Nourish Balance Thrive

My sister called me looking for help with her son's science project. "William has some questions about the paleo diet and how it affects the health of cells." It soon emerged that he had a particular list of questions that he wanted answering, and initially I thought I should do some research and answer them to the best of my ability just as I would with any list sent to me. The longer I thought about the list of questions, the more I thought it looked like the outline to a great podcast, and who better than Dr. Tommy Wood to provide the answers?

But why care about cellular health in the first place?

We tend to think of health in terms of big things, but a living organism is just a collection of organ systems. An organ system is a set of organs, and those organs are made up of tissue. Drilling down beyond the tissue, we arrive at the smallest level of organisation able to sustain life: the cell. We're all just a big bag of cells, trillions and trillions of them! Happy cells make for happy bodies, so it makes sense to care about the cell.

Can your diet affect cellular health?

Yes! Absolutely. Certain oils are capable of damaging the DNA that codes for the proteins manufactured inside of the cell. Don't eat deep fried food. Other omega-3 fats are essential for healthy mitochondrial membranes. Do eat small fatty fish.

Around 10,000 years ago, fossil records show that we became shorter, and our dental health deteriorated. At the same time, we transitioned away from hunting and gathering and became agriculturists. It seems at least possible that a switch to a grain-based diet had a deleterious effect on our health.

What about ketosis?

I've talked a lot about high-fat ketogenic diets on the podcast, and those shows garner a lot of interest. But do we all need to be eating ketogenic diets? Tommy thinks not, but there may be some benefits to cycling intake to mimic what would have been the natural seasonal variation of carbohydrate availability.

Beyond diet.

Through his careful research and chemical engineering inspired systems analysis, Tommy has shown that although important, diet is not the only determiner of health. Well tuned circadian rhythm and adequate sleep, appropriate stress management, time spent outdoors in nature and being part of a strong social group are also important.

Did you find the fresh, unbiased perspective of an inquisitive 12-year old helpful? Please let me know in the comments section below.

0:00:22 William Chatterton's list of questions for a school project should make for an interesting interview.

0:00:27 Let me know (in the comments below) if you found this podcast interesting!

0:00:47 Levels of organisation in biology.

0:01:54 Can your diet affect the health of new cells?

0:02:09 We're constantly growing cells, throughout life.

0:02:32 There's a very rapid turnover of cells in the gut.

0:02:48 At the same time we're constantly getting rid of the junk.

0:02:59 The building blocks are important.

0:03:18 We measure DNA damage as 8-hydroxy-2-deoxyguanosine.

0:03:29 DNA is the code that controls the manufacturer of proteins.

0:03:46 It's important then that the DNA doesn't get damaged.

0:04:00 Certain oils can cause oxidative damage to the DNA.

0:04:28 DHA is very important for mitochondrial membranes.

0:05:08 The fats story is complex.

0:05:18 Saturated fats.

0:05:31 A fatty acid is a long chain of carbon atoms.

0:05:59 The double bonds are delicated and can be broken to create a free radical.

0:06:11 Fatty acids that have carbon–carbon double bonds are known as unsaturated.

0:06:29 Polyunsaturated fats are unstable.

0:07:00 When omega-6 fats are carried around in the body, they're unprotected.

0:07:39 Omega-3s are better protected.

0:07:59 Don't eat deep fried stuff!

0:08:26 How direct is the link between diet and cell health?

0:08:49 The link is incredibly direct.

0:08:56 Food is the most important determiner of cell health.

0:09:17 Circadian rhythm and stress is important.

0:09:30 Being part of a social group.

0:09:52 Don't focus just on food.

0:10:04 Food is the first thing people figure out.

0:10:35 Everybody wants one thing they can fix.

0:10:52 Being sociable can be easier than you think

0:11:05 Give your mum a hug.

0:11:50 What is the most nutrient dense meal you could eat for cell health?

0:12:02 Small fatty fish.

0:12:13 DHA, selenium, iodine.

0:12:25 Collagen.

0:12:34 Eggs with yolks and liver.

0:12:43 Dark green leafy vegetables.

0:12:54 Preferably wild grown plants.

0:13:30 The new surf and turf!

0:13:57 Not being squeamish about certain foods at certain times of day.

0:14:39 How does a ketogenic diet affect the health of a cell.

0:15:01 Adding fat doesn't necessarily make it ketogenic.

0:16:16 My diet has zero refined carbohydrates.

0:16:30 Still lots of vegetables.

0:16:40 At this point, you've gotten rid of most of the crap.

0:17:15 Ketogenic diets can cause an increase in oxidative stress inside of the mitochondria in the short term

0:17:42 Reactive oxygen species are signalling molecules.

0:17:59 ROS Goldilocks principle.

0:19:14 Some people will say that the ketogenic diet is bad because of this initial increase in ROS.

0:19:55 Should everyone be eating a ketogenic diet?

0:19:58 No, certainly not all of the time.

0:20:11 Sodium and potassium and selenium can be difficult to hold onto in ketosis.

0:20:38 The extra stress of the diet can also be problem.

0:21:13 Seasonal ketosis.

0:22:00 Wills is already eating a high-fat diet.

0:22:21 What happened to our diet in between the paleolithic and the era of the Food Pyramid?

0:23:32 Carbohydrate consumption may have changed.

0:23:53 Access to fire and cooking has made a difference.

0:24:10 Eating fish.

0:24:19 If you didn't live near the sea, you ate brain.

0:24:40 Around 10,000 years ago, we became agriculturalists.

0:25:04 Seeds and grasses like wheat.

0:25:19 Where there is a fossil record, we see health deteriorated.

0:25:43 People got shorter and had worse teeth.

0:25:57 We can't say definitely that farming was the cause.

0:26:23 There's no benefit from eating wheat.

0:26:59 When the food shows up in front of you, that's what you eat.

0:27:36 1980 saw the first dietary guidelines with grains as the foundation.

0:27:53 Part of this decision was driven by economics.

0:29:00 The perfect storm of refined carbohydrates plus vegetable oils and refined sugar.

0:29:51 This combination used to be impossible to obtain.

0:30:26 Will the Food Pyramid change soon?

0:30:44 People are working on this problem.

0:31:04 People don't eat according to the food pyramid, but it is used to create the foods that we eat.

0:32:05 Farming is heavily subsidised, this creates momentum.

0:33:16 Nothing is going to change any time soon.

0:33:26 Wording has changed around the word saturated fat and the caution on cholesterol has been removed.

0:34:00 Tommy's two presentations on MS and dairy.

0:34:22 Terry Wahls has largely reversed her MS with her protocol.

0:35:00 Tommy comes from a family of chemical engineers.

0:35:04 His stepbrother has MS.

0:35:11 Chemical engineers are problem solvers.

0:35:27 They built a root cause analysis for MS.

0:35:42 Gluten and casein allergies.

0:35:56 Mitocondria that are not working properly.

0:36:14 Terry also advocates ketosis.

0:36:27 Tommy and Terry represent two groups of people that came up with the same conclusion using different methods.

0:37:09 Do you think that Terry Wahl's work is original?

0:37:31 There's nothing new under the sun.

0:37:53 Tommy has ideas, and then doesn't want to tell anybody about it for fear they will steal it.

0:38:21 Terry is the first person to apply these principles in MS patients and in clinical trials.

0:39:24 I had tremendous results eating the AIP diet.

0:39:40 The book The Paleo Approach.

0:39:48 Personalising the Wahls Protocol.

0:40:14 This would look like a high-plant, dairy-free, low-carb diet.

0:41:07 Not everybody needs to be that strict.

0:41:32 Eat the yolks.

0:42:11 Start with the basic elimination diet.

0:42:23 Reintroduce later.

0:42:55 You can go too far, but most people don't go far enough.

0:43:12 Be really strict for two months and then reintroduce.

0:43:56 Then the signal ratio is great enough for you to know what's causing the problem.

0:44:41 Are there any other diets that can produce the same results.

0:45:03 Yes, the Swank Diet.

0:45:25 This is the most successful diet for MS patients.

0:45:33 Terry Wahls doesn't have that much data yet.

0:45:50 The problem is the diet is a very low fat vegan diet.

0:46:14 The stricter you were with the diet, the better you did.

0:46:34 Actively engaging in your treatment has a positive effect.

0:46:58 Recent research is not impressive.

0:47:53 The Swank Diet is probably better than what people were eating before.

0:48:33 It's impossible to create a blinded trial.

0:49:11 Swank is better than standard American but perhaps not the best.

0:49:22 If these diets are so successful, then should doctor be making dietary prescriptions?

0:49:47 Yes they should, but doctors are not trained in nutrition.

0:50:18 Tommy is a traditionally trained doctor.

0:50:42 We are in an era of evidence-based medicine.

0:51:12 Clinical trials are not going to happen for diet.

0:51:35 Therefore, the doctors are not going prescribe a diet.

0:51:58 There's always confounding factor.

0:52:08 Someone will always say the evidence isn't good enough.

0:52:35 Nowadays you can use clever statistics to show that your new drug is not inferior.

0:53:03 Rather than showing superiority.

0:53:49 You cannot control for diet and lifestyle.

0:54:29 Is there any one simple takeaway message?

0:54:52 Yes, just eat real food.

0:55:04 Go to your local grocery store and buy ingredients.

0:55:19 Turn that into food and you will avoid all of the trouble.

0:55:37 Even better, go to the local farmer's market.

0:55:54 Getting enough sleep.

0:55:57 Being part of a social group.

0:56:01 Don't worry about the things you can't control.

0:56:08 Occasionally lift heavy.

0:56:16 Circadian rhythm.

Something wonderful is happening in Iceland, and it has nothing to do with geysers, volcanoes or even Björk. A group of medical doctors led by Dr. Guðmundur Jóhannsson are actively engaging in a discussion of the utility of high-fat, low-carb, moderate-protein diets for treating some of the chronic health complaints they see in practice.

Imagine for a moment you're a doctor working in emergency care. How frustrating must it be only to see the end stages of the diseases caused by insulin resistance? You'd be just like a mechanic working on the damage done to an engine caused by failure to change the oil. Not only is the situation potentially preventable, it's also expensive enough to bring down the entire national health service.

My question is why Iceland? Is it the manageable size? Dr. Jóhannsson has been able to bring around 200 doctors to the discussion on a Facebook group. Doesn't sound like a lot, but that's a significant proportion of all the doctors on the island. Is it because they have nationalised health care? Nationalised means there's a finite budget, and that may be relevant here, but I don't see this happening in the UK, and they also have a national health service.

For now, we may have to accept that the Icelandic people are smarter than the rest of us. I'm hoping we will follow their lead.

I'm still excited about geysers and volcanoes because this May I will be visiting Iceland with my wife and food scientist Julia and chief medical officer Dr. Tommy Wood. Tommy will be speaking alongside Gary Taubes, Professor Tim Noakes and many other like-minded experts in the field at the Icelandic Health Symposium's Foodloose conference.

Please let me know if you will be there!

0:01:00 Dr. Guðmundur Jóhannsson is a medical doctor from Iceland, trained in Sweden.

0:01:46 Guðmundur was overweight in medical school.

0:02:05 He quickly figured out it was the carbohydrates that were causing the problem.

0:02:45 I've visited Sweden on several occasions and the Swedes are not fatphobic.

0:03:13 The Icelandic people have started consuming more carbs in recent decades.

0:04:02 Guðmundur is an emergency doctor.

0:04:22 It's frustrating to only see people at the end stages of disease.

0:04:39 Some of this could be prevented.

0:05:10 With the right information, diabetes is preventable.

0:05:35 I work with registered nurse Amelia Luker, her motivation for a career change was similar.

0:06:08 It's so much more costly to treat once the disease has developed.

0:06:27 From insulin resistance to injecting insulin is a long process.

0:06:51 Tommy's mum is from Iceland.

0:07:25 Is the health care system in Iceland similar to those in the US or UK?

0:07:33 Tommy sees it as very similar to the NHS in the UK.

0:07:39 The Icelandic people have upgrade options.

0:08:02 Would an Icelandic doctor ever talk to a patient about food?

0:08:14 Doctors are not trained in nutrition biochemistry or exercise physiology.

0:08:38 More and more doctors are choosing to further their education.

0:08:55 In Iceland, there is a Facebook group for doctors.

0:09:18 200 doctors is a significant number.

0:10:14 Why is this situation unique to Iceland?

0:10:31 Iceland is so small, news travels fast.

0:10:49 Where did the idea for the Foodloose conference come from?

0:10:53 Book: Good Calories, Bad Calories by Gary Taubes.

0:11:15 The problems extend further than diabetes and cardiovascular disease.

0:12:15 Professor Tim Noakes has been on my podcast.

0:12:28 Why do people want to come to Iceland?

0:13:26 The Icelandic doctors are not necessarily on board with low-carb, but they are taking part in the discussion.

0:13:46 Tommy will be speaking alongside Gary Taubes and Tim Noakes.

0:13:52 Axel F. Sigurdsson.

0:14:00 Aseem Malhotra.

0:14:05 Denise Minger.

0:14:13 Maryanne Demasi will be moderating.

0:14:19 ABC Australia Catalyst Program.

0:14:28 The presenters will present and then give the audience a chance to ask questions.

0:14:57 Tommy has been on a panel with Aseem Malhotra before.

0:15:07 Tommy and Guðmundur will be publishing a paper with Axel Sigurdsson soon.

0:15:43 Gary Taubes will be talking the carbohydrate insulin hypothesis.

0:15:57 Aseem Malhotra will be talking about sugar and more.

0:16:08 Sigurdsson is going to talk about diet and heart disease.

0:16:20 Denise is going to bring in the opposing viewpoint.

0:17:53 Denise has dug up some interesting data.

0:18:10 Everybody else is going to talk about food, Tommy is going to talk about all the other things that we've found to be important.

0:18:58 Diet is the first thing people figure out.

0:19:10 Everything else is important!

0:19:38 May 26 is the main day, workshops will take place on the 27th.

0:19:52 There will be culinary workshop for people that would like to meet with the speakers.

0:20:13 High-fat, low-carb, moderate protein cooking classes.

0:21:11 What else should people see and do in Iceland?

0:21:18 Iceland is all about nature.

0:21:22 You don't go for the weather.

0:21:23 It's like a sample from all parts of the world.

0:21:45 Hiking, kayaking and biking.

0:22:08 Tommy and my family will be doing touristy stuff, come join us!

0:22:33 The Golden Circle.

0:22:42 Gullfoss waterfall.

0:22:47 The first parliament in the world.

0:22:57 The Blue Lagoon.

0:23:26 Day trips to hike up glaciers.

0:23:34 Not far Reykjavik.

0:23:51 If you're going to Iceland you have to be .prepared for anything.

0:24:06 Probably around 10c

0:24:35 The difference between summer and winter in Iceland is that in the summer you can see the rain.

0:25:12 If you're going to the conference, please email me.

0:25:32 foodloose.is

0:25:56 Updates in our Concierge Clinical Coaching group.

0:27:01 Tommy recently posted his talk for doctors on insulin resistance.

0:27:17 All the members have done testing with us.

0:27:52 Physicians for Ancestral Health.

0:28:18 Modelling insulin resistance.

0:29:03 Guðmundur and Bob Hanson has been sending the studies to put into the model.

0:30:11 It's not as simple as restricting carbohydrate.

0:30:51 Wasting is saving study.

0:31:08 The ketogenic diet may be an advantage at altitude.

0:31:36 Ketones create the same amount of energy using less oxygen.

0:32:15 Too much muscle mass could be a disadvantage at altitude.

0:32:41 People have been asking about adaptogens.

Cancer is like a computer program gone wrong, the kernel panic of the human body. Unfortunately, we have no reboot button, and so cancer is the most serious of diseases. This year, almost six hundred thousand Americans will die from cancer. Despite the fact that cancer receives more NIH funding than any other illness, the death rates remain the same as in the 1950s.

Tripping Over the Truth: The Return of the Metabolic Theory of Cancer tells the story of molecular biologist and science writer Travis Christofferson's journey to discover why cancer has remained so elusive. The central theme of the book is that we've fundamentally mischaracterized the origin of cancer. Most scientists hold to the belief that cancer is a genetic disease, Travis explores the idea that cancer is, in fact, a disease of damaged metabolism.

The metabolic theory of cancer stems from Nobel laureate Otto Warburg's observation in 1924 that cancer cells lack the ability to produce energy using anything other than an ancient and inefficient process of fermentation. Warburg's idea failed to gain critical mass, and by the 1960s had largely faded into oblivion. In 2012, Thomas Siegfried, Ph.D., released his book Cancer as a Metabolic Disease where he expanded on Warburg's original hypothesis. In his book, Siegfried described how all cancer cells have damaged mitochondria, the organelle responsible for creating energy with oxygen.

Inspired by The Emperor of All Maladies by Siddhartha Mukherjee, Travis has done a excellent job of telling the rich story behind the metabolic theory of cancer. In this interview, Travis and I discuss some of the potential benefits and mechanisms of a ketogenic diet, hyperbaric oxygen, gluconeogenesis inhibitors and ketone supplements as possible cancer therapy.

I would like to thank Dr. Tommy Wood for some of the questions asked in this interview, especially those about glioblastoma and women with the BRCA1 mutation and breast cancer.

0:00:15 Book: Tripping Over the Truth: The Return of the Metabolic Theory of Cancer Illuminates a New and Hopeful Path to a Cure

0:00:34 How Travis became in terested in biology.

0:00:54 Travis has a fundamental curiosity.

0:01:10 The best doctors are the ones that do experiments on themselves.

0:01:22 Book: Cancer as a Metabolic Disease: On the Origin, Management, and Prevention of Cancer by Tom Siegfried.

0:01:38 Book: The Emperor of All Maladies: A Biography of Cancer by Siddhartha Mukherjee.

0:02:16 Travis wanted to tell the rich story behind the science in Tom's book.

0:03:01 Podcast: Dominic D'Agostino on the Tim Ferriss show.

0:03:30 The Emperor is gene centric.

0:03:46 The difference between the genetic and metabolic theories of cancer.

0:04:08 Radiation, cell repair.

0:04:09 In the genetic theory, cancer arises through lesions on DNA.

0:04:43 The genetic theory is still the dominant theory.

0:04:55 In the metabolic theory, cancer is proliferated by damage to the mitochondria.

0:05:07 Cancer resorts to less efficient fermentation.

0:05:25 This less efficient metabolism sends a message to the DNA.

0:05:42 This new theory makes cancer look like a disease of order.

0:06:02 Everything that causes cancer damages mitochondria.

0:06:39 Paul Davies, cosmologist.

0:07:07 Worked with Stephen Hawking.

0:07:33 Video: Anna Barker at TEDMED 2010.

0:07:53 Cancer is incredibly complex compared to other diseases.

0:08:19 In 2008 atavistic model

0:08:48 Three million studies on cancer on PubMed.

0:09:20 In the beginning, there was single celled organisms.

0:09:26 With multicellular life, the rules changed.

0:09:43 The foetal genes are reexpressed in cancer.

0:10:03 This new understanding gives hope.

0:10:17 What can we do with this new knowledge.

0:10:28 Look after our mitochondria.

0:10:38 A ketogenic diet is a great way to achieve this.

0:10:48 Also intermittent fasting.

0:10:57 Metformin as an oncology drug.

0:11:20 Exploiting the express of early genes.

0:11:44 The Warburg Effect.

0:11:53 Hyperbaric oxygen.

0:12:01 Cancer cells decouple of the adaptive immune system.

0:12:07 Cancer patients with high fever then spontaneous remission.

0:12:25 Cancer cannot withstand infection.

0:12:56 How does the ketogenic diet work against cancer?

0:13:04 Lowering blood glucose.

0:13:11 Glucose is the preferred fuel of cancer.

0:13:25 Some cancers can utilise ketones.

0:13:45 But there's promise in all cancers.

0:14:05 There's some kind of signalling mechanism.

0:14:27 Less side-effects with chemo after fasting.

0:15:05 Dr. Tommy Wood pointed me at some studies showing that certain breast cancers can use ketones as fuel. One study of women with the BRCA1 mutation showed that those with upregulated ketone metabolism did worse, which suggests that a cancer can develop metabolic flexibility too, and would be able to avoid death on a ketogenic diet.

0:15:27 Everybody is different and your results therefore will vary.

0:15:51 The brain can obtain up to 80% of its energy requirenents from ketones.

0:16:09 Some neurons are too small to include a mitochondria.

0:16:21 There is a trial going on in Arizona with glioblastoma.

0:16:25 Dr. Adrienne C. Scheck.

0:16:29 Results by April.

0:16:41 Kid in Norway, prognosis is 8 months, that was 3 years ago.

0:17:12 Tumor has shrunk and remained stable now for 3 years.

0:17:31 Metabolic therapies are good at managing cancer, but may not be the cure.

0:17:55 The studies are all done from the same line of glioblastoma.

0:18:17 Glioblastoma is where the research started, but the principle is sound

0:18:41 Will glioblastoma be the first cancer that we see a cure for?

0:18:48 Glioblastoma is usually about a year from the time of diagnosis to death.

0:19:17 How do cancers show up in a PET scanner?

0:19:24 PET scanners detect radiolabeled glucose.

0:19:43 The tumour outcompetes normal cells for glucose and show they show up in the scanner.

0:20:25 If the tumours have been lighting up in scanners for a long time, why has it taken so long for anyone to think of this?

0:20:41 Dr. Scheck's study is using a standard ketogenic diet.

0:20:43 In some people that doesn't drive down glucose very far.

0:21:06 You can drive blood glucose very low.

0:21:21 In extended fasts, blood glucose would go down in the 60s (mg/dL).

0:21:24 Now we have exogenous ketone supplementation.

0:21:27 And gluconeogenesis inhibitors.

0:22:50 What were gluconeogenesis inhibitors originally designed for?

0:23:05 We're only just starting to appreciate Metformin.

0:23:06 25-30% reduction in the chances of getting cancer on Metformin.

0:23:07 Nobody really knows how is works.

0:23:31 Phenylbutyrate.

0:23:55 Metformin also inhibits complex 1 of the ETC.

0:24:07 ROS are bad, but also signalling molecules.

0:24:23 Another line of research has shown that Metformin works through altering the gut microbiome.

0:24:44 Podcast: Exercise is an antioxidant.

0:25:02 Podcast: Tommy and me on the Robb Wolf podcast.

0:25:11 Podcast: Insulin resistance.

0:25:15 Podcast: Iron overload.

0:25:46 In biology, you focus on one thing. One protein, one pathway.

0:25:55 Dr. Coe? in Travis's book.

0:25:56 ATPase.

0:26:15 You need someone to do the detailed work, but then you need someone to step back.

0:26:30 Physics already has a mechanism in place to do that.

0:27:05 In physics, you can come up with an idea and there's more than enough data to test it out.

0:27:31 Worse, in nutrition the data conflicts each other.

0:27:33 The NCI said that 80% of the basic research in cancer biology were not reproducible.

0:27:56 Sorting through the studies is an art form.

0:28:08 Warren Buffett.

0:28:22 What do you think of the meta-analysis?

0:28:53 This is the Gold Standard of science!

0:29:11 Book: Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health by Gary Taubes

0:30:36 Ketone supplements are not currently be used in cancer therapy.

0:31:09 Dominic D'Agostino specialises in ketone supplementation.

0:31:34 Ketones are far more than a macronutrient.

0:31:49 Ketones are anti-inflammatory.

0:32:08 Seasonal ketosis.

0:32:22 Dr. Veech at the NIH: "it's not normal to have a McDonald's on every street corner".

0:32:30 It's normal to starve periodically.

0:32:53 Alzheimer's is now being called type 3 diabetes.

0:33:41 Is it a good idea to be constantly in ketosis?

0:33:58 Dr. Peter Attia.

0:34:32 Two studies, one at the National Institute of Aging, one at the University of Wisconson

0:34:37 Caloric restriction in monkeys.

0:34:49 Caloric restriction doesn't help as much as we thought.

0:35:02 The monkeys fed a high-sugar diet did worse.

0:35:27 When is all this going to be more widely know, or even the standard of care?

0:35:40 Things move slowly, it's easy to get depressed.

0:35:57 The trial in Arizona could be groundbreaking.

0:36:34 3-Bromopyruvate (3BP) could be the final piece for the metabolic therapy.

0:37:05 Heroin as the treatment for cocaine addiction.

0:37:47 Radical mastectomy.

0:38:25 This went on for 80 years.

0:38:37 In the end, we discovered that a local lumpectomy was as effective.

0:38:58 The trials are so slow and expensive.

0:39:16 You have to eat something, why not this?.

0:39:42 Travis talked at Paleo f(x).

0:39:57 Anecdotally, word is getting out there.

0:40:24 The ketogenic diet to treat recurrence.

0:40:37 The ketogenic diet is empowering.

0:41:11 Travis wrote an article about recurrence on his website.

0:41:20 It's not about always about a single cell that got left behind.

0:41:36 20% of cases are new, i.e. the environment for cancer is still there.

0:42:09 The same is true of bacteria, if you create the environment, it will grow.

0:42:25 Nobody wants to take high-fat diets seriously for weight loss until we're talking about cancer.

0:42:48 Cachexia is the the worst case scenario.

0:43:40 Valter Longo, PhD.

0:44:21 The state of ketosis doesn't say anything about weight loss, and may even be protective against muscle wasting.

0:44:42 Travis and Dominic's articles on Robb Wolf's website.

0:45:41 The Charlie Foundation.

0:46:04 Travis's new blog with podcast, M

Cortisol: the emergency responder hormone that when chronically elevated, makes you fat, stupid and unsexy. Nobody wants an excess of cortisol, but like all things in physiology there's a sweet spot; low cortisol doesn't feel right either.

Which you have?

Both sets of symptoms are very similar, in fact, all of these symptoms could be attributable to half the diseases known to man. The only way to know for sure what's going on with your cortisol is to do the test.

I tested over 500 endurance athletes

And all but a handful had low free cortisol. Free cortisol is the active fraction of the hormone, but it only accounts for 1% of the total cortisol production and so forms just part of the puzzle. I can't give you any more information than this because free cortisol is all a saliva test measures.

Luckily the testing has gotten more sophisticated

Mark Newman is an analytical chemist and the founder of Precision Analytical, a lab using GC and LC-tandem mass spectrometry to measure not just free cortisol, but also the metabolites tetrahydrocortisol and tetrahydrocortisone. Their DUTCH test is a game changer. The extra information in this test enables me to be a better detective. Now I can differentiate between problems with cortisol production and cortisol clearance. The two have very different implications.

Not just cortisol

The DUTCH also measures no less than eight androgens, eight oestrogens and two metabolites of progesterone. The results can be overwhelming at first, but as you begin to appreciate the pathways that these hormones take, the picture becomes clear.

Testosterone

Testosterone can metabolise down one of two pathways: the more androgenic alpha pathway that leads to the hormone DHT, thinning scalp hair and prostate problems for older men or a potentially more desirable and less androgenic beta pathway. The good news is that once you understand your metabolism, there are nutritional supplements that you can take to inhibit the alpha pathway.

Oestrogen

Saliva isn't a very accurate way to measure oestrogen. Not only is urine more precise, but it also enables us to test the metabolites that tell us all about both phase 1 and phase 2 metabolism. Oestradiol is the most abundant oestrogen, and its friend oestrone breaks down in one of two different directions. This can produce two very different, and not always desirable outcomes. The only way to know what's happening to you is to do the test

Establishing a baseline

During this interview, Mark makes an important point. Let's say you feel good right now. Wouldn't it be nice to have the complete picture of your hormone metabolism for future reference? Or perhaps you suspect a problem. Either way, you can order a DUTCH though me and then together we figure out a plan to optimise your hormones. Don't be that guy guessing using the list of symptoms you found on the Mayo Clinic website.

0:00:50 Mark Newman is an analytical chemist with a master's degree in forensic science.

0:01:07 Mark started with urine testing then moved onto saliva testing.

0:01:41 DUTCH stands for Dried Urine Test for Comprehensive Hormones.

0:02:11 The DUTCH combines the best of saliva and urine.

0:02:51 Educational videos.

0:03:32 The DUTCH is the culmination of Mark's life work.

0:05:01 My first saliva test showed high cortisol at night, and low cortisol during the day.

0:05:51 We've run over 546 saliva tests now.

0:06:12 All the results look the same.

0:06:31 The question is WHY low cortisol?

0:07:01 Mark has managed data from one million saliva results.

0:07:23 Mark started with the idea that cortisol makes you fat, yet salivary cortisol isn't higher in fat people.

0:07:40 The free cortisol is just one piece of the puzzle.

0:08:07 With urine testing, you also get to look at the metabolites.

0:08:24 Free cortisol is only about 1% of the total.

0:08:53 40% of patient that have low free cortisol do have elevated production (metabolites).

0:09:45 What drives cortisol production also drives clearance.

0:10:00 In obesity there is high production AND clearance, overall free cortisol is often low.

0:10:33 In hypothyroidism cortisol clearance is sluggish.

0:11:06 The DUTCH is the only way to get all three dimensions.

0:11:51 I get the impression all the tests will look dated in 10 years time.

0:12:32 Mark is skeptical when I say "everybody's low".

0:13:01 Reference ranges can be very problematic.

0:13:38 You cannot easily compare results from different tests.

0:14:13 Not everybody has low cortisol.

0:14:55 Morning serum cortisol is better than nothing.

0:15:08 Saliva is better still and DUTCH better yet.

0:15:27 The term adrenal fatigue needs some work.

0:15:44 Adrenal glands are not like ovaries (they don't tend to give out with age).

0:16:16 The problem with cortisol is probably often in the brain, not the adrenal gland.

0:17:01 The misinformation has been driven by oversimplification.

0:18:03 How are the reference ranges for the DUTCH defined.

0:18:20 You start with a bunch of healthy people.

0:18:35 The range is then two standard deviations either side of the mean.

0:18:53 This is useful for finding pathology.

0:19:17 Reference ranges require more thought than simple maths.

0:20:00 Some reference ranges are set up so that everyone is low.

0:20:23 The analytes are unique and so are the reference ranges.

0:21:07 People are critical of blood tests, both blood is very well established and standardised.

0:21:35 Saliva testing has some shoddy standards for some tests.

0:22:06 Intranasal ACTH experiment.

0:22:30 If the lab is not curious enough to do that type of experiment you have to wonder.

0:23:16 Everyone should get test to establish a baseline.

0:23:30 Hormonal symptoms overlap a lot.

0:23:51 Then when people read or hear about symptoms, they say gee that's me.

0:24:18 Lots of things can drive cortisol.

0:24:59 Hormones are worth exploring around menopause.

0:25:28 Everybody is tired.

0:26:17 Mark's sister-in-law is healthy in spite of low hormones, should anything happen in the future, having the baseline would be important.

0:27:20 DHEA comparison.

0:27:34 Mark is a skeptic when it comes to labs, he always suspects they could be wrong, even his own…that's why having multiple markers (as in DUTCH) for hormones can be helpful.

0:28:19 Etiocholanolone and Androsterone.

0:28:43 Inflammation blocks sulfation DHEA à DHEAS.

0:29:24 The DHEA-S can misrepresent what's really going on.

0:29:55 The DUTCH represents 14 hours worth of DHEA production.

0:30:31 The DUTCH paints the big picture of hormones.

0:31:01 Iron overload in master's athletes.

0:31:24 The DUTCH helps me be a better detective.

0:31:36 Inflammation makes prostaglandins that drive aromatase.

0:32:19 Narrowing down a list possibilities to a list of probabilities.

0:32:43 DHEA and women.

0:33:03 DHT is three times as potent as testosterone.

0:33:18 Insulin can push alpha metabolism.

0:33:36 The beta pathway is less androgen.

0:33:42 Saw palmetto, nettles, pygeum, EGCG, progesterone, zinc, finasteride all block the alpha pathway.

0:33:48 DHT can cause acne, thinning scalp hair.

0:34:37 The DUTCH has 4 alpha pathways measured.

0:34:59 PCOS is a leading cause of infertility.

0:35:36 Could we take supplements without doing the tests?

0:35:59 Mark thinks that's a bad idea in some cases.

0:36:50 Pragmatism can work.

0:37:05 Thinning scalp hair can have a number of causes.

0:37:29 If you can afford the test, do it.

0:37:42 Some of the supplements are also expensive.

0:37:51 DIM for oestrogen metabolism.

0:38:03 Pushes oestrogen down the 2-OH pathway.

0:39:11 DIM as a goitrogen.

0:39:39 I3C metabolises to DIM.

0:40:52 Mark's testing matrix.

0:41:18 People take progesterone at night because it helps with sleep.

0:41:27 Oral progesterone is gone four hours later.

0:42:09 Saliva and serum are not good ways to measure oral progesterone supplementation.

0:43:13 Mark has spent 10 years putting the testing matrix together.

0:43:43 What testing oestrogen can tell you about your methylation status.

0:43:47 Oestradiol is the main oestrogen.

0:44:01 Saliva testing for oestrogen is almost useless.

0:44:20 In serum and urine there's a 10 fold difference in oestrogen between pre and postmenopausal women.

0:44:23 In saliva, it's a 2 fold difference at best.

0:44:44 This is one of the main reasons why Mark switched to urine.

0:45:11 DIM acts on phase one metabolism.

0:45:23 Phase two includes methylation.

0:45:34 Genetic defects affect phase two.

0:45:51 Methylation is an important thing to do well.

0:45:56 Mark has two very messed up COMT genes.

0:46:04 Mark's MTHFR genes are fine.

0:46:17 On the DUTCH test, Mark is a poor methylator.

0:47:40 The DUTCH is cheap to ship (filter paper is light).

0:48:07 The test is still expensive, unfortunately.

0:48:33 Precision Analytical uses GC-MS/MS and LC-MS/MS.

0:49:14 Providers should go to dutchtest.com.

0:49:26 Five tests at half price.

0:50:12 Mark will help doctors interpret the results.

0:50:28 Testing (lab testing, not sample collection) is a four day process.

0:50:55 Organic acids tests are run in batches.

0:51:10 Mark developed organic acids testing for BioTech Lab (US BioTek).

0:51:49 You can order a DUTCH though me and then I can connect with you on the phone or Skype to explain what the results mean

Have you ever been trapped in a small meeting room with a guy in a grey shirt with sweat marks under the arms? The meeting has a clear agenda, but all you can think about is that smell. Yikes, just thinking about this is enough to make me want to take a shower, scrub my armpits and apply some deodorant.

Is the problem an antiperspirant deodorant deficiency? Why have humans evolved to a strong revulsion complex to what is a normal human smell? Have artificial fragrances warped our sense of smell?

It's not normal

For our teenage boys to smell of basil, lavender, and rich vanilla. It's not normal for women to emanate Daisy Fresh, Peach Burst, Blossoming Orchid, Tropical Rush, and Berry Cool. These are all things that have been impressed upon us by the companies that make person care products, and I think it's important that we are aware of it.

Are you telling me I should stink?

Yes, a little bit, sometimes. But also I want you to think about where the smell is coming from, and I want you to think about how the smell differs when you change your diet. I noticed a significant reduction in my body odour after adopting a minimally processed, real food diet.

Beyond diet

You're probably familiar with the problems surrounding the overuse of antibiotics. Certain of the bacteria that live in our guts are considered keystone species, and without them, we're in trouble. Bees are also a keystone species crucial to the survival of plants in agriculture. The same problem is happening on our skin.

Jasmina Aganovic is a chemical and biological engineer from MIT

And she's here to talk about how the preservatives in our personal care products maybe killing a particular keystone species of ammonia oxidising bacteria that should live on our skin. These bacteria help us by eating something harmful (ammonia) and producing something beneficial (nitric oxide).

Mother Dirt

Is the name of the company that manufactures a skin probiotic product called AO+ Mist spray. I've been using the spray for the past couple of months and so far, so good. No stink!

0:04:25 Why would you care about the skin microbiome?

0:05:54 Why do we shower as often as we do?

0:07:34 Bad bacteria were the first to be found.

0:08:10 Now we have a new appreciation of the microbiomes.

0:08:56 We've been programmed since childhood on how we should smell.

0:09:55 What is it about teenagers?

0:10:45 Skin care products for acne.

0:11:29 How the skin microbiome affects acne.

0:12:03 Acne seems to be lasting until later in life.

0:12:54 The bacteria typically linked to acne is P. acne and is not problematic.

0:13:37 But when you introduce harsh soaps and skin care products into the environment, you remove the keystone peacekeepers.

0:15:07 Are skin care products antibiotics?

0:16:06 The preservatives in skin care products may be problematic.

0:16:29 12% of children now have eczema.

0:17:07 Now we can manipulate the skin microbiome.

0:17:29 AOBiome founder David Whitlock noticed animals rolling in dirt.

0:18:12 Soil based ammonia oxidising (AO) bacteria.

0:19:25 We've wiped out the AO bacteria in the last 50-70 years.

0:19:44 The bacteria is very sensitive to surfactants and preservatives.

0:20:44 The AO bacteria is a keystone species for the skin.

0:21:30 AOBiome have been investigating the possibility of reintroducing the AO bacteria.

0:22:45 AOBiome are in a phase 2 clinical trial for the treatment of acne.

0:24:03 C. diff treatment with S. boulardii.

0:25:41 The AO bacteria do take up residence, but you'd need a very sensitive test to find it.

0:26:23 Bumblebees are keystone species like the AO bacteria.

0:27:04 It's important that you use products that are compatible with the bacteria.

0:27:39 Even if you do still use soap you will still see benefit.

0:28:39 Stinky armpits.

0:29:17 Natural deodorants can contain aluminium.

0:29:51 Food choices affect body odour.

0:30:27 60% of AO Mist users are able to give up deodorant.

0:31:07 Is clean really the smell of freesia?

0:31:32 Part of this is coming to terms with the way humans smell.

0:32:02 Triclosan persists in the skin.

0:32:41 AO Labs helps with product development.

0:34:18 Laundry detergents stink in the US.

0:35:55 Humans were not supposed to have body odour.

0:36:18 There is a plausible mechanism for reduction in body odour.

0:37:10 Bacteria consumes ammonia in sweat, that's what smells.

0:37:58 AO bacteria consume ammonia and produce nitric oxide.

0:38:24 The nitric oxide could become systemic.

0:39:04 Diaper rash.

0:39:33 People who use the most amount products also have the most problems.

0:40:36 Spending time outdoors is beneficial.

0:41:35 The name Mother Dirt is deliberate.

0:42:25 People who are forced to use sanitisation.

0:43:14 Certain situations require a sterile environment.

0:43:49 You can still benefit from AO Mist.

0:44:17 Hand sanitizer will wreck your hands.

0:45:15 The potential effect of the product on eczema.

0:45:44 Mother Dirt cannot make any claims before FDA approval.

0:46:13 Inflammatory skin disorders are the primary focus.

0:47:03 Where to find out more about AO Mist and the skin microbiome.

0:47:27 motherdirt.com

0:47:35 aobiome.com

0:48:08 Mother Dirt special offer.

0:48:23 AO+ Mist spray.

0:48:40 Discount code NBT25.

0:48:58 Code expires at the end of February.

Engineers get into a lot of trouble when their designs fail. Think about the consequences of a collapsing bridge or a broken aeroplane wing. Failed software systems can also have catastrophic consequences for human life.

Why is nutrition science any different? Poor food choices have far reaching consequences for both the individual and society as health care costs spiral out of control.

Yet still we have obese vegan nutrition professors sipping diet coke as they teach dogma with no basis in science to impressionable young students. This madness has to end!

Diana Rodgers is helping with bringing an end to the madness by embracing the traditional Registered Dietician education, whilst practicing everything she’s learnt through her interaction with real food pioneers Robb Wolf and Matt LaLonde.

Diana has found that by working from within the system, with a credible certification, she’s likely to affect much more change in our current establishment nutrition policy.

This isn’t her only concern though. Diana has also become a champion of sustainability. She’s fighting the good fight when it comes to paleo-bashers, and meat haters, who say this way of eating isn’t sustainable for our environment.

As the owner of a working farm, Diana is here to show us just what it will take to not only eat for our optimal health, but also the optimal health of our environment. From her interesting perspective of nutritionist and farmer, Diana has some great insight into the Paleo State of the Union and where we must go from here.

Thinking about sustainability is part of a logical progression that starts with adopting a real-food diet. Are you at that point yet? What plans do you have for keeping your paleo sustainable? Let me know in the comments below.

0:00:00    Sustainable Dish website.

0:00:33    Diana's story on her site.

0:00:45    Robb Wolf.

0:01:18    Diana has coeliac.

0:01:32    Diana is close to becoming a Registered Dietician (RD).

0:01:48    Paleo State of the Union Paleo FX panel.

0:02:21    Chris Kresser is teaching practitioners.

0:02:34    Mark Sisson.

0:02:50    Robb and Diana are more interested in sustainability.

0:03:05    Savory Institute.

0:03:28    Paleo convention in Berlin.

0:03:53    Veganism is popular in Germany.

0:04:09    AHS New Zealand talk.

0:04:40    Julie has converted vegetarian and vegans for health reasons.

0:05:04    How do you reason with these people?

0:05:31    Religion is out.

0:05:46    Diana's rebuttal of the Outside Magazine's article.

0:06:10    WHO Red Meat causes cancer.

0:06:24    Well managed cattle improve soil quality.

0:06:48    Herbivore poop is required for a healthy soil microbiome.

0:06:56    The soil retains more water.

0:07:05    Monocropping damages soil quality.

0:07:43    Diana's farm just outside of Boston is mostly a vegetable farm.

0:08:04    Chickens eat the vegetable matter.

0:08:59    What is holding people back from the sustainability questions.

0:09:18    Sustainability doesn't sell books, it’s not not lucrative.

0:09:57    Sustainability is not including in an RD education.

0:10:25    Diana works at a hospital that still uses styrofoam.

0:12:09    Why become an RD?

0:12:22    Blood sugar and digestion has always been a problem for Diana.

0:13:18    Weston A Price.

0:13:35    Sally Fallon and Robb Wolf said go get your RD.

0:14:23    Diana started a practice but didn't feel like she had the tools.

0:14:51    Wanted credibility.

0:15:05    Matt Lalonde.

0:16:31    Most of the professors are obese vegans.

0:16:58    Biochemistry is sound.

0:17:11    There's no coaching included in the syllabus.

0:17:32    Diana got rejected from internships with a 4.0.

0:17:51    Lawyer thought it was related to Paleo.

0:18:25    Real Food Radio podcast.

0:18:42    Blog post about house call rotation.

0:20:35    Lack of critical thinking in the younger, more impressionable students.

0:21:04    Weight Watchers not working.

0:21:23    Now she's doing a Whole30.

0:24:20    How do we make sustainability into Paleo from the start?

0:24:48    It's a natural progression.

0:25:08    The Homegrown Paleo Cookbook.

0:25:25    Container and community gardens.

0:26:18    Community gardens bring people together.

0:26:35    Volunteer at a farm in exchange for food.

0:26:53    On the East Coast, you go to the farm to collect your food, not the other way around.

0:27:26    This creates a sense of ownership.

0:27:56    Education programs including sheep shearing.

0:28:15    Growing farm lovers.

0:28:37    Small farms face a lot of pressure from housing development.

0:30:15    Local versus sustainable.

0:31:09    eatwild.com.

0:31:25    CAFO (industrial farmed) beef versus CAFO chicken or pork.

0:32:13    Go to the farmer's market and talk to the vendors.

0:32:42    CAFO chicken and pork never see the light of day.

0:33:00    Antibiotic resistance.

0:33:59    Defending Beef.

0:34:06    Interview Modern Farm Girls podcast.

0:34:46    Local might trump organic in some situations.

0:35:25    Chickens do pretty well on grain.

0:36:05    Pigs also do well on grain.

0:36:17    No soy.

0:37:00    The Whole30 works because the rules are very clear.

0:37:20    Real life is grey.

0:38:48    Julie has got to the place where she can consider sustainability.

0:40:40    Diana recommends fixing yourself first.

0:41:37    Modification not radical change.

0:41:50    What about parenting.

0:43:31    Knee jerk reactions when first adopting Paleo.

0:43:49    Kids can end up food hoarding.

0:44:24    Whose breakfast is healthier?

0:44:48    Old beliefs die hard.

0:45:08    Kids can get stressed by not being able to articulate.

0:45:33    The kids eat whatever on play dates.

0:45:57    Diana encourages the kids to think about how they feel after making poor food choices.

0:46:25    Food and sleep are means to an end.

0:47:13    A little moderation goes a long way.

0:48:18    Really great market is called Staff of Life.

0:49:13    Ivy already recognises the gluten free concept.

0:50:03    The gift of being able to make the connection with the way you feel.

0:50:56    Michelle Tam's Nom Nom Paleo.

0:51:55    Sustainable Dish website.

0:52:08    Paleo Lunches and Breakfasts On the Go.

0:52:52    Diana is focussing on finishing her RD.

0:53:09    Sustainability book in the planning.

The monotone of an EKG machine detecting flatline. It doesn't get any worse than that. For realtor Douglas Hilbert, the list of low points doesn't end there. Doug filed bankruptcy at the age of 28, had his home foreclosed on, had two vehicles repossessed, lost multiple businesses, lost 130 "investment" properties and ended up in drug rehabilitation numerous times. Each day was a rollercoaster ride of caffeine and nicotine highs followed by alcohol induced lows.

Back then, depression and anxiety were the norm. Now aged 37, Doug feels better than at any time in his life.

So what did Doug do?

Doug describes exactly what he did in his new book Letters to My Son: Choosing Yourself First, and I am honoured to get more than one mention.

It starts with food.

Doug had good results eating a low-carb paleo diet but has found a high-fat, low-carb, moderate protein ketogenic diet to be even better. If there's one lesson to be learned, it's just eat real food.

Prioritising sleep.

Our modern environments are seldom conducive to quality sleep, and Doug has been able to improve his sleep by hacking his environment. Avoiding light at night, especially from the screens of electronic devices, has helped tremendously. A dark and cool bedroom has also enabled Doug to get the sleep he so desperately needed.

Expressing gratitude and guided meditation.

It's so easy to get caught up in the trivial and the negative. Doug has found that by focusing on the positive things, people, events or anything that are actually present in his real life taps into the positive energy in himself and gets his brain to attach to something with a lasting effect. How do you tap into the positivity? You write down a list of all the things you're grateful for. Sometimes it's brutally difficult to come up with anything, and things such as air make the list. It's not about getting the perfect list, it is about the practice.

Doug practices Vipassana, which is "insight" meditation. He has practiced with Buddhist monks, nuns and lay persons at temples and other centers, as well as on extended retreats. From day one Doug was taught to focus on the breath and just observe the thoughts, feelings, emotions and sensations that arise. Six years later he's doing the same thing. There's no goal; he just observes what goes on, and every once in awhile, he picks up something insightful into the nature of the mind and existence.

Eliminating the guesswork and getting himself tested.

Like me, when Doug started to feel so much better, he developed a burning desire to know what was going on inside his body. After all, biochemistry drives behaviour. Doug tested saliva, urine and stool and corrected the problems he found using nutritional supplements. He then went on to become a certified Functional Diagnostic Nutrition practitioner and now runs a health coaching business of his own.

0:00:00 Letters to My Son: Choosing Yourself First by Douglas Hilbert

0:01:12 Doug's low point was an EKG flatline.

0:01:58 Overeating, smoking, drugs, working 100 hours a week.

0:02:22 Terrible physical shape.

0:02:31 Failed business, lost a ton of money.

0:02:43 Doug quit racing triathlon to try and save the business.

0:03:02 When the business still failed, Doug was left with nothing.

0:03:26 Using drugs to lose weight.

0:05:00 Doug has been in rehab three times.

0:05:26 Cycling and triathlon as a way to channel energy.

0:06:05 Spiritual based rehab didn't work, finally a science based approach worked.

0:06:34 "Biochemistry drives behaviour" - Dr Robert Lustig.

0:07:16 Even in sobriety, Doug still had a lot of anxiety and depression.

0:07:48 Doug now feels the best he ever has at 37.

0:08:46 We've recently tested Doug's cortisol, and whilst it's not perfect, it's better.

0:09:13 Doug feels fantastic without taking any prescriptions.

0:10:15 Doug was 50lb overweight at the start of the book, but never had much trouble shedding the extra.

0:11:23 Doug is using Elite HRV to guide activity.

0:11:52 Leanest ever through eating rather than exercise.

0:12:41 Doug has been prescribed a statin but refused.

0:13:54 Peter Attia's YouTube videos.

0:14:16 Despite exercise, Doug's triglycerides were once 459.

0:14:47 Doug has been doing very well on a ketogenic diet.

0:15:18 Doug wasn't performing or thinking well on 150-200g of carbs per day.

0:15:41 Doug's organic acids result showed an elevation of ketones the first time we tested.

0:16:08 A ketogenic diet has enabled Doug to write a book.

0:17:21 All the men do really well on a ketogenic diet.

0:18:22 Doug's triglycerides are now 88.

0:18:52 Ketosis is for keeps.

0:19:04 Vegetarianism lead to the worst test results.

0:19:45 Diet is not the only part, but it's the foundation.

0:20:04 Try meditating on a high-carb breakfast.

0:21:25 Doug is going to keep testing, and if anything changes, he'll make another decision.

0:22:17 The only thing that has got me into trouble is being close-minded.

0:23:23 Just eat real food!

0:24:37 NBT programs always include diet, rest walking and some kind of stress management.

0:25:21 Doug has writing in his family.

0:26:19 For Doug, writing is cathartic.

0:27:51 Publishing creates accountability.

0:28:39 Writing a gratitude list.

0:29:16 Appreciating the things you really need.

0:30:05 Doug will express gratitude and meditate as required every day.

0:31:54 Humans invent something to worry about in the absence of something really worth worrying about.

0:34:55 Doug's podcast habit.

0:36:27 Reading can be hard when you're not feeling good.

0:36:49 Podcasts are great if you have a job that requires you travel a lot.

0:39:53 Simon Hunter recommended Overcast.

0:43:18 Doug mentions me and my podcast in his book.

0:44:00 Doug is a certified Functional Diagnostic Nutrition practitioner.

0:46:23 Not getting too caught up on the physical.

0:49:08 Email Doug: [email protected].

0:49:21 Doug on Facebook.

Are you a busy realtor struggling to cope with the pressures of your work? Book a free consultation and we'll help you figure out the way forward.

Apple Frudel.

Banana Chocolate Chip Bread.

Cinnamon French Toast Bread.

Blueberry Snack'N Waffle.

Cocoa Puffs Cereal Bar.

Cheerios Cereal Bar.

Cinnamon Pop Tart.

Strawberry Splash Pancake.

Super Donut.

All these "food" items were taken from the breakfast menu for my nephew's school. Presumably an expert designed this menu because it bares the logo of ChooseMyPlate.gov.

If you can't trust the experts, who can you trust?

How do you protect yourself from misinformation that has the potential to hurt you and your children's health?

There is only one way, and that's to learn how to evaluate scientific evidence and think critically.

Danny Lennon is a nutrition educator and critical thinker, and his Sigma Nutrition podcast is a powerful platform.

As you can probably tell from his accent, Danny is from Ireland.

After completing a degree in biology and physics, Danny worked as a teacher for a while before returning to the University of Cork to complete a master's degree in Nutrition Science.

After failing to achieve the results he deserved from training, Danny set out to discover the truth about what works in nutrition and health. His goal is to teach us how to be our own expert, to enable us to separate the brilliant from the misleading, even if the difference is more subtle than a Super Donut on your breakfast menu.

If you're listening to this interview, my guess is that you're already an accomplished nutrition critical thinker. My question to you is how do we get this message out there more efficiently? Please let me know in the comments section below.

0:00:00 Danny Lennon's Sigma Nutrition Radio podcast.

0:00:51 Sigma Nutrition Radio has helped me professionally.

0:01:10 Why is Danny interested in nutrition?

0:01:33 Danny has always been an athlete.

0:01:41 Danny studied biology and physics.

0:02:06 Boyd Eaton paper on evolutionary biology.

0:02:06 Necessity is a great teacher!

0:02:34 Danny taught science for a while.

0:02:50 Danny was born just outside London, grew up in Dublin, now in Limerick.

0:03:36 I have Kelly on both sides of my family!

0:03:53 Is there an obesity problem in Ireland?

0:04:35 Danny is a type-A!

0:04:57 Danny was eating a very low-fat diet with lots of whole grains, something with hindsight he wouldn't recommend.

0:05:52 Danny wasn't as lean as he should have been given how much training he was doing.

0:06:38 I used to eat a completely fat-free diet, thank you Teflon!

0:07:07 Danny has a classical education.

0:07:55 Danny started to wonder who else he could help.

0:08:15 Vitamin D research at the University of Cork under Prof. Kevin Cashman

0:08:44 Understanding individuality.

0:09:28 Biochemistry in a master's degree is fine.

0:09:59 But the public health education is questionable.

0:10:25 The falsely claimed dangers of red meat consumption as an example.

0:10:54 Danny did his own research and sent them to his professor.

0:11:22 The 80s and 90s were the nutritional stone age.

0:11:59 Robb Wolf interview with RD who struggled (Laura Schoenfeld).

0:12:30 My wife Julia decided not to become registered or licensed.

0:12:54 What motivates Danny to teach.

0:13:25 The podcast allows Danny to educate at a level he enjoys.

0:14:18 Danny likes to inspire people to think critically for themselves.

0:15:00 Danny's podcast on calorie restriction and longevity with Dr. Eric Ravussin.

0:15:29 An upcoming interview is a powerful motivator for learning.

0:16:04 My social isolation podcast with Bryan Walsh.

0:16:50 Sarcopenic obesity.

0:17:12 Danny aims to provides the best platform for getting the information out there.

0:17:36 The dangers of "canned answers".

0:18:18 Danny does not write down a list of questions.

0:18:36 My interview with Jason Fung.

0:18:58 A list of questions didn't work for me.

0:19:24 Danny picks guests to create a narrative that spans multiple episodes.

0:20:32 The narrative clusters two or three podcasts.

0:20:32 Adrenal fatigue with Bryan Walsh.

0:21:05 How do you reconcile when a guest says something you think is wrong and unhelpful?

0:21:51 A podcast interview is not a debate!

0:22:11 Practitioners talk about what they do.

0:22:29 Danny can still raise counterpoints.

0:23:06 I've had guests that have said things I've thought was questionable.

0:23:44 How does the information you glean from the podcast fit into your practice.

0:23:53 There's a common core consensus e.g. sleep, minimally processed foods.

0:25:18 It's OK to change your mind based on the new information.

0:25:29 Danny is always thinking about key messages, and he would like you to do the same.

0:26:05 Getting caught up in the details.

0:27:26 The basics come first.

0:27:52 Snowing people with everything you've learnt is a mistake.

0:28:45 My fictitious example: overtrained half marathon runner.

0:29:27 Initial starting point is to look at the big picture.

0:30:00 No need to jump into test until you've addressed the basics.

0:30:29 The test results are not going to change what we do first until we've addressed the basics.

0:30:57 Depending on the person, changing one thing at a time can be helpful.

0:31:26 Sleep and diet first.

0:32:21 Regaining weight and regressing because people think they need to make changes all the time.

0:33:05 Modification in preference to complete overhaul.

0:33:47 Usually people come to me having already done the basic stuff.

0:34:11 Some people seem better able to make change once they've seen a test result.

0:34:52 Getting emotional commitment is important.

0:35:39 A diagnosis is a powerful motivator.

0:36:31 Getting to the underlying goals.

0:36:51 Quantification can be important

0:37:24 Danny sets up a series of consultations.

0:38:11 Avoids snowing.

0:38:11 This adds accountability.

0:38:28 12 week block of coaching.

0:38:43 Danny works with a lot of boxers and MMA fighters.

0:39:14 Maybe I've been doing this wrong: too many things at once.

0:39:58 I do get great results but we spend so much time following up.

0:40:47 The intermediates and advanced people might do better with taking it all on at once.

0:41:36 Every coach should have a coach.

0:42:00 Otherwise you end up second guessing.

0:42:40 I love ticking boxes and following plans.

0:43:04 I have at least one example of a person that did better with weekly contact.

0:43:35 Lacking the call to action.

0:44:16 Sign up at sigmanutriton.com.

0:45:01 Danny's article on key fundamentals.

0:45:33 Danny finds writing harder.

0:45:56 Danny tends towards perfectionism and long articles.

0:48:23 The Ridiculously Simple Guide to Sustainable Fat Loss.

0:48:47 The 2016 Sigma Nutrition Conference is in February.

0:49:42 For fitness professionals.

0:50:02 In Dublin.

0:50:15 Possibly one or even to in England.

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:

1. Hits alpha cells in the pancreas to suppress glucagon.
2. Then goes to the liver to suppress gluconeogenesis (and stimulate lipogenesis).
3. 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.

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.

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 comfo