Nourish Balance Thrive

If you’d have asked me six months ago what insulin did, I would have answered, “it stuffs energy into cells”. I think most people would say something similar. My answer isn’t wrong, but facilitating the uptake of energy into cells is not the most first or most important thing that insulin does. Last week I completed the first few modules of an introductory physiology course from Duke University, and I found this in one of the lectures: The type two diabetic is a situation where we have receptor desensitization and the individual does not respond correctly to insulin. Insulin is present in the system, but the receptor is desensitized. And so, you don't get the movement of glucose from the blood into the skeletal muscle cells correctly. These statements don’t directly answer my question “what does insulin do?”, but they imply that insulin is required to move glucose (energy) into a cell. This is wrong, and they’re not the first to make the mistake. This quote from “Insulin: understanding its action in health and disease”, explains: The effects of this ‘black age’ are still with us because these incorrect hypotheses have, with the passage of time, been turned into dogma and become cast into ‘tablets of stone’ in undergraduate textbooks. They are also carried forward into postgraduate teaching. For example, even in well respected texts it is still common to find statements such as ‘The basic action of insulin is to facilitate glucose entry into cells, primarily skeletal muscle and hepatocytes.’ So what does insulin do? The basic action of insulin is anti-catabolic, that is, it halts breaking down. Insulin works in this order: Hits alpha cells in the pancreas to suppress glucagon. Then goes to the liver to suppress gluconeogenesis (and stimulate lipogenesis). Then goes to the peripheral body to do other stuff. So if you're using insulin to stimulate glucose uptake, you're already WAY above the concentrations needed to affect the pancreas and liver, which is going to make those cells insulin resistant first. You've also already shoved a lot of fat into those cells first, which is going to interfere with glucose metabolism. So what should you do? Don’t worry about insulin facilitating the uptake of glucose into cells, and instead focus on creating the demand for glucose through movement. Lift weights. I want you to have the same teaching experience that I have enjoyed. One of my most frequently asked questions is “How did you learn so much in so little time? How did you build a successful functional medicine practice in less than two years?”. The answer is I had two great teachers: necessity and Dr. Tommy Wood. If it weren’t for Tommy, I’d still be dependant on protocols rather than understanding the principles by which our programmes work.   Concierge Clinical Coaching is my way of sharing my expertise and education with you, the health and performance enthusiast. You already have necessity, let me give you the other part. As a member of our programme, you’ll have the ability to ask both Tommy and me your diet, lifestyle, training and supplementation questions. You will have ongoing access to us for input on everything from your latest blood test results to advice on diet and training optimisation. As the science and questions evolve, we will be there to help guide you through your personalized route to long-term health and performance. In short, we will be your functional medicine practitioner, coach and nutritionist all rolled into one. Here’s the outline of this interview with Dr. Tommy Wood: 0:00:13    What Tommy ate over Christmas. 0:01:02    Tommy is OK with vegetable oils and gluten, so long as it's Christmas! 0:02:20    We love buying our meat from a local farmer. 0:03:01    What is insulin? 0:03:13    Optimising Insulin Facebook group. 0:03:40    Tommy's presentation on insulin resistance. 0:04:01    Most people have been taught that the primary role of insulin is to put glucose into cells. 0:04:26    Insulin isn't very good at pushing insulin into cells. 0:04:40    Insulin is a peptide hormone secreted from the beta cells of the pancreas. 0:04:54    Expecting food can increase insulin. 0:05:26    Insulin decides where nutrients go. 0:05:43    So what is insulin's primary role? 0:06:01    Insulin is anabolic. 0:06:27    The main thing insulin does is anti-catabolic. 0:06:48    Insulin prevents the breakdown of fat. 0:07:27    Insulin first acts on the alpha cells of the pancreas. 0:07:29    The alpha cells secrete glucagon. 0:07:48    Glucose is gone, glucagon. 0:08:00    Insulin turns off glucagon. 0:08:32    Only tiny amounts of insulin are needed to turn off glucagon. 0:08:47    Next insulin goes to the liver. 0:08:57    Turns off gluconeogenesis. 0:09:17    Now at greater concentrations, insulin acts in the periphery to tell cells to stop breaking down fat. 0:09:32    There are some nice experiments showing this in forearm muscles. 0:09:53    10 uIU/mL cells start taking up fatty acids. 0:10:16    Insulin only causes glucose uptake at levels of 40-50 uIU/mL. 0:11:03    How did this mistaken belief become common knowledge? 0:11:06    Partly from work done in type 1 diabetes. 0:11:41    Without the action of insulin, the catabolic hormones act unopposed. 0:12:14    Roger Unger glucagon presentation. 0:12:39    Without insulin, there is uncontrolled glucagon release. 0:13:13    Insulin given as medicine is to act against glucagon. 0:13:31    No one was really thinking about this. 0:13:42    Insulin does increase the uptake of glucose into cells so this was an easy mistake to make. 0:14:15    Your high blood sugar might be coming from the liver. 0:14:56    The problem with injecting insulin into subcutaneous fat. 0:15:57    My carbohydrate experiment. 0:16:17    I did an oral glucose tolerance test at home using a dried blood spot test. 0:16:37    My insulin never got above 7.4 uIU/mL. 0:16:56    Most people eating a standard western diet end up relying on insulin to stuff glucose into cells. 0:17:26    Carbohydrates plus fat is maximally insulinogenic. 0:17:56    This is not something we're necessarily adapted to. 0:18:12    It may have been an advantage to store the excess. 0:18:45    75% of glucose should go into muscles. 0:19:08    I did exercise during my test. 0:19:46    We know that I'm very insulin sensitive. 0:20:01    My muscles are primed to take the extra glucose. 0:20:20    So the carbs go straight into muscles without the insulin. 0:21:07    Most glucose uptake into muscle does not require insulin. 0:21:32    This pattern is common in people eating a high-fat diet. 0:21:56    High insulin smashes the pancreas and liver over the head. 0:22:25    The problems come when the muscles don't need the glucose. 0:22:52    My blood glucose peaked at 200 mg/dL. 0:23:08    The peak was in part due to a stress response. 0:23:31    Insulin is not for putting glucose into cells, exercise should create the demand. 0:23:48    If all your cells are overloaded already, then you create a problem. 0:24:09    Cortisol and adrenaline are there to drive up glucose. 0:24:55    We will repeat the experiment without the carbs. 0:25:18    I'm going to do an experiment to see how much cortisol I produce during a race. 0:25:56    Elevated fasted blood glucose, aka the dawn effect. 0:26:24    This questions comes up a lot. 0:26:38    A low-carb diet can cause physiological insulin resistance. 0:26:58    We're not sure if this is anything to do with insulin resistance at all. 0:27:17    Cortisol waking response. 0:27:58    Cortisol should come up before you wake. 0:28:15    People may have heart attacks more often at that time for this reason. 0:28:28    A lot of potential things could be going on here. 0:28:44    Anything which is interfering metabolic health could be causing this. 0:29:10    Are people looking at food quality? 0:29:40    Ketogenic diets can increase cortisol. 0:29:59    Insulin resistance leads to fast cortisol metabolism. 0:30:21    Previously we would have seen this as low cortisol on a saliva test. 0:30:44    It's not that the ketogenic diet is stressful per se, but that the cortisol is no longer being metabolised so quickly. 0:31:28    People that haven't addressed other health issues may find a ketogenic diet stressful. 0:32:03    The dawn effect is likely multifactorial and complicated but not normal. 0:32:35    My fasted blood glucose was creeping up into the 90s. 0:32:49    Now it's down in the low 80s and even high 70s. 0:33:09    Could nicotinamide riboside (NR) be lowering my fasting blood glucose? 0:33:21    NR is a precursor for NAD. 0:33:35    NAD is an electron acceptor. 0:33:46    The ratio of NAD to NADH is important. 0:34:00    In type 2 diabetes there's lots of extra NADH compared to NAD. 0:34:18    Nutritional deficiencies can cause problems. 0:34:38    You can end up with not enough NAD to accept the electrons from all the calories you're taking in. 0:35:00    If NAD goes up with respect to NADH it could signal more glucose to enter the cell. 0:35:29    As always, there are confounders. 0:35:41    Beta-alanine. 0:35:46    Eating more carbs and sleeping better. 0:35:57    Not much data on NR in humans. 0:36:20    I've been racing but not training. 0:36:39    conciergeclinicalcoaching.com 0:37:04    What goes on behind the scenes at NBT. 0:37:22    Tommy is a huge part of my education. 0:37:53    Tommy sends me 1,000 words with six papers attached. 0:38:11    Tommy is a research scientist. 0:38:18    You need someone to guide you through the literature. 0:38:37    If something is published we assume it's good science but that isn't always the case. 0:39:00    So much vested interested and cognitive dissonance. 0:39:13    We have our own biases! 0:39:31    Tommy is about as evidence driven as you can get. 0:39:47    Metabolic Fitness Pro. 0:39:58    Names are just variables. 0:40:09    How can I bring this experience to more people. 0:40:36    The main feature is a private Facebook group. 0:41:13    On the Facebook group you will be following along with the studies we're looking at. 0:41:39    We didn't have enough time to explain the results after the O2 Boost programme. 0:42:00    Information is best absorbed in chunks. 0:42:12    Run some tests, think about it, ask some questions. 0:42:29    I can't afford to answer everyone's questions via email. 0:42:49    Tell us if you think this is a bad idea! 0:43:09    Context is important during our discussions so we can't just throw stuff up on the blog. 0:43:52    We develop a relationship but then fail to follow up very well. 0:44:17    You get continuous feedback. 0:44:31    You keep on testing. 0:44:40    Once a month live Q&A webinars. 0:44:58    We will produce transcripts from the webinars. 0:45:30    You will be able to ask questions during the webinar live. 0:45:56    Tweaking biochemistry is where I see benefits now. 0:46:29    Having Tommy answer my questions is priceless. 0:47:03    My network of experts. 0:47:22    So even if I don't have the answer, I probably know someone that does. 0:47:46    The main benefit of the podcast is networking. 0:48:09    Joe Friel. 0:48:35    These contacts are my greatest asset. 0:48:52    The Internet is changing everything. 0:49:16    We're pricing it low, act now! 0:49:34    The first 7 days are free (not $10).

Your performance on a mountain bike has four pillars of support: cardio, mobility, skills and strength. Most riders only worry about one or maybe two. Could you be a good rider with just one pillar? Maybe, but why limit yourself? This week it’s been raining pretty solidly here in northern California, and honestly, I couldn’t care less. In years gone by, I'd have been donning rain gear and even spending time on the trainer in an attempt to maintain my aerobic engine, but now I understand that cardio is just one of the four pillars. I get plenty of time to improve my cardio on the trail, so in the rainy months, it makes sense to work on my strength and mobility. James Wilson is a strength and skills coach whose programmes and teaching have been tremendously helpful to me over the past few years. James helped me understand that I wasn’t going to get any faster by doing more of the same and that road riding wasn’t going to make me a better mountain biker. Light hands and heavy feet make for better mountain biking, and flat pedals have helped me learn this by providing instant feedback of my weight being somewhere other than on my feet. Flat pedals are also extremely comfortable and allow me to easily stick a foot out moto-style on tight switchbacks. But what about pulling up on the backstroke? As you’ll hear in this podcast, and as has been shown in the studies cited below, there is no advantage in pulling up on the backstroke, and so this is not a good reason to be using clipless pedals. Not long after we recorded this interview, my new Catalyst pedals arrived and since then I've been enjoying wiggling my toes as I pedal comfortably in a midfoot position. The pedals are long enough to support my whole foot yet narrow enough to minimise rock strikes. But yet I still race clipless! Am I suspending disbelief? Please let me know in the comments below. Here’s the outline of this interview with James Wilson: 0:00:00    I've had fantastic results following James's training programmes. 0:00:52    James has been developing a pedal for about a year. 0:01:28    Do not listen to this podcast if you're easily offended by flat pedals on an MTB. 0:02:23    The controversial article I wrote. 0:03:10    I've ridden mountain bikes since I was a kid, but then I fell away from the sport. 0:03:43    When I moved to the US I got into road bikes. 0:04:05    I used to think weight was the most important thing. 0:04:45    Why is strength training important for mountain bikers? 0:05:05    James hates the word cyclist. 0:05:32    Mountain biking is not road biking. 0:06:25    Road biking doesn't necessarily transfer to MTB. 0:07:16    High-tension cardio on the trail. 0:08:02    The best MTB riders in the world pedal the least. 0:08:18    Aaron Gwin winning a World Cup race without a chain. 0:08:39    James's article on Pinkbike about what makes a great downhill racer. 0:09:12    Gray Cook: "The grip is the window to the core". 0:09:41    Functional core strength is extremely important. 0:10:07    Pedalling is not the only skill. 0:10:26    Mobility and strength are equally important. 0:10:40    Mobility first. 0:10:57    Can you do a bodyweight squat? 0:11:14    Is your squat "stress proof"? 0:11:50    You can make your gas tank bigger, or you can improve your miles per gallon. 0:12:15    Your body will cycle through muscle fibres. 0:12:41    More muscles fibre recruitment means more performance. 0:12:56    Most people take a unidirectional approach, i.e. cardio. 0:14:01    Strength training is the fast track. 0:14:21    Riding will make you stronger. 0:15:09    Training fills in gaps. 0:15:40    Riding already provides us with plenty of cardio. 0:16:22    When you look at it this way, strength training is obvious. 0:16:59    Lee McCormack on my podcast. 0:17:40    Your aerobic engine will only take you so far. 0:18:06    Lack of mobility can stop you from getting into a basic attack position. 0:18:37    Skills and mobility are connected. 0:18:53    You should be able to pick up a high-level skill in about 10 minutes, otherwise you're not ready. 0:19:15    The same is true of the kettlebell swing. 0:19:38    Running into the wall at James's skill camps. 0:20:32    Most skills problems boil down to lack of mobility and strength. 0:21:03    It should look effortless. 0:21:10    James's article on arete (Greek for excellence with style and grace). 0:21:44    Don't worry about speed, worry about style and grace. 0:22:12    You should be able to just tell when you see a good rider. 0:22:31    Strava times can be deceptive. 0:23:16    Smoother is also more consistent and free of injury. 0:23:45    The difference between a good rider and a good local rider. 0:24:34    If you have authentic skills, you will be able to apply them under any circumstances. 0:25:11    New riders don't know who to look up to. 0:25:38    Sometimes fast and good are concordant. 0:26:06    Consistency is key. 0:26:55    James has been through the learning process. 0:27:14    James's way is not the only way. 0:27:32    Some guys will be fast without skills. 0:28:13    Joe Friel talked about the importance of strength training on my podcast. 0:28:42    I hate going to the gym, can I still benefit? 0:29:10    You don't need to be able to go to the gym. 0:29:35    The term strength training has value, but is limiting. 0:30:01    You can train in a way without becoming bulky. 0:30:16    Push-pull, squat, hip hinge, loaded carry. 0:30:50    Loaded carry. 0:31:04    Gyms can produce zoo humans. 0:31:51    The transfer from stationary to moving (or functional). 0:32:21    Loaded carries: farmer's walk, rack walk, overhead, then mix it up. 0:33:10    Bearhug a sandbag. 0:33:28    Pushes and pulls with sleds. 0:33:44    The principle is being able to move under load. 0:34:10    This teaches high-tension cardio. 0:34:28    These are miracle exercies for MTB. 0:34:46    The upper back is the forgotten part of the core. 0:35:12    Rounded shoulders are not normal. 0:35:22    You can't breath properly with rounded shoulders. 0:35:49    Better breathing can equate to better performance. 0:36:21    Do loaded carries! 0:36:46    Dan John: “If it's important, do it every day”. 0:37:19    What are YOUR specific gaps. 0:37:35    The windmill and the stick windmill. 0:37:48    If you can't do these movements, good luck cornering on a MTB. 0:38:19    You can do these exercises without going to the gym. 0:38:33    Once you understand the principles, you can find a method. 0:38:55    Body weight is helpful, but can eventually be limiting. 0:39:10    James's article about the steel mace. 0:39:56    You don't need a bunch of fancy equipment. 0:40:16    Loaded carry with kids. 0:40:33    Zoo humans. 0:41:10    How about adults do you know that could hang from a tree for 30 seconds? 0:41:35    Not being able to throw. 0:41:57    Athletics is about being a zoo human, MTB is a neat trick. 0:42:20    If a rock falls on me... 0:42:52    If you can't deadlift your own body weight you're in trouble. 0:43:18    The loss of these innate abilities is sad. 0:43:55    We do loaded carries in the gym because we don't carry our kids any more. 0:44:20    Ditch your stroller! 0:44:45    Taking the escalator to the gym. 0:45:07    Find ways to challenge your innate human abilities. 0:45:31    Go play with your kids outside. 0:45:58    Go on a hike and get off the trail. 0:46:35    Squatting. 0:46:56    We're not MTBers, we're human beings that ride MTB. 0:47:18    Katy Bowman on my podcast. 0:47:39    Book: Move Your DNA. 0:47:52    Katy on the Joe Rogan podcast. 0:48:11    Having a couch in your living room 0:48:27    Book: Alignment Matters. 0:49:09    Flat pedals have taught me to be a better mountain biker. 0:49:41    Fallacy: riding a bike is different, throw out all the rules. 0:50:30    A lot of the equipment we know today originates from the safety cycle. 0:51:22    When people tell you need need clipless pedals, ask for the proof. 0:52:13    It's so hard to know where to start with people. 0:52:31    There is no science that supports pulling up on the backstroke. 0:52:50    Global Cycling Network video. 0:53:23    Even with crappy equipment, the test rider was still more efficient on flats! 0:54:09    The performance advantages attributed to clipless are not there. 0:54:50    We've been led to believe that clipless allow us to use our legs differently. 0:55:20    Pulling up on the backstroke is inefficient. 0:55:39    Effect of Pedaling Technique on Mechanical Effectiveness and Efficiency in Cyclists, Korf et al. 0:55:39    Effects of Pedal Type and Pull-Up Action during Cycling, Mornieux et al. 0:55:47    The Flat Pedal Manifesto. 0:56:09    When we say clipless pedals, we mean SPD. 0:56:54    How hard you can push with your quad vs how hard you can pull with your hamstring. 0:57:31    We're prewired, so we should pedal like we walk. 0:57:54    This sounds like reflexes in physiology! 0:58:20    You don't need to overpull, you just need to focus on pushing down hard. 0:58:46    Cycling leads the world in doping, and far behind in exercise science. 0:59:14    The running world has shown many times that interfering with the running stride makes matters worse. 1:00:12    Yet the cycling world is still trying to teach cyclists how to pedal. 1:00:36    The rules don't change because you're on a bike. 1:00:50    Pulling up doesn't work because you're trying to do something that unnatural. 1:01:37    James's flat pedals. 1:02:04    Suspending disbelief. 1:02:21    Pushing through the ball of the foot. 1:02:43    Why am I training my foot to do something different in the gym. 1:03:03    Greg Choat on midfoot pedalling. 1:03:18    Your foot acts differently depending on whether or not contact is lost. 1:03:43    In deadlifting and pedalling, the foot does not break contact. 1:04:13    Therefore, the midfoot pedalling position makes sense. 1:04:46    Study showing no difference in power or economy of midfoot position. 1:05:11    Tight calves. 1:05:25    With midfoot, the tension moves to the hips. 1:05:36    Study showing the hips are the main driver at all intensities. 1:06:08    An evidence driven approach to pedalling. 1:06:31    Midfoot requires stabilizing both ends of the arch. 1:06:55    The existing pedals do not support the foot properly. 1:07:16    Why can you deadlift without shoes but need stiff soled shoes on the bike? 1:08:00    Every pedal has been designed with the assumption of pedalling through the ball of the foot. 1:08:34    Standing on a pedal should be like standing on the ground. 1:09:13    James's pedals are for a midfoot position. 1:09:38    You can still shift your weight forward and back. 1:10:03    Numb toes is caused by shoving toes into the toe box. 1:10:59    Your feet stay on the pedals much easier with the midfoot position. 1:11:36    Freedom and comfort of flats. 1:11:59    Feet feel great with flats. 1:12:24    We now have a flat pedal without drawbacks. 1:12:42    Everything boils down to feet, hips and shoulders. 1:13:28    The Catalyst Pedal. 1:13:44    The Catalyst is 5" front to back, 1.5" longer. 1:14:20    Rock strikes with oversized flats. 1:15:00    The pedals are well tested. 1:15:42    pedallinginnovations.com 1:16:05    This is the only pedal based on science. 1:16:33    30-day money back guarantee. 1:17:18    You must be willing to adopt the midfoot position. 1:17:46    My preferred position is midfoot. 1:18:50    If you're open minded and willing to try something different. 1:20:08    bikejames.com 1:20:27    Free 30-day programmes. 1:20:47    The Ultimate MTB programme. 1:20:56    The No Gym No Problem programme. 1:21:22    Saving people from time on the trainer!

Standing on the shoulders of giants is what I do at Nourish Balance Thrive, and none more giant (figuratively!) than strength and conditioning coach, author and speaker Jason Seib. I’ve been listening to Jason and Sarah Fragoso’s Everyday Paleo podcast (now renamed JASSAFIT) since my earliest days eating a paleo diet, and I still find their wisdom and practical advice helpful both personally and professionally. If you head over to his website and sign up for Jason’s list, he’ll send you the instructions I’ve been using in my practice called The Fat Loss Directive. Like all good solutions, the new AltShift diet scratches a personal itch. Jason’s wife Sheryl was unable to shake off the baby fat despite eating a nutrient dense paleo diet and so Jason recommended, as always, more walking and strength training. These changes yielded some good results: greater muscle mass and strength, but unremarkable changes in Sheryl's appearance. Jason then suggested the next most logical thing: reducing carbohydrates. This change worked for a while, and then it didn't, and so they kept tweaking. They checked Sheryl was eating enough food and getting enough sleep (she was). Despite small victories, Sheryl was still stuck. The questions and answers that arose from the experimentation process would eventually lead to what I would describe as a cyclical ketogenic diet that enabled Sheryl to lose five inches in her waist in just six weeks (pictured on the right). Sheryl is not alone, and at the time of writing the AltShift Facebook group has a happy 3,929 members. Here’s the outline of this interview with Jason Seib: [0:01] Christopher’s introduction of Jason Seib, coach, podcaster, author. [1:30] How Jason’s experience as a personal trainer makes his work more credible. [2:46] What is the AltShift diet Jason has developed and why did he create it? [8:15] Why the “per day” mindset of diet planning isn’t the wisest. [11:43] The kinds of things Jason tracks with his test groups. [15:18] “New Bike Syndrome” and how it relates to weight loss diets. [20:21] Is the AltShift diet plan for everyone? [34:14] What do the terms “5 shift” and “3 shift” mean in Jason’s plan? [42:10] The difficult points in Jason’s plan for most people, and how they get past it. [47:40] Why most people need 2 to 3 passes through the AltShift cycle to begin getting it. [50:10] The tensions between scientific studies and daily practices. [56:27] Where Jason agrees with Vinnie Tortorich. [58:01] How the vast majority of people don’t even know this diet approach exists. [1:00:40] Other things Jason is working on. RESOURCES MENTIONED IN THIS EPISODE Jason’s website and podcast The Fat Loss Directive (subscribe to receive your copy) The AltShift Diet BOOK: Brain Rules The AltShift Diet Facebook Community @JasonSeib on Periscope PEOPLE MENTIONED IN THIS EPISODE Vinnie Tortorich John Medina Jimmy Moore Tommy Wood Chris Kresser Dominic D’Agostino Jillian Michaels Sarah Fragoso

Gas, bloating, diarrhoea, constipation, reflux. Modern allopathic medicine still does more harm than good for these common and chronic health complaints. I often think about what my life might be like now if I’d listened to my gastroenterologist and written off diet, lifestyle and infections as a potential cause of my gut issues. I wonder if by now I’d still be taking anti-inflammatory steroids or if I would have gotten to the point where I needed surgery. A better solution was to take a deep dive into gut testing to uncover the root causes underlying my bloating and diarrhoea. Stool testing allowed me to find amoebic and pinworm infections, urinary organic acids showed yeast overgrowth. Together with some diet and lifestyle changes these problems were treatable with botanical herbs and with just one prescription medicine. My guest today is physician, researcher, author, critical thinker, educator and health enthusiast Dr. Michael Ruscio. Michael is a functional medicine practitioner who emphasizes nutritional and lifestyle solutions to the types of problems described above. He runs a busy practice in Walnut Creek, California where he spends two days a week seeing patients and three days researching and writing. Together with a small team of researchers, Michael is in a unique position to help people through his experience both as a practitioner and researcher. Best of all, he’s willing to divulge all his trade secrets on my podcast! This interview might not be the best place to start if you’re new to the idea of functional medicine and testing. If that’s you then I’d highly recommend listening to some of the early episodes of Michael’s podcast. In this interview, Michael and I go in some technical details of SIBO and other infections like Blastocystis hominis, Yersinia, Toxoplasmosis and Epstein-Barr. We also talk about how some of these infections might interfere with vitamin D metabolism, either by interfering with the vitamin D receptor, or perhaps increasing conversion of 25-OH D to 1,25-OH D. As a result, we're seeing low levels of 25-OH D on a blood test, but that's because it's all been activated, which is potentially immunosuppressive. There's also some evidence that inflammation (certain inflammatory cytokines) upregulates the enzyme CYP27B1, which creates 1,25-OH D. Here’s the outline of this interview with Dr. Ruscio: [0:05] Christopher’s introduction of Michael and his podcast. [2:50] Michael’s upcoming conference in the UK. [7:58] What is the SIBO protocol? [8:28] Great results from a case study Dr. Ruscio did with Christine, a patient who he guided into a new protocol,and why the principles of what he did are more important than the methods. [11:32] How Dr. Ruscio came to understand the principles behind his approach to intestinal health, and how he was forced to think through the varying positions he was being taught. [13:13] How emergency medicine and functional medicine are vastly different for good reason when it comes to protocols. [14:24] An example of why it’s vital to think through the principles and not just follow protocols. [21:11] Why it’s important to be careful with therapeutic trials. [24:16] Why researchers fall prey to omitting facts or studies contrary to their position, and why it’s vital for everyone to raise the bar on the practice of sharing data. [28:25] The gut infections Michael has seen and what he does to treat them. [33:20] Why diet and lifestyle come first. [38:19] Why Dr. Ruscio works with patients in phases and how he goes about it. [39:35] What does Dr. Ruscio do with things he can’t “fix?” [43:02] The things looked for when testing for Epstein-Barr virus. [44:30] Michael’s increasing respect for natural treatments for virus conditions. [47:45] The relationship of Vitamin D to infections and health and some surprising opinions Dr. Ruscio has in light of the Vitamin D hype today. [54:44] How you can connect with Dr. Ruscio. RESOURCES MENTIONED IN THIS EPISODE Michael’s podcast The SIBO protocol episode Re-find Health Conference in London for practitioners with Michael is on Jan 17, 2016 Melissa Hartwig of The Whole30 will be speaking at the same conference the day before

So small, so abstract, it’s very hard to get your head around the idea that mitochondria are important. For me, knowing that these tiny organelles make up 10% of our total body weight (25% of the heart) helps put things into perspective. Mitochondria allow us respire with oxygen and produce vast amounts of an energy molecule called ATP. In fact, each one of us produces our body weight in ATP every day! The greater the number of healthy mitochondria, the better you feel and the faster you go. Even more incredible, recent research suggests that mitochondria come from a bacterial lineage and at some point made friends with our cells to form modern eukaryotes. My guest today is functional medicine practitioner and medical doctor, Robert Rountree. Dr. Rountree was named recipient of the Linus Pauling Functional Medicine Award at IFM's 2015 Annual International Conference, held in Austin, Texas. Dr. Rountree received the award for his pioneering work in the development of Functional Medicine and his role as a highly inspirational and informational member of IFM’s faculty. Dr. Rountree is the Chief Medical Officer at Thorne Research. I learned everything I know about the mitochondria through Bryan Walsh’s Metabolic Fitness Pro and the Khan Academy. As promised, here’s the picture of the mitochondrial membrane: One of the most interesting supplements Dr. Rountree talks about during our interview is NiaCell® (nicotinamide riboside). I’ve since done a lot of reading and Dr. Tommy Wood agrees the research is promising. NAD+ levels control almost everything from mitochondrial biogenesis to ability to deal with inflammation and DNA damage. NAD+ drops with inflammation damaged mitochondria. If you’ve done a urinary organic acids test and you have an accumulation of malate, isocitrate, and alpha-ketoglutarate (all need NAD+) as well as lactate (produced in order to regenerate NAD+ from NADH), and possibly quinolinate and kynurenate (both feed into NAD+ production), then you either have high NAD+ requirements or poor NAD+ turnover. In these cases nicotinamide riboside is especially worth worth considering. Here’s the outline of this interview with Dr. Rountree: [0:05] Christopher’s welcome of Robert. [0:27] Dr. Rountree’s receipt of the 2015 Linus Pauling award and background as Chief Medical officer at Thorne. [2:00] Bob’s interest in nutraceuticals and nutritional treatments and the relationship to functional medicine. [4:28] Christopher’s interest in chatting with Bob about mitochondrial issues and true health. [6:25] Why athletes and people in general should care about their mitochondrial health. [7:32] The mitochondria as the core of healthy metabolic functioning. [9:09] How the mitochondria work: a very basic overview. [12:30] What does a mitochondria look like and what are they? [16:16] Things that make the interplay between cell and mitochondria work better. [17:54] How mitochondria and free radicals impact athletes. [19:18] The importance of using true “antioxidants.” [21:52] Problems that happen with damaged mitochondria: Parkinson’s and diabetes. [25:57] Are the gains needed possible from dietary changes alone? [29:06] How large amounts of carbohydrates damage the cellular pathways in the body. [31:07] What Dr. Rountree recommends for his patients in this area. [34:30] The testing that can be used to measure mitochondrial functioning. [40:00] The use of an unfamiliar nutrient supplement: nicotinamide riboside. [46:08] Why you want more mitochondria to achieve peak performance. [48:00] The supplements Dr. Rountree uses personally and why he believes everyone needs more than food to bolster resistance to chemicals in the environment. [51:44] Dr. Bob’s research and current practice and what he’s doing that is most exciting to him. RESOURCES MENTIONED IN THIS EPISODE The Electron Transport Chain at the Khan Academy NiaCell® (nicotinamide riboside) PolyResveratrol-SR® N-acetylcysteine (NAC) Milk Thistle Curcumin Phytosome is in the EXOS multivitamin CoQ10 Genova Diagnostics Organix organic acids test PEOPLE MENTIONED IN THIS EPISODE Dr. Tommy Wood Linus Pauling Pathway Genomics Dr. Stephen Sinatra

This week I’ve got Dr. David Minkoff, MD on the show to talk about protein supplementation. Before going any further, I should make it clear I’m all for real food. Spend your money at the farmer’s market before you spend on any supplement. Having said that, I’ve also had great results taking supplements, and I’ve seen many other athletes enjoy the same. Close to the top of the list, especially for athletes with digestive complaints, are free-form essential amino acids. Dr. Minkoff is a board certified pediatrician and fellow in Infectious Diseases and has extensive postgraduate training in Complementary and Alternative Medicine. He’s an expert in Functional Medicine, Chelation, Allergy Elimination, European Biological Medicine, Neural Therapy, Longevity/Aging Medicine, Enderlein Therapy, Insulin Potentiated Therapy, and more. And equally important, Dr. Minkoff is an athlete himself, having competed in over 40 IRONMAN competitions. During this interview, we talk about protein and their amino acids building blocks. Free-form amino acids have helped me in three different ways: #1: messed up gut. Back when I was suffering from a lot of gas, bloating and diarrhoea, free-form amino acids helped me with my recovery. I got to the point where I stopped lifting weights because of how sore it made me afterwards, and I even felt sore after an endurance paced ride, sometimes for days. Now I understand more about physiology I can explain what might have been going on. Stomach acid denatures protein and activates enzymes. Imagine you’ve just eaten a nice piece of grass fed steak. The process of protein digestion begins in the stomach with hydrochloric acid (HCl) and an enzyme called pepsin. HCl doesn’t break apart protein into its constituent amino acids. Instead, it denatures the protein. Denaturing means to act on the hydrogen bonds that hold the protein together which allows the protein to unfold. HCl also activates pepsinogen into the active enzyme pepsin, and the pepsin then starts to break apart the peptide bonds. A peptide is just a short sequence of amino acids. If your stomach acid is low, this whole process will start to fail before absorption can start in the duodenum. Brush border enzymes break apart proteins in peptides and amino acids. Once in the duodenum, the partly digested food is called chyme. The pancreas produces digestive enzymes, some of which break down the proteins in the chyme. The key proteolytic enzyme trypsinogen activates into trypsin at the brush border of the enterocytes that line the GI tract. Think of the delicate brush border as a shag carpet, and the proteolytic enzymes contained within the shags are themselves proteins synthesised by the nucleus of the enterocyte cell. Zinc is an essential cofactor. All the enzymes described thus far are themselves proteins, and to make them your body needs zinc. Surprisingly, zinc found in food is usually bound to a protein, and to separate the zinc from the protein and absorb it, your body needs zinc! It’s a vicious cycle. Alkaline phosphatase below 70IU/L may hint at a zinc deficiency. Elevated indican on an organic acids test indicates the bacterial breakdown of protein. Elevated indican means that the bacteria, not you, are digesting the protein that you eat. Diagnosis: messed up gut. Free-form aminos are easily absorbed. Hopefully me explaining all this will help you understand that protein digestion is complicated. If it goes wrong, we’re in big trouble. Free-form amino acids like the ones in Nourish Balance Thrive Catabolic Blocker do not require the same complex digestion because the tablets are water soluble and the individual amino acids are easily absorbed on contact with the enterocytes. Even though my digestion is much better now, I still take essential amino acid tablets during my rides. I like my water plain, so I'll throw a handful of tablets into my jersey pocket every time I head out. I then take five tablets (5g) for each hour of ride time. Sounds strange, but once you get used to it, it's very easy to swallow five tablets at once and they don't seem to dissolve in my pocket. #2: making sugar from muscle. Exercise, especially hard exercise, is catabolic which is a fancy way of saying a state of breaking down. Even though I remain in ketosis most of the time, glucose is still the most readily usable form of energy and some cells lack the molecular machinery to burn anything other than glucose. For this reason, your liver will produce glucose during exercise in a process called gluconeogenesis. Gluconeogenesis uses protein to make glucose during exercise. The main source is the amino acid alanine liberated from muscle. My hope is that by taking free-form amino acids during exercise I can prevent this catabolism. I certainly notice a difference in muscle soreness after a long and or hard ride and especially after a race. #3: reducing fatigue during exercise. Eating turkey makes you sleepy because it contains the amino acid tryptophan, right? Everyone knows that. The fact that you felt sleepy after eating could have had something to do with the 800 calories of sweet potato mashed with butter and sugar that you ate with the turkey, but still, there is some truth to the tryptophan part. Large, neutral amino acids compete for access across the blood-brain barrier, and during exercise they all disappear into muscles except for tryptophan. With unabated access to the brain, tryptophan is used to make the inhibitory neurotransmitter serotonin and that may contribute to central fatigue. Nourish Balance Thrive Catabolic Blocker contains tryptophan, but the three main ingredients are the other large neutral amino acids leucine, isoleucine, and valine. These three are usually referred to as the branched-chain amino acids. The idea is that during exercise, the tablets replace the branched-chain amino acids disappearing into muscle for use as fuel and so we slow down the rate of tryptophan crossing the blood-brain barrier. I'm less sure about this one so I'll give you a reference. Here’s the outline of this interview with Dr. David Minkoff: [0:01] Introduction of Dr. David Minkoff. [0:45] Why Christopher wants to talk with Dr. Minkoff about Amino Acids and protein. [2:15] Why are Amino Acids and proteins important to the body? [6:34] How Christopher discovered that protein deficiency was an issue for him and how Amino Acid supplements helped. [8:15] How free form Amino Acids can be a great help to people and why Amino Acid deficiencies can occur in unexpected ways. [10:38] The importance of getting the RIGHT Amino Acid supplement. [16:33] The problem with whey protein. [21:02] How Dr. Minkoff’s amino acid protein supplement is produced. [22:40] The reality of Amino Acid usage with exercise: what’s happening in the body? [26:20] Lessening mental fatigue using essential Amino Acids. [33:05] How you can make room in your budget for the right Amino Acid supplement. [34:32] How to connect with Dr. Minkoff. RESOURCES MENTIONED IN THIS EPISODE Spritz speed reading app. Nourish Balance Thrive Catabolic Blocker (thank you for supporting the podcast) www.DrMinkoff.com www.Lifeworkswellnesscenter.com - Dr. Minkoff’s clinic PEOPLE MENTIONED IN THIS EPISODE Dr. Richard Feinman Dr. Tommy Wood

Today’s podcast episode is a bit different than usual because I’ve solicited questions from the Optimising nutrition, managing insulin Facebook group for kidney expert Dr. Jason Fung. If this is the first time you’ve heard of Jason, you might be better off starting with his Sigma Nutrition Radio interview and also The Aetiology Of Obesity YouTube playlist. The questions are great - they cover the topics of blood glucose levels, type 1 and type 2 diabetes issues, fasting, muscle loss, what Jason recommends as an effective treatment for diabetes and much more. Before we get into the Q&A, let’s start out by clarifying some things about diabetes that Jason was very insistent that we understand... The difference between type 1 and type 2 diabetes. Many people think that type 1 and type 2 diabetes are closely related but Jason insists that’s wrong. They are “completely different diseases” and “you can’t even talk about them in the same sentence.” Type 1 diabetes is a problem of not enough insulin. The proper course of treatment is to give insulin to the patient. That makes sense. But type 2 diabetes is a disease of too much insulin. Yet, what do we typically do for a type 2 diabetic? We give them insulin. Why? To control what we consider to be high blood sugar levels. But giving insulin to a type 2 diabetic doesn’t address the underlying cause that is the insulin resistance. Giving insulin as medicine drops blood sugar levels but the disease remains. Jason likens this method of treatment to giving an alcoholic a drink of whiskey because he’s experiencing withdrawal symptoms. Sure, the symptom will go away temporarily but the disease is still there… and it’s actually getting worse. On this episode you’re going to hear Dr. Jason Fung answer these specific questions: Q: Which is worse, insulin toxicity or glucose toxicity? Q: At what percentage of A1C could we expect the person to have diabetes? Q: Various questions about blood sugar levels and what is the right number to shoot for. Q: When is a low carb diet not enough to help with diabetes? Q: What are the benefits of fasting for type 2 diabetes? And what are the benefits of intermittent fasting? Q: Do you use fasting protocols or work with patients on a case by case basis? Q: Does fasting cause too much stress on the adrenals? Q: Is fasting different for men and women? I’ve heard it isn’t good for women to fast. Q: What happens when someone lean begins to fast? Do they begin to burn muscle? Q: Gluconeogenesis in lean individuals: Where is the substrate for glucose coming from? Q: Is there any fear of protein intake causing gluconeogenesis? Here’s the outline of this interview with Jason Fung: [0:19] Christopher’s introduction of Dr. Fung and this Q&A episode. [1:09] Jason’s background of kidney specialization and interest in type 2 diabetes. [8:03] Q&A with Dr. Fung. [45:03] Addendum with Dr. Tommy Wood. [52:29] In a week of fasting, you will likely lose a pound of lean muscle. RESOURCES AND PEOPLE MENTIONED IN THIS EPISODE The Aetiology Of Obesity YouTube playlist Jason’s website Sigma Nutrition Radio podcast Optimising nutrition, managing Insulin Facebook group Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) trial Glucose Control and Vascular Complications in Veterans with Type 2 Diabetes (VADT) trial Basal Insulin and Cardiovascular and Other Outcomes in Dysglycemia (ORIGIN) trial Minnesota Starvation Experiment George F. Cahill, Jr.

So many emails! They seem to be breeding here in my inbox. Wait, what’s this, PayPal wants to validate my social security number? That’s odd, let’s click and see what it is. A form. Ah yes, I know how to do this, it’ll only take a minute. Submit, done. One less email in your inbox, one less problem to deal with Or is it. The next day your boss appears at your cubicle with some guy you don’t recognise. This looks ominous, what could they want? They want to know Why you clicked open that message from PayPal, why you were confusing personal and company email. “It was late and I was tired”, you explain. You clicked on the link because you have brain fog And this isn’t the only situation where your focus has been less than optimal. The guy with your boss is a security expert like today’s guest Mike Zusman, and the email is called a simple phishing attack. Mike is a Cat 1 (fast) mountain biker and one of the three founders of New Jersey based security firm, Carve Systems. Mike and I have been working together for about a year to optimise his performance both on and off the bike, and I love his ideas about how security breaches could be prevented. How many phishing attacks could be prevented If our employers invested as much in their employee’s health as they do in the security systems? Not that they shouldn’t invest in security, they should, but it seems to me that there’s more than one way to approach this problem. So what is brain fog, and what causes it? Brain fog is that feeling of nothingness that sometimes happens when you’d rather be concentrating on work. The lights are on but nobody's home. Who knows what causes it, I think it’s one of the signs and symptoms of an underlying problem. There are however, some plausible mechanisms, like quinolinic acid on an organic acids result. Quinolinic acid, or quinolinate as it’s labelled on a urinary organic acids result Is a potent neurotoxin–a fancy way of saying harmful to brain cells. This image was taken from Mike’s first organic acids result: And this from the retest after treatment: We’ll never know if quinolinate was the cause of Mike’s brain fog But a plausible mechanism, together these results and improvement in symptoms is better than nothing, right? So what did Mike do? Mike made many difficult and important changes He switched to a healthy-fat, ketogenic diet with emphasis on whole foods, plants and moderate protein. Mike made the switch away from carbohydrate supplementation towards a more fat-burning approach. He also took supplements to fix the problems indicated on the test results that included small intestinal bacterial overgrowth (SIBO). Overall, Mike has been able to reduce the number abnormalities found on the organic acids result from 10 to 2. A better life: reduced stress, increased mental clarity, greater energy Mike is “feeling much better now”, more productive, racing faster and more consistently. Here’s the outline of this interview with Mike: [0:05] Christopher’s welcome of MIke and introduction of their relationship together. [1:46] Mike’s questions about his body’s ability to make the best of the training and changes he was adding to his training regimen. [3:20] Mike’s assessment of his stress levels before connecting with Christopher. [4:57] The biggest help to Mike in making changes that mattered. [6:34] The benefit of the headspace app. [7:01] The diet changes MIke has made and how he’s feeling as a result. [8:08] Moving away from the old way of eating and how Mike did it. [9:50] The importance of nutrient density and letting go of the old foods that are not nutrient dense. [10:41] The impact of Mike’s blood sugar level and health changes. [14:36] The ongoing impact of Mike’s body moving into ketosis. [16:20] Mike’s advice about the transition to a low carb, high fat diet. [19:10] Causes of “brain fog.” [20:13] Mike’s experience of headaches after racing, during stressful situations, etc. [21:13] Christopher’s response regarding the possibilities for the headaches. [22:29] The impact of removing carbs from his diet on Mike’s bike racing. [26:22] The biohack that blood testing can be. [26:51] The importance of being patient to see the changes happen. [28:45] How Mike’s dietary changes are impacting his family relationships. [32:14] New projects that have come out of Mike’s improved health. [35:29] The impact of health on high intensity professions. [41:18] Why Mike didn’t do well on the vegetarian / vegan path and what he thinks about that approach overall. [44:49] How Christopher’s work inspires Mike in his security company. RESOURCES MENTIONED IN THIS EPISODE The Ben Greenfield podcast that Mike first heard me on Headspace Genova Diagnostics 0091 Organix Comprehensive Profile Mike blog The Rich Roll Podcast episode with Andy, founder of Headspace PEOPLE MENTIONED IN THIS EPISODE Ben Greenfield Julia Kelly Rich Roll

Blood testing is an underutilized way in which you as an athlete can improve your performance. Think about a car that's not running smoothly. Sure, you could make some guesses as to why it's not running right, but you're probably going to need to do some tests to understand the underlying root causes. Your body is similar, but rather than spanners and wrenches, our toolkit consists of diet, sleep, movement, stress reduction and supplements. I have for you today a unique episode of the podcast. Dr. Tommy Wood is an athlete, a medical doctor, a research scientist, and the director of our clinical coaching programme O2 Boost. Tommy practises what he preaches, but his work life balance is far from ideal, and his test results are far from perfect. The O2 Boost process is simple. First, place an order. Shortly after, you'll receive a PDF requisition that you take directly to LabCorp, no need to visit your doctor. If you’re lucky enough to be in the UK, the process is even simpler: the test can be done at home from a fingerstick. Choosing the organic acids option enables us to make a more detailed diagnostic--that test is easy to do, you collect a sample of urine first thing, freeze it and send it to the lab using the pre-paid FedEx mailer. Once all the results are in, Tommy and I will gather some appropriate information from you and then analyse your results. Then I'll get you on the phone to discuss what to do next. We thought it'd be fun to record and broadcast our discussion of Tommy's results, and what you'll hear in this episode is not unlike what you can expect from your follow-up appointment. Perhaps you already have some blood test results you’d like us to look at? No problem, choose the “Send you own” option. Everything is important, but nothing more so than stress. I would argue that cortisol is the king of hormones, and I suspect that stress, both good and bad, may be the underlying cause of most of the imperfections that we've found in Tommy's biochemistry. Click the image to download a PDF version of Tommy’s results: Here’s the outline of this conversation with Tommy Wood: [0:03] The idea that lead to recording this O2 Boost consultation. [0:56] Tommy’s response to his blood results. [2:26] The situation Tommy is in that may have impacted his test results. [3:57] Christopher’s assessment of Tommy’s situation and the issues that may be reflected in Tommy’s results. [5:06] The possibility of “adrenal fatigue” in Tommy’s results and the possibility of dehydration. [8:17] Fasting blood glucose of 97 and Hemoglobin A1C of 5.7 - a bit elevated - and Tommy’s response to those results. [12:25] What does Tommy’s low liver enzyme results suggest? [14:26] Ferritin levels are high - and Tommy’s thoughts on that. [16:20] Tommy’s suspicion that he might be heading toward iron overload. [18:58] Tommy’s cholesterol level: 228 - above the normal level and in increase from the last time he measured. [20:07] Fasting glucose levels below 5… a very good result. [20:44] TSH of 1.0 - free T3 of 2.7 - Thyroid function appears to be a bit low - and Christopher wonders if Tommy is eating enough food. [22:38] Tommy’s homocysteine readings: a bit elevated and a possible additional clue that Tommy is headed toward iron overload. [26:05] Red blood cell size reading is inconclusive. [28:07] Vitamin D levels are 29.2 - quite a bit low (and he hasn’t been supplementing). [31:25] Total white blood cell count was 3 - low as well - and reasons why the test could be reading that way. [35:42] Christopher’s assessment of Tommy’s lifestyle and how he’s handling the stress load and busy-ness. [37:11] Should Tommy adjust his diet because of these results? [39:00] Tommy’s attempts at managing the stress load. [40:01] How results have to be considered in light of a person’s baseline. [43:31] What Tommy’s done to deal with sleep issues he’s having. [46:10] Creatinine levels are outside the normal range, which is likely a result of Tommy supplementing with creatine. [47:29] Tommy’s views on supplementation with creatine and cautions about getting a better quality creatine.. [50:52] What Tommy’s blood results show and how you can get your own O2 Boost test. RESOURCES MENTIONED IN THIS EPISODE O2 Boost Testing

For more than 35 years, Phil Maffetone has brought the latest advances in fitness and nutrition to health-care professionals around the world. Dr. Maffetone has a bachelor’s degree in human biology and a doctorate in chiropractic, with certifications in physiotherapy, Chinese medicine, and kinesiology. Dr. Maffetone has worked with world-class athletes and celebrity personalities, as well as people from all walks of life. His extensive list of clients include professional football and baseball players, race-car drivers, Olympic medalists, and, of course, six-time Hawaii Ironman Champion Mark Allen. Phil Maffetone is an internationally-acclaimed author, having published more than 20 books including the first on heart-rate monitoring (early 1980s) and the first on the benefits of barefoot running (1990s). Dr. Maffetone’s textbook, Complementary Sports Medicine (Human Kinetics 1999), is published in English, Italian, Japanese, and Korean. Dr. Maffetone continues to write extensively and lecture worldwide on health and human performance. A clever way to convince people of their carbohydrate intolerance. In the early 1980s Dr. Maffetone had a lot of experience with low-carb, high-fat diets but came against the popular notion of the day that protein and fat was unhealthy. He found it increasingly difficult to convince people that his ideas were right, so he came up with the Two-week Test as an attempt to show people the difference. His thought was that since he couldn’t convince people intellectually, he’d have to show them how good they could feel in just two weeks by adopting his recommendations. For two weeks he’d have the client eliminate all junk food, remove all moderate and high glycemic index foods, and then keep track of their symptoms and weight. If dealing with specific health issues the client would keep track of those as well (blood pressure, for example). In just two weeks many of those clients would feel so much better the wouldn’t require any more convincing on the part of Dr. Maffetone. A different time with different issues. As the winds of change have continued to blow over the health and fitness culture we’ve seen things come to a point today where many top athletes, trainers, and coaches have come around to Dr. Phil’s way of thinking about dietary issues. Still, there are problems that come even on that side of the spectrum. One of the more recent is athletes on a high-fat diet who are under eating. Dr. Phil says, “Not being hungry is a wonderful thing… if you’re healthy.” He insists that these athletes need to focus on nutrient density if they’re eating so much less. This is a wide ranging conversation covering many aspects of Dr. Phil’s experience and career as a health practitioner and coach, as well as his insights on the training practices athletes can use to increase aerobic strength as well as performance. You’ll enjoy this one! Here’s the outline of this interview with Phil Maffetone: [0:03] Introduction of Phil Maffetone, doctor, author, and pioneer of heart rate monitoring. [2:02] Phil’s description of what’s in his latest book, “The Endurance Handbook.” [3:22] What Phil recommends to improve muscular strength without sacrificing health. [8:48] The app that Dr. Phil is working on and why he’s creating it. [11:04] The work that goes into research studies and the thing that’s missing in healthcare today (Dr. / Patient relationship). [12:58] The kind of work Phil does with his clients, including testing and coaching. [24:10] What Dr. Phil has changed in his testing over the years. [30:28] Dr. Phil’s Two-week Test. [33:48] Is the Two-week Test as needed today? [37:00] What Dr. Phil believes causes insulin resistance? [42:28] How common is it for athletes on a high fat diet to undereat? [50:35] Christopher’s experience with doing workouts according to what he “feels” he needs, including interval training, and Dr. Phil’s response. [58:31] Does working the aerobic system mean that an athlete needs to do 25 hours of training a week? [1:01:00] Where would Dr. Phil start if he had no degrees but wanted to start again? [1:04:50] Dr. Phil’s certification program that’s being created. RESOURCES MENTIONED IN THIS EPISODE Endurance Planet Podcast Phil’s conversation with Robb Wolf The Big Book of Endurance Training and Racing The Endurance Handbook ”How To Achieve Athletic Potential, Stay Healthy, and Get the Most Out of Your Body Fast After Fifty Digital Fitness is a Digital Misfit (article) Podcast episode on Iron Overload Phil Maffetone’s website www.MaffetoneMusic.com PEOPLE MENTIONED IN THIS EPISODE Robb Wolf Tawnee Prazak Joe Friel Amanda Stevens (athlete) Tim Noakes Mike Pigg (athlete) George Shehan