Nourish Balance Thrive

Paul Laursen, PhD is an author, endurance coach, high-performance consultant and entrepreneur. He has competed in 17 Ironman triathlon races and has published over 125 peer-reviewed papers in exercise and sports science journals. We’ve had him on the podcast once before to discuss High-Intensity Interval Training (HIIT), and he’s since co-authored a book and developed an online course on the topic. In this podcast, Paul and I take an even deeper dive into HIIT, including the specific physiological benefits that just aren’t available with lower intensity aerobic training. He describes his book and training course, which bridge the gap between the science and application of HIIT. We also get into some of the technology, gadgets, and sports psychology concepts that Paul uses in his coaching. Here’s the outline of this interview with Paul Laursen: [00:00:04] Paul's first podcast: Why Do and How to High-Intensity Interval Training. [00:00:33] Book: Science and Application of High-Intensity Interval Training, by Paul Laursen, PhD and Martin Buchheit, PhD. [00:01:20] Revelstoke Mountain Resort. [00:02:50] Mountain biking trails in Revelstoke, British Columbia. [00:05:40] Phil Maffetone; MAF method. [00:06:25] High-Intensity Interval Training (HIIT). [00:07:09] What does HIIT training do? [00:11:43] Type 2 fast-twitch muscle fibers. [00:11:55] Ken Ford; Podcast: Optimal Diet and Movement for Healthspan, Amplified Intelligence and More with Ken Ford. [00:11:56] Joe Friel; Book: Fast After 50; Podcast: Joe Friel: World-Class Coach of Elite Athletes [00:13:30] Paul's online video online training course: Science and Application of High-Intensity Interval Training. [00:14:08] History of the book and the course; Martin Buchheit, PhD. [00:14:25] Literature Review: Part 1: Buchheit, Martin, and Paul B. Laursen. "High-intensity interval training, solutions to the programming puzzle." Sports medicine 43.10 (2013): 927-954; Part 2: Buchheit, Martin, and Paul B. Laursen. "High-intensity interval training, solutions to the programming puzzle." Sports medicine 43.10 (2013): 927-954. [00:16:15] Daniel Plews, PhD. [00:16:23] Marc Quod, Sports Physiologist from Orica-Greenedge cycling team. [00:17:28] Josh Turknett, MD; Podcast: The Migraine Miracle. [00:19:45] Simon Marshall and Lesley Paterson. Podcasts featuring Simon: 1, 2, 3, 4; and Lesley: Off Road Triathlon World Champion Lesley Paterson on FMT and Solving Mental Conundrums. [00:20:30] Using HIIT to train an elite triathlete. [00:22:40] Kyle Buckingham. [00:28:08] Measuring intensity; GPS watches, heart rate; rating of perceived exertion (RPE). [00:29:44] TrainingPeaks. [00:29:50] How work periods are prescribed; 5-zone model. [00:33:37] Gadget interference in training; Stages; SRM. [00:35:57] Quarq. [00:36:28] Garmin Connect. [00:37:29] The importance of carrying out a HIIT session as prescribed. [00:38:37] Fartlek. [00:39:29] Interval training vs. Fartlek; Study: Das, Aditya Kumar, M. Sudhakara Babu, and Kota Satish. "Effect of continuous running fartlek training and interval training on selected motor ability and physiological variables among male football players." International Journal of Physical Education Sports Management and Yogic Sciences 4.1 (2014): 13-18. [00:41:36] Use of stationary bikes to ensure precision with intervals. [00:44:55] The psychology of HIIT. [00:45:44] Book: The Chimp Paradox by Dr. Steve Peters. [00:49:03] How much better can you get with HIIT? [00:53:23] HIITscience. [00:53:33] Book: Make it Stick: The Science of Successful Learning by Peter C. Brown, Henry L. Roediger III, and Mark A McDaniel. [00:54:51] A need for accredited HIIT science instructions and tools to support HIIT prescription. [00:55:28] Heart rate variability (HRV). [00:56:11] Martin Buchheit as head of performance for Paris Saint-Germain Football Club. [00:57:33] Free content at HIITscience.com; Social media: Facebook, Twitter, Instagram.

When we launched the Blood Chemistry Calculator (BCC) in early 2018 we couldn’t have predicted the changes the software would undergo or the projects it would lead to. One such project has been researching and writing a scientific paper on the use of machine learning to predict and interpret biological age. The paper is currently in the peer review process on F1000Research, an open research publishing platform. In this podcast, I talk with lead author Dr. Tommy Wood, MD, PhD, about the importance of knowing your biological age and understanding how it can be derived from basic blood chemistry markers.  Tommy and I discuss the peer-review process and the changes we’re making to the software as a result of the feedback that’s been provided. We also discuss the individual markers that have the greatest impact on biological age, and how you can get a free predicted age report. Here’s the outline of this interview with Tommy Wood: [00:00:58] Tommy got bit by a snake. [00:02:38] Going to the doctor vs. changing lifestyle. [00:03:32] Iatrogenic antibiotic injury. [00:03:49] Antivenom: what it is, what it does and the side effects. [00:06:49] Snake oral microbiota. [00:10:23] Effects of antibiotics on gut. [00:13:29] DUTCH (Dried Urine Test for Comprehensive Hormones). [00:15:54] Our article: An interpretable machine model of biological age. [00:17:15] Why is biological age important? [00:19:12] Other tests of biological age; telomeres. [00:20:31] Epigenetic testing. [00:20:59] Effects of environment on epigenetic methylation; Studies: Nilsson, Emma, and Charlotte Ling. "DNA methylation links genetics, fetal environment, and an unhealthy lifestyle to the development of type 2 diabetes." Clinical epigenetics 9.1 (2017): 105; and Yet, Idil, et al. "Genetic and environmental impacts on DNA methylation levels in twins." Epigenomics 8.1 (2016): 105-117. Effects of lifestyle change on epigenetic methylation; Studies: Arpón, Ana, et al. "Impact of consuming extra-virgin olive oil or nuts within a Mediterranean diet on DNA methylation in peripheral white blood cells within the PREDIMED-Navarra randomized controlled trial: A role for dietary lipids." Nutrients 10.1 (2018): 15; and Delgado-Cruzata, Lissette, et al. "Dietary modifications, weight loss, and changes in metabolic markers affect global DNA methylation in Hispanic, African American, and Afro-Caribbean breast cancer survivors." The Journal of nutrition 145.4 (2015): 783-790. [00:21:05] Epigenetic shifts and aging; Study: Pal, Sangita, and Jessica K. Tyler. "Epigenetics and aging." Science advances 2.7 (2016): e1600584. [00:21:48] Insilico Medicine - Deep Biomarkers of Human Aging: aging.ai. [00:22:46] Blood Chemistry Calculator (BCC). [00:23:33] Find out your biological age with the free partial BCC report. [00:24:04] How the biological age score is determined. [00:28:13] Why we published the paper. [00:28:40] Medscape article: Journal Editors on Peer Review, Paywalls, and Preprints. [00:31:26] F1000Research. [00:33:54] GitHub; XGBoost; Python. [00:35:32] The reviewers for the peer review process: Alex Zhavoronkov and Peter Fedichev. [00:39:10] Ideas that came out of the peer review process. [00:42:49] Shapley Values and SHAP plots. [00:43:51] Machine learning competition website: Kaggle. [00:45:20] The most important blood markers for predicting biological age. [00:48:02] Total cholesterol and BUN for predicting biological age. [00:50:48] Nourish Balance Thrive on Patreon; NBT Forum.

At the recent Physicians for Ancestral Health Winter Retreat I had the opportunity to sit down in person with L. Amber O’Hearn, an outspoken advocate of plant-free eating. Since learning about the zero-carb carnivore approach in 2009, Amber has become an international speaker, researcher, and writer on the subjects of ketosis and the health benefits of eating meat. In this podcast, Amber and I discuss her health journey from veganism to low carb, and then to the more radical carnivore diet. She explains how shunning plant foods led to a dramatic improvement in both her physical and mental health, ending her 20-year battle with bipolar disorder, without the use of medication. She also describes her own version of zero-carb and discusses how a carnivore diet affects ketosis. Here’s the outline of this interview with Amber O’Hearn: [00:00:23] Physicians for Ancestral Health. [00:02:01] Amber's background. [00:03:02] The path that led her to a low carb diet. [00:09:23] Zooko Wilcox-O’Hearn. [00:11:53] David Chaum. [00:12:37] Zcash. [00:16:10] The Ketogenic Diet for Health: ketotic.org. [00:16:49] The value of end-to-end citations. [00:21:52] Amber's post on gluconeogenesis: If You Eat Excess Protein, Does It Turn Into Excess Glucose? [00:26:04] Josh Turknett MD; Talk: How to Win at Angry Birds: Moving Towards a More Efficient Practice Model. [00:26:14] Richard David Feinman; blog: The Other. [00:28:28] Reevaluating previous recommendations: Salt and DHA. [00:33:03] Bipolar disorder and pharmaceutical treatment. [00:40:31] Identifying the root cause of psychiatric illness. [00:45:06] Unwanted side effects from mood stabilizing drugs. [00:47:16] Cognitive Behavioral Therapy (CBT). [00:53:45] Zero carb/plant free diet; Zeroing In On Health, ZIOH. ZIOH Facebook group. [00:57:05] Charles Washington, founder of ZIOH group. [00:57:49] Dry fasting leads to increased fat breakdown; Study: Rutkowska, Joanna, et al. "Increased fat catabolism sustains water balance during fasting in zebra finches." Journal of Experimental Biology 219.17 (2016): 2623-2628. [01:03:58] Pregnancy: Carbohydrate cravings and hyperemesis gravidarum. [01:05:50] Paleo Baby Podcast: Chloe Archard: Paleo advocate, mom, and host of the “Eat Better” podcast. [01:06:51] Rat study: Thompson, Betty J., and Stuart Smith. "Biosynthesis of fatty acids by lactating human breast epithelial cells: an evaluation of the contribution to the overall composition of human milk fat." Pediatric research 19.1 (1985): 139. [01:07:56] Keto Summit; Jeremy Hendon. [01:09:28] Talk at Low Carb Breckenridge: L. Amber O'Hearn - Ketosis Without Starvation: The Human Advantage. [01:10:03] The Boulder Carnivore Conference. [01:10:54] What does a carnivore diet consist of? [01:11:44] Financial considerations. [01:13:56] Paleomedicina Clinic  (ICMNI) uses a Paleolithic Ketogenic Diet. [01:14:59] Stephen Phinney, MD, PhD. [01:15:24] Optimal ketone levels graphic from The Art and Science of Low Carbohydrate Performance by Jeff Volek and Stephen Phinney. [01:17:30] Autoimmune Protocol Diet (AIP). [01:18:39] Shawn Baker. [01:20:26] Andrew Scarborough. [01:21:41] Ability to eat more protein while remaining in ketosis. [01:26:07] Georgia Ede, MD. [01:26:54] Podcast: Disruptive Anthropology: An Ancestral Health Perspective on Barefooting and Male Circumcision, with Stephanie Welch. [01:27:35] Amber’s blog: empiri.ca. [01:27:46] Twitter: @ketocarnivore. Amber’s book-in-progress: facultativecarnivore.com. You can also support Amber’s work on Patreon.

Stephanie Welch is a humanist and ancestral health advocate, challenging commonly held societal beliefs and taboos in an effort she calls Disruptive Anthropology. In 2013 she became a full-time urban barefooter in Boston and in 2014 she took up intactivism, combating both male and female circumcision as a matter of health and human rights. Two years later she began studying and speaking on sexual commerce as it relates to male and female interpersonal dynamics. On this podcast, Stephanie and I talk about some of the stances she’s taken during her years of ancestral advocacy. We talk about the ways that wearing shoes undermines our innate biomechanical development and the social norms she challenges by going barefoot. We also discuss the physical and sexual consequences of male circumcision and the critical aspects of community and connection that have been lost to modern American culture. Here’s the outline of this interview with Stephanie Welch: [00:00:08] PAH Winter Retreat. [00:06:30] Noticing patterns in people’s bodies, as a massage therapist. [00:07:43] What kind of deleterious effects could happen from wearing shoes? [00:09:45] The sense of touch that comes through the sole of the foot; mechanoreceptors. [00:11:37] Flat feet. [00:14:36] Minimalist footwear; stress fractures. [00:16:49] What about sharp objects? [00:17:36] Bruce Parry TV series: Tribe (Going Tribal in the US). [00:18:16] Toughening up the feet. [00:21:46] Navigating social norms and conventions. [00:23:11] Etsy: Barefoot sandals. [00:24:12] NBT on Patreon; Forum challenge ideas. [00:27:31] Why circumcision is not Paleo; Video: Not So Vestigial: The Anatomy and Functions of Male Foreskin by Stephanie Welch BA, MA, LMT. [00:28:33] Parental disagreement about child’s circumcision: News story. [00:30:41] Medical benefits of the foreskin. [00:32:13] Does circumcision reduce the risk of disease? [00:35:49] Functions of the foreskin: protection, lubrication, sensation, mechanical action, partner stimulation, erectile stimulation and penis size. [00:36:40] Greater force needed during intercourse for circumcised men; Study: O’Hara, Kristen, and Jeffrey O’Hara. "The effect of male circumcision on the sexual enjoyment of the female partner." BJU international 83.S1 (1999): 79-84. (Note: This may not be the specific study described by Stephanie in the podcast). [00:39:11] The role of the foreskin in lubrication. [00:41:54] The role of the foreskin in male stimulation. [00:43:18] Why are people getting circumcised? [00:52:29] Circumcision later in life. [00:54:49] Evolutionary Feminism: Rekindling Women’s Sexual Power. [00:55:45] Nuclear families as the domestic unit of society. [00:56:36] Compassionate Communities; Podcast: Building Compassionate Communities to Improve Public Health, with Julian Abel, MD. [00:58:14] Tribal living vs. modern households. [01:03:55] Stephanie’s Paper: Welch, Stephanie. "Shoes Are Not Paleo." Journal of Evolution and Health 2.1 (2017): 16. [01:04:01] Paleo f(x). [01:04:22] Stephanie at the Ancestral Health Symposium. [01:04:31] Future Frontiers in Austin, Tx.

Kimberly Harmon, MD, is board certified in Family Practice with a Certificate of Added Qualification in Sports Medicine. She is the Head Football Team Physician for the University of Washington Huskies, as well as a UW Professor in the Departments of Family Medicine and Orthopaedics and Sports Medicine. Kimberly has lectured nationally and has authored numerous peer-reviewed papers on topics relating to sports injury and novel approaches to treatment. In this podcast with Dr. Tommy Wood, MD, PhD, Kimberly draws from her own research and experience to describe options for the treatment of sport-related tendon and joint injuries using minimally-invasive procedures. They discuss interventions ranging from physical therapy techniques to platelet-rich plasma to relieve pain and improve function. She also discusses some of the main medical and safety challenges faced by today’s college athletes. Here’s the outline of this interview with Kimberly Harmon: [00:01:15] Non-surgical approaches to sport-related joint and tendon problems. [00:04:16] Assessment and treatment; eccentric exercises. [00:06:48] Early intervention; Physical therapy techniques: Astym and Graston. [00:07:10] Extracorporeal shockwave therapy. [00:07:43] Nitrous Oxide; nitro patch. [00:10:27] Tenotomy. [00:10:52] Injecting whole blood into the tendon; Platelet-rich plasma (PRP). [00:12:54] Reviews of PRP studies: 1. Salamanna, Francesca, et al. "New and emerging strategies in platelet-rich plasma application in musculoskeletal regenerative procedures: general overview on still open questions and outlook." BioMed research international 2015 (2015). 2. Barile, Antonio, et al. "Anaesthetics, steroids and platelet-rich plasma (PRP) in ultrasound-guided musculoskeletal procedures." The British journal of radiology 89.1065 (2016): 20150355. 3. Jeong, D. U., et al. "Clinical applications of platelet-rich plasma in patellar tendinopathy." BioMed research international 2014 (2014). [00:14:03] Kim’s research on PRP - about 80% of people respond Mautner, Kenneth, et al. "Outcomes after ultrasound-guided platelet-rich plasma injections for chronic tendinopathy: a multicenter, retrospective review." PM&R 5.3 (2013): 169-175. [00:15:35] Cortisol vs. PRP. [00:17:12] Working treatment into recommendations for athletes. [00:18:40] Joints; treatment with PRP. [00:20:02] PRP improves joint pain and function; Studies: Bousnaki, M., A. Bakopoulou, and P. Koidis. "Platelet-rich plasma for the therapeutic management of temporomandibular joint disorders: a systematic review." International journal of oral and maxillofacial surgery 47.2 (2018): 188-198; and Tietze, David C., Kyle Geissler, and James Borchers. "The effects of platelet-rich plasma in the treatment of large-joint osteoarthritis: a systematic review." The Physician and sportsmedicine 42.2 (2014): 27-37. [00:21:00] Joint replacement. [00:21:40] Viscosupplementation; brands: Synvisc, Orthovisc, Euflexxa, Supartz; hyaluronic acid. [00:22:12] PRP vs. hyaluronic acid; Study: Ye, Ye, et al. "Platelet rich plasma versus hyaluronic acid in patients with hip osteoarthritis: A meta-analysis of randomized controlled trials." International Journal of Surgery (2018). [00:24:00] Stem cells. [00:28:00] Ablations of the nerves for arthritis; radiofrequency ablation (RFA). [00:29:36] Being the on-call doctor for the University of Washington Husky football team. [00:31:23] Problems seen in college athletes; sleep. [00:33:20] Chair of the Pac-12 Student Athlete Health and Well-Being Board. [00:34:42] Injury record database; sports analytics. [00:37:02] Find Kim: Sports Medicine Clinic at Husky Stadium; see her research on PubMed.

Dr. Mark Cucuzzella, MD is a family medicine physician and Air Force Reserve Lieutenant Colonel, as well as a Professor at West Virginia University School of Medicine. Mark has been a competitive runner for almost four decades, with more than one hundred marathon and ultramarathon finishes, and he continues to compete as a national-level masters runner. Mark also owns the first minimalist running and walking shoe store, Two Rivers Treads. In this podcast Dr. Tommy Wood, MD talks with Mark about his new book Run For Your Life, which outlines the science and the soul of running and nutrition for maintaining a vigorous life. They discuss the aspects of physiology that suggest humans evolved to run, and the features of modern living that can result in foot pain and arthritis. Mark shares his best training tips for both new and experienced runners, as well as resources for healing painful foot conditions. Here’s the outline of this interview with Mark Cucuzzella: [00:00:23] Book: Run for Your Life: How to Run, Walk, and Move Without Pain or Injury and Achieve a Sense of Well-Being and Joy, by Dr. Mark Cucuzzella. [00:01:54] Books: Fat Chance and The Fat Chance Cookbook, by Dr. Robert Lustig. [00:02:07] Gary Taubes. [00:04:33] The process of writing a book. [00:05:44] Co-writer Broughton Coburn. [00:07:18] Collaboration between Tommy and Mark on low-carb paper: Cucuzzella, Mark T., et al. "A low-carbohydrate survey: Evidence for sustainable metabolic syndrome reversal." Journal of Insulin Resistance 2.1 (2017): 1-25. [00:08:09] Running. [00:08:39] Book: Born to Run by Christopher McDougall. [00:08:42] Features of human physiology and skeleton that support bipedal running; Study: Bramble, Dennis M., and Daniel E. Lieberman. "Endurance running and the evolution of Homo." Nature 432.7015 (2004): 345. [00:09:31] Book: Story of the Human Body, by Dan Lieberman. [00:11:20] Zones of training. [00:12:10] Minimal shoes. [00:15:12] The road to health for people with obesity and type 2 diabetes. [00:15:34] Stephen Phinney, MD, PhD and Jeff Volek, PhD, RD. [00:16:41] Slow jogging; Dr. Hiroaki Tanaka. Videos: 1, 2, and how to slow jog, with Dr. Tanaka. [00:18:46] The facia and how it relates to running. [00:20:37] Lawrence van Lingen. [00:20:53] Book: Anatomy Trains, by Thomas Myers. [00:21:23] Book: Functional Atlas of the Human Fascial System, by Carla Stecco, MD. [00:22:17] Videos: Gil Hedley: Fascia and stretching: The Fuzz Speech and Strolling Under the Skin. [00:23:50] Foam rolling. [00:25:04] The gastrocsoleus complex. [00:28:23] Plantar fasciitis; Mark’s ebook. [00:29:47] Hallux valgus (bunion). [00:31:06] Relieving foot pain: Correct Toes. [00:32:59] Insole: Barefoot Science. [00:33:47] Knee osteoarthritis and pain. [00:34:28] Dr. Casey Kerrigan; Jay Dicharry. [00:36:11] Modern-day influences on osteoarthritis; Study: Berenbaum, Francis, et al. "Modern-day environmental factors in the pathogenesis of osteoarthritis." Nature Reviews Rheumatology(2018): 1. [00:37:17] Dick Beardsley, Roger Robinson. [00:39:35] Meb Keflezighi. [00:41:14] Cardiovascular benefits vs complications of training. [00:42:44] Podcast: How to Reconcile Performance with Longevity. [00:44:22] Bernard Lagat. [00:44:56] Eliud Kipchoge. [00:48:48] Runforyourlifebook.com and www.DrMarksdesk.com. [00:50:58] PAH Winter Retreat in Scottsdale, AZ.

This past January several of the NBT team members and I met up for sun and camaraderie at the Flō Retreat Center, in Uvita, Costa Rica. Flō is run by strength coach, Ben House, PhD, who’s been on the podcast once before. Previously we talked about his work with clients and the effects of hormones on building strength and lean mass. It’s now a year later and we’re continuing the conversation. On this podcast, Ben is joined by myself, Dr. Tommy Wood, Megan Roberts, and Dr. Lindsay Taylor for a discussion of some of the practical and philosophical aspects of strength training and public health. Ben also shares his strategy for evaluating scientific literature and explains why everyone can benefit by building muscle. Here’s the outline of this interview with Ben House: [00:00:00] Hikecast with Kim House. [00:00:07] Flō Retreat Center, Uvita, Costa Rica. [00:03:03] Addictions. [00:05:27] Indicators of longevity: grip strength, leg strength and muscle mass, VO2 max. [00:08:46] Megan's transformation. [00:09:47] Fat free mass index (FFMI). [00:10:02] Muscle mass and mortality; Study: Abramowitz, Matthew K., et al. "Muscle mass, BMI, and mortality among adults in the United States: A population-based cohort study." PloS one 13.4 (2018): e0194697. [00:13:27] FFMI Calculator. [00:16:16] Working as a personal trainer. [00:17:56] Getting a PhD: Learning how to learn. [00:21:32] Glycogen shunt; Studies: Shulman, Robert G. "Glycogen turnover forms lactate during exercise." Exercise and sport sciences reviews 33.4 (2005): 157-162; and Shulman, R. G., and D. L. Rothman. "The “glycogen shunt” in exercising muscle: a role for glycogen in muscle energetics and fatigue." Proceedings of the National Academy of Sciences 98.2 (2001): 457-461. [00:24:47] Dr. Josh Turknett. Podcast: The Migraine Miracle. [00:25:22] Different types of cells identified in mouse brain; Study: Tasic, Bosiljka, et al. "Shared and distinct transcriptomic cell types across neocortical areas." Nature 563.7729 (2018): 72. [00:27:18] Dr. Richard Feinman blog post: Meta-analysis is to analysis… [00:31:58] Keto not conducive to muscle gain in clinical trials; Studies: Vargas, Salvador, et al. "Efficacy of ketogenic diet on body composition during resistance training in trained men: a randomized controlled trial." Journal of the International Society of Sports Nutrition 15.1 (2018): 31. Additional studies showing loss of lean body mass on keto: 1, 2, 3, 4, 5, 6. [00:32:42] Luis Villaseñor, KetoGains. [00:34:27] Solving nuanced health problems. [00:35:49] Precision Nutrition. [00:40:36] Books: The Power of Moments and Switch by Chip Heath and Dan Heath. [00:42:01] Behavior change. [00:43:13] Is obesity solvable on a macro level? [00:50:34] Uncoupling proteins; Podcast: Mitochondria: More Than a Powerhouse, with Dr. Bryan Walsh. [00:52:00] Lindsay Taylor; Podcast: Brain Training for the Primal Keto Endurance Athlete. [01:03:24] Mike T Nelson; Podcast: How to Assess an Athlete: The Best Principles, Methods, and Devices to Use. [01:03:43] Retreats at the Flō Retreat Center. [01:06:52] Bro retreats; hypertrophy camps. [01:08:35] 2019 Functional Medicine Costa Rica Retreat: Speakers include Bryan Walsh, Pat Davidson, Seth Oberst. [01:09:46] Zac Cupples; Course: Human Matrix. [01:10:07] Lucy Hendricks, Ryan L'Ecuyer. [01:13:16] 30 minutes 2x a week to get to a sufficient FFMI. [01:14:26] Mechanisms for increasing muscle mass: muscular tension and metabolic stress. [01:19:35] Zach Moore; Podcast: Overcoming Adversity and Strength Coaching. [01:19:48] Nourish Balance Thrive on Patreon. [01:26:47] Is the Flō Retreat Center replicable? [01:30:15] Ben’s Facebook page; Functional Medicine Costa Rica; broresearch.com; Email: drhouse@broresearch.com.

Back on the show today is Greg Potter, PhD, Content Director at humanOS.me. Last time Greg was here we discussed entraining circadian rhythm to attain perfect sleep. Today we’re examining circadian biology from a different angle, focusing specifically on chronotypes. Are we biologically wired to be morning larks or night owls? Or do these tendencies stem from social conditioning and modern influences? On this podcast, Dr. Tommy Wood talks with Greg about the biological underpinnings that may have resulted in distinct chronotypes. They discuss the environmental factors that contribute to early or late tendencies and the impact of having a “late” chronotype on health outcomes. Greg also shares his best practical strategies to optimize the circadian system for the purposes of health, sleep, and productivity. Here’s the outline of this interview with Greg Potter: [00:00:00] Try a humanOS Pro Membership for $1 for the first month (use code: NBT). [00:00:10] Greg’s previous podcast: How to Entrain Your Circadian Rhythm for Perfect Sleep and Metabolic Health. [00:02:04] Satchin Panda podcast: How to Use Time-Restricted Eating to Reverse Disease and Optimize Health. [00:02:12] Bill Lagakos podcast: Why You Should Eat Breakfast (and Other Secrets of Circadian Biology). [00:02:44] Chronotypes. [00:03:33] Michael O'Shea, author of Aspects of Mental Economy (1900). [00:04:03] Colin Pittendrigh and Serge Daan. [00:04:40] Horne and Östberg study: Horne, Jim A., and Olov Östberg. "A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms." International journal of chronobiology(1976). [00:04:45] Morningness-Eveningness Questionnaire (MEQ). [00:05:45] Composite Scale of Morningness; Munich ChronoType Questionnaire (MCTQ). [00:07:19] Objective measures of biological timing: actimetry; Actiwatch; melatonin rhythm, core body temperature, cortisol. [00:09:20] The circadian system explained. [00:12:19] Time cues (zeitgebers). [00:11:39] Entrainment. [00:15:12] Phase angle of entrainment; Jeanne Duffy, PhD. [00:17:36] Intrinsically photosensitive retinal ganglion cells; David Berson, PhD; Samer Hattar. [00:18:49] Suprachiasmatic nucleus (SCN); Studies: Moore, Robert Y., and Victor B. Eichler. "Loss of a circadian adrenal corticosterone rhythm following suprachiasmatic lesions in the rat." Brain research(1972); and Abe, K., et al. "Effects of destruction of the suprachiasmatic nuclei on the circadian rhythms in plasma corticosterone, body temperature, feeding and plasma thyrotropin." Neuroendocrinology 29.2 (1979): 119-131. [00:19:36] Phase Response Curve. [00:22:03] Sleep homeostasis: the pressure to sleep that accumulates with more time awake. [00:24:26] David Samson, PhD; Sentinel hypothesis, study: Samson, David R., et al. "Chronotype variation drives night-time sentinel-like behaviour in hunter–gatherers." Proc. R. Soc. B 284.1858 (2017): 20170967. [00:28:35] Kenneth Wright, Jr.; Study: Wright Jr, Kenneth P., et al. "Entrainment of the human circadian clock to the natural light-dark cycle." Current Biology 23.16 (2013): 1554-1558; Follow up study: Stothard, Ellen R., et al. "Circadian entrainment to the natural light-dark cycle across seasons and the weekend." Current Biology 27.4 (2017): 508-513. [00:32:49] Weaker time cues: 88% of time indoors, light pollution. [00:35:56] Twin studies on diurnal type: Vink, Jacqueline M., et al. "Genetic analysis of morningness and eveningness." Chronobiology international 18.5 (2001): 809-822. [00:36:24] Familial advanced sleep phase syndrome; Study: Toh, Kong L., et al. "An hPer2 phosphorylation site mutation in familial advanced sleep phase syndrome." Science 291.5506 (2001): 1040-1043. [00:37:48] Delayed sleep phase disorder; study: Patke, Alina, et al. "Mutation of the human circadian clock gene CRY1 in familial delayed sleep phase disorder." Cell 169.2 (2017): 203-215. [00:38:17] Gene variants involved in the sleep timing; Studies: Hu, Youna, et al. "GWAS of 89,283 individuals identifies genetic variants associated with self-reporting of being a morning person." Nature communications 7 (2016): 10448; and Jones, Samuel E., et al. "Genome-wide association analyses in> 119,000 individuals identifies thirteen morningness and two sleep duration loci." Biorxiv (2016): 031369. [00:41:33] Economic benefit of later school start times: Hafner, Marco, Martin Stepanek, and Wendy M. Troxel. "Later school start times in the US." An economic analysis (2017). [00:46:03] Health effects of late chronotype. [00:47:23] Study: Knutson, Kristen L., and Malcolm von Schantz. "Associations between chronotype, morbidity and mortality in the UK Biobank cohort." Chronobiology international (2018): 1-9. [00:48:35] Chronotype and cognitive performance; Study: Kyle, Simon D., et al. "Sleep and cognitive performance: cross-sectional associations in the UK Biobank." Sleep medicine 38 (2017): 85-91; and van der Vinne, Vincent, et al. "Timing of examinations affects school performance differently in early and late chronotypes." Journal of biological rhythms 30.1 (2015): 53-60. [00:50:10] Social jetlag; Study: Wittmann, Marc, et al. "Social jetlag: misalignment of biological and social time." Chronobiology international 23.1-2 (2006): 497-509. [00:51:10] Social jet lag and poor health; Study: Roenneberg, Till, et al. "Social jetlag and obesity." Current Biology 22.10 (2012): 939-943. [00:53:01] Calculating social jetlag; Article: Jankowski, Konrad S. "Social jet lag: Sleep-corrected formula." Chronobiology international 34.4 (2017): 531-535. [00:55:23] The effect of seasonality on circadian rhythm. [00:57:40] Seasonal changes in gene expression; Study: Dopico, Xaquin Castro, et al. "Widespread seasonal gene expression reveals annual differences in human immunity and physiology." Nature communications 6 (2015): 7000. [00:58:54] Latitudinal differences in chronotype; Study: Putilov, Arcady A., et al. "Genetic-based signatures of the latitudinal differences in chronotype." Biological Rhythm Research (2018): 1-17. [00:59:22] Effect of latitude on delayed sleep phase syndrome: Pereira, Danyella S., et al. "Association of the length polymorphism in the human Per3 gene with the delayed sleep-phase syndrome: does latitude have an influence upon it?." Sleep 28.1 (2005): 29-32. [01:01:46] Book: The Power of When By Michael Breus, PhD. [01:02:31] Molding the environment to support health outcomes. [01:04:26] The most important ways to optimize the functions of the circadian system. [01:05:06] James Hewitt podcast: How to Sustain High Cognitive Performance. [01:07:12] Blog post: Writing a To-Do List Might Help You Fall Asleep Faster. [01:08:55] Digital sunset: f.lux, Twilight (Android). Night Shift (iOS). [01:11:21] Body Scan meditation: Mark Williams or Sharon Salzberg. [01:14:12] Video: AHS18 - The Athlete's Gut: Pitfalls of Fuelling Modern Performance. [01:14:25] Effects of irregular meal pattern; Study: Alhussain, Maha H., Ian A. Macdonald, and Moira A. Taylor. "Irregular meal-pattern effects on energy expenditure, metabolism, and appetite regulation: a randomized controlled trial in healthy normal-weight women, 2." The American journal of clinical nutrition 104.1 (2016): 21-32.

→ Join us at the Physicians for Ancestral Health Winter Retreat ← Dr. Luke Bennett, MD is the Medical and Sports Performance Director with Hintsa Performance, and the team doctor for the Mercedes - AMG Petronas Formula One (F1) racing team. His role with F1 involves providing general medical practice for 200 staff on the road and overseeing a team of coaches, trainers, and nutritionists who work with the drivers on the Formula One grid. In this podcast with Dr. Tommy Wood, Luke discusses his background in critical and intensive care medicine in Australia and the events that launched him from lifelong fan of motorsport to Formula One team doctor. They discuss the training, business, and performance psychology needs of F1 drivers and some of the challenges associated with life on the road. Here’s the outline of this interview with Luke Bennett: [00:00:12] Peter Attia Podcast: The Drive. [00:00:20] Hintsa Performance. [00:02:30] Royal Flying Doctor Service of Australia. [00:05:18] Taking a patient history. [00:06:35] Transitioning to working with Formula One. [00:07:47] Dr. Aki Hintsa. [00:08:39] Formula One. [00:09:33] Team doctor for the Mercedes-AMG Petronas team. [00:11:28] Haile Gebrselassie; Mika Häkkinen. [00:12:44] Pete McKnight and Dave Ferguson; Book: The Science of Motorsport, by David P. Ferguson. [00:13:55] Finding the right coach for the right driver. [00:17:14] The Core: a close and deliberate examination of what makes a person tick. [00:18:33] Psychology of sports performance in F1. [00:21:20] The complex social tapestry of F1 racing. [00:23:19] Hintsa Chairman Juha Äkräs and CEO, Jussi Raisanen. [00:25:01] Knowing where to assign your time. [00:29:23] Tim Ferriss; Financial Times, Sky News; The West Wing Weekly. [00:30:24] Sam Harris, Waking Up Podcast. [00:31:19] Shane Parrish; Farnam Street blog. [00:32:11] Ornithology. [00:34:35] Hintsa on Twitter and Facebook.

Julian Abel, MD has been a consultant in palliative care since 2001, as well as the Vice President of Public Health Palliative Care International, and the Director of Compassionate Communities UK. Since 2016 Julian has been collaborating with Frome Medical Practice in the UK to roll out their innovative model of building social connection within the community to improve health outcomes and quality of life. The initial results have been remarkable, with dramatic decreases in local emergency admissions compared to surrounding areas. On this podcast with Tommy Wood, MD, PhD, Julian describes the compassionate community model of care, including the financial and social benefits that come with weaving social support into an existing health care system. He explains how creating stronger connections within the community is a public health imperative and a socially conscious alternative to rising health care costs. He’s also developed a replicable system for bringing the concept to other communities and businesses. Here’s the outline of this interview with Julian Abel: [00:02:19] Compassionate communities: Things that matter most to people who are dying and the supportive networks that surround them. [00:03:08] Palliative care. [00:05:18] The impact of kindness and compassion on how we function. [00:06:01] Death: how best to help people with terminal illness. [00:08:40] Frome Medical Practice in Somerset; Health Connections Mendip. [00:10:47] Impact of social connection: 14% reduction in emergency admissions in Frome, compared to 28.5% increase in admissions within Somerset; Study: Abel, Julian, et al. "Reducing emergency hospital admissions: a population health complex intervention of an enhanced model of primary care and compassionate communities." Br J Gen Pract 68.676 (2018): e803-e810. [00:11:53] Social relationships and mortality; Study: Holt-Lunstad, Julianne, Timothy B. Smith, and J. Bradley Layton. "Social relationships and mortality risk: a meta-analytic review." PLoS medicine 7.7 (2010): e1000316. [00:12:37] Bringing compassionate communities into health services. [00:14:35] Benefits to health, medicine, and society. [00:16:23] Compassionate Communities UK. [00:18:32] Key functions of the model. [00:23:16] Reciprocity and altruism. [00:24:31] Systematic program implementation: How to bring these practices to new communities. [00:26:16] Public Health Palliative Care International; Compassionate City Charter. [00:29:00] Implementation within companies for staff retention and recruitment, employee morale, productivity. [00:30:25] Physicians: Emotional distance vs. compassion. [00:33:49] Placebo effect and therapeutic relationship. [00:37:14] Fitting the model into even very brief medical consultations. [00:37:31] Health Connections Mendip service directory. [00:38:48] A “malnourishment of compassion”, across all age groups. [00:41:34] Resurgence & Ecologist Magazine article: Compassion is the best medicine, by Julian Abel and Lindsay Clarke. [00:41:37] Guardian article: The town that’s found a potent cure for illness – community, by George Monbiot. [00:42:13] Highlights email discussing compassionate communities paper and intervention.