Episode #433 – Full Transcript

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From podcastL https://bengreenfieldfitness.com/podcast/qa-433/

[00:00:00] Introduction

[00:00:36] Over the Smoke

[00:05:03] Attention, Longevity Enthusiasts: This Article Is Pure Gold

[00:15:31] Intense Exercise Causes Mitochondrial Damage Even In Elite Athletes

[00:20:16] New Anti-Aging Molecule?

[00:27:28] What Happens When You Have What's Called Relative Energy Deficiency

[00:35:53] Choosing A Personal Trainer

[00:41:36] 11 Expert Tips to Stop Being a People Pleaser and Start Doing You

[00:48:50] Podcast Sponsors

[00:53:36] What Are Some Of Your Best Practices For Calorie Refeeds?

[00:58:45] Would A Food Allergy Affect HRV While Doing A 5-Day Fasting Mimicking Diet?

[01:07:36] How Does Intermittent Fasting Affect H1C And Insulin Levels?

[01:16:10] Featured Review

[01:18:51] End of Podcast

Ben:  In this episode of the Ben Greenfield Fitness Podcast: secrets of the centenarians, a new anti-aging molecule, when exercise is bad for you, does your metabolism slow down? And, much, much more.

Health, performance, nutrition, longevity, ancestral living, biohacking, and much more. My name is Ben Greenfield. Welcome to the show.

Jay, as we were briefly bantering about before this episode began, I do think I have the black lung.

Jay:  Oh, man. So, the smoke is hovering over the Ben Greenfield compound.

Ben:  There's a lot of smoke outside. The Air Quality Index is remarkably low. And, I'm a huge outdoor enthusiast. And, for me to not go outside during the day, looking outside at the sun shining through the grey blackiness apocalyptic-like settings up here in Spokane, Washington means that the Air Quality Index must be pretty dang low. I actually shot a video.

Jay:  Geez.

Ben:  I shot a video yesterday where I was showing–Well, first of all, I've been using my BioCharger, which is this crazy machine that goes [machine sound]_____. It makes pulsed electromagnetic fields and infrared and lights and all sorts of cool alien-like things that, even if there's zero science behind it all, must have some kind of a placebo effect. Although, I just–It does have some science behind of that.

Jay:  Placebo is real, man.

Ben:  I interviewed them on my podcast a while back. But, anyways, they have an oxygenation and a breath-free, and a hypoxia recipe. And, since that thing's right next to my office, I've just been sleeping in there during the day. I have a little catch-up work to do. I've been running that thing a few times a day. I don't know if you're familiar with mullein. Mullein is great as a lung support type of plant. And, it grows like weeds on my property. So, I can dehydrate that mullein and then just make a tea out of it in a French press. So, that's another little hack I've been pulling out.

And then, just based on this whole concept of like supports like, the Doctrine of Signatures in nature, and actually, some amino acid tracing studies that they've done showing that the glandular of certain organs, when consumed, help us support said organ. So, in this case, I've been taking some of the Ancestral Supplements Desiccated Lung Extract. I just sprinkle a little bit of that in bone broth during my lunch time. I bought a little pair of scissors on Amazon that lets you cut open capsules. So, I cut open the capsules and sprinkle them into my bone broth. So, that's my big old biohacks lung support protocol for the smoke.

Jay:  I might need to start doing something like that, I don't know, almost as a preventative measure because the way we got on this discussion is I was telling you that I'm headed to Montana, and the part of Montana that's much more of the western part of Montana. So, not super, super far from where you are. So, I can only imagine that there's plenty of smoke there as well.

And, here on the East Coast, obviously, I don't deal with that. I think there's a little bit that's come our way, but obviously not as concentrated as you guys. So, I'm wondering if I should get some lung capsules or do some other things. My wife as well because we want to have a good 10th year anniversary out there in Montana.

Ben:  I would get the Ancestral Supplements lung capsules. I would get–well, you're not going to get a BioCharger and travel with that. But, I would consider getting a travel nebulizer, like you would get just on Amazon. And then, I would nebulize. There's a pretty good lung support formula that Dr. John Lieurance makes. It's called Glutastat. I use their nasal spray a lot when I travel. But, you can also nebulize with it. It's like glutathione, a bunch of different essential oils. But, it's got some really great lung support in there, too. And, that could be useful as well for when you're coughing up all the black flakes, the black romantic flakes that you want to share with your wife during your guys' anniversary. Which part of Western Montana, by the way?

Jay:  Missoula. So, we'll be at 16,000-acre ranch in Missoula, Montana.

Ben:  Alright, well, we won't bore people with the details. But, email me separately, dude, because you literally are pedal to the metal almost two hours or less from my house.

Jay:  You do?

Ben:  Yeah.

Jay:  We got to meet up. Love it.

Ben:  Yeah, we may have to have a steak feed over the smoke.

Well, this is our live clubhouse Q&A. For those of you who aren't familiar with this, we record this Q&A live on Clubhouse. And, we always, via my newsletter and my social media, send out a link to join in on the clubhouse live chat. And, typically, we dive into some cool news flashes and articles for a little while. And then, we open things up to Q&A. So, I guess, that means that we should follow our own rules and jump in today's news flashes. What do you think, Jay?

Jay:  Yeah, man. Let's rock and roll.

Ben:  Alright. I came across a really cool article. It's basically–Well, it's initially about this gal, Jeanne Calment. Jeanne Calment, being one of the longest-lived humans on record. Although, she recently passed. She was 115 years old, I believe, when she passed. And, this article is about the longest-lived humans. It's like an observational article about the habits and routines and life story and history of, basically, a whole host of people who pretty much, across the board, lives to about the age of 115, which I think I've established another podcast interviews that I've done seems to be right now still the approximate ceiling on human life span, about 115 years old or so.

What they got into was a lot of the practices of some of these people and how they ate, how many kids they had, what kind of little routines that they had. I thought there were some notable takeaways. And, just to preview–and, we always link to these kinds of articles that we talk about in the shownotes. So, for today's shownotes, go to BenGreenfieldFitness.com/433. And, I'll link to this article. But, for example, and these are all 115-ish year-old centenarians, there was Charlotte Hughes, who, every day, had a stiff brandy, bacon, and eggs.

Jay:  We're going to do it right now.

Ben:  It's right there. That's going to help you live a long time, with a smile on your face versus being cold and hungry and libidoless trapped inside a cryotherapy chamber and eating any [00:06:52]_____ capsules. This gal, Jeanne Calment, who I already mentioned, a French lady, she had a glass of port and she also had a cigarette every day, one cigarette every day.

She was also really into her cakes and her chocolates. And, of course, there's no doubt, we've shown in many studies that smoking will shorten your life. And, indeed, it appears to be tobacco packaged up with all these other carcinogens that seem to have a pretty powerful known factor in reducing human lifespan. Yet, we do see amongst several of these people–Jeanne Calment would smoke one, actually, in some cases, two cigarettes per day, but claimed that she rarely inhaled.

Another guy, Chris Mortensen, who is the world's oldest man, he actually smoked quite a bit on pipes and cigars but claimed also to not inhale. These people are reminding me a bit of President Obama, former President Obama. He did not inhale. And so, there is this idea of the hormetic effect of certain plant defense compounds that may actually induce an endogenous antioxidant response that helps you grow stronger. I personally think that exercise, sunshine, cold water, heat, plant defense molecules from herbs and spices, etc., are probably a better way to get that hormetic effect versus smoking cigarettes. Yet, it is interesting that these people did smoke several of them.

Jay:  Sure.

Ben:  I've talked about the longevity effects of, probably, for similar reasons, microdoses, so to speak, of alcohol. A lot of these people had alcohol nearly every day.

Jay:  That's common theme.

Ben:  For example, Maria Esther is another one. She had a small cup of wine every day with lunch. Jeanne Calment, like I mentioned, had a glass of port every day. That Charlotte Hughes lady I talked about, she had a stiff brandy every day. And so, once again, we see that that not large intake of alcohol or not frequent episodes of alcohol that are more of like a binge episode but small amounts of alcohol everyday seem also to be a characteristic of many of these folks. Only very few of them said that they–There's one that said they never damaged their body by a liquor, Emiliano Mercado del Toro. He attributed his longevity to a healthy diet. Daily, he would have boiled cornmeal, cod, and coconut milk. And, his favorite drink, instead of alcohol, he actually drank a lot of coffee.

And, along the same lines of vices, I noticed how often chocolate would pop up on many of these people's list of go-tos as well, which I don't know if that has something to do with increasing human lifespan, as much as there's not a lot of human beings walking the face of this planet that don't have some certain fondness in their heart for chocolate. So, I would imagine, if you were to do a survey of any random handful of people, you'd probably see chocolate popping up over and over again. Although, I'm lucky because, barely anybody in my family actually likes chocolate, especially dark chocolate.

Jay:  Weirdos.

Ben:  So, I get most of that to myself. So, a few other things. It seems that most of these people, especially the men, in particular, this is interesting, didn't have that many kids. About half of the folks on this list had no children or only one child. Yet, amongst the women, the longest-lived women, and maybe this has something to do with the whole matriarchal philosophy where women who feel as though even when their past childbearing years are given some type of matriarchal role where they pass wisdom along, tell stories, care for other people in the village or the community, etc., that that induces meaning and purpose in their life. Thus, they live a longer time, even if they're a woman who, you'd think from an evolutionary standpoint–sorry, ladies, about saying this. But, just put your ancestral hat on here momentarily. If a woman can't have kids anymore, nature wouldn't necessarily see a lot of value in her being alive.

Yet, in humans, we see that that doesn't happen in women who are given more matriarchal roles in society. Thus, dictating that, even when you're past childbearing age, if you have life's purpose based on caring for, perhaps, a lot of the children and grandchildren and great, great grandchildren you may have produced, that there's actually a longevity-inducing effect. And, sure enough, many of the women in this paper, they had 8, 10, 15 children.

Whereas, one of the men, you don't see that effect quite as much. And, interesting, many of them outlived their children.

Jay:  That's crazy.

Ben:  Few things I noticed, because I like to take notes as I read an article like this, not because I'm a transhumanist who wants to live forever. I just want to equip myself to be able to throw a football around with my grandkids and not be relegated to a wheelchair in my later years, you found that many of them were super self-reliant. They insisted on driving themselves to the grocery store. They love to walk into old age. They love to go out to restaurants. They just seem super tough and self-reliant. They built a lot of their own homes. They took care of themselves. They insisted on not being placed in the hospice. Not giving up on caring for themselves, very self-sufficient and, to a certain extent, self-actualized. That was an interesting anecdote.

And then, one last thing that I noted was that, most of them when they did die, they died from frailty, their physical function declined markedly, typically, after about 105 or so. That was when they began to just have difficulty or would slip and break a hip or have a broken bone. It wasn't really cancer or heart disease, etc., that seemed to take a lot of these people out. It was just frailty, which advises us, in the area of fitness, we know that the amount of muscle and the amount of bone density and the amount of mobility that you possess going into your later years is what you're stuck with.

And so, focusing at an early age on functional strength training, on mobility, on being able to do exercises that go beyond the Nautilus at the gym, but carrying weights and walking them around, being able to balance on one foot or one leg, being able to walk for longer periods of time at a decent pace, these all seem to be skills that would serve you in fighting the battle against frailty as you age. So, just a fascinating article.

Jay:  Yeah, for sure. There are a couple of things that also stood out for me. I love that they said that one of the things that they also shared was their will to live and their sense of humor. And, I really resonated with that one because I just feel like it's such an important yet overlooked thing. We always think about, how can we enhance ourselves from a physiological fitness perspective? And, that's great. There's importance to it. But, also, too, just enjoying life, being passionate about our pursuits, experiencing meaning in our lives. And then, also, too, just having fun and just enjoying laughter and making other people laugh. It's one of those things that I really resonated with that one.

And, the other thing, too, I like that when you talked about the whole idea of self-reliance. So, I actually had my great–One of my great-grandmothers lived until she was in her mid-90s. So, not centenarian, but pretty damn close. And, one of the things about her is she was such a firecracker. She was like, “I'm going to do everything until I die. I will be the one to drive myself to church, to drive myself down to the local grocery store, to go do my own thing.” And anytime anybody tried to give any bit of help to her, she would just bite at him and be like, “What are you trying to do here? I want to live my life like the way I want to live it.” And so, I'm like, “Yeah.”

And, that's actually how my grandparents are, too. They're close to their 90s. And so, hopefully, that gene pool is being just passed down directly to me and that's where I'm headed as well. But, it's an interesting observation, for sure.

Ben:  Every old person needs to know a few good jokes.

Jay:  Yeah, dirty old man jokes.

Ben:  Like my favorite of late, what do you call a pig that does karate?

Jay:  Pork chop.

Ben:  Pork chop, you got it.

Jay:  I got it, yes.

Ben:  Good one. Alright, so we won't give up our day jobs, folks. Don't worry. We are not in the comedy category on any of your fine, fine podcast players. And, we promise that we probably won't be anytime soon. So, anyway, that article is called “Biographical notes on the longest living humans.” And, we'll link to that at BenGreenfieldFitness.com/433.

Now, speaking of anti-aging and living long time, this was a controversial paper in the Journal of Applied Physiology that hit the news outlets a few weeks ago. It was a new research that found that elite athletes, meaning people who exercise the pointy end of exercising, have temporary mitochondrial impairment after their intense workouts. So, this was a study where they looked at mitochondrial capacity, the body's ability to be able to generate exercise, and the health of the mitochondria itself.

And, they took a bunch of athletes. They used, in this case, male elite athletes, people who had won national titles or even internationally recognized for their performance in, in this case, cycling and triathlon. And, they had them trained for four weeks really hard. They basically did a four-week training program where they did two to four days of low- to moderate-intensity endurance exercises or workouts. And then, they had three days of intense training with some pretty intense high-intensity interval training, two days. And, they were training for 12 to 20 hours per week, which is pretty decent, if you add it up. That's pushing two-plus hours a day on most days with pretty heavy training. Although, most of the folks in the study obviously were used to heavy training, this was a new workout protocol for them for the four weeks. It was thrown a curveball at their bodies.

And, to the research team's surprise, actually, because they didn't expect this, the trained participants' mitochondrial capacity was impaired after the month-long training period. And, the researchers had hypothesized that the elite athletes would actually be more resistant to those kinds of alterations. But, it turns out that wasn't the case, that they saw, essentially, reduction in mitochondrial capacity, the ability to produce ATP, probably, some of the effects of excessive inflammation, overtraining, perhaps, from the impact that had on things like sleep and heart rate variability, etc., also, affect mitochondrial function.

But, what I think a lot of people don't realize when they see the results of this study because a lot of people responded to this by saying, “Well, no more high-intensity interval training for me. I'm done. I'm not going to push my body to the extent where I'm reducing my mitochondrial capacity.” Well, the study also found that the reduced mitochondrial capacity didn't affect these folks' exercise performance at all, because they still had oxygen delivery going from their heart to their muscles. And, the researchers hypothesized that oxygen delivery and oxygen uptake actually played a more important role than mitochondrial function and performance. So, it's not as though they showed that doing a month of hard training like this actually affected your ability to be able to perform. And, that oxygen delivery from the heart balanced out the reduction in mitochondrial capacity.

They also found that there was an upregulation of three different proteins, proteins with pretty strong antioxidant properties, that increased after the period of intense training. Thus, showing that, similar to what I was talking about cigarettes and alcohol when we're talking about the old people, the body is mounting up a pretty robust production of its own endogenous antioxidants and its own cellular resilience in response to this period of stressful training.

So, what this means is that, essentially, everything that you would want to happen for a bounce-back in mitochondrial density and function for an increase in fitness and for an increase in oxygen delivery and oxygen output was actually occurring. But, the trick is that you need to work in periods of time for the body to actually absorb that training and for the body to recover from that training. So, all this study shows me is that, yeah, four weeks of hard exercise, especially, in elite athletes, does exactly what we wanted to do. And, the only thing you want to make sure that you provide in that scenario is some kind of deload week or detraining period of time. That's the whole definition or, partially, the definition of puritization in exercise. You have certain periods of time where you train hard and certain periods of time where you train easy.

And, really, my main takeaway from this exercise, just don't beat yourself up for much longer than four weeks without a deload week or without a detraining week for you to be able to soak up the effects of all that exercise that you did. So, this doesn't cause me to want to swear off high-intensity interval training. All this tells me is that recovery is important and that high-intensity interval training actually works for stressing out the mitochondria the way we want to.

Jay:  Wouldn't another way to look at this, too, basically using what you're saying, just in, maybe, more technical language, is to avoid overtraining in an anaerobic state and focus more on recovery in an aerobic state?

Ben:  Yeah, basically. Just smart recovery. And, I thought that this might really have some relevance and crossover to another study that I found that actually showed a pretty powerful way to protect the mitochondria. And, this study was done in, I think it was mice. It was an article in Nature Magazine. I'm sorry. It wasn't mice, it was worms. I get worms and mice mixed up. They look really the same, if you [00:20:55]_____ or you really have a poor eyesight.

Jay:  They're so similar.

Ben:  Anyways, though, this study was on worms. But, they do a lot of anti-aging studies in worms and yeast and fruit flies and rodents and find that there is some crossover to humans. And, in this case, they found that, with age, you see this protein. It's a protein. It's a mouthful, but I'll just give you the abbreviation. It's called NFYB-1.

So, this protein called NFYB-1 switches on and off genes that affect your mitochondrial activity. And, the activity of that NFYB-1 protein goes down during aging, meaning that the mitochondria are going to work as well. And, as a result of that, the worms weren't living as long as they age due to the activity of this NFYB-1.

Now, what NFYB-1 does is it can allow molecules to be broken down and recycled as nutrients. So, almost like the cellular autophagy that we hear about, the natural cellular cleanup. And, it especially does that in mitochondria.

Now, they found that there's a certain crucial protein in the mitochondria that's responsible for the activity of something called cytochrome c oxidase. Cytochrome c oxidase is one of the parts of the mitochondria that can do things like accept biophotons of light from sunlight and infrared light and produce ATP, which is one reason why red light and sunlight exposure is so good for the mitochondria.

And, this crucial mitochondrial protein is called cardiolipin, we've mentioned a couple times before on the podcast. But, it looks like cardiolipin content seems to decline remarkably with aging. In addition, the cardiolipin tends to be damaged by polyunsaturated fatty acids, by vegetable oils. And, they've actually found that that fully saturated fats or a diet that includes some amount of saturated fats and DHA, to a certain extent, as well, such as you would get from you sardines, mackerel, anchovies, herring, grass-fed beef, etc. Well, it turns out that DHA and saturated fats help your body to produce this protective cardiolipin.

What they found, though, was that, when they directly fed the worms cardiolipin, there is a restoration of mitochondrial function and worm health and anti-aging effect, because these cardiolipins are so essential for the human mitochondria. So, A, we now see that cardiolipin is this protective molecule for the mitochondria that has now been shown to have a life-extending mechanism. And, B, it makes you think about whether or not some of these folks producing anti-aging formulas, which a lot of companies are right now, all these different mitochondrial protection or mitochondrial regeneration formulas, whether or not, we're just going to see cardiolipin as one of the next–like NAD, one of the next anti-aging molecules that might be available for sale, probably, at a disproportionately high price, at really high margins, and without any information for people —

Jay:  No, it's mutually.

Ben:  –to, maybe, first think about avoiding vegetable oils and getting enough saturated fat and DHA in their diet. But, that aside, it would be interesting to see if we're going to see more cardiolipin supplementations protocols that appear on the market. Although, I should note that a lot of the mitochondrial support formulas, for example, Thorne has one called Neurochondria. And, it's really good. It's like acetyl-L-carnitine, coenzyme Q10, and glutathione, and phosphatidylserine, which may actually help as one of the building blocks to support cardiolipin activity in the mitochondria. You'll see a lot of these type of compounds in some of these mitochondrial support compounds that may support cardiolipin to the extent to where we don't have to actually supplement with cardiolipin. But, I'd be curious to see some type of cardiolipin study take place in humans now as well.

Jay:  I'm surprised they aren't already actually making that as a supplement.

Ben:  I couldn't find much cardiolipin for sale. I don't know. Maybe, people pop in in the comments section of this particular podcast at BenGreenfieldFitness.com/433. You could let me know if you know of a company that's currently producing cardiolipin approved for human consumption, that type of thing. It'd be interesting to check out. I think, probably, one of the closest things–and, this flies under the radar, is there's a doctor named Dr. Dayan Goodenowe. And, he actually wrote a–I might be butchering his name. But, I've had some email communication with him. He just wrote a book called “Breaking Alzheimer's.” I recently finished that book. And, it's about these things called plasmalogens and how a decline in plasmalogens is directly correlated to increased risk of dementia and Alzheimer's.

And, these tiny molecules, these plasmalogens that tend to decline with age, have a real protective effect on the mitochondrial membrane. So, he actually has a scan. I've done a couple of his scans called a ProdromeScan, where he looks at your plasmalogen levels. And then, his company, Prodrome Sciences, actually makes these things called plasmalogens that you can actually supplement with. And, if I have the APOE4 gene variant, for example, with the increase risk for Alzheimer's and dementia, after reading his book and going through his test and seeing some of the stuff that he produces, I think that I would probably work some type of plasmalogen supplementations or, at least, a ProdromeScan in to see where I was at, because I think that this is probably one of the closest things out there right now to, probably, having some of the effects of supplementations with cardiolipin.

So, I actually had a before and after video of my own ProdromeScan and some more information on him and what he does. And, I'll link to that in the shownotes. I had a couple of weekly roundups where I showed my pre-results and my post-results three months later. I didn't keep supplementing with plasmalogens afterwards because I was comfortable with levels we're at and feel like I'm getting enough mitochondrial membrane support with my fatty acid intake and my DHA intake. But, again, if I had the, particularly, APOE4 gene variant responsible for increased risk of dementia and Alzheimer's, I'd certainly look into this, or cardiolipin and other mitochondrial support as well.

Jay:  That's interesting. Did you get that guy on the podcast?

Ben:  Yeah, I may. Now that I finished his book and have some pages folded over, I might have him on and interview him. But, super interesting that the new anti-aging darling, Cardiolipin TM.

So, a couple of other things that I think were interesting. There was a study that came out that looked at, basically, what happens when you have what's called relative energy deficiency. So, this paper was looking at what are called non-pharmacological strategies to treat energy deficiency. So, what energy deficiency means is, basically, what you're probably seeing amongst a lot of, I don't know, Olympic gymnast now or what you see in a cross-country runner or many triathletes and chronic repetitive motion athletes who are also trying to keep their body weight low, you'll tend to see this a lot.

So, essentially, it is high energy expenditure, low-fat mass, low energy intake, resulting in this cluster of issues that result in metabolic down-regulation. So, what I mean by that is, when you decrease energy intake, you're not eating a ton of calories and you're working out a lot, which I would suspect a small number of the listeners to this podcast might fall into that category because it's very easy to do, you see a drop in what's called uncoupling protein activity in the mitochondria. The body stops burning calories as much to generate heat as like an energy conservation mechanism.

You also see a drop in the hormones that would result in energy being elevated or metabolism being elevated. You see a drop in leptin. You see a drop in thyroid hormone. You see a drop in sex hormones, like LH and FSH, which are responsible for enhancing fertility just as an ancestral mechanism because the human body doesn't want to bring new human bodies or babies into the world during a time of stress or during a time of starvation.

You actually see a drop in just overall low-level physical activity during the day. You see a drop in the thermic effect of food. You see a drop in sympathetic nervous system tone. You see a drop in the activation of brown adipose tissue, which is the metabolically active form of fat. All this stuff happens when you have long-term energy restriction, paired with high amounts of exercise, like that study we were talking about earlier in the athletes, dictating that the body just goes into shutdown mode to begin to hold on to fat, to begin to hold on to calories.

And, the appetite dysregulation and, also, things like the drop in bone density, the drop in stored minerals, the breakdown of the body's own amino acids, and the degradation in muscle and the muscle loss that occurs as a response to that, can be problematic and can stick with an athlete for months and months on end if they're not careful. And, that's what this latest study was trying to tackle, is how do we actually present some solutions to this type of metabolic adaptation that occurs with longer periods of time in an energy deficit while exercising?

And so, they did come up with some of the things that that work if you're someone who likes to exercise who's also cognizant of the amount of food that you take in as far as what you can do to actually protect yourself from the alteration in hormone levels and the drop in muscle mass, the drop in energy expenditure, and all the things that happen when the body basically just goes into hibernation mode, if that makes sense.

So, some of the things that seem to mitigate the effects of metabolic adaptation is, first, a higher protein intake during the drop in calorie intake. Meaning, if you're going to lower calories, try and at least make sure that the drop in calories that, when you're lowering calories, try and have more of it come from carbohydrates and fat than from protein. Try to maintain at least 0.55 grams of protein per pound of body weight up to about 0.8 grams of protein per pound of body weight. You can use amino acid. You can use whey proteins. You can use collagen that lower-calorie sources than fatty ribeye steaks, if you're on a calorie cut to do that. But, basically, if you're going to cut calories, try to keep your protein intake from dropping. So, that's one of the recommendations that seems to help.

The next is refeeds. And, it appears that doing a refeed about twice a week helps to stave off a lot of the effects of metabolic adaptation. Meaning, have a couple times during the week, a couple of meals during the week, to which you're just basically eating as much food as you feel like shoving into your face. And, that just sends this body a message that–and, this would be something like five days of low-calorie intake or intermittent fasting, etc., but, with two days where you're not fasting a lot or where you're eating to calorie excess or to calorie maintenance or even a meal a couple of times during a week where you're just going out in the town and having a meal at your favorite restaurant, not worrying about pushing yourself away from the table when you're 80% full, just getting to that point where you're sending your body a message a couple of times a week that food is not something that is scarce, or calories are not something that is scarce.

Another one is that, if you are doing this as well, what's called a diet break seems to help also. So, after about four weeks of dieting, even if you're doing refeeds during those four weeks of dieting, throwing in one week for every four weeks that you're dieting is really, really helpful at avoiding a lot of those metabolic adaptations. Meaning, diet, eat calorie deficient, try and get a couple refeeds during those four weeks, during which your calorie deficient and exercising a lot. But, then, have one week where it's really good nutrient-dense meals, maybe, more sauna, walking in the sunshine, maybe, some cold soak, some yoga, some less calorie-burning intensive type of activities. And, if you're going to go the whole year like that, compared to your neighbor who might seem more weight loss early on in that phase by just straight-up living a completely stoic lifestyle and like a monk for weeks and weeks on end, they might lose more weight than you or get better body composition than you or see a greater drop in adipose tissue than you over the first several months. But, what happen is, if you look at it over the course of a year, long-term, you're going to be more successful at, not only losing weight, but keeping the weight off, because when you do these refeeds and when you go four weeks of dieting one week off, what you see is you don't see quite as much of what is called fat cell hyperplasia, where fat cells tend to grow in size and, basically, they're waiting to munch up calories once you finish your diet. And, that's why people see this yo-yo dieting type of effect or a real gain in fat after a long period of time spent losing weight. Well, if you do these refeeds, that type of fat cell hyperplasia doesn't seem to occur to as great an extent.

So, essentially, you're creating a scenario for long-term successful healthy weight loss without that starvation mode happening, without that drop in leptin and thyroid hormones and fertility hormones and a lot of things that would happen to somebody who may get better short-term results but more deleterious long-term results and, possibly, permanent adaptations to their hormones and their endocrine system that would dictate that, long-term, they're going to have more problems in the person who goes a little bit more slowly with weight loss, keeps their protein high, does refeeds, and follows a lot of the recommendations in this latest article.

The other thing that the article touched on is that, in many cases, we see bone density being an issue here. So, making sure that you induced bone stress and also intake a bone-building nutrients. So, you'd basically want to keep your intake of vitamin D, A, E, K, and your minerals high, while also doing some amount of weight training that loads the bone along its long axis, squats and overhead presses, and things like that, if you are engaged in a sport or engage in activity that has some type of relative energy deficiency because you want to keep weight off or you want to lose weight or your sport dictates that you stay light. So, basically, paying attention to bone also appears to be a really, really important part of this as well.

Jay:  It sounds like, in the end, it's like play the long game, not the short one.

Ben:  Yeah. And, I'll link to that paper as well in the shownotes.

A couple of other things. First of all, this is pretty interesting. The Journal of Strength & Conditioning Research looked at what people would look at if they're going to hire a personal trainer. And, this probably comes as no surprise. So, if you were to take into account experience of the personal trainer, like how many years they've worked with clients and what kind of success those clients have seen during the time that trainer worked with them, if we were to look at that trainer's certification, education, classes taken, what kind of university degrees they might have attained, or the robustness of the personal training certification that they do have, is it a weekend certification, open-book test, or has this person studied for years to understand human anatomy and physiology, what continuing education credits has that person taken, and what do they look like, what's their body type like, are they a ruler shape or are they athletic V-shape, or are they more of an apple shape, and how do they look aesthetically, what do you think would be the number one reason that someone would hire a personal trainer, like take out their wallet and hire a personal trainer to create their exercise program and be in charge their bodies?

Jay:  Well, considering my education is in behavioral science, I hope I get this one right. But, I would bet money that most individuals are going to base it off of the individual's aesthetics. They're going to look and say, “Does that person either practice what they preach?” Or, “If they are doing what they're preaching, is it working for them?” I would say aesthetics or the physique of the individual will be the primary thing they look for.

Ben:  Ding-ding, winner, winner, chicken dinner.

Jay:  Yeah.

Ben:  Basically, it's the physique of the personal trainer, which, to me, is super scary because we live in an era of Instagram and social media and, also, drugs where a trainer can cheat their way, take steroids, use performance-enhancing drugs, often, things that are inaccessible or unaffordable to the general population, put photos of them ripped or toned, or showing their booty next to their cat on Instagram. And, a person is far more likely to hire that personal trainer versus, let's say, a trainer with a realistic body who has a really great education, who's going to actually get them good results.

It shocked me how high on the scale simply looking at what a trainer looks like, and in this study, they're actually using pictures. Exactly the type of thing you'd see on Instagram. And, I just want to warn people that, yeah, you'd love to work with someone who appears to practice what they preach. But, if that's your only metric or you're putting that pretty high up on the totem pole, then that can be dangerous because that does not mean that trainer has competence, that does not mean they have knowledge, that does not mean any of those things are increased relative to that person's physique. They might be. That person might have a really good physique and a good body of knowledge. But, don't assume so.

And, this was just a real eye-opening study for me. I didn't realize how many people just almost ignore a trainer's education or knowledge or results, and instead, just hire them based on what they look like. So, I would caution or listeners, be careful. Make sure you look into, does that person have a really good training certification from the NSCA or the ACSM or the NASM? Is it a weekend trainer certification? If they have a certification, have they gone to college at all for four to six years, studying exercise science, anatomy, physiology, biochemistry? Or, are they just a pretty face on Instagram? And, if they're a pretty face on Instagram, I'm not saying they wouldn't be able to get your results. There's a lot to be said for practical experience and anecdotal hands-on experience. But, there's even people on Instagram who literally have never stepped foot in a gym and worked with real people and seeing how real people move in real-life situations, handling real weights. And, instead, they just post a photo and say, “Here's what I look like. Hire me.”

And, usually, when you hire them, they're having you do pretty much what they do for their program, which isn't necessarily customized to you, you're not on all the drugs that that trainer is on, which is another thing a lot of people don't realize. Like, how many peptides and SARMs and hormones and just steroids and drugs, in general, these people are on that dictate that they're getting those results with far less work than you might put in.

Jay:  This is an interesting one, Ben, because I get it. I get it because the natural inclination of the human brain is to respond to things that they see–and so, with our eyes–and go with the easiest heuristic. So, our heuristic is, typically, “This person obviously is doing everything they say they're doing. And, therefore, I must go with them,” without taking into account all of the other variables that you mentioned. And, the other one goes, and I've seen this with other health influencers as well, it's like some people will look at certain health influencers and be like, “I'm not sure that you're practicing what you preach. Or, if you are, it's obviously not working for you, is things that I've heard from plenty of individuals about health influencers.”

And, there's a part of it that may be true. It may be that that's the case. But, it's not always the case. And so, this means that we need to avoid just these easy heuristics that we've developed and really do due diligence in studying up on these individuals and their background, their education, and then, again, what kind of success have they had in their professional career? Are these people who have trained like world-class Ironman or whatever it may be that you're training for, or, “They don't really have much education. They look awesome. And, they don't really have any much success to write home about.” So, we just have to do due diligence.

Ben:  Yeah, exactly.

So, one last thing, and I guess, perhaps, this is somewhat relevant to what we were just talking about, that is not necessarily fitness-related, but it really spoke to me. And, it was an article written by a former podcast guest of mine, Vanessa Van Edwards. I interviewed her about her book, “Captivate,” which is a human behavior hacking type of books, just to show how to read people and how to captivate a conversation and body language tips and stuff like that.

But, she wrote a really good article about people pleasers. I'm a people pleaser. I don't know about you, Jay, but I have a hard time saying “no.” I love to make other people happy. Sometimes, I'll go out of my way to please someone even if it means taking my own valuable time or resources away from me, or sometimes, my family in order to do so. And, she just had a great article that was, essentially, 11 ways to stop being a people pleaser, if you are one of those people who constantly feels responsible for other people's emotions or you find yourself always apologizing, “I'm sorry for being just a few minutes late,” or you say “yes” to parties that you don't really want to go to, or you feign interest even when you're bored, or you laugh when other people laugh even when it's not funny, or you offer to help someone all the time even if you're busy. There's something to sacrificing yourself for other people. But, sometimes, it can get a little bit ridiculous.

And so, she had some really great tips. And, just a quick preview of her tips, and then I'll let people delve into the nitty-gritty in the article, which I'll link to if you go to BenGreenfieldFitness.com/433. She has all these anti-people pleasing phrases. Instead of saying “yes,” say, “Let me get back to you.” It's okay with playing the waiting game. She says, whenever you don't know it's not a hell yes, “let me get back to you,” is a very good response.

Next is to delay. Anytime somebody asks you do anything, just stop, take a deep breath. She shows that human brains need about 50 to 100 milliseconds to block out all distractions and focus on relevant information. And, that takes just stopping and taking a breath when people ask you something. If somebody on the phone says, “Do you want to come out to the party tonight?” don't be like, “Yeah, I think I can make it. Let me check my schedule.” Just stop and take a breath and analyze it logically.

She recommends just starting to say “no” to little things, like when a waitress ask you if you want to order a drink with your meal, it's perfect example. How many of us, the waitress comes out, you don't really want a cocktail, you've finished that first cocktail and they come out, and they say, “Would you another one?” Sometimes, you feel like saying “yes,” and you are literally subconsciously just trying to please the waitress or the waiter. You really don't want another cocktail. You're just like, “I got to be nice. I got to order because they've asked me.” So, just saying “no” in those little situations or just being like, “Well, I'd a glass of water or refill on my soda water instead.” And, that's perfectly fine to do. Especially, if you're like me and you travel to restaurants with hydrogen tablets and electrolytes. For me, any glass of water is easily turned into a cocktail or, at least, something more fun than just a regular glass of water. I've always got stuff in my fanny pack that I'm putting into my water. And, that actually keeps me from spending money on slash-drinking cocktails.

Jay:  Always prepared.

Ben:  Yeah, exactly. So, few others. I'm not going to tell you all of them because the article's a little bit long in the tooth. But, a few others that really stood out to me are two. Basically, not necessarily apologize all the time for feeling as though you aren't on the same page as another person, knowing that it's okay to have your opinion, just basically stop saying “sorry” too much. It's okay to just say, “No, I don't want to do that,” just because–Not, “No, I can't do that,” but, “No, I don't want to do that. That's just not me. I'm not interested in it. That's not who I am.”

And, what I'll do a lot of times is I'll meet somebody in the middle. Somebody recently asked me–And, this is relevant to the podcast, just opening the kimono. They asked me if they could shadow me for the whole day and walk around with me and follow everything I do and just basically be a fly on the wall and just watch me and get to my house, 5:00 a.m., just following around the whole day. And, the inside of me, as a people pleaser, want to say, “It's a great idea. I'd love to bless you and for you to learn all these things from me as you follow me around during the day.” But, I really knew deep down inside all that was going to do was distract me from my job, result in me feeling like an asshole, because I'd be so busy I wouldn't actually be able to stop and explain to this person and everything that I was doing the whole time. And, that, ultimately, it might be a disappointment for them. They would just be following this guy around with his head down and not explaining anything he's doing, and they're just scratching their head the whole time.

And so, I said, “Well, listen. I'm sure you have lots of questions about my daily routine and how I organize my day and how I work with my team and how I prioritize family time and me time and how I structure things and when I write and when I read, etc. So, why don't you just come up with a list of all your questions, the things that you really would be looking for if you shadow me during the day? And, at some point, we'll just have a phone call. You ask me all these questions. And, I'll record it. And, we'll make a podcast on it, with all my daily routines and my show.” And, they're like, “Yeah, I can do that. And so, we're just going to have a call.” And, I'm going to take care of him, help him out. But, I'm going to help him out and also turn it into a podcast and meet him in the middle.

And so, sometimes, you don't necessarily have to say–You can say “no,” but when you say “no,” just offer something that meets him in the middle, that you know is sustainable for you. That makes sense?

Jay:  Yeah, for sure. It's such an interesting thing, because being here in Southern culture, people pleasing is such a immensely big problem here in the South.

Ben:  “Let me get you more fried chicken, honey.”

Jay:  Yeah, exactly. Mom, if you're listening, pay attention. The one thing that I've really noticed is that, and I think that most people would probably agree with this, is that, in general, most people want to be liked. They don't want to be disliked. And so, us saying “no” to something or us not pleasing someone–So, a lot of times, we turn that back and we reflect that on who our character is or who we perceive our character is. Well, I'm someone who can't follow through or I'm someone who isn't nice to people, or I'm someone who isn't liked. And, these are these cognitive constraints that we have that aren't really real. But, we like to tell ourselves that about our character when we say “no” or don't please people.

And, it's just a matter of shaking that. But, it's easier said than done. But, it's a matter of really standing firm on things that we don't want to do. Engage in the things that we do. Help people when we can. But, also, remember too that our time is valuable just as their time is valuable. There's no difference there. So, it's good lessons to keep in mind, for sure.

Ben:  Like she says in the article, “You can't please everyone. You're not pizza.” You're not pizza.

Jay:  That's true.

Ben:  That should be the name of this podcast, “You're Not Pizza.”

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Female: Hello, guys. First of all, Ben, I'm such a big fan of yours. I have “Boundless” and the cookbook. But, when you're talking about refeeds, I usually follow a pretty low-calorie diet, mostly keto. What are some of your favorite things to do a refeed with? And, if it's in your cookbook, that's great, too.

Ben:  Well, during a refeed, I don't cheat on deep-fried Twinkies and Domino's Pizza. I simply eat more of the good stuff. For example, I love to go out to my favorite restaurant for refeed. Lately, I've been going to this Mediterranean restaurant called Baba's here in Spokane. And, I'll get a lamb shank and hummus and pita and tahini and tzatziki and some eggplant fries. And, they're wonderful. Cauliflower dish, and just invite a bunch of friends out and eat a bunch of shared plates and not worry at all about how many calories I'm consuming.

When at home, I like to get a big old cut of meat out of the freezer and do a ribeye steak with, instead of something I might have on a normal day, roasted vegetables or carrot fries, instead something a little bit more dense, like sweet potato fries or sourdough bread with butter and honey. I would, instead of not having dessert, because a lot of times, I don't have dessert and I do the Kion Aminos instead, I'll take 20 grams of that because it just crushes my appetite when I'm dieting down or being cognizant of calories. A lot of times, I'll just do something amino acids for dessert. But instead, during a refeed week, I'll do a really good brand of ice cream. I've been geeking out on this stuff called Good Kind ice cream, which is this really good banana-based ice cream. And, I'll sprinkle a little energy bar on top of that and, maybe, some coconut flakes and some bee pollen, little chocolate sauce. And, you'll have something like that for dessert.

It appears that, based on a lot of the studies on refeeding, that keeping the amino acid pulsing high during the day is actually a good idea, meaning that not only will I, say, take those amino acids I normally have for dessert and do little bits of amino acids throughout the day, but I also, on my refeed weeks or the weeks where I'm trying to take better care of my body and keep my metabolism elevated, I will be sure not to skip meals. It's meal frequency that, especially, from a protein and an amino acid level standpoint, seems to be the most important when it comes to the distribution of meals across the day.

So, if you normally skip breakfast, don't skip breakfast. Have your eggs, bacon, avocado, or a nice superfood smoothie or something during that week that you're refeeding, rather than breakfast skipping and doing longer periods of time intermittent fasting. In many cases, for example, for my lunchtime salad, which is normally a low-calorie lunchtime salad with greens and some type of low-calorie filler. I like sea moss gel or pumpkin mash or the Japanese yam Miracle noodles, instead during a refeed week, again, with my lunchtime salad, I'll do sourdough bread with honey and butter or a higher-calorie dressing on top of my greens, like one of the Primal Kitchen Caesar or ranch dressing, instead of just balsamic vinaigrette and salt and pepper.

I, a lot of times, like I mentioned, with dinner, will eat more of the good stuff, but especially, the bigger fattier cuts, like the pork chops and the ribeye steaks versus, say, doing a lot more of the fish and the chicken and the leaner cuts, so the lower-calorie cuts during a week like that.

When paired with lower exercise calorie burning overall, doing a lot less high-intensity interval training on those refeed weeks and instead doing a lot more sauna, a lot more walking, a lot more cold pool, a lot more yoga, that typically tends to make you feel like a million bucks by the end of the week. And, I have some clients who I coach who are afraid they'll make them fat. But, it doesn't happen. What we see is just long-term gradual decreases in body fat without a drop in muscle mass and without a drop in a lot of the hormones responsible for appetite and responsible for fat-burning and responsible for thyroid upregulation occurring.

So, basically, for me, it's just more of the good stuff, less meal skipping, less of the lower calorie fillers, like sea moss gel and pumpkin mash and Miracle noodles. And, instead, simply more of the good stuff from a real nutrient density standpoint.

The last tip I would give you would be, if you go to the website for the Weston A. Price Foundation, that diet is very rich in fermented foods and ghee and butter and lard and coconut oil and big fatty cuts of meat and broth. And, that's a really good example of, A, the type of diet that's super nutritionally dense and nourishing for refeed period. And, B, that's also the type of diet that, if I'm working with a pregnant woman or a breastfeeding woman or somebody who's showing low levels of hormones but still exercising a lot and needs a lot more hormonal support, particularly from nutrient density and fats, that's the type of diet that I would have somebody like that follow. So, you could look up the Weston A. Price Foundation to better wrap your head around that, particular eating protocol.

But, those are a few of the tips that I've got for you for the refeed week. Great question.

Stephanie: Hi, guys. I just want to say I love the podcast. So, thank you so much for doing this. I've been tracking my HRV for quite some time now. And, I'm consistently around the low 30s. The only thing that I've noticed that's really worked for me in a big way is a five-day fasting-mimicking protocol. And, I guess my question is what do you make of this? Do you think that there might be an underlying food allergy that's stressing my body? And, also, is there a way to keep these numbers higher without consistently being in a caloric deficit? Thanks.

Ben:  And, Stephanie, again, explain to me one more time, why are you doing the five-day–the alternate fasting type of diet? What is it that you're noticing when you're eating a lot of food?

Stephanie: So, I'm noticing that my HRV is quite low when I am eating this regularly. And then, when I'm doing the five-day fasting-mimicking protocol, my HRV skyrockets and it gets to the 50s, 60s, and it lasts there for a couple weeks after. But then, it drops back down again once I incorporate in my regular diet. So, I'm wondering, do you think that this might be an allergy stressing the body or if there's any way to keep those high HRV numbers without being in a caloric deficit.

Ben:  So, we happen to have, probably, one of the nation's leading experts on HRV as my trusty sidekick. Jay, knows a ton about HRV. So, I'm going to let him take this one away with the comment that, if you are calorie-deprived, and that's having the impact that we've already discussed that it can have, then, that can be an issue. But, at the same time, if you're consuming calories from food, if your body has an autoimmune reaction to those foods, or even a psychosomatic reaction to that food, such as it's associated with a stressful event in life, or a blood sugar response to that food, or something else, even an inflammatory gut response to that food, dictating you want to do some gut testing like Genova Diagnostics' three-day gut panel, for example, that could all impact HRV in response to food intake. But, I'm curious to hear what you have to say about this one, Jay.

Jay:  So, I actually think this is a great question and one that I have fielded on numerous occasions because people have made this connection between either fasting or if they're doing an elimination type diet, they see fluctuations or modulations in HRV. Here's the one thing that I really try to drive home to people when it comes to utilizing HRV as a biometric, is a lot of people say, “How can I raise my HRV?” Well, let's ask the question of what we're actually raising.

So, when we're raising a number, what we're raising is that time in between heartbeats, which is indicative of adaptations and resiliency of the autonomic nervous system. Now, there are many different contributors to the autonomic nervous system fluctuations or HRV modulation that we have to consider. One would be the rate that you're breathing. One would be stress load. The other would be–And, when I say stress load, I mean physiological and psychological or psychosomatic stress. And then, also, too, blood pressure regulation.

So, all of these things are factoring in to what is then contributing to this one number, or many numbers, depending on what device you're using, that we call HRV or heart rate variability. One of the things that I tell people from the very get-go is that we get so wrapped up in this objective measure that we forget the subjective measure. We forget to actually check in with how we're feeling, because a lot of times, people are so considerate–I would say a better word for that is “concerned,” of how can I raise my HRV because I see that Ben Greenfield has a 120 HRV or Jay Wiles has a 130 HRV. I had to one-up you there, Ben.

Ben:  Mm-hmm.

Jay:  But, the thing is that we're not actually one-upping one another. There are different genetic contributions that can take somebody from–that's basically sedentary and not very active and can actually have them up in the one 120s and 130s. I've seen it plenty of times. And, I've seen very fit individuals who are very keyed into nutrition, keyed into their nervous system modulations from a stress load standpoint, who are in the 20s and the 30s.

So, I never get overly concerned with where that number is as a baseline. What I do is I take that baseline and say, “How can we make considerations from what we're doing based on that baseline?” Now, for you, Stephanie, one of the interesting things that you did indicate is that when you make some pretty significant shifter changes, you'll see this modulation of nervous system functioning. Could it have something to do with HPA axis dysregulation due to foods or an allergen? Potentially. That's why Ben was mentioning earlier that you should get tested for it. I certainly agree with that.

But, also, too, one of the things that we see happening for almost everybody is that, when people fast, especially, within the first 24 to 38 hours, is we'll see this transient raise in orthostatic HRV. But then, after about that 42-hour three to four days fast, we typically will see people's HRV go down because the body is basically saying, “Are you starving? Do I need to conserve energy and resources here? What was going on?” And so, we'll see HRV go down. And then, when they refeed, we'll actually see it go back up.

Now, again, that's not every case, and it may not be for you, Stephanie. But, obviously, something is happening and there's a shift.

So, if I were you, it would be worthwhile checking in to see if there is a potential food allergen by getting one of these Genova Diagnostics test, seeing a functional medicine practitioner or a health coach who can do that for you. I think that there is support for that. However, what I would say is don't get so wrapped up in what that baseline number is because your 20s of an HRV doesn't mean that you are more stressed or physically worse than me at a 140. The baseline number is not nearly as important as fluctuations from that baseline number, and then, also, too, your ability to modulate stress in the moment or take better control of your stress.

So, for instance, if you were to put a chest strap on you and we were to look at an EKG, or even you could use some different wearable technology, and we look to see, when we manipulate your breathing, can you take your 20 HRV and bring it up to a 50, 60, 70? Maybe, you can. And, if you can, then that means you have extremely strong control and resiliency of your nervous system, especially, your parasympathetic vagal break. But, if you can't do that, if you can only get it up to 21, 22, and you started at 20, then, we have a vagal brake problem, which could be contributed by food. It could be contributed by stress, by overactivity, whatever it may be.

So, I'm sorry. I don't want to get too long in the tooth here, but there's different things that you have to look at. But, always make sure that you are taking equally as much of a consideration into your subjective experience of how you feel and not just base it on objective data. Just use that as a backup. So, that's how people–I'm an HRV expert, but I tell people, “Don't only rely on HRV. Rely on HRV, plus your level of subjectivity.” Hope that made sense.

Ben:  That's great feedback, Jay. And, I run with this a lot with people, like, “Food affects me deleteriously.” In some way, gas bloating, HRV, sleepiness, brain fog, whatever. The long-term solution is not don't eat because that's not very sustainable. Last time I checked for living a long time, you actually do need, unless you're a real true ninja of a breatharian, some amount of calorie intake at some point in your life. So, while fasting can be a short-term solution for helping to heal the gut and turn over some of the cells in the lining of the gut, etc., especially, for people with SIBO or some type of underlying yeast or fungus or gut inflammatory type of problem, you can't just fast your way out of that. Go back to the way that you were eating and expect for everything to be fixed.

Jay:  Exactly.

Ben:  In most cases, there are some underlying issues with your psychosomatic approach to food or the actual composition of your diet that needs to be adjusted.

Jay:  Well, I can raise people–It's just like this. Would this be sustainable? I could raise your HRV right now, Ben, by engaging your mammalian dive reflex. By putting your face into cold water, I could get your HRV up within 30 seconds, anywhere from 20 to 30 points. I guarantee I can do it. Or, you can do it, I should say. But, is that sustainable? Are you going to go around with your face on water all day every day? No, just like you're not going fast all the time. It's just, obviously, you cannot live life that way.

So, you have to take the metric for what it is, not something that says–Well, as I should say, you should take the metric for what is in the sense that it is something that provides you with data that allows you to check-in with your subjective experience.

Ben:  You got it. Alright, well, that's a great question. Let's do one more question here.

Angelique: Question regarding H1C and insulin. I've had work done with functional medicine doctor for a few years. So, I have a couple years of blood work to repair. My most recent was done during intermittent fasting. My H1C was 5.9 and my insulin was 2.8. Historically, I've had 5.3 and 5.2. I follow a really, really clean diet, plant-based, as well as just introducing really healthy grass-fed beef lately. At that time, I was doing intermittent fasting. So, curious of any feedback on that. I'm planning on doing a retest because these numbers just don't make sense. This is Angie, and I'm done speaking.

Ben:  Alright, cool. So, hemoglobin A1c, that's simply like a three-month running snapshot of what your blood glucose is, or at least an approximation of it. It refers to glycated hemoglobin. So, glycated hemoglobin. So, HbA1c is something that is going to develop or, basically, have a certain amount of percentage in your bloodstream. And, HbA1c itself develops when hemoglobin, which is a protein in your red blood cells that carries oxygen through your body, binds with glucose in the blood. And, that causes that protein to become glycated. Hence, the name glycated hemoglobin.

So, when your body processes sugar, of course, as you would imagine, glucose in the bloodstream is going to attach to hemoglobin. And, the amount of glucose that combines with that hemoglobin is proportional to the total amount of sugar that's going to be in your system. And, what they recommend for the most part is that you keep your hemoglobin A1c below about 6% or so.

Now, due to increased turnover of, particularly, red blood cells in people who exercise a lot, athletes, exercising individuals, exercise enthusiasts, etc., it's not that great of a value, just because you can see artificially elevated hemoglobin A1c levels in that population dictating that, if I see someone with high HbA1c and they're an athlete and exercising person who you would expect to have pretty good metabolism and they're eating a diet that's not really high in sugars and vegetable oils and other things that would contribute to that glycation, I like to look at some other parameters, like what's the fasting glucose look like? What's the insulin look like? What's the insulin growth factor look like?

And, for me, personally, well, to put this in perspective for you, I recently did an HbA1c tests and at the same time had been wearing a continuous blood glucose monitor. My continuous blood glucose monitor was giving me values on a typical day of 80 to 90, not a lot of variability, pretty well under control, looked great. My hemoglobin A1c came back at 6.8, which, for me, is really high. Yet, I'm not that concerned about that because I'm looking at my blood glucose all the time. It's super stabilized. And, I'm sure that a big part of that elevation in hemoglobin A1c is due to the fact that I'm exercising. I've just got a higher red blood cell turnover. And, a lot of my exercise includes some amounts of endurance training. So, if you fall in that category, I don't even know how much faith you would want to put in that HbA1c data, if that makes sense.

So, that's one thing to think about. And so, really, I would get a continuous blood glucose monitor. Insurance might not cover it for you, but anybody can get one. Anybody can go to Levels and talk to them about getting one, or you can look into the FreeStyle Libre or the Dexcom G4 as a couple of ways that you can track your blood glucose continually. But, there are a few random things that can increase hemoglobin A1c. Smoking increases it. I'm assuming you're not smoking. A lot of times, you have a deficiency in iron or a deficiency in vitamin B12 or a deficiency in folate. Those can all raise hemoglobin A1c because they almost cause anemia-like symptoms. And so, that would also be something to look into, is what's your iron at, what's your vitamin B12 at, and what's your folic acid at?

  1. pylori infection, which a lot of people have in the gut, I would get your gut tested because, a lot of times, that is correlated with high levels of hemoglobin A1c. You also see high levels of hemoglobin A1c when urea is high. A diet that's really high in uric acid or even poor kidney function, so if you get your labs and you look at your estimated glomerular filtration rate, your eGFR, and your creatinine levels, and other markers of kidney function, you'd want to make sure that you just double-check the kidneys and make sure those are working well.

We know that poor sleep is definitely associated with higher levels of hemoglobin A1c. So, usually, you see that with sleep apnea. And, people with sleep apnea tend to have high hemoglobin A1c levels. So, you may want to consider a sleep study test, too. People who use a lot of opiates have high hemoglobin A1c. So, I would think about that. People who drink a lot of alcohol, also, have high levels of hemoglobin A1c. I doubt, based on what you've just described about yourself, Angelique. You're like a booze-chugging cigarette smoker, unless you want to live to 115-plus years old, like Jeanne Calment.

Jay:  Exactly.

Ben:  So, I'd look at gut function. I'd look at sleep. I would look at iron, B12, and folate deficiencies. And then, I would also consider using a continuous blood glucose monitor, so you can see if this is just a relic that you don't actually have to pay that much attention to. And, that's where I'd start. Anything you want to throw in there, Jay?

Jay:  Yeah, man. So, I would agree with all of those. I'm going to speak to CGM second. But, first, I'll also say that overall stress load. So, if you're having high cortisol spikes, high adrenaline spikes, dysregulation in the HPA axis, that can also influence blood glucose fairly heavily if that's something that sustained. The thing that I tell people, and I don't know if you think this is the same thing for you, Ben, but for me, I think, out of all of the wearables or said wearables that I've ever tried, that the most informative one that I've ever had has been a CGM. I just think it is incredible amount of very useful and practical information that can just show you, what is this doing throughout my daily routine? And so, I know you've had this happen, too, Ben, because I think I remember you saying it. But, for me, obviously, I know certain foods are going to have higher variability from a glycemic index for me than others. But, the big one, too, is if you're doing a daily sauna routine, that, for me, blast my GI load way up. So, I see super high spikes after a sauna session.

Ben:  Me, too.

Jay:  So, if you're seeing that day in and day out, again, those are going to cause your mean to skew over to the right side more than what would be expected from somebody who's not doing that. So, again, these are things are artificially, I would say, inflating your blood sugar and blood glucose. I hate to use the word, “artificially.” But, it's just doing it in an entirely different mechanism than, let's say, just shoving Sour Patch Kids and Twinkies down our throats. So, CGM for the win. Definitely, get one if you haven't had one.

Ben:  That's actually a really good point, because I have been doing–You'd think I wouldn't do this in the summer, but I actually have really liked my sauna this summer because it almost gets more warm, and I'd really get a good deep sweat. And, I actually enjoy it quite a bit. I was doing a ton of sauna, almost every day, six or seven days a week, leading into my last blood tests, in which the hemoglobin A1c levels were elevated.

And, I see the same thing as you. My blood glucose goes up, too. And, I've talked about this on podcasts before, you see a short-term rise in blood glucose when you're in the sauna. But, long-term, that results in better glucose management and better insulin sensitization the rest of the day. So, it's not a big issue. Just like a cup of coffee will temporarily raise blood glucose, but actually appears to be pretty good for things like type 2 diabetes and blood glucose management, etc., same as exercise, for example.

So, basically, I would pay attention to looking into some of the stuff that Jay and I shared with you. And, maybe, also, look into whether or not you're doing a lot of sauna.

Well, I think, we're out of time because I've got a client I got to run off and call here in a few minutes. That's my real job. Podcasting is my favorite job. I can actually talk to people.

Jay:  This is your hobby.

Ben:  So, anyways, though, before we go, let's give away a goodie bag because we love to give out cool gifts to people who go to any platform that they listen to this podcast on and leave a review. So, if you leave us a review and then you hear your review read on the show, all you got to do is email [email protected] And, if you email [email protected], what will happen is we will send you, if you include your T-shirt size when you email us, your t-shirt size and your address, we'll send you a handy-dandy gear pack with a BPA-free water bottle or a cool beanie tech T-shirt and, possibly, another cool thing that we throw into the mix these days.

So, that being said, Jay, do you want to choose our big review of the day?

Jay:  I will. I will. So, this is entitled, “My health and wellbeing thanks you.” And, even though I think that this is contrary to what this person is about to say, this is from EvilJpr.

Ben:  Evil?

Jay:  It's E-V-I-L-J-P-R, Evil. So, EvilJpr says, “From the podcasts to the books to the products you recommend, Ben, your podcasts have been a game-changer for my health and wellbeing, as well as my marriage.” Big one. “I have an entire notebook filled with things I have learned. And, I get so excited to share them with all of those around me. Keep doing what you do and changing lives one-by-one.”

Ben:  We change lives. We change marriages. I think it was podcast 431 where we give you tips for having more sex and many urge, which basically comes down to —

Jay:  Probably, what he's referring to.

Ben:  That was a tip for guys. Guys, be more vulnerable and you'll get more.

Jay:  Wherever you go with that.

Ben:  I need to be reading the urban dictionary more. You'll get more booty. Geez, I'm showing my age.

Jay:  If that was–

Ben:  Slash, trying to keep it clean for the kids in the minivans.

Alright, well, that's a great review. Email [email protected], and we'll hook you up with some cool swag.

In the meantime, I'd like to thank all of our wonderful and intelligent and highly driven and curious Clubhouse listeners for listening live, all the rest of you, for listening when this podcast comes out. All the shownotes because we work so hard on the links to everything we talk about, all the news flashes, all the tips, all the products, all the insiders, the calendar, we'll link to all that if you go to BenGreenfieldFitness.com/433.

Well, thanks for listening to today's show. You can grab all the shownotes, the resources, pretty much everything that I mentioned over at BenGreenfieldFitness.com, along with plenty of other goodies from me, including the highly helpful, “Ben Recommends” page, which is a list of pretty much everything that I've ever recommended for hormones, sleep, digestion, fat loss, performance, and plenty more.

Please, also, know that all the links, all the promo codes that I mentioned during this and every episode helped to make this podcast happen and to generate income that enables me to keep bringing you this content every single week. So, when you listen in, be sure to use the links in the shownotes, to use the promo codes that I generate because that helps to float this thing and keep it coming to you each and every week.

 

 

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Listener Q&A:

Q: What Are Some Of Your Best Practices For Calorie Refeeds?….53:40

In my response, I recommend:

Q: Would A Food Allergy Affect HRV While Doing A 5-Day Fasting Mimicking Diet?…58:45

In my response, I recommend:

Q: How Does Intermittent Fasting Affect H1C And Insulin Levels?…1:07:40

In my response, I recommend:

 


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