Nourish Balance Thrive

Professor Tim Noakes is a towering but controversial figure in the health and fitness world, having written more than 50 scientific books and articles covering a variety of topics that challenge the industry standards of both medicine and sports nutrition. After discovering that the current international dietary guidelines have little basis in science, Tim Noakes began his own research on the effects of dietary protein, carbohydrate and fat. His research convinced him that a high-fat, low-carb diet is the best option for many people. In today's episode Christopher Kelly chats with Tim about the benefits of a low-carb, high-fat diet, but not before covering the issue of hydration for athletes and why more harm than good is being done by the promotion of an overhydration myth. This is an engaging, thought-provoking conversation you won't want to miss.

Is it true that endurance athletes need to overhydrate in preparation for competition?

In his book "Waterlogged," Professor Tim Noakes gives a definitive, "No" answer to that question. His studies have proved again and again that the body itself is the best regulator of proper and necessary hydration and will push every person on the planet toward drinking when it is truly needed through the sensation we call "thirst." He holds that this is equally true for endurance athletes. Professor Noakes and Christopher Kelly spend the first part of this conversation discussing the research and reasons for his contentions about hydration and discuss the terrible effects overhydration can and has produced.

Professor Tim Noakes's surprising path to a low-carb, high-fat diet.

Professor Tim Noakes has been a marathon and ultramarathon runner for most of his adult life so he's long known the general correlation of good nutrition for performance. But when he returned to school to receive a medical education he bought into the standard nutritional guidelines touted by the medical community. Correspondingly, his personal dietary habits changed, and in time a decline in his personal health followed. As he began to see the reality of his own health Tim was motivated to find an answer. A book recommendation from a friend turned his thinking back to the low-carb, high-fat way of eating (banting) and his health turned dramatically toward the better in a relatively short period of time. You can hear the entire story of Professor Noakes's discoveries and how it's resulted in the creation of his program "The Real Meal Revolution" in this episode.

A real answer for type 2 diabetes.

Professor Tim Noakes is one of many who is living proof that type 2 diabetes can be reversed. After experiencing his own health struggles caused by adherence to the dietary guidelines promoted by the medical community, he became diabetic himself. His path to healing came from rejecting the status quo dietary recommendations and adopting what his research was showing to be much better… a low-carb, high-fat diet. You can hear his story of how that change came about, the dramatic impact it has had on his life, and testimonies of the many people who have followed his dietary recommendations and seen their type 2 diabetes reversed. It's an illuminating conversation on this episode of the podcast.

The Noakes Foundation: Supporting a global dietary revolution to reverse obesity and type 2 diabetes.

After being left frustrated by a decline in his personal health, Professor Tim Noakes has made it his mission to reverse the global trends of diabetes and obesity. The Noakes Foundation is the organization he's formed to conduct research and disseminate its findings in order to be a catalyst for that change. The foundation's purpose is to reveal what genuine healthy nutrition looks like and, in doing so, make a difference in the lives of millions of people. Tim Noakes's work is poised to shake the health/nutrition world, and hopefully, the entire world beyond that. In this episode, Professor Noakes will speak about his findings, why obesity is an unnatural state for the human body, and how his research and experience has led him to a dietary solution for type 2 diabetes. Be sure to listen.

Here's the outline of this interview:

• [0:05] Introduction of Professor Tim Noakes, writer and researcher.
• [1:43] Introduction to today's two topics: Hydration & Low Carb Diets.
• [2:26] How Tim's book, "Waterlogged" has impacted Christopher and how the issue of hydration is a life and death issue.
• [4:57] Professor Noakes's response to the claims that thirst indicates a loss of hydration and a loss of power for athletes.
• [8:57] Why the right approach to hydration is to monitor it by thirst, not amount.
• [10:38] How does specific gravity relate to issues of hydration?
• [12:01] How the feedback loops in human physiology impact things like thirst, weight loss, and others.
• [13:38] What causes an afternoon loss of energy? Eating too much sugar.
• [14:30] Intestinal hyperpermeability: Does dehydration cause it?
• [17:57] How Professor Noakes got into studying the low carb diet.
• [24:20] Professor Noakes's opinion about the recent study done by the NIH, written by Kevin Hall.
• [26:31] Why hunger and obesity are a brain issue, not a metabolism issue.
• [28:58] How the low carb, high fat diet has impacted Christopher's sports performance.
• [30:34] How does Professor Noakes define insulin resistance?
• [31:58] What are the markers one should watch for in terms of diabetes?
• [35:56] Professor Noakes's prescription for diabetes and what we could do to avoid it in the entire population.
• [42:25] Can insulin resistance be reversed?
• [45:00] Professor Noakes's upcoming study of the patients who say that switching to a "banting" diet has cured their Type II diabetes.
• [47:56] How might a low carb diet impact the production and health of red blood cells?
• [48:54] Why traditional medicine fails and how complementary medicine makes a huge difference.
• [52:27] What is the Real Meal Revolution and why has it been so successful?
• [57:46] Who is this real meal revolution for? Is it only therapeutic?
• [1:02:26] Steps Christopher has taken with his 2 year old daughter in terms of her nutrition.
• [1:05:42] Professor Noakes' final comments: Why traditional medicine got it all wrong and what should be done instead.

RESOURCES MENTIONED IN THIS EPISODE

Books:

Challenging Beliefs, Memoir of a Career by Tim Noakes

Waterlogged by Tim Noakes

The New Atkins For The New You, by Professor Westman, Professor Phinney, and Professor Volek

Raising Superheroes

Principles of Healthy Diets by Weston Price

Other Resources:

Kevin Hall's NIH study referenced

N-acetylcysteine

Berberine

The Real Meal Revolution Program

Ketone breath meter

PEOPLE MENTIONED IN THIS EPISODE

Eric C. Westman

Stephen D. Phinney

Jeff S. Volek

Kevin Hall

Dr. Tommy Wood

Weston Price

Professor Jay Wortman

Kevin Hall's study "Calorie for Calorie, Dietary Fat Restriction Results in More Body Fat Loss than Carbohydrate Restriction in People with Obesity" was picked up by almost all the popular news outlets. The BBC, The Guardian, Time Magazine, The Washington Post and LA Times all weighed in. Stephen Guyenet and Bill Lagakos both wrote very interesting articles worthy of your attention. The examine.com and NHS commentary were also good.

Dr. Tommy Wood described the study as "groundbreaking" and "the most well designed and best controlled ever".

From the title, the conclusion was clear, the low-fat diet resulted in more fat-loss than the low-carb diet. Unfortunately, and as always, it's a bit more complicated than that.

Professor Richard Feinman described the study as "a very distressing paper", not for its conclusion, but for the missing data. "Nobody loses an average amount of weight," said Feinman, "habeas corpus datorum" (show me the body of the data).

During the interview, Dr. Feinman mentions QED Statistics, and the two studies "Carbohydrate restriction improves the features of Metabolic Syndrome. Metabolic Syndrome may be defined by the response to carbohydrate restriction" and "Dietary carbohydrate restriction as the first approach in diabetes management: Critical review and evidence base".

Richard David Feinman is Professor of Biochemistry at the State University of New York (SUNY) Downstate Medical Center in Brooklyn, New York. Dr. Feinman's original area of research was in protein chemistry and enzyme mechanism, particularly in blood coagulation and related processes. Dr. Feinman has talked about flawed studies on my podcast once before.

Dr. Tommy Wood is a qualified medical doctor, graduating from Oxford University in 2011. He has a previous Bachelor's degree in Natural Sciences and Biochemistry from Cambridge University. After working as a junior doctor in the UK for two years, Dr. Wood is now working towards a Ph.D. in neonatal brain metabolism at the University of Oslo, Norway. Tommy is a regular contributor to my podcast, and for that I am ever grateful.

Addendum, 7 September, 2015

During the interview, Dr. Feinman said, "They've chased out everybody who has integrity". This statement was the result speaking of-the-cuff, and what he meant was "They've chased out everybody who can't put up with the state of the field. The remaining ones may have great integrity but greater tolerance for the mess in nutrition".

I've just got back from three wonderful weeks of travelling in the UK, and while I was there, I ran into some old friends who've been listening to my podcast. "Lots of great information, but not much prescriptive," they said. "What the heck is it that you do for a living now?". Well, that's the question that this show attempts to answer.

And who better than Amelia to help me describe what it is that we do at Nourish Balance Thrive. Amelia and I have been working together for about a year now, and I'm proud to announce that she's now my first full-time employee.

In a nutshell:

Nourish Balance Thrive is the wellness programme created by athletes, for athletes. We've had great results recommending a Paleo diet, especially The Whole30 and Autoimmune Paleo protocol, along side environment hacks to improve sleep and manage stress. We don't design training plans, but we do recommend walking and lifting heavy things. If you're already doing these things and aren't getting the brochure experience, then now might be a good time to start doing some testing. Each set of results are unique, but the set of tests I use don't vary much.

The tests are:

• The BioHealth 205 Adrenal Stress Profile
• The Genova Diagnostics 0091 Organix Comprehensive Profile
• The BioHealth 401H GI Pathogen Screen
• A basic blood chemistry with CBC, CWP, iron panel, Vitamin D, A1c, insulin, homocysteine, B12, folate and more.

Am I missing a test you've found to be helpful? Let me know in the comments below.

I know from personal experience that when you've been feeling like crap for a long time, perception of normal becomes distorted. You can now quantify your normal and track its improvement using my Health Assessment Questionnaire, coded by my own fair hand using the Python programming language.

In the show, I mentioned this LED lighting kit.

I've got Dr. Tommy Wood back on the podcast to talk about supplementing with carbohydrates for endurance performance. I had a terrible time with maltodextrin-based sports gels back a few years ago, and I've since noticed that some of the best athletes I know do well on long rides without eating anything. But still, the studies show a clear advantage in supplementing with carbohydrates during workouts lasting longer than one hour. Luckily Tommy is here to help me understand the studies, the potential pitfalls and the biochemistry of supplementing with carbs.

For the past couple of years, I've been supplementing with UCAN Superstarch during long, hard workouts and races. I think of UCAN as the training wheels that enabled me to be a better fat burner. Now I'm left wondering, is there something out there that works better? Or is there something as good but cheaper, e.g. waxy maize? Or fructose?

Tommy and I intend to find out which is best for me using an oral glucose tolerance test.

In the show, I mention the UCAN study, and also these two studies on waxy maize and fructose. I also said that I wasn't sure whether or not I'm ketosis. I've since measured blood ketones at 2.1 mmol/L and six green flashes on a Ketonix Sport breath meter.

On the show this week, author and podcast host Jimmy Moore. I wanted to get Jimmy on to talk about his new Ketogenic Cookbook. I have a paper copy of the book, and I love it. The pictures are big and beautiful, and there's tons of variety. Who said a ketogenic diet is too restrictive? It's just not true.

For those of you that don't already know, I've been working with Jimmy over the past few months in an attempt to him break through a fat-loss plateau. Jimmy has done blood, saliva, urine and stool testing, and I've been helping him understand the results. Jimmy published his results and then broadcast the interview in which I do the interpretation.

In this episode, I'm joined by my wife and food scientist Julia to discuss the changes that Jimmy has made to his diet. Julia recommended going dairy-free for a month and introducing a wide variety of non-starchy vegetables.

In the interview, I mention the uBiome test.

Amir works for a large technology company in Silicon Valley and came to me for help to resolve his chronic inflammation, bloating, allergy and food sensitivity issues:

I couldn't eat a piece of food without feeling sluggish afterwards right away, to the point where it would really interfere heavily with my job and the work that I was doing. I have to perform at work. It's quite challenging not to be able to think clearly throughout the day. It was to the point where I was really dreading foods.

The Paleo diet has been extremely helpful, and AIP even better:

The last two months I've been very strict on my diet, I mean, very, very clean living, no booze, no nothing. I think that also makes a big difference. For the past two months, I would say I've been doing exceptionally well.

Diet and lifestyle hacks are always helpful, but if you don't get the brochure experience, then it's time to do some testing to figure out why. In Amir's case, we found low cortisol (a.k.a adrenal fatigue) and small intestinal bacterial overgrowth (SIBO). And now:

On good days, I feel outstanding. I see it in my physical performance and when I look in the mirror too. A lot of the drawbacks that I had before are pretty much gone. I feel really energetic. I picked up lots of new hobbies, actually, which is an indicator of feeling like you have more energy to tend to the things that you want to do. I think that was the goal overall, just making sure that I can do the things again that I like.

On the left, Amir's organic acids result from July 2014, on the right, the April 2015 retest. Each row describes an abnormality; fewer is better.

Functional Medicine expert Dr. Michael Ruscio lectures to doctors and students nationwide and runs a private practice in California. I first became aware of his research through a series of excellent Robb Wolf podcasts, here, here and here.

Dr. Ruscio now hosts this podcast that I've been enjoying tremendously.

Over the past few weeks, I've been developing a tool to help people better understand their µBiome test results and open up the possibility of automating analysis of the bacteria that reside in our guts. This type of microbiota testing goes beyond the core of what I do at Nourish Balance Thrive, and I was keen to get Dr. Ruscio on to discuss its potential clinical relevance.

Dr. Ruscio is open to the idea of testing and manipulating the microbiota but feels that the association between test results and health outcomes are not yet understood. Furthermore, Dr. Ruscio remains skeptical that we can "custom manipulate the microbiota" to produce a health outcome.

I also couldn't resist the opportunity to ask Dr. Ruscio about his thoughts on treatment for small intestinal bacterial overgrowth (SIBO).

Have you done the µBiome test? Did you find any bifidobacteria? Have you been able to manipulate the results using probiotics and prebiotics? Was there any association with your health or athletic performance? Let me know in the comments section below.

Dr. Tommy Wood is a qualified medical doctor, graduating from Oxford University in 2011. He has a previous Bachelors degree in Natural Sciences and Biochemistry from Cambridge University. After working as a junior doctor in the UK for two years, Dr. Wood is now working towards a Ph.D. in neonatal brain metabolism at the University of Oslo, Norway.

I was inspired to record this interview by the questions I received after people heard my interview with Jimmy Moore in which we review his recent lab work.

To keep in balance, we have both positive and negative ions in the blood. The positive ions (cations) measured on a basic blood chemistry are sodium and potassium. The negative ions (anions) are chloride and bicarbonate. Just to confuse you, bicarbonate is labelled CO2. The anion gap is the sodium plus the potassium minus the chloride and the bicarbonate. Put another way, the anion gap is the unmeasured anions in the blood.

The anion gap is a calculated number and is relevant because the greater the number, the greater the likelihood of an acidosis. The only way to know for sure is to analyse blood gas.

If you have an anion gap greater than 30, then it's very likely you have an acidosis.

In the show, I mention the Khan Academy Chemistry module and Bryan Walsh's Metabolic Fitness Pro training course. Both of these have helped me understand blood chemistry.

Have you run a basic blood chemistry recently? What was your anion gap?

Patrick Arnold is an organic chemist renowned in the field of performance enhancement and sports supplements. Patrick first hit the public eye in the late 1990's when he introduced androstenedione ("Andro") to the world of professional sport.

Patrick has since turned his attention away from prohormones and towards exogenous ketone supplements (BHB). Will ketone supplements ever be banned from sport? Patrick thinks not:

It's a good question. No. I can't see how it could possibly be a banned substance. I mean, BHB is present in many foods, be it in small levels. BHB is naturally occurring in your body. It's a actual energy substrate. It's an actual nutrient. I mean, it's right there along with protein, carbs and fats.

I've been using KetoForce for almost two years now in mountain bike, gravel grinder and cyclocross races. Of course, I don't know if it improves my performance, but 30ml (three capfuls) reliably raises my blood ketone levels by about 1.5mmol/L.

I make KetoForce more palatable using this recipe, courtesy of the late Chef Rachel Albert:

• 30ml of KetoForce
• 250ml (8oz) of water
• The juice of half a lime
• One teaspoon of apple cider vinegar
• Rachel used Stevia, I skip it

More recently, Patrick has introduced KetoCaNa, a more palatable and portable powdered form of BHB.

Are you using ketone supplements to help with your athletic performance? What sport? Have you been able to quantify the difference? Please, let me know in the comments below.

In this episode, I'm joined again by Toréa Rodriguez FDN, a former biochemist, Silicon Valley executive, and professional pilot. Now she is a Certified Functional Diagnostic Nutrition practitioner and health coach herself. We discuss her current progress with her Hashimoto's, gut healing protocols and her personal experience using an AIP low inflammatory diet.

Toréa now works full-time helping other people recover from autoimmunity. Book a free consultation to find out how she can help you.