Nourish Balance Thrive

Dr. Ben Bikman is an Associate Professor of Physiology & Developmental Biology at Brigham Young University. He has a PhD in Bioenergetics and did his postdoctoral work in Cardiovascular and Metabolic Diseases such as obesity. In this interview with Dr. Tommy Wood, MD, PhD, Ben talks about his recent tenureship and research on the metabolic effects of insulin and ketones on fat cells. Also discussed are two schools of thought in obesity research and how both groups may be right about various aspects of weight loss. As you might be able to tell, I struggled a bit to find a picture of Tommy in the lab to match Ben's. Props to Tommy for allowing me to use the pic on the left (taken in jest), I thought it too funny to go to waste. Here’s the outline of this interview with Ben Bikman: [00:01:59] Dr Ben Bikman recently made tenure. [00:02:46] The tenureship process. [00:04:14] Presentation: Insulin vs. Ketones - The Battle for Brown Fat by Dr Ben Binkman. [00:05:16] Podcast: Recap: Icelandic Health Symposium 2017 and Satchidananda Panda. [00:06:20] The Pubmed warrior; Ivor Cumins aka the The Fat Emperor. [00:07:16] Publishing a book. [00:07:44] Dr Jeff Gerber and Dr Rod Tayler organizers of Low Carb Breckenridge. [00:09:40] Removing the invisible barrier between the scientists and the public. [00:12:36] American Heart Association. [00:13:01] Study: Hall, Kevin D., et al. "Energy expenditure and body composition changes after an isocaloric ketogenic diet in overweight and obese men." The American journal of clinical nutrition 104.2 (2016): 324-333. [00:14:33] Calorie type is more important. [00:14:58] Study: Walsh, C. O., Ebbeling, C. B., Swain, J. F., Markowitz, R. L., Feldman, H. A., & Ludwig, D. S. (2013). Effects of diet composition on postprandial energy availability during weight loss maintenance. PloS one, 8(3), e58172. [00:15:58] The Biggest Loser. [00:16:58] The importance of protein. [00:18:22] Protein increases glucagon. [00:20:16] Just eat real food. [00:20:48] Ben's research on adipocytes, studies not completed yet. [00:22:20] White vs brown fat. [00:22:50] Uncoupling to create heat. [00:24:18] Fat mass also changed. [00:24:49] Study: Roberts, Megan N., et al. "A Ketogenic Diet Extends Longevity and Healthspan in Adult Mice." Cell Metabolism 26.3 (2017): 539-546. [00:25:35] Study: Lim, Gareth E., et al. "14-3-3 [zeta] coordinates adipogenesis of visceral fat." Nature communications 6 (2015). [00:27:15] Wasting away in T1D. [00:27:35] Elliot Joslin of the Joslin Diabetes Center and Francis Benedict. [00:28:55] Ketones can be insulinogenic. [00:29:33] Study: Biden, Trevor J., and Keith W. Taylor. "Effects of ketone bodies on insulin release and islet-cell metabolism in the rat." Biochemical Journal 212.2 (1983): 371-377. [00:30:12] Exogenous ketones and weight loss. [00:30:59] Study: Holdsworth, David A., et al. "A ketone ester drink increases postexercise muscle glycogen synthesis in humans." Medicine and science in sports and exercise 49.9 (2017): 1789. [00:33:16] Human clinical studies. [00:37:26] Ben is not an advocate of chronic ketosis. [00:39:17] Breakfast and lunch are easy to change. [00:40:49] Study: (PURE) Dehghan, Mahshid, et al. "Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study." The Lancet(2017). [00:43:43] Dr Ben Bikman on social media: Instagram, Facebook, Twitter.

Andy is a tenured Professor in the Center for Sport Performance at California State University Fullerton, and Director of the Biochemistry and Molecular Exercise Physiology Laboratory. Having previously been a competitive football player, weightlifter, and martial artist, Andy now uses what he learns in his research to help amateur and elite or Olympic athletes in multiple sports, from UFC to the NFL. Andy recently co-authored a book with Brian MacKenzie and Phil White called Unplugged. As the name suggests, a major theme in the book is avoiding the pitfalls of modern technology. One theme of the book is the use of hormetic stressors - pushing your physiology with cold or fasting, for instance, to improve health and performance. In this interview, Andy talks about how he is using that in terms of recommendations for the general public, and in his elite athletes. Our favourite Andy Galpin quote from this episode: When you're optimising, you're not adapting Here’s the outline of this interview with Andy Galpin: [00:02:51] Molecular-level studies vs human clinic trials. [00:04:26] Leg strength. [00:05:42] Study: Bathgate, Katie & Bagley, James & Jo, Edward & NL, Segal & Brown, Lee & Coburn, Jared & CN, Gullick & Ruas, Cassio & Galpin, Andrew. (2016). Physiological Profile of Monozygous Twins with 35 Years of Differing Exercise Habits. The Journal of Strength and Conditioning Research. 30. S43-S44. [00:07:38] Endurance 90% slow-twitch, untrained 50% fast-twitch. [00:09:48] Podcast: The Joe Rogan Experience #996 with Dr. Andy Galpin. [00:10:33] Intra-muscular triglycerides (IMTGs). [00:11:41] Marbling. [00:14:35] Specificity of training. [00:18:32] Polarised training. Study: Hydren, Jay R., and Bruce S. Cohen. "Current scientific evidence for a polarized cardiovascular endurance training model." The Journal of Strength & Conditioning Research 29.12 (2015): 3523-3530. [00:19:30] Brian McKenzie, CrossFit Endurance -website coming soon. [00:23:26] Body conditioning for long events. [00:24:24] Book: Unplugged: Evolve from Technology to Upgrade Your Fitness, Performance, & Consciousness by Brian MacKenzie, Dr. Andy Galpin and Phil White. [00:25:29] The misuse of technology in training. [00:28:05] Technology makes no adjustment for context. [00:31:07] Tim Ferriss. [00:31:46] Collect the minimum amount of data possible. [00:32:28] Use the least amount of technology possible. [00:32:51] Tracking subjective measures. [00:33:26] Study: Saw AE, Main LC, Gastin PB. Monitoring the athlete training response: subjective self-reported measures trump commonly used objective measures: a systematic review. British Journal of Sports Medicine. 2016;50(5):281-291. doi:10.1136/bjsports-2015-094758. [00:33:43] Shawn M. Arent, PhD. [00:39:05] Hormetic stress. Podcast: Getting Stronger with Todd Becker. [00:40:49] Mike Bledsoe at Barbell Shrugged, coffee. [00:43:41] When you're optimising, you're not adapting. [00:44:28] Coach Cal Dietz, Minnesota Golden Gophers. [00:44:45] Michael Phelps swim coach, Bob Bowman. [00:45:24] Benjamin Levine, MD. [00:47:29] Low-carb diets for performance. [00:49:19] The whole point is to overreach. [00:50:56] Podcast: Wired to Eat with Robb Wolf where he discusses the 7-day carb test. [00:51:40] Book: Wired to Eat: Turn Off Cravings, Rewire Your Appetite for Weight Loss, and Determine the Foods That Work for You by Robb Wolf. [00:54:05] Nothing is forever. [00:54:36] Book: Unplugged: Evolve from Technology to Upgrade Your Fitness, Performance, & Consciousness by Brian MacKenzie, Dr. Andy Galpin and Phil White. [00:54:50] Andy Galpin on Twitter, Instagram, Facebook, and YouTube. [00:55:06] Podcast: The Body of Knowledge hosted by Andy Galpin, PhD and Kenny Kane. [00:55:32] andygalpin.com and Dr. Andy Galpin on Patreon.

In this special episode, NBT client Ryan Baxter takes over the mic to ask Dr Tommy Wood, MD, PhD, some excellent questions around fuelling for Obstacle Course Racing (OCR). Whilst Tommy’s answers are somewhat specific to OCR, all athlete may find some helpful tips here. Below are the questions that Ryan asked, and a summary of Tommy’s response. Q: Diet can be like politics or religion, how do you effectively communicate your ideas about how athletes should fuel? Be honest about the fact that there is more than one way to skin the cat Start with real food - eliminations and diet subtypes are secondary It’s OK to supplement if needed Q: What is the most common problem you see when it comes to nutrition and athletes? Undereating and underfuelling Worrying too much about the minutiae Thinking they can eat whatever they like because they exercise Focusing too much on supplements without wanting to get the basics right You need to figure out if you’re somebody that should worry *more* or less about their nutrition Most of the people I work with often need to worry less Over-restriction Most “average” people need to worry more Q: As far as day to day nutrition what do you think that should look like? Any specific macro recommendations? This assumes no goal for changes in body composition Eat 120-160g of protein per day, in 3-4 meals For OCR athletes, I’d eat at least 1g/lb carbohydrate per day Depends on intensity and can be cycled by day The rest should come from fat, from whole food sources Q: Chris Masterjohn just posted two videos [1, 2] on fueling athletic performance with carbs vs fats.  My overall interpretation of his analysis was that he feels that if you are doing intense exercise you need to be fueling with carbs.  What are your thoughts on the carbs vs fats debate. Masterjohn has nicely presented the evidence to answer a question that should be obvious but sadly has generated a lot of debate. Simplistically, you need to right fuel for the given exercise or intensity, and if you want to be regularly performing at glycolytic activities, you should be eating carbohydrates. You can still do glycolytic work when restricting carbohydrates, and it may help to mitigate the downregulation of glycolytic pathways, but your absolute performance will probably drop. If you’re restricting carbohydrates, *why* are you doing it? Metabolic health? If so, focus on that rather than performance. “Fat adaptation”? Can be achieved whilst also eating carbohydrates! Fat oxidation rates increase with VO2Max. Q: Our team is very diverse both in age range and fitness.  We have people who are in their teens and up and we have people who are beginners to those who race in the elite class.  Do you have recommendations about how to someone might go about finding the right nutrition for themselves? An appropriate (and good) multivitamin is usually a good idea Start with the rough recommendations above Older people (40-50+) may need more protein If still hungry, eat more! If poor recovery, or weight loss despite not feeling hungry Eat more carbohydrates Increase calorie density of foods If regular GI symptoms (diarrhoea, bloating etc), consider a period of elimination of the main potential culprits: Grains, dairy, soy, eggs FODMAPs If this is beneficial for you - do more digging! Q: We have some vegetarians on the team, would you suggest anything specific for them? Don’t fall into the typical vegetarian traps Not eating vegetables Not eating fish (if not vegan) Eating “faux” meat Making bread and cheese dietary staples Don’t usually have as much of a problem eating enough carbohydrate Make sure you get enough protein (may need to increase intake to compensate for lower essential amino acid intake) Controversial May only be necessary if trying to maximise muscle mass Q: Do you have any supplements that you would recommend every athlete take or is supplementation an individual recommendation? Creatine Vitamin D (if levels are low) Citrulline and beta-alanine for repeated HIIT/Sprint/higher-rep weight training performance Caffeine and nitrates (beetroot shots?) restricted the rest of the time and then used as an ergogenic aid Q: Everyone always focuses on macronutrients when it comes it nutrition, but what about micronutrients?  Should we focus on them as well?  Can you talk about how they might affect your athletic performance? Micronutrients are essential for all the basic synthetic and enzymatic functions in the body. B6 for red blood cell production Multiple B vitamins for various parts of energy production Copper for proteins involved in iron absorption Copper, zinc, and selenium for enzymes involved in handling oxidative stress Zinc inhibits copper uptake Many athletes both zinc *and* copper deficient Selenium and iodine for thyroid function Chris Masterjohn series Q: I think every athlete knows about the importance of staying hydrated, but do you have any recommendations when it comes to hydrating during training or racing?  Should we be drinking a specific amount on a set schedule or should we just be mindful of how thirsty we are? All the best evidence says you should just drink to thirst. Tim Noakes “waterlogged” - documents the adverse effects of hyponatraemia in marathon runners and US Army when trying to stay “hyper hydrated”. Where it has been studied, the people that perform the fastest at longer distances (IRONMAN triathlon or ultramarathons) tend to lose the most amount of bodyweight (i.e. are the most dehydrated). Maybe genetic or involve other factors, but suggests dehydration is not the limiting component. Q: OCR is a unique sport that combines lots of different aspects of physical fitness, so you think there are special fueling requirements for OCR athletes? OCR typifies the need for metabolic flexibility - the ability to utilise all substrates at the right time, and switch between them. Overtly restricting one macronutrient is unlikely to be beneficial Cycle training intensities/modalities and fuel appropriately to get the best of all pathways. Q: We have a coach who likes to push us pretty hard over the course of a 2hr class.  As an example, his warmup was a burpee ladder which essentially amounted us doing 15 minutes of burpees. And that is the warmup, how should we fuel for training sessions like this like this? Should we fuel beforehand/after/both? I don’t think most people need intra-workout nutrition for this kind of session. Unless struggling to maintain weight or want to gain muscle mass Consider small amount of carbs and amino acids (as during a race) Get a real food meal in as soon as feasible and comfortable Can use a shake if you need more calories or protein or will be a long time before you can eat. Not essential Liquid calories not recommended unless failing to get enough from food. Q: OCR races can vary greatly in distance, there are some that are 5k in distance all the way up to ultra-endurance races that last 24 hours. Of course, we are doing a lot more than just run during these races. When should we start concerning ourselves with intra-race nutrition? What would you suggest? Probably don’t need intra-race nutrition unless going over 2-3 hours Greater dependence on fat-burning/aerobic pathways at that distance Combination of slow-digesting carbohydrate and some amino acids UCAN, PHAT FIBRE, oats, sweet potato powder MAP, BCAAs, protein powders Fats for longer efforts if tolerated Can be real-food based Nuts (macadamias are popular) and seeds (i.e. chia) Pemmican NAC or glutathione for much longer efforts (i.e. 24h races) Q: After a tough training session or race, we all want to recover as fast as possible to get back to training or racing.  Rest is important as is mobility etc, but is there anything from a nutrition perspective we can do to recover faster? Depends on how soon you want to/need to recover Antioxidants Cold baths Don’t eat crap food and minimise the post-race beers Eat enough protein If you tend to be nauseated or get GI symptoms after races, consider not eating for 2-4 hours afterwards to give the gut a break.     If “fat adapted”, your body should be better able to handle this Q Are there signs or symptoms that we might not be fueling properly? What do you see in practice when athletes are not fueling correctly? Poor sleep Fatigue Slow recovery and soreness Low libido Here’s the outline of this interview with Ryan Baxter: [00:01:51] Get this kid some carbs! [00:02:13] The Loft private Facebook group. [00:06:10] FDN: Functional Diagnostic Nutrition training. [00:07:49] Behaviour change. Podcast: How to Create Behaviour Change with Simon Marshall, PhD. [00:10:19] Testing currently utilized by Nourish Balance Thrive. [00:11:37] Insulin. Podcast: Poor Misunderstood Insulin with Dr. Tommy Wood. [00:13:03] Mindfullness. Podcast: How to Think Yourself Younger, Healthier, and Faster with Dr. Ellen Langer, PhD. [00:14:29] Nutrition recommendations for OCR. [00:15:58] 120 - 160 g PRO, 1g CHO per lb of bodyweight? FAT? [00:19:28] Net vs total CHO, fibre. [00:20:30] YouTube: Carbs and Sports Performance: The Principles and Carbs and Sports Performance: The Evidence with Chris Masterjohn, PhD. [00:25:31] Podcast: Metabolic Flexibility with Chris Kelly. [00:33:47] Pre/during/post training nutrition. [00:35:25] Dr Tommy Wood's Nutrient-Delivery Smoothie. [00:35:42] Wild Planet sardines. [00:37:56] Nutrition for Spartan Beast and Ultra Beast events (~6 hours). [00:39:47] UCAN and Phat Fibre. [00:39:57] Catabolic Blocker. [00:41:04] Pemmican. [00:41:18] 100-200 kCal per hour. [00:41:38] NAC. [00:42:49] Podcast: Professor Tim Noakes: True Hydration and the Power of Low-Carb, High-Fat Diets. [00:44:01] Justin's nut butters. [00:44:28] Pro Bar Mixed Berry. [00:45:00] Primal Kitchen’s bars and Ben Greenfield’s Nature Bite bars. [00:45:48] Supplements. [00:46:13] Creatine. [00:46:29] Vitamin D (test 25-OH-D). [00:46:59] Citrulline and Beta-Alanine: Why and How You Should Supplement with Creatine and Beta-Alanine. [00:47:12] Caffeine. [00:47:26] Nitrates, e.g. beet shots. [00:49:10] Nourish Balance Thrive Highlights email series.

This interview with Dr Tommy Wood, MD, PhD was recorded in person, September 2017 the day after the Icelandic Health Symposium conference on longevity. The conference speakers were Rangan Chatterjee, Lilja Kjalarsdóttir, Satchidananda Panda, Ben Greenfield, Bryan Walsh, Doug McGuff, and Diana Rogers. You could listen to this podcast for a recap and commentary on the conference and the practitioner workshop that took place the day after the presentations. Here’s the outline of this interview with Tommy Wood: [00:00:44] Gudmundur Johannsson at IHS. [00:01:03] Icelandic Health Symposium 2016. Podcast. [00:01:33] Ben Greenfield Fitness. [00:01:43] Podcasts: How to Run Efficiently with Drs Cucuzzella & Wood, How to Fix Autoimmunity in the over 50s with Dr Deborah Gordon and Social Isolation: The Most Important Topic Nobody is Talking About with Dr Bryan Walsh. [00:04:04] Dr Doug McGuff. [00:04:21] YouTube Channel: Jeff Kendall-Weed. [00:04:47] Dr Rangan Chatterjee. [00:05:21] The Bredesen Protocol. Podcast: Why You Should Skip Oxaloacetate Supplementation, Fueling for Your Activity and More! [00:06:33] Book: The Four Pillar Plan: How to Relax, Eat, Move and Sleep Your Way to a Longer, Healthier Life by Rangan Chatterjee. [00:10:30] BBC One Series: Doctor in the House. [00:10:57] Podcast: How to Create Behaviour Change with Simon Marshall, PhD. [00:11:25] Lilja Kjalarsdóttir. [00:13:37] Podcast: Metabolic Flexibility with Christopher Kelly. [00:16:11] Carnitine. [00:18:30] Keto-mojo meter. [00:19:12] Protein acetylation. [00:20:04] Inhibiting HDACs (Histone Deacetylase). [00:21:16] Bone health. [00:22:02] The importance of strength training. [00:24:04] Study: Schnell S, Friedman SM, Mendelson DA, Bingham KW, Kates SL. The 1-Year Mortality of Patients Treated in a Hip Fracture Program for Elders. Geriatric Orthopaedic Surgery & Rehabilitation. 2010;1(1):6-14. doi:10.1177/2151458510378105. [00:25:31] Doug's belt exercises. [00:29:08] Satchinananda Panda. [00:31:54] Satchinananda Panda’s list of publications. [00:35:06] Podcast: National Cyclocross Champion Katie Compton on Ketosis and MTHFR. [00:35:19] App: myCircadianClock by Satchidananda Panda. [00:35:54] App: myLuxRecorder by Satchidananda Panda. [00:36:58] Seasonal Affective Disorder. [00:37:36] Caloric restriction or TRE? [00:38:53] Changing building codes. [00:40:04] Sunglassesswharehouse.com (looks like their blue blockers are discontinued). [00:40:49] Ben Greenfield is agnostic on diet. [00:45:32] Podcast: Social Isolation: The Most Important Topic Nobody is Talking About with Dr Bryan Walsh. [00:46:34] The science of thought-driven physiology. [00:46:47] Study: Park, Chanmo, et al. "Blood sugar level follows perceived time rather than actual time in people with type 2 diabetes." Proceedings of the National Academy of Sciences (2016): 201603444. [00:47:04] Study: Crum, Alia J., and Ellen J. Langer. 2007. Mind-set matters: Exercise and the placebo effect. Psychological Science 18, no. 2: 165-171. [00:47:26] Study: Berga, Sarah L., et al. "Recovery of ovarian activity in women with functional hypothalamic amenorrhea who were treated with cognitive behavior therapy." Fertility and sterility 80.4 (2003): 976-981. [00:48:18] Study: Levy, B., & Langer, E. (1994). Aging free from negative stereotypes: Successful memory in China among the American deaf. Journal of Personality and Social Psychology, 66(6), 989-997. [00:49:07] Ken Ford at IHMC. [00:50:57] What is health? [00:52:36] Hedonism vs Eudaimonia. [00:55:28] Tommy's purpose: to make as many people as healthy as possible. [00:56:42] My purpose: solving problems. [00:58:01] Hormetea. [00:59:42] Newsletter: Nourish Balance Thrive Highlights email series. [01:02:30] Blood chemistry. [01:05:11] Blood glucose course by Dr Bryan Walsh. [01:05:38] Podcast: Is the Paleo Diet Sustainable with Diana Rodgers. [01:07:08] Lab-grown meat. [01:10:36] Philip Lymbery, CEO Compassion in World Farming. [01:11:15] Guy the Gorilla. [01:12:10] Podcast: Episode 47: Dr. Tommy Wood Talks About Neonatal Brain Injuries and Optimizing Human Performance. Studies regarding calorie restriction in monkeys: 1, 2. [01:15:04] Event organisation: support@nourishbalancethrive.com

Simon Marshall, PhD, trains the brains of endurance athletes and fitness enthusiasts to become happier and more mentally tough. He is former Professor of Family and Preventive Medicine at the University of California, San Diego and Professor of Exercise Science at San Diego State University where he was Director of the Graduate Program in Sport & Exercise Psychology. He has published over 100 scientific articles on the psychology of exercise and has been cited in the scientific literature over 10,000 times. He has served as an invited expert on exercise science for the National Institutes of Health, the Centers for Disease Control and Prevention, and the American Cancer Society. He is currently the Performance Psychologist for the BMC Racing team, an elite WorldTour professional cycling team. As the sherpa-husband of professional triathlete Lesley Paterson, he is the founding member of Team S.H.I.T. (Supportive Husbands in Training) and competes in triathlon or cycling events as the husband of Lesley Paterson. Find Simon over at braveheartcoach.com Here’s the outline of this interview with Simon Marshall: [00:00:24] Podcast: Off Road Triathlon World Champion Lesley Paterson on FMT and Solving Mental Conundrums. [00:01:55] Event: Mastermind Talks. [00:02:17] Podcast: Radical Candor™ with Dr Tommy Wood. [00:04:27] Sports psychology background. [00:06:45] Getting lost in the process. [00:09:20] Constant horizon seeking. [00:09:54] Journal Article: Brickman, P., Coates, D., & Janoff-Bulman, R. (1978). Lottery winners and accident victims: Is happiness relative? Journal of Personality and Social Psychology, 36(8), 917-927. [00:11:00] Book: The Subtle Art of Not Giving a F*ck: A Counterintuitive Approach to Living a Good Life by Mark Manson. [00:12:55] The use of swearing. [00:14:44] Offense is taken at the ear, not at the mouth. [00:16:34] Behaviour change. [00:18:48] Nike Slogan: Just do it. [00:19:19] Knowledge is not usually enough. [00:20:29] Motivation is important. [00:21:03] YouTube: Dr. Jonathan Fader Demonstrates Motivational Interviewing Skills and also see MINT: Motivational Interviewing Network of Trainers. [00:21:56] Stages of change model (diagram). [00:22:29] Buying a house example. [00:24:35] Resolving ambivalence. [00:25:08] Cognitive dissonance. [00:26:19] Procrastination, denial. [00:27:36] Anxiety. [00:29:08] Peer to peer support. [00:30:33] We bond on vulnerabilities. [00:31:01] Podcast: NBT People: Toréa Rodriguez. [00:31:08] YouTube: Bob Newhart-Stop It. [00:33:05] PaCE: Patient and Clinician Engagement (PaCE) Program 2.0. [00:35:17] Self-awareness. [00:36:34] Frequency of monitoring is most important, not accuracy. [00:37:30] Just in time interventions. [00:39:10] Breadcrumbs app. Lots of apps with this name! [00:40:07] Apple watch has haptic technology. [00:40:36] Podcast: How to Think Yourself Younger, Healthier, and Faster with Dr Ellen Langer, PhD. [00:45:37] Book: Scrum: The Art of Doing Twice the Work in Half the Time by Jeff Sutherland. [00:46:55] Tool: Trello and the kanban board. [00:48:07] Implementation intentions. [00:49:30] Project: Human Behaviour-Change Project with Professor Susan Michie, UCL. [00:50:39] 200 studies a day! [00:52:20] Software engineers are lazy. [00:54:48] Do you ever have feelings you don't want? [00:56:37] App: Headspace. [00:57:24] Andy Puddicombe. [01:00:06] Behaviour change in athletes (it's all about performance). [01:01:13] Braveheart Coaching. [01:05:22] Gratitude for athletes (3 things every day for 3 weeks). [01:08:11] The audiobook version of The Brave Athlete arriving Nov/Dec 2017 or get the print version now. [01:08:39] Athlete SMOG test at Braveheart Coaching.  

For decades we’ve heard that diabetes prevention is simple—lose weight, eat less, and exercise more. But something is wrong with the conventional wisdom. Nearly 115 million people live with either diabetes or prediabetes in the United States, and that number is growing. It is time to reverse this trend. Virta was founded in 2014 with the goal of reversing diabetes in 100 million people by 2025. They have made this possible through advancements in the science of nutritional biochemistry and technology that is changing the diabetes care model. James McCarter, MD, PhD, is Head of Research at Virta, and in this interview, Dr McCarter explains how Virta is using a combination of a very low carb, ketogenic diet together with 1-on-1 health coaches and some sophisticated machine learning techniques to predict sentiment in natural language and spot anomalies in blood biomarkers. After the recording was made, Dr McCarter realised that he was off by about a decade on Joslin. Rather than 1920s, Dr. Elliott Joslin actually began keeping a diabetes registry early in the 20th century and published The Treatment of Diabetes Mellitus in 1917.  “Joslin carried out extensive metabolic balance studies examining fasting and feeding in patients with varying severities of diabetes. His findings would help to validate the observations of Frederick Madison Allen regarding the benefit of carbohydrate- and calorie-restricted diets.” Here’s the outline of this interview with James McCarter, MD, PhD: [00:01:00] Divergence, Inc. [00:01:43] Presentation: The Effects of a Year in Ketosis with James McCarter, MD, PhD at the Quantified Self Conference and Exposition. [00:02:44] Books by Gary Taubes. [00:03:13] Omega 3:6 ratios. [00:05:54] Rapeseed and Canola. [00:06:44] Wild Planet sardines. [00:07:11] The Virta story. [00:07:18] Sami Inkinen. [00:07:38] Study: SD. Phinney, BR. Bistrian, WJ. Evans, E. Gervino, GL. Blackburn, The human metabolic response to chronic ketosis without caloric restriction: preservation of submaximal exercise capability with reduced carbohydrate oxidation., Metabolism, volume 32, issue 8, pages 769-76, Aug 1983, PMID 6865776. [00:08:48] Jeff Volek, PhD, RD on PubMed. [00:09:51] Fear of fat. [00:10:13] USDA dietary guidelines. [00:12:59] The goal is to reverse T2D in 100M people. [00:14:09] Study: NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants. Lancet (London, England). 2016;387(10027):1513-1530. doi:10.1016/S0140-6736(16)00618-8. [00:14:29] Joslin Diabetes Center. [00:16:37] The causes of T2D. [00:17:35] Calories are now more accessible. [00:18:22] Sugar and refined carbohydrate intake. [00:20:26] Prerequisites for the Virta program. [00:22:19] Telemedicine, health coaches, online nutrition and behaviour education, biometric feedback, peer community. [00:23:53] Getting off meds. [00:24:50] HbA1C > 6 or glucose > 120 mg/dL [00:25:32] Purdue University. [00:26:28] Podcast: Econtalk: Mark Warshawsky on Compensation, Health Care Costs, and Inequality. [00:29:02] Study: American Diabetes Association. Economic Costs of Diabetes in the U.S. in 2012. Diabetes Care. 2013;36(4):1033-1046. doi:10.2337/dc12-2625. [00:29:27] Study: McKenzie AL, Hallberg SJ, Creighton BC, Volk BM, Link TM, Abner MK, Glon RM, McCarter JP, Volek JS, Phinney SD. A Novel Intervention Including Individualized Nutritional Recommendations Reduces Hemoglobin A1c Level, Medication Use, and Weight in Type 2 Diabetes. JMIR Diabetes. 2017;2(1):e5. [00:30:45] Discontinuing 2/3 of the meds. [00:32:54] Health coaching. [00:34:18] Behaviour change. [00:35:30] Biometrics, blood BHB. [00:38:10] Reducing blood pressure and CRP. [00:38:30] Study: Youm, Yun-Hee, et al. "The ketone metabolite [beta]-hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease." Nature medicine 21.3 (2015): 263-269. [00:39:49] Blood levels of BHB and weight loss. [00:41:36] STEM-Talk #43: Jeff Volek Explains the Power of Ketogenic Diets to Reverse Type 2 Diabetes. [00:43:33] Machine learning. [00:45:57] The Team at Virta including Nasir Bhanpuri, Catalin Voss and Jackie Lee. See article Will robots inherit the world of healthcare? For links to their talks. [00:46:49] Random Forest. [00:47:06] Nourish Balance Thrive 7-Minute Analysis. [00:48:05] Natural Language Processing. [00:48:57] Nourish Balance Thrive Highlights email series. [00:50:26] Finding purpose in your work. [00:51:59] Using machine learning to change behaviour. [00:53:25] Book: Hooked: How to Build Habit-Forming Products by Nir Eyal. [00:54:11] Podcast: How to Avoid the Cognitive Middle Gear with James Hewitt. [00:55:37] $400 per month for one year. [00:57:58] Blog Post: Does Your Thyroid Need Dietary Carbohydrates? By Stephen Phinney, MD, PhD. [01:00:21] Article: Understanding Local Control of Thyroid Hormones:(Deiodinases Function and Activity) and Podcast: The Most Reliable Way to Lose Weight with Dr. Tommy Wood. [01:02:12] Podcast: How Busy Realtors Can Avoid Anxiety and Depression Without Prescriptions or the Help of a Doctor with Douglas Hilbert.

When a 13-time National Champion reaches out to say that she’s been enjoying your podcast, there’s only one thing you can do: invite her onto the show. I love to spend time talking to elite athletes to find out what makes them tick, and one trait I’ve seen consistently in cyclists is they spend a lot more time maintaining the engine than they do worrying about equipment. Frequently, and like me, the athlete is forced to be their own health detective. Never was this truer than for Katie, and in this interview, she talks about her experience tracking down the causes of her chronic leg pains that often prevented her from racing and training. Katie also talks about her experience eating a very high-fat, ketogenic diet, and it's one that we’ve seen consistently with the clients we work with at NBT. Photo: CX Magazine. Here’s the outline of this interview Katie Compton: [00:00:50] Why cyclocross? [00:02:51] Single-speed MTB. [00:03:58] Level of commitment. [00:05:36] Book: The Chimp Paradox: The Mind Management Program to Help You Achieve Success, Confidence, and Happiness by Steve Peters. [00:06:43] The start of a World Cup Cyclocross race. [00:08:51] Training track at the USOC Training Center in Colorado Springs, CO. [00:09:32] Health issues. [00:10:14] App: Overcast podcast player. [00:11:03] Leg pains. [00:11:39] Allergies, thyroid, asthma, staph, giardia. [00:12:08] MTHFR. [00:14:29] MRSA infection, abscess. [00:14:37] Podcast: All Things Thyroid with Dr. Michael Ruscio on Livin’ La Vida Low Carb. [00:15:33] Homozygous MTHFR A1298C. [00:16:08] 23andMe genetic testing. [00:17:52] Folic acid. [00:18:22] Methylfolate supplement. [00:19:48] Reducing processed food intake. [00:21:09] Enriching grains. [00:21:39] 100g CHO per day. [00:22:15] Racing in ketosis. [00:24:44] Increased aerobic capacity. [00:25:52] Avoiding sports nutrition products. [00:27:33] Study: Zinn C, Wood M, Williden M, Chatterton S, Maunder E. Ketogenic diet benefits body composition and well-being but not performance in a pilot case study of New Zealand endurance athletes. Journal of the International Society of Sports Nutrition. 2017;14:22. doi:10.1186/s12970-017-0180-0 and Podcast: Caryn Zinn PhD on ketogenic diet for athletes. [00:30:55] Missing 5th gear. [00:32:05] Decreased recovery after high intensity work. [00:32:52] Quantifying things, power, calories. [00:34:34] App: myCircadianClock by Satchin Panda Lab. [00:36:42] Coping with jet lag. [00:39:10] Disordered eating. [00:40:30] Don't stress over the pesky details. [00:41:06] Book: The Subtle Art of Not Giving a F*ck: A Counterintuitive Approach to Living a Good Life by Mark Manson. [00:42:11] Sweet potato, squash, fruit, brown rice, buckwheat flour. [00:44:27] Buffalo and Elk. [00:44:54] Eating in Belgium. [00:47:33] Trek Factory Racing and a video of the Trek Service Course in Belgium presented by Shimano. [00:48:19] Katie Compton on Twitter and Instagram.

Solving a problem requires understanding what caused it, and rarely is it good enough to move straight to remediation. The same applies to weight (fat) loss, and in this podcast, Dr Tommy Wood, MD, PhD and me discuss the underlying causes of over fatness and draw on three specific examples that represent common patterns we’ve seen in the 1,000 athletes we’ve worked with over the past three or four years. Here’s the outline of this interview with Dr Tommy Wood: [00:00:13] Podcast: Mind Pump Simulcast. [00:01:44] Problem solving. [00:03:22] Sustainability. [00:03:38] First Example: Elite female runner. [00:04:23] Relative energy deficit. [00:08:42] Description of NEAT or Non-Exercise Activity Thermogenesis. [00:09:03] Study: Pontzer, Herman, et al. "Constrained total energy expenditure and metabolic adaptation to physical activity in adult humans." Current Biology 26.3 (2016): 410-417. [00:11:33] Greasing the groove. [00:12:44] Counting and cycling calories. [00:14:27] 10% deficit. [00:15:42] Pharmacological interventions. [00:16:34] Second Example: Christopher Kelly. [00:16:48] Gravel grinder events. [00:17:07] Belgian Waffle Ride. [00:18:05] Reintroducing carbs. [00:19:45] Thyroid on keto. [00:20:26] Kiteboarding. [00:20:55] eBook: What We Eat (scroll to bottom of page). [00:22:24] Self regulating. [00:23:42] Visceral and subcutaneous fat. [00:25:25] Visceral fat has a higher fat turnover. [00:26:34] Killing fat cells with cold thermogenesis. [00:26:59] Lipodystrophy. [00:27:34] Gut health. [00:27:57] Blastocystis, Cyclospora. [00:30:47] Gut health and inflammation. [00:30:59] Podcast: Arrhythmias in Endurance Athletes with Peter Backx, PhD. [00:31:50] HsCRP. [00:32:14] Podcast: The Hungry Brain with Stephan Guyenet, PhD. [00:33:56] Study: Jönsson, Tommy, et al. "Digested wheat gluten inhibits binding between leptin and its receptor." BMC biochemistry 16.1 (2015): 3. [00:34:47] Paleo On The Go. [00:35:43] Visceral fat firewalls off the gut. [00:36:10] LPS (endotoxin) translocation across the gut wall. [00:40:22] Getting a dog. [00:41:28] MitoCalc developed by Alessandro Ferretti and Weikko Jaross as discussed in this NBT blog post by Dr. Tommy Wood. [00:43:21] Time restricted eating. [00:44:24] Walking. [00:45:13] Podcast: The Importance of Strength Training for Endurance Athletes with Mike T. Nelson. [00:46:27] Third example: 35 lb to lose. [00:47:44] The under eating thyroid pattern. [00:48:16] Understanding Local Control of Thyroid Hormones:(Deiodinases Function and Activity). [00:50:35] Resistance training. [00:51:13] Muscle is more metabolically active. [00:52:07] Podcast: Breaking Through Plateaus and Sustainable Fat-Loss with Jason Seib. [00:53:02] DXA or DEXA Scan. [00:53:14] Waist-hip ratio. [00:54:08] I'll happy when... [00:54:41] Icelandic Health Symposium 2017 featuring Dr. Satchidananda Panda, Dr. Tommy Wood and others. [00:55:58] Study: Longo, Valter D., and Satchidananda Panda. "Fasting, circadian rhythms, and time-restricted feeding in healthy lifespan." Cell metabolism 23.6 (2016): 1048-1059. [00:56:16] There are over 600 genes regulated by circadian rhythm, reference 1, 2, 3 and 4. [00:56:56] Continuous feeding. [00:57:58] Eat when it's light outside. [00:58:47] Yearly cycles. [00:59:55] Frontloading calories. [01:00:40] The Nourish Balance Thrive 7-Minute Analysis.

James Hewitt is Head of Science & Innovation at Hintsa Performance. His work includes consulting with Formula 1 drivers and teams, work in elite sport and with global corporations, a wide-range of written articles, presentations, keynotes and workshops in Europe, the United States and Asia. In this interview with Dr Tommy Wood, James discusses a polarised approach to cognitive performance, arguing that time spent in the middle gear is time wasted. James also explains why smartphones are so compelling yet interfering with our ability to concentrate. Here’s the outline of this interview with James Hewitt: [00:01:15] Book: Exponential by James Hewitt and Aki Hintsa. [00:03:31] Website: Hintsa Performance. [00:04:20] Newsletter: Nourish Balance Thrive Highlights. [00:04:50] Article: A day in the life of Scott, hopelessly distracted office worker by James Hewitt. [00:05:38] Polarised training. [00:06:18] Cognitive task load model. [00:08:01] World Economic Forum Report: The Future of Jobs and Skills in the Middle East and North Africa: Preparing the Region for the Fourth Industrial Revolution. [00:09:18] Podcast: Pedro Domingos on Machine Learning and the Master Algorithm, TED Talk: The Wonderful and Terrifying Implications of Computers that Can Learn with Jeremy Howard. [00:11:00] Study: Frey, Carl Benedikt, and Michael A. Osborne. "The future of employment: how susceptible are jobs to computerisation?." Technological Forecasting and Social Change 114 (2017): 254-280. [00:11:10] Report: A Future That Works: Automation, Employment, and Productivity by McKinsey Global Institute. [00:12:29] Default mode network. [00:13:31] Smartphones. [00:14:59] Novelty seeking. [00:16:26] Study: Kushlev, Kostadin & Dunn, Elizabeth. (2015). Checking Email Less Frequently Reduces Stress. [00:17:11] Lecture: Dopamine Jackpot! Sapolsky on the Science of Pleasure by Robert Sapolsky. [00:19:25] Productivity without purpose. [00:19:45] Study: Levitas, Danielle. "Always connected: How smartphones and social keep us engaged." International Data Corporation (IDC). Retrieved from (2013). [00:21:05] Three questions: priority, opportunity, elimination. [00:22:30] Attention restoration. [00:24:40] Mornings. [00:25:21] Book: The Power of When: Discover Your Chronotype--and the Best Time to Eat Lunch, Ask for a Raise, Have Sex, Write a Novel, Take Your Meds, and More by Michael Breus. [00:25:43] Study: Akacem LD, Wright KP, LeBourgeois MK. Bedtime and evening light exposure influence circadian timing in preschool-age children: A field study. Neurobiology of sleep and circadian rhythms. 2016. [00:28:59] Study: Williamson AM, Feyer A Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication Occupational and Environmental Medicine 2000;57:649-655. [00:30:06] Study: Van Dongen, Hans Pa, et al. "The Cumulative Cost of Additional Wakefulness: Dose-response Effects on Neurobehavioral Functions and Sleep Physiology From Chronic Sleep Restriction and Total Sleep Deprivation." Sleep 26.2 (2003): 117-126. [00:32:21] Galvanic skin response. [00:34:43] Sex differences in rapid switching. [00:37:46] Changing behaviour. [00:38:01] Derek Sivers. [00:39:25] Implementation intention. [00:42:15] Positive vision. [00:45:45] Apps: Depak Chopra Meditation Apps. [00:50:16] Device: The PIP stress tracker. [00:52:44] Device: Muse headband. [00:53:49] Ways to connect: Hinsta.com, JamesHewitt.net, James Hewitt on Twitter.

Aaron Alexander has been professionally working with clients of all ages seeking a variety of goals from pain relief to improved athletic performance for over 10 years. He is currently seeing clients at his office, Align Therapy, inside of Crossfit LA, Santa Monica. Aaron began the journey as a nationally certified personal trainer specializing in corrective exercise and nutrition consultation. During that time Aaron studied psychology at the University of Hawaii. Soon after, he evolved into becoming a licensed manual therapist studying myofascial release, neuromuscular therapy and trigger point therapy at Maui School of Therapeutic Massage. A fascination with connective tissue lead him to study structural integration at the Rolf Institute in Boulder, CO. Being an LMT and CPT on top of a Rolf Structural Integration Practitioner, Aaron has a strong understanding of the intricacies of the body and mind. Here’s the outline of this podcast with Aaron Alexander: [00:02:17] The link between posture and the way we feel. [00:04:35] Sustaining posture. [00:06:37] Front squat, deadlift, kettlebells, martial arts. [00:07:20] 150 interviews on the Align Therapy podcast. [00:07:54] Interview: Self-Care and Integrated Movement for the Modern World with Aaron Alexander. [00:08:05] Chin up bar. [00:09:54] Body language. [00:12:16] Changing our environment. [00:13:44] YouTube: Functional Chair with Hip Hinging with Aaron Alexander.. [00:14:36] YouTube: Reverse Bad Posture on a Cell Phone with Aaron Alexander. [00:15:31] The rubber band on Aaron's website. [00:18:30] Creating the stack. [00:19:37] Interview: The Importance of Strength and Mobility for Mountain Bikers with James Wilson. [00:20:46] Travel tips. [00:23:19] NEAT: Non-Exercise Associated Thermogenesis. [00:25:23] Stand up paddling. [00:26:32] Youtube: How to Swing an Axe/Maul When Splitting Firewood. [00:29:30] Kiteboarding. [00:31:38] Interview: The Importance of Strength Training for Endurance Athletes with Mike T. Nelson. [00:32:18] Overhead squat, break the stick. [00:33:17] Uneven beach muscles. [00:35:32] Vision. [00:35:47] Abraham Maslow and Maslow’s Hammer. [00:36:43] The road trip. [00:38:19] Finding your tribe. [00:40:01] Robb Wolf. [00:40:14] Book: Stealing Fire: How Silicon Valley, the Navy SEALs, and Maverick Scientists Are Revolutionizing the Way We Live and Work by Steven Kotler. [00:40:36] Robert Sapolsky. [00:41:49] Study social group. [00:43:36] Podcast: Aaron Alexander on Mind Pump. [00:44:54] AcroYoga. [00:48:27] The EPP pre-requisites. [00:49:05] Mastermind Talks. [00:50:07] Standing on the shoulder of giants. [00:51:34] YouTube Channel: Nourish Balance Thrive. [00:52:38] The Glottal T. [00:53:57] Group coaching. [00:56:26] Align Therapy Courses. [01:00:23] Gym bodies. [01:01:08] UJ Ramdas Productivity Planner on IntelligentChange.com. [01:02:17] Santa Cruz Nomad. [01:03:32] Productivity Planner. [01:07:33] Movement makeover. [01:09:21] Interview: The Migraine Miracle with Josh Turknett. [01:11:46] Lack of intention. [01:12:54] Go see Aaron at Crossfit LA in Santa Monica. [01:13:15] Barbell Shrugged. [01:15:55] Align Podcast. [01:16:27] Band with door anchor.