Nourish Balance Thrive

Doctor Bryan Walsh is back with us today, discussing the diagnostic benefits of a simple blood chemistry.  He says the results of common and inexpensive lab panels can be mined for meaningful health information, potentially saving patients a lot of time and money on testing – that is, if you know what these blood markers actually mean (and your average doctor probably doesn’t). Fortunately for us, Bryan knows and loves to teach. In this podcast, he shares a bit about his own journey - what led him to study these basic blood markers, and what now inspires him to teach others.  If you like this episode, visit Bryan’s Metabolic Fitness Pro website, where he continues to develop new educational material for health practitioners and other avid learners. Here’s the outline of this interview with Bryan Walsh: [00:00:58] Bryan's WellnessFX videos. [00:02:07] Textbook: Fischbach's A Manual of Laboratory and Diagnostic Tests 10th Edition. [00:04:27] Albumin. [00:05:58] Study: Allen, Larry A., and Christopher B. Granger. "Risk assessment in the genomic era: Are we missing the low-hanging fruit?." American heart journal 157.5 (2009): 799. [00:06:36] Podcast: How to Understand Glucose Regulation with Dr. Bryan Walsh. [00:06:49] Organic Acids Test. Podcast: How to Measure Your Metabolism with Organic Acids with Dr. William Shaw, PhD. [00:07:33] Blood has to be the first place you go. [00:08:13] Reference ranges. [00:08:40] A lab determines a bell-shaped curve for the population of a given region; the reference range might then be +/- 2 standard deviations. [00:10:21] Vitamin D. [00:13:41] Functional reference ranges. [00:14:30] Harry Eidenier, PhD, widely considered to be the Grandfather of Functional Blood Chemistry analysis. [00:18:26] Total cholesterol. [00:19:18] Bilirubin: A metabolic breakdown byproduct of red blood cell destruction. [00:21:22] Study: Ong, Kwok-Leung, et al. "The relationship between total bilirubin levels and total mortality in older adults: the United States National Health and Nutrition Examination Survey (NHANES) 1999-2004." PloS one 9.4 (2014): e94479. [00:24:19] Insulin and c-peptide. [00:25:07] GGT Studies: Long, Y., et al. "Gamma-glutamyltransferase predicts increased risk of mortality: A systematic review and meta-analysis of prospective observational studies." Free radical research 48.6 (2014): 716-728. and Koenig, Gerald, and Stephanie Seneff. "Gamma-glutamyltransferase: a predictive biomarker of cellular antioxidant inadequacy and disease risk." Disease markers 2015 (2015). [00:25:52] Podcast: How to Measure Hormones, with Mark Newman, 8-OHdG. [00:27:57] GlycoMark, adiponectin. [00:28:39] HDL cholesterol 2.65mmol/L (in US, 102 mg/dL). [00:29:35] Study: Rosenson, Robert S., et al. "Dysfunctional HDL and atherosclerotic cardiovascular disease." Nature reviews cardiology 13.1 (2016): 48-60. [00:30:43] HDL - Above 75-80 could indicate dysfunction in the body (e.g., cancer, autoimmunity, liver dysfunction). [00:32:14] Study: Iannello, S., et al. "Low fasting serum triglyceride level as a precocious marker of autoimmune disorders." MedGenMed: Medscape general medicine 5.3 (2003): 20-20. [00:34:20] Undereating as a possible cause of low triglycerides. [00:35:17] Complete Blood Count (CBC) and haemoglobin. [00:36:19] Red blood cells (RBCs), white blood cells (WBCs) and platelets. [00:36:52] Mean corpuscular haemoglobin (MCH) and mean corpuscular haemoglobin concentration (MCHC). [00:37:40] CBC indicates ability to carry oxygen around the body. [00:38:18] B12, folate, iron, copper and zinc deficiencies. [00:38:55] Red cell distribution and mortality studies:  Patel, Kushang V., et al. "Red cell distribution width and mortality in older adults: a meta-analysis." Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences 65.3 (2009): 258-265. and Lippi, Giuseppe, et al. "Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients." Archives of pathology & laboratory medicine 133.4 (2009): 628-632. [00:41:37] Causes of low RBC count: Production, destruction and loss. [00:43:22] First, look at the MCV. [00:45:19] Normal RDW: low RBC probably due to destruction or loss. [00:45:38] Occult blood stool test to determine if there is a GI bleed (loss). [00:45:49] Reticulocytes: an underrated blood marker. [00:46:33] Erythropoietin (EPO). [00:49:30] HbA1C. [00:51:42] Estimation of RBC lifespan from the reticulocyte count: RBC survival (days) = 100/[Reticulocytes (percent) / RLS (days)], where RLS = 1.0, 1.5, 2.0 and 2.5 days at hematocrits of 45, 35, 25, and 15 percent, respectively. [00:53:17] Bryan and Tommy in a box. [00:54:16] Fatty Liver Index. Study: Bedogni, Giorgio, et al. "The Fatty Liver Index: a simple and accurate predictor of hepatic steatosis in the general population." BMC gastroenterology6.1 (2006): 33. [00:55:58] Website: Metabolic Fitness Pro. [00:57:46] Relying on protocols without knowing the physiology. [00:58:18] Website: Drwalsh.com. [00:58:32] Glucose course: Everything you ever wanted to know about glucose regulation. Detox course: Everything you wanted to know about detoxification.

Dr. Gari Clifford, DPhil has been studying artificial intelligence (AI) and its utility in healthcare for two decades. He holds several prestigious positions in academia and is an Associate Professor of Biomedical Informatics at Emory University and an Associate Professor of Biomedical Engineering at Georgia Institute of Technology. We met him at the San Francisco Data Institute Conference in October where he chaired sessions on Machine Learning and Health. Gari recently held a competition challenging data scientists to develop predictive algorithms for the early detection of Atrial Fibrillation, using mobile ECG machines. He shares insight into the complexity of using AI to diagnose health conditions and offers a glimpse into the future of healthcare and medical information. Here’s the outline of this interview with Gari Clifford: [00:01:07] The road to machine learning and mobile health. [00:01:27] Lionel Tarassenko: neural networks and artificial intelligence. [00:03:36] San Francisco Data Institute Conference. [00:03:54] Jeremy Howard at fast.ai. [00:04:17] Director of Data Institute David Uminsky. [00:05:05] Dr. Roger Mark, Computing in Cardiology PhysioNet Challenges. [00:05:23] 2017 Challenge: Detecting atrial fibrillation in electrocardiograms. [00:05:44] Atrial Fibrillation. [00:06:08] KardiaMobile EKG monitor by AliveCor. [00:06:33] Random forests, support vector machines, heuristics, deep learning. [00:07:23] Experts don't always agree. [00:08:33] Labeling ECGs: AF, normal sinus rhythm, another rhythm, or noisy. [00:09:07] 20-30 experts are required to discern a stable diagnosis. [00:09:40] Podcast: Arrhythmias in Endurance Athletes, with Peter Backx, PhD. [00:11:17] Applying additional algorithm on top of all final algorithms: improved score from 83% to 87% accuracy. [00:11:38] Kaggle for machine learning competitions. [00:13:44] Overfitting an algorithm increases complexity, decreases utility. [00:15:01] 10,000 ECGs are not enough. [00:16:24] Podcast: How to Teach Machines That Can Learn with Dr. Pedro Domingos. [00:16:50] XGBoost. [00:19:18] Mechanical Turk. [00:20:08] QRS onset and T-wave offset. [00:21:31] Galaxy Zoo. [00:24:00] Podcast: Jason Moore of Elite HRV. [00:24:34] Andrew Ng. Paper: Rajpurkar, Pranav, et al. "Cardiologist-level arrhythmia detection with convolutional neural networks." arXiv preprint arXiv:1707.01836 (2017). [00:28:44] Detecting arrhythmias using other biomarkers. [00:30:41] Algorithms trained on specific patient populations not accurate for other populations. [00:31:24] Propensity matching. [00:31:55] Should we be sharing our medical data? [00:32:15] Privacy concerns associated with sharing medical data. [00:32:44] Mass scale research: possible with high-quality data across a large population. [00:33:04] Selling social media data in exchange for useful or entertaining software. [00:33:42] Who touched my medical data and why? [00:36:31] Siloing data, perhaps to protect the current industries. [00:37:03] Health Insurance Portability and Privacy Act (HIPPA). [00:37:34] Fast Healthcare Interoperability Resources (FHIR) protocol. [00:37:48] Microsoft HealthVault and Google Health. [00:38:46] Blockchain and 3blue1brown. [00:39:28] Where to go to learn more about Gari Clifford. [00:39:53] Presentation: Machine learning for FDA-approved consumer level point of care diagnostics – the wisdom of algorithm crowds: (the PhysioNet Computing in Cardiology Challenge 2017).

UJ Ramdas is the Co-founder of Intelligent Change, Co-Creator of the Five Minute Journal - a simple and effective tool to help you get reliably happier. He cares deeply about the intersection of behaviour and business and loves reading, coffee and meditation. Perform better, have a better day, and sleep better. UJ is with us today to discuss how you can experience these benefits and more using tools he created with his company, Intelligent Change. UJ has a background in behavioural science and hypnosis, and since 2013 has been producing the Five Minute Journal, which condenses hundreds of articles, books, and research into a simple daily practice. The benefits can be dramatic, including improved productivity, better connection with others, and increased satisfaction with life. He also shares the details of his latest project, the Five Minute Journal for Kids. Here’s the outline of this interview with UJ Ramdas: [00:00:38] UJ's first experience mountain biking. [00:00:49] MastermindTalks. [00:01:34] Mike Brcic of Sacred Rides. [00:02:12] Santa Cruz factory. [00:05:08] Jeff Spencer. [00:06:50] Mailboxes. [00:07:33] Book: The Chimp Paradox by Dr Steve Peters. [00:08:31] Five Minute Journal. [00:10:36] Book: The Brave Athlete by Dr Simon Marshall and Lesley Paterson. [00:10:56] The Five Minute app. [00:12:29] Tim Ferriss and Ben Greenfield. [00:12:58] I'm grateful for... [00:14:32] It's not about the thinking, it's about the feeling. [00:15:58] Layous, Kristin, et al. "The proximal experience of gratitude." PloS one 12.7 (2017): e0179123. [00:17:19] Amazing things that happened that day. [00:20:55] Amazing things resistance. [00:22:46] Tackle obstacles. [00:24:39] The downside of optimism, see Bright-sided by Barbara Ehrenreich. [00:27:33] Freehand journaling. [00:29:11] Five Minute Journal for Kids. [00:33:08] @ujramdas on Instagram and Twitter. [00:34:48] intelligentchange.com [00:35:10] Productivity Planner.

Diana Rogers, RD, LDN, NTP, is a “real food” nutritionist, international speaker, and writer who lives on a working organic farm in Carlisle, Massachusetts. She is also a consultant to some of the most influential people in the ancestral health world and the host of the Sustainable Dish Podcast. We met her in September when she presented at the annual conference of the Icelandic Health Symposium hosted by Dr. Tommy Wood, MD, PhD. In this interview with Tommy, she discusses her current project, a film entitled Kale vs. Cow: The Case for Better Meat, in which she defends the nutritional and environmental benefits of eating meat from local and sustainable sources. In doing so, she challenges common assumptions about plant-based diets. As promised at the beginning of the audio, here’s the link to the AIMed and BASEM conferences. Here’s the outline of this interview with Diana Rogers: [00:00:22] Nom Nom Paleo, Dr. Kirk Parsley, MD. Podcast: How to Get Perfect Sleep with Dr. Kirk Parsley, MD. [00:00:44] Undiagnosed coeliac. [00:01:42] Book: The Paleo Solution: The Original Human Diet by Robb Wolf. [00:01:51] The Weston A. Price Foundation. [00:03:11] Vegetarian undertones of the RD qualification. [00:04:48] Background for the film. [00:05:22] Chef's Table documentary series on Netflix. [00:07:14] Nina Teicholz. [00:07:57] Echo chambers. [00:09:33] Presentation: Icelandic Health Symposium: Kale vs. Cow with Diana Rodgers. [00:11:46] Problems with modern monocropping. [00:13:18] Energy requirements for local food. [00:15:00] Geothermal energy in Iceland. [00:16:18] Avocados and tropical oils. [00:17:38] Savory Institute. [00:18:01] Book: The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy by Nina Teicholz. [00:21:02] Cow farts and burps. [00:21:40] TED Talk: Allan Savory: How to fight desertification and reverse climate change. [00:23:21] Intensive mob grazing then allowing the ground to rest. [00:25:29] Food security through diversification. [00:26:25] Are there too many people on the planet? [00:28:47] Book: Limits to Growth by Donella H. Meadows and Updated Book: Limits to Growth: The 30-Year Update by Donella H. Meadows and Jorgen Randers. Also see this editorial by Tommy’s Dad: Mineral Resources and the Limits to Growth by Bernard J. Wood. [00:30:32] Peak phosphorus. [00:32:20] Full accounting on lab meat. [00:35:00] To donate: sustainabledish.com/film. [00:35:47] Belcampo Meat Camps. [00:35:58] Thrive Market. [00:36:06] Campaign on Generosity: sustainabledish.com/film. [00:37:44] Robb Wolf, Mark Sisson, Chris Kresser, JP Sears. [00:38:09] Sustainable Dish on Instagram.

Sarah Wnenchak has been working with us for the past 18 months and she recently kindly agreed to be interviewed for my podcast. We think that Sarah’s neurological and hormonal problems originated from several rounds of antibiotics for tonsillitis, and as the pictured Doctor’s Data Comprehensive Stool Analysis before and after shows, she responded very well to a herbal weeding and probiotic seeding protocol. Perhaps the most crucial change Sarah made while working with us was the switch from oral birth control to The Fertility Awareness Method. Sarah is now a Bulletproof certified health coach and consults with clients on diet and lifestyle alongside her vinyasa style yoga teaching at Truly Yoga Studio where she is the founder. Here’s the outline of this interview with Sarah Wnenchak: [00:00:44] Bulletproof Training Institute. [00:01:14] Tonsillitis. [00:01:23] 5 rounds of antibiotics. [00:02:51] Hormones and oral birth control. [00:05:31] Neurological symptoms as side effects. [00:06:43] Depression and anxiety. [00:07:08] Higher order anxiety. [00:08:38] Inability to feel pleasure. [00:10:44] Newsletter: Nourish Balance Thrive Highlights series. Article referenced in Highlights #25: New Research: Birth Control Pill, Depression and Autoimmunity by Kelly Brogan MD. [00:12:22] Podcast: The Truth About Fertility and the Fertility Awareness Method with Julie Kelly and Toréa Rodriguez. [00:12:33] Book: Taking Charge of Your Fertility, 20th Anniversary Edition: The Definitive Guide to Natural Birth Control, Pregnancy Achievement, and Reproductive Health by Toni Weschler. [00:12:42] About basal body temperature, Daysy basal thermometer and the Daysy app. [00:16:35] Gluten sensitivity and sugar cravings. [00:17:56] Including more fats as ghee, butter and MCT. [00:18:26] Iron, magnesium and B vitamin deficiencies. [00:20:53] Vinyasa yoga. [00:22:14] You don't realise how bad you feel until you feel better. [00:22:57] Podcast: How to Create Behaviour Change with Simon Marshall. [00:24:20] Mindfulness meditation. Podcast: How to Think Yourself Younger, Healthier, and Faster with Dr. Ellen Langer, PhD. [00:25:10] Ritual. [00:25:35] Grounding and connecting with nature. [00:25:50] Dry skin brushing. [00:27:55] DUTCH and circadian rhythm. [00:28:45] f.lux and amber light bulbs. [00:30:04] Essential oils. [00:30:53] Doctor's Data Comprehensive Stool Analysis with Parasitology (CSAP). [00:31:36] Sarah’s before CSAP results and after CSAP results -- see above. [00:31:49] Study: Taha Rashid and Alan Ebringer, “Autoimmunity in Rheumatic Diseases Is Induced by Microbial Infections via Crossreactivity or Molecular Mimicry,” Autoimmune Diseases, vol. 2012, Article ID 539282, 9 pages, 2012. doi:10.1155/2012/539282. [00:32:07] Raintree C-F. [00:33:00] Finding a purpose. [00:35:02] Khan Academy, Metabolic Fitness Pro, Kalish Mentorship, Functional Diagnostic Nutrition (FDN). [00:35:31] Bulletproof certification, Bulletproof Conference info, and Bulletproof Conference 2017 live stream. [00:37:17] Dr Mark Atkinson. [00:38:15] Satya Health and Wellness. [00:38:37] Truly Yoga Studio.

After spending years directing urinary and salivary hormone testing, analytical chemist Mark Newman set out to combine the best of both worlds with the DUTCH (Dried Urine Test for Comprehensive Hormones). For the past couple of years, we’ve been happily using the DUTCH as a tool for improving health and performance in athletes as part of our Elite Performance Program. In this interview, Mark discusses the recent expansion and improvement of the DUTCH to include the cortisol awakening response (CAR), and several markers related to hormone and neurotransmitter metabolism. Here’s the outline of this interview with Mark Newman: [00:00:54] DUTCH (Dried Urine Test for Comprehensive Hormones). [00:02:49] Cortisol clearance. Video: Tutorial on cortisol. [00:03:32] 8-Hydroxy-2-deoxyguanosine (8-OH-dG). [00:05:02] Obesity. [00:05:21] Cushing’s syndrome. [00:05:44] Fat sequesters hormones. [00:08:58] Thyroid and cortisol clearance. [00:09:20] Studies: 1, 2, and 3. [00:11:51] Circadian rhythm. [00:12:39] Cortisol awakening response (CAR). [00:14:31] Studies: References 1, 2, 3, 4, and 5.                  [00:16:34] Why you can't see the CAR with urine. [00:18:08] Correlations between glucose, c-peptide, and cortisol. [00:19:50] The CAR is a proxy. [00:21:30] Clinical implications of the CAR. [00:25:28] 8-OH-dG on PubMed. [00:26:43] Joergensen, Anders, et al. “Association between urinary excretion of cortisol and markers of oxidatively damaged DNA and RNA in humans.” PLoS One 6.6 (2011): e20795. [00:27:00] Melatonin is an antioxidant. [00:27:14] 4-OH oestrogen metabolite. Video: Estrogen Tutorial. [00:28:26] Will there be a full OAT? [00:28:53] Neurotransmitters. [00:29:57] Kynurenine pathway. Article: Electrons, Neurotoxins, NAD+, and Mitochondria by Tommy Wood MD, PhD. [00:31:01] NAD and vitamin B6, xanthurenic acid. [00:32:01] MMA, folate. [00:32:52] Article: New Research: Birth Control Pill, Depression and Autoimmunity by Kelly Brogan MD. [00:33:37] Hydroxymethylglutarate (HMG) is the precursor to Coenzyme Q10 (CoQ10) production. [00:35:41] Evidence-based markers. [00:37:09] Doing experiments, DIM. [00:39:14] Adding markers, value vs noise. [00:40:58] Great Plains OAT (Organic Acids Test). [00:41:15] Podcast: The Cortisol Awakening Response with Mark Newman, MS. [00:41:39] Machine Learning. Podcasts: How to Teach Machines That Can Learn with Dr. Pedro Domingos, PhD and How “Machine Learning” Can Predict Your Blood, Urine, Stool, Saliva & More! With Dr. Tommy Wood. [00:42:16] Mass spec, immunoassay test. [00:45:17] Predicting the CAR. [00:45:56] Linear correlations. [00:50:06] Receptor activity, house analogy. [00:51:10] Elite Performance Program and the 7-Minute Analysis. [00:52:11] Getting the DUTCH done. [00:53:50] The Institute for Functional Medicine (IFM). [00:55:07] The process of elimination. [00:55:43] Precision Analytical at dutchtest.com.

This episode is a roundtable discussion with Tommy Wood, MD, PhD and New York Times best-selling author Robb Wolf on Robb’s new Keto Masterclass, a 45-day program to kickstart your keto lifestyle. The masterclass is an online training course that I completed ahead of recording this episode. Think of the class as a comprehensive instruction manual complete with troubleshooting guide for fat loss and improved metabolic health. If you’re brand new, the course is perfect for you. If you’ve been living the lifestyle for some time, it may still be helpful to read the manual to see if there’s anything you’ve missed. Here’s the outline of this interview with Robb Wolf and Dr Tommy Wood: [00:01:15] Ken Ford on STEM-Talk. [00:01:33] Books: The Paleo Solution: The Original Human Diet, Wired to Eat: Turn Off Cravings, Rewire Your Appetite for Weight Loss, and Determine the Foods That Work for You. [00:03:34] CrossFit. [00:05:28] Ryan Levesque, Ask Method. [00:07:30] Blog: Optimizing Cycling Stage Race Performance using Nutritional Ketosis by Sami Inkinen. [00:10:05] The course is for the Weight Watchers crowd. [00:12:50] Facebook Video: Paleo vs keto video with Robb and Nicki. [00:14:42] The NBT 7-minute analysis. [00:16:10] Facebook Group: Richard Nikoley's Ketotard Chronicles. [00:17:00] Mike Rowe and Dirty Jobs. [00:19:28] When are you fixed? [00:20:10] Book: Diabetes Epidemic & You by Joseph R. Kraft to learn about the Kraft test (5 hour GTT), Lipoprotein Insulin Resistance Index (LP-IR): A Lipoprotein Particle–Derived Measure of Insulin Resistance. [00:20:34] 7-day carb test. [00:20:59] Eating while the sun is up. [00:22:16] Full carnivore, ketotic.org guys. [00:22:59] The Keto Summit. [00:23:33] Ketogains. [00:23:48] Electrolytes. [00:24:47] Calories and food quality matter. [00:25:55] Thyroid and adrenal issues. [00:27:01] Undereating. [00:28:09] Doc Parsley’s Sleep Remedy. [00:28:27] Blog: Virta Health: Does Your Thyroid Need Dietary Carbohydrates? By Stephen Phinney, MD, PhD. [00:28:58] Managing symptoms. [00:30:11] Warren Buffett. [00:30:48] Stephen Phinney, MD, PhD. [00:31:46] Loren Cordain, PhD on sodium. [00:33:38] Jeff Volek, PhD, RD. [00:33:53] Book: The Salt Fix: Why the Experts Got It All Wrong--and How Eating More Might Save Your Life by James DiNicolantonio. [00:34:56] Sodium, potassium, magnesium, calcium (be careful). [00:36:22] Studies: DeFronzo, R. A. "The effect of insulin on renal sodium metabolism." Diabetologia 21.3 (1981): 165-171 and Brands, Michael W., and M. Marlina Manhiani. "Sodium-retaining effect of insulin in diabetes." American Journal of Physiology-Regulatory, Integrative and Comparative Physiology 303.11 (2012): R1101-R1109. [00:37:35] Presentation: Oxidative Stress & Carbohydrate Intolerance: An Ancestral Perspective by Chris Masterjohn, PhD. [00:39:05] Ted Naiman ways to enter ketosis infographic. [00:40:50] Pitocin, brand name medication for oxytocin.   [00:42:33] Marty Kendall’s Nutrient Optimiser. [00:44:41] Metabolic flexibility and undereating. [00:46:21] Podcasts: High Ketones and Carbs at the Same Time? Great Performance Tip or Horrible Idea with Mike T. Nelson and The Importance of Strength Training for Endurance Athlete with Mike T. Nelson. [00:46:42] Podcasts: National Cyclocross Champion Jeremy Powers on Racing, Training and the Ketogenic Diet and National Cyclocross Champion Katie Compton on Ketosis and MTHFR. [00:47:07] Keto-mojo meter. [00:48:17] What to measure. [00:49:57] Myostatin inhibition. [00:50:37] Study:  Roberts, Megan N., et al. "A Ketogenic Diet Extends Longevity and Healthspan in Adult Mice." Cell Metabolism 26.3 (2017): 539-546 and Podcast: A Ketogenic Diet Extends Longevity and Healthspan in Adult Mice with Megan Hall. [00:53:24] Metformin works so well because of multiple mechanisms. [00:54:03] Acetone. [00:54:35] Cori cycle. [00:55:49] Book: The New Evolution Diet: What Our Paleolithic Ancestors Can Teach Us about Weight Loss, Fitness, and Aging by Arthur De Vany. [00:56:41] Tracking body mass. [00:57:37] Performance benchmarks. [00:59:03] Simon Marshall and Podcast: How to Create Behaviour Change with Simon Marshall. [00:59:31] Paul Itoi, senza.us. [01:00:25] Loss aversion. [01:01:27] Podcast: Breaking Through Plateaus and Sustainable Fat-Loss with Jason Seib. [01:02:04] Studies: Bistrian, Bruce R., et al. "Nitrogen metabolism and insulin requirements in obese diabetic adults on a protein-sparing modified fast." Diabetes 25.6 (1976): 494-504 and Furber, Matthew, et al. "A 7-day high protein hypocaloric diet promotes cellular metabolic adaptations and attenuates lean mass loss in healthy males." Clinical Nutrition Experimental(2017). [01:06:30] Very similar weight loss regardless of the diet. [01:07:11] Presentation: Low Carb Breckenridge 2017: The way to a man's heart is through the stomach with Dr. Tommy Wood. [01:09:44] Keto Masterclass details. [01:10:19] Epigenetics. [01:12:13] Podcast: Why You Should Skip Oxaloacetate Supplementation, Fueling for Your Activity and More! with Dr. Tommy Wood. [01:13:21] Price $49! [01:15:28] Get Keto Masterclass. [01:16:30] Ivor Cummins.

Dr Jeffry N. Gerber, MD, FAAFP is a board-certified family physician and owner of South Suburban Family Medicine in Littleton, Colorado, where he is known as “Denver’s Diet Doctor”. He has been providing personalized healthcare to the local community since 1993 and continues that tradition with an emphasis on longevity, wellness and prevention. In this interview, Dr Gerber describes the major root causes of cardiovascular disease, the most important of which is insulin-resistant Type 2 Diabetes. Worried about your heart disease risk? Get a coronary artery calcium (CAC) score. Your CAC score (and the rate of progression of your CAC score) is probably the best easily-available predictor of cardiac events. A recent paper from the CARDIA study also showed that an elevated CAC score was highly predictive of long-term heart disease risk in younger adults (18-30 year-olds). Here’s the outline of this interview with Dr. Jeffry N. Gerber, MD: [00:01:27] Clinical experience. [00:02:27] Interest in low-carb diets. [00:03:21] Presentation: Ivor Cummins: “Roads to Ruin?” The Pathways and Implications of Insulin Resistance. [00:03:38] Book: Diabetes Epidemic & You by Joseph R. Kraft. [00:04:23] Professor Grant Schofield and Catherine Crofts, PhD. Podcast: Hyperinsulinaemia and Cognitive Decline with Catherine Crofts, PhD. [00:05:08] Hyperinsulinemia and CVD. [00:06:39] The 2 hour insulin test < 30 UI/mL. [00:07:20] Fiorentino, Teresa Vanessa, et al. "One-hour postload hyperglycemia is a stronger predictor of type 2 diabetes than impaired fasting glucose." The Journal of Clinical Endocrinology & Metabolism 100.10 (2015): 3744-3751. [00:07:51] < 5 UI/mL fasting insulin. [00:10:40] What causes CVD? [00:11:49] Carl von Rokitansky. [00:12:02] Rudolf Virchow. [00:12:19] Blog: Dr. Malcolm Kendrick. [00:13:49] Russell Ross. [00:15:40] List of things that cause CVD. [00:16:44] Nitric Oxide. [00:17:43] Jerry Reaven. [00:19:19] Vega, Gloria Lena, et al. "Triglyceride–to–high-density-lipoprotein-cholesterol ratio is an index of heart disease mortality and of incidence of type 2 diabetes mellitus in men." Journal of Investigative Medicine 62.2 (2014): 345-349. [00:20:17] The Framingham study. [00:21:53] LDL-P and advanced testing. [00:22:32] CAC score. [00:23:41] Intimal media thickness. [00:26:11] Ordering a scan. [00:26:41] 64-slice EBCT machine. [00:27:08] Valenti, Valentina, et al. "A 15-year warranty period for asymptomatic individuals without coronary artery calcium: a prospective follow-up of 9,715 individuals." JACC: Cardiovascular Imaging 8.8 (2015): 900-909. [00:28:15] Soft plaque. [00:28:57] CT angiogram. [00:29:44] Don't let perfect be the enemy of very good. [00:30:34] How to get a zero score. [00:31:28] Industrial seed oils. [00:32:02] D3/K2, magnesium, vitamin C. [00:33:29] Statins. [00:33:47] Absolute risk reduction data. [00:34:13] Ridker, Paul M., et al. "Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein." New England Journal of Medicine 359.21 (2008): 2195. [00:34:40] NICE guidelines for prevention of cardiovascular disease. [00:36:45] Studies: Puri, Rishi, et al. "Impact of statins on serial coronary calcification during atheroma progression and regression." Journal of the American College of Cardiology 65.13 (2015): 1273-1282, Sattar, Naveed, et al. "Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials." The Lancet 375.9716 (2010): 735-742, and Preiss, David, et al. "Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta-analysis." Jama 305.24 (2011): 2556-2564. [00:37:22] Interview: Calcification and CAC with the Expert: Professor Matthew J. Budoff, MD, FAAC, Part 1 and Professor Matthew J. Budoff Part 2: Primary Care Physicians and CAC. [00:37:41] Book: Eat Rich, Live Long: Mastering the Low-Carb & Keto Spectrum for Weight Loss and Longevity by Ivor Cummins and Dr. Jeffry Gerber – February 6, 2018. [00:38:50] Four body types: Skinny, insulin-resistant type, the overweight, typical T2 diabetic type, the overweight, insulin-sensitive type, and the metabolically healthy type. [00:40:50] Conference: Low-Carb Breckenridge 2018. [00:41:28] Dr Rod Tayler. [00:42:25] Dr Andrew Mentee and the PURE study. [00:42:46] List of speakers at Low-Carb Breckenridge 2018. [00:43:06] IHMC STEM-Talk Episode 41: Dr David Diamond talks about the role of fat, cholesterol, and statin drugs in heart disease.         [00:44:15] Dr Jeffry N. Gerber, MD, FAAFP. [00:45:27] Rebuttal: 9NEWS – Explaining the science behind the keto diet with Dr Jeffrey Gerber.

This episode brought to you by Rock Lobster Cycles, beautiful bicycles handbuilt in Santa Cruz, California. In our last interview, scientist and world champion rower Dr Brianna Stubbs had recently successfully defended her PhD in Biochemical Physiology and reached a juncture in her career. Ten months later, Brianna has retired from professional rowing but continues her passion for biochemistry with San Francisco based nootropics company HMVN where she is working to commercialise the D-BHB ketone monoester developed at Oxford University alongside Prof. Kieran Clarke. The big news is the wait is over! After over a decade of research, the ester is finally here. This interview is two rolled into one. In the first part, we talk about Brianna’s transition out of academia and professional sport and into the world of Silicon Valley startups. In the second part, Brianna talks about the benefits of the ketone ester and takes on some of Dr Tommy Wood’s challenging questions given to me by ahead of the interview but unseen by Brianna. If you’re only interested in hearing about the ketone monoester, skip to the 24-minute mark. Here’s the outline of this interview with Brianna Stubbs, PhD: [00:01:23] Retirement from rowing. [00:02:56] Podcast: Off Road Triathlon World Champion Lesley Paterson on FMT and Solving Mental Conundrums. [00:03:19] App: Strava. [00:04:17] The move to San Francisco. [00:05:00] Professor Kieran Clarke, PhD, CEO of TdeltaS. [00:05:24] HVMN. [00:08:27] World Rowing Championships. [00:09:40] Rodent and then human experiments. [00:10:37] Finding purpose and resolving ambivalence. [00:12:09] Journaling. [00:12:55] Mentoring. [00:14:42] Podcast: How to Create Behaviour Change with Simon Marshall. [00:15:08] YouTube: HVMN Enhancement Podcast: Ep. 46: Correcting Nutritional Deficiencies ft. Christopher Kelly. [00:15:38] Tony Hsieh of Zappos.com. [00:16:38] Body composition. [00:17:39] BHRT (Bioidentical Hormone Replacement Therapy). Podcast: The Critical Role of Oestradiol for Women’s Cognition with Dr. Ann Hathaway, MD. [00:17:57] DXA scan. [00:18:09] Intermittent fasting. [00:19:22] We Fast Facebook Community. [00:20:42] Put on 20lb, mostly muscle. [00:24:51] Podcast: World Champion Rower and Ketone Monoester Researcher Brianna Stubbs. [00:25:19] Dr. Richard Veech, Hans Krebs. [00:26:52] Ketone metabolism. [00:28:04] Study: Cox, Pete J., et al. "Nutritional ketosis alters fuel preference and thereby endurance performance in athletes." Cell metabolism 24.2 (2016): 256-268. [00:28:47] Case Report: Newport, Mary T., et al. "A new way to produce hyperketonemia: use of ketone ester in a case of Alzheimer's disease." Alzheimer's & Dementia 11.1 (2015): 99-103. [00:29:20] FDA GRAS (generally recognized as safe). [00:29:32] WADA. [00:30:38] Who is the ester for? [00:31:54] Article and Studies: Reference 1, 2 and 3. [00:33:30] Glycogen sparing or impairing? [00:35:57] WINGATE test. [00:36:08] If you've got ketones, you don't break down as much protein? BCAA. [00:36:32] Study: Vandoorne, Tijs, et al. "Intake of a Ketone Ester Drink during Recovery from Exercise Promotes mTORC1 Signaling but Not Glycogen Resynthesis in Human Muscle." Frontiers in physiology 8 (2017). [00:37:27] Pro cycling. [00:39:00] Study: Youm, Yun-Hee, et al. "The ketone metabolite [beta]-hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease." Nature medicine 21.3 (2015): 263-269. [00:40:05] Why is glucose required for an increase in exercise performance? [00:41:12] Anaplaerosis. See Tommy’s letter published recently in the journal Strength and Conditioning. [00:42:19] Should we stop using the salts? [00:42:41] Appetite suppressing effects of ketones. [00:43:02] D and L isomers. [00:44:11] Dominic D'Agostino, PhD. [00:45:14] Are diet and lifestyle still the most important factors? [00:46:36] Caffeine, nitrates, beta-alanine. [00:47:31] Ketone ester 30 min rowing performance. [00:49:21] Podcast: SNR #195: Brendan Egan, PhD – Exogenous Ketone Supplementation. [00:52:25] Study: Volek, Jeff S., et al. "Metabolic characteristics of keto-adapted ultra-endurance runners." Metabolism 65.3 (2016): 100-110. [00:52:41] Intramuscular triglycerides. [00:53:07] Ketones as signaling molecule. [00:53:46] YouTube: HDAC inhibitors and Podcast: A Ketogenic Diet Extends Longevity and Healthspan in Adult Mice with Megan Hall. [00:54:27] Nicotinic acid receptor. [00:55:11] Book: Behave: The Biology of Humans at Our Best and Worst by Robert M. Sapolsky. [00:56:16] General anesthesia. [00:57:11] Two papers, Kieran hyperglycemia and Veech (ask Tommy) [00:59:02] Exogenous ketones lower blood glucose. [00:59:46] Biden pancreatic islet study [01:00:26] Insulin is anti-proteolytic. [01:00:37] George Cahill paper [01:03:03] Who's it for? [01:03:12] Price. [01:04:06] Intestinal Alk Phos. See Why You Should Skip Oxaloacetate Supplementation, Fueling for Your Activity and More with Dr. Tommy Wood. [01:06:12] Product page at HVMN.

Our Scientific Director Megan Hall (née Roberts) recently had some of the work from her Master’s degree published in the journal Cell Metabolism, which is seriously impressive. The paper appeared on Science Daily, and generally caused a bit of a stir in the low carb community. As we have direct access to the horse’s mouth, I’ve asked Megan to join me in this episode of the podcast to summarise the findings and give some thoughts on how it might relate to human health. Here’s the outline of this interview with Megan Hall: [00:00:55] Mastermind Talks. [00:01:47] The lead up to the study. [00:02:17] Time-restricted feeding. [00:02:38] Are they eating longer because of a less crappy diet? [00:04:21] Calorie restriction was the focus of Megan's lab. [00:05:27] Stephen Phinney, MD, PhD and Jon Ramsey, PhD. [00:06:13] Study design. [00:07:36] High-fat diets in rodents. [00:08:39] Two arms: longevity and healthspan. [00:10:55] Grip strength in a rodent. [00:11:40] Novel object test. [00:12:55] fMRI for body composition using the EchoMRI. [00:13:13] The results. Study: Roberts, Megan N., et al. "A Ketogenic Diet Extends Longevity and Healthspan in Adult Mice." Cell Metabolism 26.3 (2017): 539-546. [00:15:40] Valter Longo, PhD and USC Longevity Institute. Studies: Brandhorst, Sebastian, et al. "A periodic diet that mimics fasting promotes multi-system regeneration, enhanced cognitive performance, and healthspan." Cell metabolism 22.1 (2015): 86-99 and Wei, Min, et al. "Fasting-mimicking diet and markers/risk factors for aging, diabetes, cancer, and cardiovascular disease." Science translational medicine 9.377 (2017): eaai8700. [00:16:27] Study: Sleiman, Sama F., et al. "Exercise promotes the expression of brain derived neurotrophic factor (BDNF) through the action of the ketone body β-hydroxybutyrate." Elife 5 (2016): e15092. [00:17:34] Motor function and coordination. [00:18:58] The importance of preserving type IIA muscle fibers. Podcast: The Most Reliable Way to Lose Weight with Dr Tommy Wood and The High-Performance Athlete with Drs Tommy Wood and Andy Galpin. [00:19:18] Study: Zou, Xiaoting, et al. "Acetoacetate accelerates muscle regeneration and ameliorates muscular dystrophy in mice." Journal of Biological Chemistry291.5 (2016): 2181-2195. [00:20:04] Exercise performance. [00:21:13] Physiologic insulin resistance. [00:22:06] Podcast: Real Food for Gestational Diabetes with Lily Nichols. [00:24:21] Keto vs low-carb. [00:27:05] Studies: β-Hydroxybutyrate: A Signaling Metabolite and Ketone bodies as signalling metabolites. [00:27:49] YouTube: Histone deacetylation and inhibition. [00:29:19] I mentioned the Khan Academy, but in the end Megan liked these videos on HDAC inhibitors and cancer and Histone deacetylation and inhibition (also mentions p53!). [00:30:49] FOXO proteins. [00:31:30] Lysine residues. [00:31:48] Mn SOD. [00:32:10] mTOR, Dr. Ron Rosedale. [00:34:04] REDD1 protein. [00:34:32] P53 protein, metformin. [00:35:30] Less cancer in KD mice. [00:36:00] Warburg Effect. [00:36:21] Replicability. [00:36:57] Study: Newman, John C., et al. "Ketogenic Diet Reduces Midlife Mortality and Improves Memory in Aging Mice." Cell Metabolism 26.3 (2017): 547-557. [00:38:28] Press coverage of the study, “Eat Fat, Live Longer” at Sciencedaily.com. [00:41:01] Soybean oil in rodent diets. [00:41:34] Sex-dependent differences. [00:43:23] Takeaways. [00:44:21] Dogma displacement inertia. [00:45:19] Exogenous ketones. Study: Stubbs, Brianna Jane, et al. "On the metabolism of exogenous ketones in humans." Frontiers in Physiology 8 (2017): 848. [00:46:34] What does this mean for humans? [00:47:42] Weightloss. [00:48:36] Micromanaging the details. [00:50:33] Who are you and what are your goals -- Robb Wolf. Podcast: Wired to Eat with Robb Wolf. [00:51:55] Nourish Balance Thrive Highlights Series sign up. [00:53:11] Megan's purpose. [00:53:39] Book: Find Your Why: A Practical Guide for Discovering Purpose for You and Your Team by Simon Sinek and David Mead.