciences (2020). [00:01:25] Background and interest in environmental chemicals. [00:03:35] Endocrine-disrupting chemicals. [00:04:37] Phthalates and how they affect the body. [00:06:08] Effects of Phthalates on the microbiome. [00:07:15] Butyrate; Podcast: Microbiome Myths and Misconceptions, with Lucy Mailing, PhD. [00:08:58] Potential effects of pesticides: increased lipid accumulation, decreased glucose tolerance, increased expression of adipogenic genes; Review: Xiao, Xiao, John M. Clark, and Yeonhwa Park. "Potential contribution of insecticide exposure and development of obesity and type 2 diabetes." Food and Chemical Toxicology 105 (2017): 456-474. [00:10:44] Reducing exposure to phthalates. [00:12:26] Environmental Working Group (EWG) database. [00:14:09] Bisphenols. [00:16:51] "BPA-free" - not necessarily safer. [00:18:13] Effects of bisphenols on the gut microbiome. [00:18:43] Bisphenol exposure in mice, effects on microbiome; Study: Javurek, Angela B., et al. "Effects of exposure to bisphenol A and ethinyl estradiol on the gut microbiota of parents and their offspring in a rodent model." Gut Microbes 7.6 (2016): 471-485. [00:19:00] Akkermansia beneficial for intestinal immunity; Study: Ottman, Noora, et al. "Pili-like proteins of Akkermansia muciniphila modulate host immune responses and gut barrier function." PloS one 12.3 (2017). [00:20:24] Podcast: How to Use Probiotics to Improve Your Health, with Jason Hawrelak, PhD. [00:21:12] Persistent organic pollutants: polychlorinated biphenyls (PCBs), Polycyclic aromatic hydrocarbons (PAHs), Perfluorochemicals (PFCs), flame retardants and their adverse health effects. [00:24:42] Exercise can attenuate change in the gut microbiome caused by PCBs; Study: Choi, Jeong June, et al. "Exercise attenuates PCB-induced changes in the mouse gut microbiome." Environmental health perspectives 121.6 (2013): 725-730. [00:25:54] Hepcidin; Podcast: The Athlete’s Gut: Why Things Go Wrong and What to Do About It, with Megan Hall. [00:27:20] Strategies for limiting exposure. [00:29:20] Heavy Metals - lead, cadmium, arsenic and their effects on the microbiome. [00:32:49] Higher arsenic levels can lead to higher Citrobacter population; Study: Wu, Fen, et al. "The role of gut microbiome and its interaction with arsenic exposure in carotid intima-media thickness in a Bangladesh population." Environment international 123 (2019): 104-113. [00:33:29] Arsenic exposure increases TMAO; Study: Kuroda, Kaoru Yoshida Yoshinori Inoue Koichi, Hua Chen Hideki Wanibuchi Shoji Fukushima, and Ginji Endo. "Urinary excretion of arsenic metabolites after long-term oral administration of various arsenic compounds to rats." Journal of Toxicology and Environmental Health Part A 54.3 (1998): 179-192. [00:34:18] Chris Masterjohn and Chris Kressor on TMAO. [00:34:40] Glyphosate alters gut microbiota; Studies: Blot, Nicolas, et al. "Glyphosate, but not its metabolite AMPA, alters the honeybee gut microbiota." PloS one 14.4 (2019) and Aitbali, Yassine, et al. "Glyphosate based-herbicide exposure affects gut microbiota, anxiety and depression-like behaviors in mice." Neurotoxicology and teratology 67 (2018): 44-49. [00:40:33] Pig GI tract similar to humans; Dr. Sharon Donovan. [00:42:34] Siloxanes (silicone products). [00:43:52] Siloxanes; Associated with hypothyroid in cats: Poutasse, Carolyn M., et al. "Silicone pet tags associate tris (1, 3-dichloro-2-isopropyl) phosphate exposures with feline hyperthyroidism." Environmental science & technology 53.15 (2019): 9203-9213; associated with age of menopause: Chow, Erika T., and Shruthi Mahalingaiah. "Cosmetics use and age at menopause: is there a connection?." Fertility and sterility 106.4 (2016): 978-990. [00:45:03] Nicolas Taleb; Incerto series. [00:45:31] Hot flashes and potential causes. [00:45:51] Podcast: The Postmenopausal Longevity Paradox and the Evolutionary Advantage of Our Grandmothering Life History, with Kristen Hawkes, PhD. [00:47:23] Link between phthalate exposure and hot flashes (research coming soon). [00:50:29] Genetic mutation in sperm linked to autism risk. Study: Breuss, Martin W., et al. "Autism risk in offspring can be assessed through quantification of male sperm mosaicism." Nature Medicine 26.1 (2020): 143-150. [00:50:45] Effects of phthalates on men include early reproductive aging; Study: Barakat, Radwa, et al. "Prenatal exposure to DEHP induces premature reproductive senescence in male mice." Toxicological Sciences 156.1 (2017): 96-108. [00:51:14] Things to do to reduce exposure; CertiPUR-US. [00:55:17] Contact Dr. Flaws. Instagram. [00:57:13] heeds.org for information on endocrine-disrupting chemicals.

Peter Gray, Ph.D., a research professor at Boston College, has conducted and published research in comparative, evolutionary, developmental, and educational psychology. His current research and writing focus primarily on children's natural ways of learning and the life-long value of play, concepts discussed in his book, Free to Learn. Dr. Gray is also president of the nonprofit Alliance for Self-Directed Education and a founding board member of the nonprofit Let Grow.  On this podcast, Dr. Gray draws evidence from anthropology, psychology, and history to argue that we must entrust children to steer their own learning and development. He shares the story of his own son’s behavioural difficulties, which led the family to explore alternatives to traditional education. He also describes his own research on the long-term outcomes of children who are unschooled and addresses some of the main concerns parents have about informal education. Here’s the outline of this interview with Peter Gray: [00:00:10] Book: Free to Learn: Why Unleashing the Instinct to Play Will Make Our Children Happier, More Self-Reliant, and Better Students for Life, by Peter Gray. [00:00:44] The story of Peter’s son, Scott. [00:04:40] Sudbury Valley School in Framingham, MA.  [00:12:42] Podcast: How to Support Childhood Cognitive Development, with Josh Turknett, MD. [00:13:13] Education in hunter gatherer populations. [00:19:42] Biological theory of education. [00:21:45] Book: The Art of Tracking, the Origin of Science, by Louis Liebenberg. [00:25:11] Agriculture as catalyst for change. [00:31:06] Book: Against the Grain: A Deep History of the Earliest States, by James C Scott. [00:32:48] The importance of play. [00:33:52] Curiosity and playfulness. [00:37:07] Books: The Play of Animals and The Play of Man, by Karl Groos. [00:41:51] Book: The Moral Judgement of the Child, by Jean Piaget. [00:43:37] Unschooling. [00:44:14] Agile Learning Centers. [00:45:03] The Alliance for Self-Directed Education. [00:46:38] Unschooling rising in popularity among homeschoolers. [00:49:19] Study of 232 unschooling families: Gray, Peter, and Gina Riley. "The challenges and benefits of unschooling, according to 232 families who have chosen that route." Journal of Unschooling & Alternative Learning 7.14 (2013). [00:49:42] Study of 75 adults who were unschooled: Gray, Peter, and Gina Riley. "The challenges and benefits of unschooling, according to 232 families who have chosen that route." Journal of Unschooling & Alternative Learning 7.14 (2013). [00:51:21] Getting into college. [00:55:24] Age mixing and scaffolding. [01:01:00] "Please Trespass" sign. [01:01:30] Book: Playborhood: Turn Your Neighborhood Into a Place for Play, by Mike Lanza. [01:06:36] Peters Blog: Freedom to Learn. [01:07:13] Find Peter on Facebook.  [01:08:40] The hole in the wall project.

With summer right around the corner, huge kiosks of sunscreen are on display at stores everywhere, reminding us to fear the sun. We’ve been told for years that sunlight is something to guard against - and, of course, most of us know someone who’s had a suspicious mole removed. But we also know the sun is needed for vitamin D production - plus, it just feels great on our skin! And obviously our ancestors weren’t slathering on Coppertone when they left the cave. It seems to be a no-win situation until you learn the facts about sunlight. NBT Scientific Director Megan Hall is with me today to talk about the critical role of sunlight for health and wellness. She outlines the many benefits of sun exposure that go far beyond vitamin D production and sets the record straight on UVA vs UVB rays, skin cancer, and how sunscreen is actually working against you. Here’s the outline of this interview with Megan Hall: [00:00:11] Megan's new puppy. [00:03:35] Podcast w/ Kira Furie: Breaking Through the Diet Culture: Medical Care for Every Size. [00:05:42] Vitamin D and conditions associated with low levels. [00:07:40] Book: Hidden Valley Road: Inside the Mind of an American Family, by Robert Kolker. [00:08:22] Optimal Levels and dosing of Vitamin D. [00:12:55] Vitamin D Calculator. [00:13:47] COVID-19 and Vitamin D; Studies: 1. Glicio, El James. "Vitamin D Level of Mild and Severe Elderly Cases of COVID-19: A Preliminary Report." Available at SSRN 3593258 (2020); 2. De Smet, Dieter, et al. "Vitamin D deficiency as risk factor for severe COVID-19: a convergence of two pandemics." medRxiv (2020); 3. D’Avolio, Antonio, et al. "25-hydroxyvitamin D concentrations are lower in patients with positive PCR for SARS-CoV-2." Nutrients 12.5 (2020): 1359; 4. Meltzer, David O., et al. "Association of Vitamin D Deficiency and Treatment with COVID-19 Incidence." medRxiv (2020). [00:15:20] Vitamin D and ACE2. [00:17:46] Benefits of sunshine beyond vitamin D. [00:18:01] Circadian rhythm. [00:18:29] Satchin Panda; Podcast: How to Use Time-Restricted Eating to Reverse Disease and Optimize Health. [00:18:30] Bill Lagakos; Podcast: Why You Should Eat Breakfast (and Other Secrets of Circadian Biology). [00:18:35] Nitric oxide. [00:19:01] Malcolm Kendrick; Podcasts: Why Cholesterol Levels Have No Effect on Cardiovascular Disease (And Things to Think about Instead) and A Statin Nation: Damaging Millions in a Brave New Post-health World. [00:19:25] Homocysteine; glycocalyx. [00:21:20] Ivor Cummins; Podcasts with Ivor: How Not to Die of Cardiovascular Disease and Coronary Artery Calcium (CAC): A Direct Measure of Cardiovascular Disease Risk. [00:22:24] UV exposure suppresses symptoms of metabolic syndrome; Study: Geldenhuys, Sian, et al. "Ultraviolet radiation suppresses obesity and symptoms of metabolic syndrome independently of vitamin D in mice fed a high-fat diet." Diabetes 63.11 (2014): 3759-3769. [00:22:54] Melatonin. [00:25:39] Serotonin; Study: Lambert, Gavin W., et al. "Effect of sunlight and season on serotonin turnover in the brain." The Lancet 360.9348 (2002): 1840-1842. [00:26:26] Immunomodulation. [00:26:45] Vitamin D and Multiple Sclerosis; Reduced risk of MS: van der Mei, Ingrid AF, et al. "Past exposure to sun, skin phenotype, and risk of multiple sclerosis: case-control study." Bmj 327.7410 (2003): 316; Reduced risk of depression and fatigue: Knippenberg, S., et al. "Higher levels of reported sun exposure, and not vitamin D status, are associated with less depressive symptoms and fatigue in multiple sclerosis." Acta Neurologica Scandinavica 129.2 (2014): 123-131; MRI neurodegeneration scores inversely associated with sun exposure: Zivadinov, Robert, et al. "Interdependence and contributions of sun exposure and vitamin D to MRI measures in multiple sclerosis." J Neurol Neurosurg Psychiatry 84.10 (2013): 1075-1081. [00:27:20] UV treatment increased glucagon-stimulated insulin secretion; Study: Colas, C., et al. "Insulin secretion and plasma 1, 25-(OH) 2D after UV-B irradiation in healthy adults." Hormone and metabolic research 21.3 (1989): 154-155. [00:27:27] Prevention and treatment of skin conditions; Study: Søyland, E., et al. "Sun exposure induces rapid immunological changes in skin and peripheral blood in patients with psoriasis." British Journal of Dermatology 164.2 (2011): 344-355. [00:27:49] Sun exposure related to life expectancy; Study: Lindqvist, Pelle G., et al. "Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort." Journal of internal medicine 280.4 (2016): 375-387.  [00:30:14] Outline of this interview. [00:31:04] UVA and UVB rays; UVB needed for Vitamin D Production: Wacker, Matthias, and Michael F. Holick. "Sunlight and Vitamin D: A global perspective for health." Dermato-endocrinology 5.1 (2013): 51-108. [00:31:31] Inverse correlation between dose of UVB and melanoma: Study: Godar, Dianne E., Madhan Subramanian, and Stephen J. Merrill. "Cutaneous malignant melanoma incidences analyzed worldwide by sex, age, and skin type over personal Ultraviolet-B dose shows no role for sunburn but implies one for Vitamin D3." Dermato-endocrinology 9.1 (2017): e1267077. [00:33:43] Sunscreens; coral bleaching: Downs, Craig A., et al. "Toxicopathological effects of the sunscreen UV filter, oxybenzone (benzophenone-3), on coral planulae and cultured primary cells and its environmental contamination in Hawaii and the US Virgin Islands." Archives of environmental contamination and toxicology 70.2 (2016): 265-288.  [00:43:20] Join the discussion on the NBT forum when you support us on Patreon.

Kira Furie earned her BS in Biological Sciences and her BA in Dance, graduating from UC Santa Barbara in 2018. She spent time dancing professionally in New York City and is currently working on a research project with an Addiction Medicine MD based in Los Angeles, California. Her interdisciplinary background, personal experience with injuries, yoga teaching, and research have given her a specific interest in Integrative Medicine, which she hopes to implement in her future medical practice. On this podcast, Megan Hall interviews Kira about the series of injuries that led to her interest in physical therapy and later to medicine. Influenced heavily by the prevalence of eating disorders and the Health at Every Size movement, Kira discusses her current plans to bring prevention and wellness aspects to medical practice, while promoting a body-positive environment. She also describes “thin privilege” - an aspect of the current medical system that many of us take for granted. Here’s the outline of this interview with Kira Furie: [00:01:23] Kira's background and interest in medicine. [00:05:27] An untreated hip injury leading to more problems. [00:10:40] Video: Brené Brown on Empathy. [00:11:10] Psychology and yoga. [00:12:39] The Minimalists Podcast. [00:13:47] Sports and Performance Psychologist Simon Marshall, PhD.  [00:14:20] Prevention. [00:14:43] Jeffery N. Wilkins, MD, Addiction Medicine Specialist in LA. [00:15:17] Primary vs. Secondary Prevention. [00:17:34] Lack of connection as the greatest factor leading to addiction. [00:19:00] The importance of connection; Podcasts on social connection: Building Compassionate Communities to Improve Public Health, and Maintaining Social Connection in the Era of COVID-19, both with Julian Abel. [00:19:37] Health at Every Size (HAES). [00:19:51] Book: Intuitive Eating, 4th Edition: A Revolutionary Anti-Diet Approach, by Evelyn Tribole and Elyse Resch. [00:19:57] Book: Body Respect: What Conventional Health Books Get Wrong, Leave Out, and Just Plain Fail to Understand About Weight, by Linda Bacon, PhD. and Lucy Aphramor, PhD. Read the intro to the book. [00:21:11] Lindo Bacon (formerly Linda); Review: Bacon, Linda, and Lucy Aphramor. "Weight science: evaluating the evidence for a paradigm shift." Nutrition journal 10.1 (2011): 9. [00:23:22] Thin privilege. [00:25:19] Body Mass Index (BMI) as a health marker. [00:26:40] People in "overweight" category live longer; Study approved by CDC: Flegal, Katherine M., et al. "Excess deaths associated with underweight, overweight, and obesity." Jama 293.15 (2005): 1861-1867. [00:28:14] Looking ahead as a future physician. [00:32:41] Physicians for Ancestral Health.

This week, something slightly different, an episode first published on the new XTERRA Podcast hosted by our friends Dr Simon Marshall and Lesley Paterson. If you haven’t done so already, you might want to take a moment to add the XTERRA podcast in your app. In particular, I’d like to draw your attention to the second episode where they talk to experts about how to cope with COVID-19 and share their own stories of dealing with uncertainty, the good and bad of social media, and how the concept of ‘structure, routine, and reward’ can help. Back to the episode, you’re about to hear. If you’re an endurance athlete and complain of fatigue, insomnia, hormone problems, anxiety, depression, bloating, or other gut issues – you are not alone. In this episode of the XTERRA Podcast five-time off-road triathlon World Champ Lesley Paterson and her husband, sports psychologist Dr. Simon Marshall, talk about their own struggle-journey through the aforementioned health issues and share what they learned along the way.

There are so many great reasons to do resistance training - even for endurance athletes and self-described non-athletes who simply want to increase healthspan. We know that strength training improves quality of life, bone health, insulin sensitivity, body composition, and neurological health. However, in this uncertain era of COVID-19, commercial gyms are almost universally closed and many people are challenged to find new ways to maintain their training regimen. On this podcast, NBT Head of Strength and Conditioning, Zach Moore, CSCS is with me to discuss the best strategies for adapting your strength training routine - or starting one - when you don’t have a gym. He describes creative ways to use bodyweight and household items to challenge yourself and load muscles and shares his favourite online resources to refer to for proper form. If you're just considering adding strength training to your routine, Zach also offers a simple way to get started. Here’s the outline of this interview with Zach Moore: [00:03:44] Outline for this podcast.   [00:04:07] 4-quadrant model. [00:04:32] Study: Westcott, Wayne L. "Resistance training is medicine: effects of strength training on health." Current sports medicine reports 11.4 (2012): 209-216. [00:04:44] The importance of type II muscle fibers as we age; Study: Nilwik, Rachel, et al. "The decline in skeletal muscle mass with aging is mainly attributed to a reduction in type II muscle fiber size." Experimental gerontology 48.5 (2013): 492-498.  [00:06:53] Joe Friel; Podcast: Joe Friel: World-Class Coach of Elite Athletes; Book: Fast After 50: How to Race Strong for the Rest of Your Life. [00:07:57] Subjective quality of life; Study: Hart, Peter D., and Diona J. Buck. "The effect of resistance training on health-related quality of life in older adults: Systematic review and meta-analysis." Health promotion perspectives 9.1 (2019): 1. [00:09:26] Bone health; Studies: 1. Chen, Hung‐Ting, et al. "Effects of different types of exercise on body composition, muscle strength, and IGF‐1 in the elderly with sarcopenic obesity." Journal of the American Geriatrics Society 65.4 (2017): 827-832. 2. Hong, A. Ram, and Sang Wan Kim. "Effects of resistance exercise on bone health." Endocrinology and Metabolism 33.4 (2018): 435-444. [00:11:35] Muscle as a glucose sink and improvement of insulin sensitivity; Studies: 1. Han, Seung Jin, et al. "Association of thigh muscle mass with insulin resistance and incident type 2 diabetes mellitus in Japanese Americans." Diabetes & metabolism journal 42.6 (2018): 488-495. 2. Croymans, Daniel M., et al. "Resistance training improves indices of muscle insulin sensitivity and β-cell function in overweight/obese, sedentary young men." Journal of applied physiology 115.9 (2013): 1245-1253. [00:13:11] Body Composition. [00:14:47] Fewer injuries in athletes; Study: Fleck, Steven J., and Jeff E. Falkel. "Value of resistance training for the reduction of sports injuries." Sports Medicine 3.1 (1986): 61-68.  [00:15:47] Resistance exercise results in fewer injuries than other sports, especially if someone is there to teach proper form. Studies: Aasa, Ulrika, et al. "Injuries among weightlifters and powerlifters: a systematic review." Br J Sports Med 51.4 (2017): 211-219; Faigenbaum, Avery D., and Gregory D. Myer. "Resistance training among young athletes: safety, efficacy and injury prevention effects." British journal of sports medicine 44.1 (2010): 56-63. [00:16:40] Improved endurance performance; Study: Blagrove, Richard C., Glyn Howatson, and Philip R. Hayes. "Effects of strength training on the physiological determinants of middle-and long-distance running performance: a systematic review." Sports medicine 48.5 (2018): 1117-1149.  [00:16:50] Podcast: The Importance of Strength Training for Endurance Athletes, with Mike T. Nelson. Podcast: The Importance of Strength and Mobility for Mountain Bikers, with James Wilson. [00:17:02] Neurocognitive health; Study: Herold, Fabian, et al. "Functional and/or structural brain changes in response to resistance exercises and resistance training lead to cognitive improvements–a systematic review." European Review of Aging and Physical Activity 16.1 (2019): 10. [00:18:19] Strength training when the gym is closed. [00:21:58] Incorporating movement into your day. [00:22:19] Habit stacking; Podcast: How to Get Motivated, with Simon Marshall, PhD. [00:28:35] Strength training for endurance athletes. [00:30:58] Elite Performance Members Club Forum. [00:32:43] Simple workout structure: 2x/week, lower body + upper body push + upper body pull. [00:37:57] Why some people struggle with strength training. [00:40:01] Zach’s recommended strength training YouTube channels: Jerry Teixeira for bodyweight exercises; Alan Thrall for barbell exercises when you’re back at the gym. [00:41:11] Podcast: Movement Analysis and Breathing Strategies for Pain Relief and Improved Performance, with Zac Cupples. [00:42:08] Exercise videos: pistol squat, Nordic hamstring curl, rows using a table, one-arm pushups. [00:46:29] Podcast: How to Protect Your Brain from Decline, with Josh Turknett, MD. [00:48:11] Podcast: Nudge Tactics for Performance and Health, with Simon Marshall, PhD. [00:49:40] Blood flow restriction training. [00:53:03] The XTERRA Podcast, with Simon Marshall and Lesley Paterson. [00:53:56] Recovery. [00:54:49] Podcasts on sleep: with Greg Potter: How to Entrain Your Circadian Rhythm for Perfect Sleep and Metabolic Health; Morning Larks and Night Owls: the Biology of Chronotypes; What to Do When You Can’t Sleep; Better Sleep for Athletes; and Matthew Walker's "Why We Sleep" Is Riddled with Scientific and Factual Errors; with Ashley Mason:  Mindfulness and Cognitive Behavioral Strategies for Diabetes and Sleep Problems; and How to Use Cognitive Behavioral Therapy for Insomnia. [00:55:07] Sleep important for muscular adaptation with strength training; Study: Jåbekk, Pål, et al. "A randomized controlled pilot trial of sleep health education on body composition changes following 10 weeks resistance exercise." The Journal of Sports Medicine and Physical Fitness (2020). Also, see this graph. [00:55:23] Diet: protein, anti-inflammatory whole foods. [00:56:49] Getting the people you live with involved. [01:01:27] Support NBT on Patreon.

This week we’re doing something a little different, and sharing with you the latest Endurance Planet podcast, hosted by holistic health and endurance sports coach, Tawnee Prazak Gibson, MS, SCSC, CISSN. The episode features Julian Abel, MD, the Director of Compassionate Communities UK, who has been on the podcast before describing the social, financial, and health benefits that come with integrating social support into healthcare. I also participated in this podcast with Tawnee and Julian, and I thoroughly enjoyed the conversation. On this podcast, the three of us discuss the importance of social connection during this era of physical distancing and uncertainty. Many of us have had our daily routine sufficiently shaken. With this can come feelings of isolation and loneliness, yet it can also yield insight into what truly makes us happy. Julian, Tawnee and I talk about maintaining relationships during this challenging time, as well as reintegrating with others as lockdown mandates are lifted. We also discuss cohousing and alloparenting, and what my family is doing to build a stronger community. Here’s the outline of this interview with Julian Abel and Tawnee Gibson: [00:00:20] Endurance Planet Podcast. [00:00:31] Previous podcast with Julian Abel: Building Compassionate Communities to Improve Public Health. [00:01:41] Dr. Simon Marshall and Lesley Paterson at Braveheart Coaching. [00:03:00] Book: The Brave Athlete: Calm the F--k Down and Rise to the Occasion. [00:03:02] Endurance Planet Podcast: Simon Marshall, PhD, and Lesley Paterson: How To Be A Brave Athlete By Managing Your Brain. [00:03:16] Uncertainty and loneliness related to COVID-19. [00:07:24] Calming anxiety. [00:11:59] Deficit model of happiness. [00:13:03] Working from home. [00:13:21] Cal Newport; Podcast: How to Live Well in a High Tech World; Book: Deep Work: Rules for Focused Success in a Distracted World. [00:13:44] Stimulus control; Podcast with Ashley Mason: How to Use Cognitive Behavioral Therapy for Insomnia. [00:15:07] XTERRA podcast with Simon Marshall and Lesley Paterson. [00:15:22] Creating certainty in an uncertain world. [00:15:31] Book: Willpower by Roy Baumeister; Atomic Habits by James Clear. [00:16:02] External sources of happiness vs. focusing on what's important. [00:17:22] Book: Propaganda, by Edward Bernays. [00:21:22] Maintaining relationships during physical distancing. [00:24:39] Brad Kearns podcasts on parenting: Surprising Parenting Tips, Part 1 (Inverse Power of Praise) and Surprising Parenting Tips, Part 2 (The Importance of Perseverance Through Struggle). [00:25:26] Books: The Drama of the Gifted Child, by Alice Miller; Will I Ever Be Good Enough? By Dr. Karyl McBride. [00:30:35] Cordon sanitaire: restriction of movement. [00:34:54] Book: Loneliness: Human Nature and the Need for Social Connection, by John T. Cacioppo. [00:36:06] Podcasts with Stephanie Welch: Disruptive Anthropology: An Ancestral Health Perspective on Barefooting and Male Circumcision and The Need for Tribal Living in a Modern World. [00:36:36] Article: The Nuclear Family Was a Mistake, by David Brooks. [00:38:12] Podcast: The Human Milk-Oriented Microbiota: Babies and Beyond, with Megan Sanctuary. [00:38:41] Podcast: Contemplating Cohousing: A Paradigm for Modern Day Tribal Living, with Julie Kelly. [00:41:28] Solitude Deficiency. [00:43:31] Book: Mothers and Others: The Evolutionary Origins of Mutual Understanding, by Sarah Blaffer Hrdy  by Sarah Hrdy. [00:50:43] Public Health Palliative Care International (PHPCI) COVID19 resources. [00:52:44] Podcast: The Postmenopausal Longevity Paradox and the Evolutionary Advantage of Our Grandmothering Life History, with Kristen Hawkes. [00:59:47] Book: Rebel Ideas: The Power of Diverse Thinking, by Matthew Syed. [01:01:06] Reintegrating with others after lockdown. [01:03:53] Article: The Coronation, by Charles Eisenstein. [01:04:00] Book: The Power of Bad: How the Negativity Effect Rules Us and How We Can Rule It, by John Tierney and Roy Baumeister. [01:05:09] Article: Abel, Julian, et al. "Circles of care: should community development redefine the practice of palliative care?." BMJ supportive & palliative care 3.4 (2013): 383-388. [01:06:52] Harvard Study of Adult Development. [01:08:50] Christopher Ryan; Book: Civilized to Death: The Price of Progress and podcast: Civilized to Death: Are We Really Making Progress? [01:09:33] Book: Running with Sherman: The Donkey with the Heart of a Hero, by Christopher McDougall.