Patrick Samy is the co-founder and CEO of Span Health, a start-up that offers health coaching informed by biometric data from lab work and wearable devices. Like me, Patrick started out as a software engineer confronted with his own health challenges. Pairing his curiosity for biology with his background in computer science, and adding in a new generation of more accurate consumer health and fitness devices, Patrick is leading Span Health to enable everyday athletes to take their health and performance to a new level.

In this podcast, Patrick talks about the value of personal biometric data for finding your individual path to optimal performance and longevity. He shares lessons learned from his own experiments with wearable data trackers, and trends he's observed while working with clients. We also discuss his go-to devices and biomarkers to track, and the lifestyle interventions that make the biggest difference.

[00:00:49] The story behind Span Health.

[00:04:09] The intersection between biology and computer science.

[00:07:53] Lessons learned by collecting personal health data.

[00:10:12] Span's founding team members, Dr. Adam Bataineh, Chief Medical Officer and Rachel Lett, Chief Care Officer.

[00:11:58] Timing of workouts and eating as critical factors.

[00:14:10] Heart rate variability (HRV) as a marker of recovery.

[00:16:10] Early time restricted feeding (eTRF): Podcasts on eTRF with Greg Potter, PhD, Satchin Panda, PhD, and Bill Lagakos, PhD.

[00:17:38] Oura Ring.

[00:18:30] Continuous Glucose Monitors (CGMs); Podcast: Continuous Glucose Monitoring to Prevent Disease and Increase Healthspan, with Kara Collier, RDN from Nutrisense.

[00:23:57] Span Health's vision for health coaching.

[00:34:01] Peter Attia, MD; Podcast: The Critical Factors of Healthspan and Lifespan.

[00:35:03] PhenoAge; Podcast: How to Measure Your Biological Age, with Megan Hall.

[00:35:07] Overall wellness score based on data by Horne, et al. (2009): Horne, Benjamin D., et al. "Exceptional mortality prediction by risk scores from common laboratory tests." The American journal of medicine 122.6 (2009): 550-558.

[00:38:16] Kraft insulin assay.

[00:39:12] Robert Lustig, MD.

[00:43:15] Wearable devices; Most people quit wearing activity trackers after a while; Study: Finkelstein, Eric A., et al. "Effectiveness of activity trackers with and without incentives to increase physical activity (TRIPPA): a randomised controlled trial." The lancet Diabetes & endocrinology 4.12 (2016): 983-995.

[00:48:58] Getting new clients.

[00:50:25] Span Health Blog.

[00:50:39] Span Health on Twitter; Patrick on Twitter.

Kelly Casperson, MD is a board-certified urologist and self-taught women's sexual health expert. Years of helping care for women has shown her that we, as a society, are not doing enough to teach women about their mind, body and relationships. Kelly aims to break down societal barriers and combat limiting beliefs that are keeping women from awakening into their best intimate experience. She is basically the friendly expert you never had, to teach you - You Are Not Broken.

On this podcast, Kelly talks about women's sexual health and wellness, including the biological and psychological issues that stand in the way of having a great sex life. She talks about spontaneous vs. responsive desire, and why unrealistic expectations may be a huge barrier to intimacy. Kelly also offers great tips for improving sexual health and function, from mind-body strategies like mindfulness and meditation to purely physiological options like topical estrogen and lube.

[00:00:49] Jessa Zimmerman; Book: Sex without stress; a couple's guide to overcoming disappointment, avoidance, and pressure; Podcast: How to Have Intimacy With Ease.

[00:01:05] Podcast: Recapture the Rapture: Rethinking God, Sex, and Death in a World That's Lost Its Mind, with Jamie Wheal.

[00:02:01] Kelly's background and interest in urology.

[00:06:59] FDA approved medication for low libido in women.

[00:08:44] Spontaneous vs. responsive desire.

[00:14:09] Discrepancies in desire.

[00:15:16] Scheduling sex.

[00:18:15] Meditation and mindfulness.

[00:19:44] Orgasm inequality.

[00:22:56] Multiple orgasms.

[00:25:43] Book: Come As You Are: Revised and Updated: The Surprising New Science That Will Transform Your Sex Life, by Emily Nagoski, PhD.

[00:26:15] Foreplay is everything and everything is foreplay.

[00:28:34] Types of arousal.

[00:29:58] Topical estrogen.

[00:31:36] Podcast: The Critical Role of Oestradiol for Women's Cognition, with Anne Hathaway.

[00:34:20] Oral birth control.

[00:36:08] Podcast: The Postmenopausal Longevity Paradox and the Evolutionary Advantage of Our Grandmothering Life History, with Kristin Hawkes.

[00:38:43] Podcast: How We Really Burn Calories, Lose Weight, and Stay Healthy, with Herman Pontzer, PhD.

[00:39:36] Vibrators don't cause desensitization; Study: Herbenick, Debra, et al. "Prevalence and characteristics of vibrator use by women in the United States: Results from a nationally representative study." The journal of sexual medicine 6.7 (2009): 1857-1866.

[00:40:47] Everybody should use lube; Uberlube.

[00:43:36] Podcast: Disruptive Anthropology: An Ancestral Health Perspective on Barefooting and Male Circumcision, with Stephanie Welch.

[00:48:17] Book: You Are Not Broken (coming soon).

[00:49:09] The You Are Not Broken Podcast.

[00:49:22] Kelly's website.

[00:49:51] Find Kelly on Instagram.

Peter Dobromylskyj is a UK-based veterinary anaesthetist and nutrition blogger whose blog Hyperlipid is amongst the longest-running and most highly respected in the low-carb and ancestral health communities. Peter has been writing about the biochemistry of nutrition since 2006, and has authored over 800 posts aimed at reviewing, analysing, and interpreting nutrition literature. Given his outside-the-box thinking and unconventional approach to metabolism and health, Peter's work has amassed a large and devoted following.

Today, NBT Scientific Director Megan Hall interviews Peter to talk about insulin resistance, including the factors that cause it and why the condition is actually physiologically adaptive. Peter compares dietary saturated fats to polyunsaturated fatty acids (PUFAs), and explains why the scientific literature can be misleading when determining which truly promotes health. He gives specific science-based recommendations for how much PUFA to include in your diet, and also offers advice on what to feed your pets.

For additional resources on insulin resistance and the influence of dietary fat sources, be sure to see the outline Megan wrote to prepare for this podcast.

[00:01:52] Insulin resistance is physiologically adaptive.

[00:02:23] Reactive Oxygen Species (ROS) as signaling molecules.

[00:04:52] Dr. David Speijer, Researcher at the University of Amsterdam.

[00:05:31] Dr. Nick Lane, Professor of Evolutionary Biochemistry.

[00:11:29] Protons thread on the Hyperlipid blog.

[00:22:58] When insulin sensitivity becomes insulin resistance.

[00:30:37] How long it takes to become insulin resistant.

[00:34:55] Acipimox reduces free fatty acid circulation and temporarily reverses insulin resistance; 1. Santomauro, A. T., et al. "Overnight lowering of free fatty acids with Acipimox improves insulin resistance and glucose tolerance in obese diabetic and nondiabetic subjects." Diabetes 48.9 (1999): 1836-1841; 2. Aday, Aaron W., et al. "Impact of Acipimox Therapy on Free Fatty Acid Efflux and Endothelial Function in the Metabolic Syndrome: A Randomized Trial." Obesity 27.11 (2019): 1812-1819.

[00:36:19] Effects of caffeine on insulin resistance.

[00:37:34] Phil Maffetone.

[00:38:25] In mice, stearic acid reduces visceral adipose tissue; Study: Shen, Ming-Che, et al. "Dietary stearic acid leads to a reduction of visceral adipose tissue in athymic nude mice." PLoS one 9.9 (2014): e104083.

[00:38:34] Overfeeding studies in humans: 1. Rosqvist, Fredrik, et al. "Overfeeding polyunsaturated and saturated fat causes distinct effects on liver and visceral fat accumulation in humans." Diabetes 63.7 (2014): 2356-2368; 2. Iggman, David, et al. "Association of adipose tissue fatty acids with cardiovascular and all-cause mortality in elderly men." JAMA cardiology 1.7 (2016): 745-753.

[00:44:10] Raphael Sirtoli's Podcast: Carnivore Cast.

[00:45:02] Butter fat → higher postprandial levels of FFAs and triglycerides; Study: López, Sergio, et al. "Distinctive postprandial modulation of β cell function and insulin sensitivity by dietary fats: monounsaturated compared with saturated fatty acids." The American journal of clinical nutrition 88.3 (2008): 638-644.

[00:46:50] Tucker Goodrich.

[00:47:38] How much polyunsaturated fat is needed to cause metabolic dysfunction?

[00:48:27] Leptin-deficient mouse study: Reeves, Valerie Lynn. "A diet enriched in stearic acid protects against the progression of type 2 diabetes in leptin receptor deficient mice (DB/DB)." (2012).

[00:49:57] Aim for 2-4% of calories from linoleic acid (over 8% is obesogenic).

[00:51:26] Efforts to lose weight with unsaturated vs. saturated fat stores.

[00:53:29] Animal based keto with 15% polyunsaturates; Study: Hall, Kevin D., et al. "Effect of a plant-based, low-fat diet versus an animal-based, ketogenic diet on ad libitum energy intake." Nature Medicine 27.2 (2021): 344-353.

[00:58:46] Electron transport chain (see this figure) and mitochondria.

[00:58:57] Summary so far.

[01:01:33] What dogs/pets should be eating.

[01:09:05] Labradors may have problems with leptin signaling; Book: Raw Meaty Bones Promote Health, by Tom Lonsdale.

Elevated blood glucose is one of the earliest and most common indicators of worsening metabolic health, insulin resistance and cardiovascular disease. For our clients, fasting blood glucose and triglycerides are amongst the first things we test to get a snapshot view of metabolic health. We've now added HbA1C - a marker that offers a broader look at glycemic history - to our baseline blood panel, to better evaluate our clients.

On this podcast, NBT Scientific Director Megan Hall talks about the HbA1C blood test: what it is, who needs it, and why you should care. Megan talks about the optimal reference range for this test, and when to become concerned about your result (hint: it's sooner than your doctor would have you believe). She also talks about exactly what to do if your A1C is out of range, and how a continuous glucose monitor can help you evaluate your body's response to different foods and other environmental factors.

[00:00:48] HbA1C (aka glycated haemoglobin): a marker of your glycemic history.

[00:02:27] Glucose to A1C conversion chart.

[00:02:52] Megan's outline for this podcast.

[00:03:04] Why you should care about HbA1C.

[00:03:48] Optimal ranges for HbA1C: 5.0% to 5.4%.

[00:04:33] Studies supporting optimal reference range: 1. Zhong, Guo-Chao, et al. "HbA 1c and Risks of All-Cause and Cause-Specific Death in Subjects without Known Diabetes: A Dose-Response Meta-Analysis of Prospective Cohort Studies." Scientific reports 6.1 (2016): 1-11; 2. Schöttker, Ben, et al. "HbA 1c levels in non-diabetic older adults–No J-shaped associations with primary cardiovascular events, cardiovascular and all-cause mortality after adjustment for confounders in a meta-analysis of individual participant data from six cohort studies." BMC medicine 14.1 (2016): 1-17; 3. Li, Fu-Rong, et al. "Glycated hemoglobin and all-cause and cause-specific mortality among adults with and without diabetes." The Journal of Clinical Endocrinology & Metabolism 104.8 (2019): 3345-3354; 4. Pai, Jennifer K., et al. "Hemoglobin a1c is associated with increased risk of incident coronary heart disease among apparently healthy, nondiabetic men and women." Journal of the American Heart Association 2.2 (2013): e000077.

[00:06:12] Prediabetes range: 5.7% to 6.4% (above 6.4% is diabetes).

[00:07:06] Only 12% of the population is metabolically healthy; Study: Araújo, Joana, Jianwen Cai, and June Stevens. "Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016." Metabolic syndrome and related disorders 17.1 (2019): 46-52.

[00:07:31] Limitations and caveats of the A1C blood marker.

[00:08:05] Partial marker of mean glycemic exposure; Article: Bloomgarden, Zachary. "Beyond HbA1c." Journal of diabetes 9.12 (2017): 1052-1053.

[00:08:53] Things that cause HbA1C to be falsely low or high.

[00:10:14] Study: Virtue, Mark A., et al. "Relationship between GHb concentration and erythrocyte survival determined from breath carbon monoxide concentration." Diabetes Care 27.4 (2004): 931-935.

[00:12:36] Racial and ethnic differences: Herman, William H., and Robert M. Cohen. "Racial and ethnic differences in the relationship between HbA1c and blood glucose: implications for the diagnosis of diabetes." The Journal of Clinical Endocrinology & Metabolism 97.4 (2012): 1067-1072.

[00:12:42] Other markers of glycemic regulation.

[00:12:55] Drawbacks of Glycomark.

[00:14:08] Reticulocytes - helpful to calculate RBC lifespan.

[00:14:40] Equation: RBC survival (days) = ~ 100 / [Retics (%) / RLS (days)]

[00:15:44] Sign up for our group program to get a blood test + bloodsmart.ai report + 4 group coaching sessions + help videos.

[00:16:44] Continuous Glucose Monitor (CGM).

[00:17:26] Podcast: Continuous Glucose Monitoring to Prevent Disease and Increase Healthspan, with Kara Collier, RDN.

[00:17:46] Get $50 off your Nutrisense membership when you support NBT on Patreon.

[00:18:26] Studies demonstrating that HbA1C is not the perfect marker: 1. Cohen, Robert M., et al. "Red cell life span heterogeneity in hematologically normal people is sufficient to alter HbA1c." Blood, The Journal of the American Society of Hematology 112.10 (2008): 4284-4291; 2. Wright, Lorena Alarcon-Casas, and Irl B. Hirsch. "The challenge of the use of glycemic biomarkers in diabetes: reflecting on hemoglobin A1C, 1, 5-Anhydroglucitol, and the glycated proteins fructosamine and glycated albumin." Diabetes spectrum 25.3 (2012): 141-148; 3. Dubowitz, N., et al. "Aging is associated with increased HbA1c levels, independently of glucose levels and insulin resistance, and also with decreased HbA1c diagnostic specificity." Diabetic Medicine 31.8 (2014): 927-935.

[00:18:58] What to do if your A1C is out of range: Diet, lifestyle, measure other markers, monitor blood glucose.

[00:19:35] Cellular vs. acellular carbs.

[00:22:25] Simon Marshall, PhD. on stress management: How to Manage Stress.

[00:24:19] 4-quadrant model.

[00:26:07] Retest after 2-3 months.

[00:27:58] Join our group program.

Michael S. Sorensen is a business executive by day and a bestselling author, speaker, and relationship coach by night. He has helped hundreds of thousands of people across the world heal broken relationships, revitalize their confidence, and become masters of connection in business, love, and life. Unique among others in his field, Michael is not a therapist, social worker, or medical professional. Instead, he gained his knowledge by going to therapy himself—1-2 times per week, for over five years—and voraciously consuming every relationship and self-help book he could get his hands on.

On this podcast, Michael talks about one of the most valuable (yet little-known) communication skills - validation. The subject of his book, I Hear You, validation is the key to calming fears and uncertainties, increasing feelings of love and appreciation in relationships, and giving advice and feedback that sticks. Michael shares his 4-step method for validating others (and oneself), talks about how to identify emotions, and shares why validation is such a simple yet powerful interpersonal tool.

[00:00:31] Book: I Hear You: The Surprisingly Simple Skill Behind Extraordinary Relationships, by Michael S. Sorensen.

[00:00:43] Licensed Marriage and Family Therapist, Anna Dow.

[00:00:54] Book: Never Split the Difference: Negotiating as if Your Life Depended on It, by Chris Voss.

[00:01:31] How Michael came to the skill of validation.

[00:03:38] Defining validation.

[00:05:16] Simon Marshall, PhD.

[00:06:49] Listening vs. validation.

[00:07:45] Podcast: The Postmenopausal Longevity Paradox and the Evolutionary Advantage of Our Grandmothering Life History, with Kristin Hawkes, PhD.

[00:09:37] Benefits of validation.

[00:11:25] Invalidating statements.

[00:14:35] When to validate.

[00:15:11] 4 step method: Listen empathically, validate, advice/feedback, validate again.

[00:16:56] How to identify emotions.

[00:18:16] Emotion wheel.

[00:18:56] Podcast: From Magic to Mindfulness: The Evolution of an Entrepreneur, with Jason Connell.

[00:19:23] Book: It's Not Always Depression: Working the Change Triangle to Listen to the Body, Discover Core Emotions, and Connect to Your Authentic Self, by Hilary Jacobs Hendel.

[00:24:52] Validation vs. reflective listening.

[00:27:23] Validating when you don't agree.

[00:33:05] Why it's a short book.

[00:34:41] The I Hear You Relationships Podcast.

[00:35:35] Validating ourselves.

[00:37:32] Find Michael: Amazon, michaelssorensen.com.

Back on the podcast with me today is Physical Therapist and Certified Strength and Conditioning Coach Zac Cupples. When it comes to physiology, movement and biomechanics, Zac is among the best and has become an invaluable resource to me and many of our clients. He offers online movement consultation, mentoring, and fitness training, with expertise in the areas of rehab, training, nutrition, sleep, stress management, breathing, pain, and sports science.

​On this podcast, Zac and I are talking about the impact of mouth and face structure on breathing, sleeping, and overall health. Zac discusses some of the causes of abnormal facial development, and the problems that result, including sleep disorders, crowded and crooked teeth, and worsened athletic performance. He also describes the best way to assess for breathing problems at night and offers some tips for prevention and intervention.

[00:01:15] Utilizing breathing to enhance movement.

[00:05:10] Abel Romero; Podcast: How to Avoid Chronic Pain, Improve Mobility and Feel 100% Confident in Your Lifting.

[00:06:59] Mike T. Nelson's Flex Diet Podcast: S2_EP_23_Cranial Face Structures, Nasal Breathing, Orthodontics, Tongue Position, and More Unlikely Performance Limiters: Interview with Zac Cupples.

[00:08:53] Kevin Boyd's Amazing Shrinking Face presentation.

[00:10:17] Tongue and lip tie (picture).

[00:14:39] Dr. Joseph Sanelli; Dr. Soroush Zaghi; Dr. Brian Hockel.

[00:15:55] Book: Six-Foot Tiger, Three-Foot Cage: Take Charge of Your Health by Taking Charge of Your Mouth, by Dr. Felix Liao DDS.

[00:18:33] Latera nasal implant.

[00:21:07] Dr. Movahed.

[00:27:25] When you should do a sleep study.

[00:29:12] Pulse oximeter vs. sleep study.

[00:29:28] WatchPAT / WatchPAT One; Study: Yuceege, Melike, et al. "Reliability of the Watch-PAT 200 in detecting sleep apnea in highway bus drivers." Journal of clinical sleep medicine 9.4 (2013): 339-344.

[00:29:39] Apnea Hypopnea Index (AHI).

[00:30:01] Respiratory Disturbance Index (RDI).

[00:30:39] Upper Airway Resistance Syndrome vs. sleep apnea.

[00:34:22] Risks of untreated sleep apnea.

[00:37:35] Measuring progress.

[00:38:53] i-Sleep Home Sleep Solutions in Reno (use HST10 discount code for 10% off).

[00:39:31] Lofta at-home sleep study.

[00:40:28] Book: Jaws: The Story of a Hidden Epidemic, by Sandra Kahn and Paul R. Ehrlich.

[00:40:42] Book: Gasp!: Airway Health - The Hidden Path To Wellness, by Dr. Michael Gelb.

[00:42:07] Factors leading to airway problems.

[00:44:24] Book: Nutrition and Physical Degeneration: A Comparison of Primitive and Modern Diets and Their Effects, by Weston A Price.

[00:45:38] Dental intervention for children.

[00:47:05] Finding an orthodontist.

[00:47:19] Podcast: Airway Dentistry with Dr. Brian Hockel.

[00:49:14] Academy of Orofacial Myofunctional Therapy (AOMT).

[00:50:20] Daniel Lieberman books: Exercised and The Story of the Human Body.

[00:50:47] Book: Burn by Herman Pontzer; Podcast: How We Really Burn Calories, Lose Weight, and Stay Healthy.

[00:58:41] Elevate Sports Performance and Health Care, Las Vegas NV.

[00:59:28] zaccupples.com; YouTube, Facebook, Twitter, Instagram.

For the last 18 months or so NBT Scientific Director Megan Hall has been holding weekly Office Hours sessions on Zoom. It's a chance for our clients and Patreon supporters to ask questions about just about anything related to improving health and performance and get answers based on the scientific literature. This has become such a valuable resource for the NBT community that I wanted to share just a taste of it on the podcast today.

Today you can listen in on one of Megan's recent Office Hours sessions. First, she discusses ways to increase the body's nitric oxide (NO) production, including the best foods and the supplements arginine and citrulline. NO's most important function is vasodilation, meaning it relaxes the inner muscles of the blood vessels, causing them to widen and increase circulation. Later she talks about natural ways to keep mosquitos away, including her favourite non-toxic insect repellant and other lesser-known strategies for staying bug-bite free.

[00:00:01] Podcast: Why Cholesterol Levels Have No Effect on Cardiovascular Disease (And Things to Think about Instead), with Malcolm Kendrick.

[00:00:13] Podcast: The Pleiotropic Effects of Sunlight, with Megan Hall.

[00:01:53] Nitric oxide precursor: L-citrulline.

[00:03:02] Study: Tsuboi, Tomoe, Morihiko Maeda, and Toshio Hayashi. "Administration of L-arginine plus L-citrulline or L-citrulline alone successfully retarded endothelial senescence." PloS one 13.2 (2018): e0192252.

[00:04:15] Figure 1 from Study: Figueroa, Arturo, et al. "Influence of L-citrulline and watermelon supplementation on vascular function and exercise performance." Current opinion in clinical nutrition and metabolic care 20.1 (2017): 92-98.

[00:06:24] L-citrulline may reduce blood pressure in hypertensive individuals; Studies: 1. Kapil, Vikas, et al. "Inorganic nitrate supplementation lowers blood pressure in humans: role for nitrite-derived NO." Hypertension 56.2 (2010): 274-281; 2. Bonilla Ocampo, Diego A., et al. "Dietary nitrate from beetroot juice for hypertension: A systematic review." Biomolecules 8.4 (2018): 134.

[00:06:29] L-citrulline may help with erectile dysfunction; Study: Cormio, Luigi, et al. "Oral L-citrulline supplementation improves erection hardness in men with mild erectile dysfunction." Urology 77.1 (2011): 119-122.

[00:07:52] Dosing L-citrulline.

[00:08:34] Concentrated nitrate supplements and foods.

[00:10:12] Supplementing L-citrulline; Allergy Research Group L-Citrulline powder.

[00:10:58] Eat more watermelon, dark chocolate, and beetroot; Studies: Bonilla Ocampo, Diego A., et al. "Dietary nitrate from beetroot juice for hypertension: A systematic review." Biomolecules 8.4 (2018): 134; 2. Sudarma, Verawati, Sri Sukmaniah, and Parlindungan Siregar. "Effect of dark chocolate on nitric oxide serum levels and blood pressure in prehypertension subjects." Acta Med Indones 43.4 (2011): 224-8; 3. Faridi, Zubaida, et al. "Acute dark chocolate and cocoa ingestion and endothelial function: a randomized controlled crossover trial." The American journal of clinical nutrition 88.1 (2008): 58-63; 4. Ried, K., P. Fakler, and N. P. Stocks. "Cochrane Hypertension Group National Institute of Integrative Medicine. Effect of cocoa on blood pressure." Cochrane Database Syst Rev (2017).

[00:11:30] Natural ways to keep mosquitos away.

[00:11:51] Blog post: 12 Mosquito Repellant Plants.

[00:12:09] Yellow light bulbs.

[00:12:40] Nature Spray (nontoxic natural mosquito repellent).

[00:13:20] Citronella Candles.

I'm so excited to introduce you today to a good friend of mine. Jason Connell is a licensed psychotherapist practising in the state of Colorado, with a Master's Degree in Clinical Social Work from Fordham University. He works with a focus on Accelerated Experiential Dynamic Psychotherapy (AEDP), a therapeutic methodology that works toward healing trauma and expanding positive transformational experiences. He is also a certified meditation teacher and has advanced training in motivational enhancement.

On this podcast, Jason and I talk about his personal and professional evolution, from entertaining the masses as a magician at the age of 6 to embracing his current role as a teacher and psychotherapist. He describes his young adult life of travelling and volunteering (and inspiring others to do the same), and becoming a public speaker as a "22-year old jackass." Perhaps most valuable are Jason's insights on entrepreneurism and the importance of authentic communication.

[00:01:32] Becoming a child magician.

[00:03:06] Book: Train Dreams: A Novella.

[00:06:39] Book: Mindset: The New Psychology of Success.

[00:12:09] Traveling, volunteering, and becoming a keynote speaker.

[00:16:07] Podcast: Free to Learn: Unleashing the Instinct to Play, with Peter Gray, PhD.

[00:17:57] Charge way more than your competition.

[00:25:51] Teaching others to get speaking gigs.

[00:35:23] Healing psychological injuries.

[00:40:25] Becoming a licensed therapist.

[00:46:00] Thoughts on Cognitive Behavioral Therapy (CBT).

[00:50:23] Simon Marshall, PhD.

[00:50:49] Acceptance and Commitment Therapy (ACT)

[00:51:22] Book: The Happiness Trap: How to Stop Struggling and Start Living: A Guide to ACT, by Russ Harris.

[00:51:39] Accelerated Experiential Dynamic Psychotherapy (AEDP).

[00:54:23] Eye Movement Desensitization and Reprocessing (EMDR).

[00:54:51] Psychotherapist Jessica Fern; Podcast: Polysecure: Attachment, Trauma and Consensual Nonmonogamy; Book: Polysecure: Attachment, Trauma and Consensual Nonmonogamy.

[01:02:04] Dr. Ken Ford; Podcast: Optimal Diet and Movement for Healthspan, Amplified Intelligence and More with Ken Ford.

[01:05:55] Jason's website.

Anaemia is an incredibly common blood condition in which you lack enough red blood cells - or haemoglobin within them - to adequately deliver and supply oxygen to the body's tissues. Worldwide, children and pregnant women are disproportionately affected, though we've had a number of clients benefit from lifestyle changes aimed at increasing haemoglobin. And I can tell you from personal experience, anaemia can have a measurable impact on athletic performance.

On this podcast, NBT Scientific Director Megan Hall and I are talking about low oxygen deliverability resulting from anaemia and the many factors that can lead to this condition. We discuss in detail the blood tests that suggest anaemia is affecting your health, along with science-based optimal reference ranges for the most important markers.

Megan also details steps you can take to improve your oxygen deliverability status if your haemoglobin is low (and taking an iron pill is not always the answer!).

There's a ton of great information in this one, so be sure to follow along with the outline Megan wrote to prepare for the podcast.

[00:03:07] What is oxygen deliverability? Background and physiology.

[00:05:00] Anaemia.

[00:07:00] Why care about haemoglobin?

[00:07:02] Haemoglobin's effect on athletic performance.

[00:09:56] Causal relationship between iron deficiency anaemia and aerobic capacity; Review: Haas, Jere D., and Thomas Brownlie IV. "Iron deficiency and reduced work capacity: a critical review of the research to determine a causal relationship." The Journal of nutrition 131.2 (2001): 676S-690S.

[00:11:06] Haemoglobin and anaerobic threshold.

[00:12:10] Study of speed skaters: Kuipers, Harm, et al. "Hemoglobin levels and athletic performance in elite speed skaters during the olympic season 2006." Clinical Journal of Sport Medicine 17.2 (2007): 135-139.

[00:12:16] Megan's outline for this podcast.

[00:13:51] Fatigue and energy levels.

[00:14:33] Anaemia and quality of life issues.

[00:15:46] Anaemia during pregnancy.

[00:16:38] Potential causes of anaemia.

[00:30:14] Malcolm Kendrick podcast discussing sickle cell anaemia and endothelial damage: A Statin Nation: Damaging Millions in a Brave New Post-health World.

[00:32:25] "Sports anaemia" ("pseudoanaemia"); Studies: 1. Eichner, E. RANDY. "Sports anemia, iron supplements, and blood doping." Medicine and science in sports and exercise 24.9 Suppl (1992): S315-8; 2. Weight, L. M., et al. "'Sports Anemia'-A Real or Apparent Phenomenon in Endurance-Trained Athletes?." International journal of sports medicine 13.04 (1992): 344-347.

[00:33:55] How to tell if it's a true anaemia: history, diet, symptoms, blood chemistry.

[00:34:16] Occult blood testing: test on 3-4 consecutive days.

[00:37:02] Blood chemistry markers that can reveal anaemia.

[00:40:54] Elevated MCV in athletes. (elevated = greater than 92 fL); Studies supporting reference range: 1. Anderson, Jeffrey L., et al. "Usefulness of a complete blood count-derived risk score to predict incident mortality in patients with suspected cardiovascular disease." The American journal of cardiology 99.2 (2007): 169-174 and 2. Mueller, Thomas, et al. "Association between erythrocyte mean corpuscular volume and peripheral arterial disease in male subjects: a case control study." Angiology 52.9 (2001): 605-613.

[00:43:55] Haemoglobin - optimal reference ranges: 13.0 - 14.5 g/dL (women) and 14.5 - 16 g/dL (men); Study supporting reference range: Fulks, Michael, Vera F. Dolan, and Robert L. Stout. "Hemoglobin Screening Independently Predicts All-Cause Mortality." (2015): 75-80.

[00:44:22] Elevated haemoglobin and sleep apnea.

[00:45:23] Red blood cells (RBC) - optimal reference ranges: 4.4 to 4.8 m/cumm (women) and 4.8 to 5/5 m/cumm; Study: Kim, Yong Chul, et al. "The low number of red blood cells is an important risk factor for all-cause mortality in the general population." The Tohoku journal of experimental medicine 227.2 (2012): 149-159.

[00:46:40] RDW (optimal is up to 13%); Studies supporting reference range: 1. Anderson, Jeffrey L., et al. "Usefulness of a complete blood count-derived risk score to predict incident mortality in patients with suspected cardiovascular disease." The American journal of cardiology 99.2 (2007): 169-174; 2. Hou, Haifeng, et al. "An overall and dose-response meta-analysis of red blood cell distribution width and CVD outcomes." Scientific reports 7.1 (2017): 1-10; 3. Lippi, Giuseppe, et al. "Relation between red blood cell distribution width and inflammatory biomarkers in a large cohort of unselected outpatients." Archives of pathology & laboratory medicine 133.4 (2009): 628-632; 4. Öztürk, Zeynel Abidin, et al. "Is increased red cell distribution width (RDW) indicating the inflammation in Alzheimer's disease (AD)?." Archives of gerontology and geriatrics 56.1 (2013): 50-54.

[00:48:02] Test reticulocytes to identify production, destruction, or loss.

[00:49:10] Iron panel: ferritin, serum iron, TIBC.

[00:50:10] What to do about anaemia?

[00:51:03] Review: Tardy, Anne-Laure, et al. "Vitamins and minerals for energy, fatigue and cognition: a narrative review of the biochemical and clinical evidence." Nutrients 12.1 (2020): 228.

[00:51:22] Nutritionally dense foods list on the NBT forum. (Support NBT on Patreon to get access to the forum).

[00:55:24] Join our group program (blood test + bloodsmart report + forum + 4 group coaching session).

[00:57:04] Josh Turknett's 4-quadrant model.

Back on the podcast today is Eric Helms, PhD. Eric is a research fellow at the Sports Performance Research Institute New Zealand at Auckland University of Technology, pursuing research in training, nutrition and psychology for strength and physique sport. He has a PhD in Strength and Conditioning with a research focus on autoregulating powerlifting, a masters with a research focus on protein and macronutrient manipulation for dieting bodybuilders, a second masters in exercise science and health promotion. Also an athlete, Eric earned pro status as a natural bodybuilder with the Professional Natural Bodybuilding Association in 2011 and is a powerlifter in the International Powerlifting Federation.

Today's podcast is a Q&A, with Eric fielding questions on some of the best diet and weight lifting strategies. Eric offers an insider's view on the psychological effects of dieting for competition and also describes some of the most popular non-linear eating strategies and who might benefit from them. He discusses the power of refeeds and diet breaks when it comes to maintaining weight loss, and explains why a flexible approach is more likely to result in long-term success. Eric also addresses the "repetitions in reserve" -based rating of perceived exertion and describes the benefit of using muscle and strength pyramids.

[00:02:00] Eric's home gym essentials.

[00:04:34] Previous NBT Podcast: The Nutrition and Science of Natural Bodybuilding, with Eric Helms.

[00:05:04] Athlete identity: Coping with injury, retirement, not being able to train.

[00:08:45] Diversifying your happiness portfolio.

[00:10:31] Simon Marshall PhD.

[00:13:55] Psychological effects of dieting and being super lean.

[00:18:33] Relative Energy Deficiency of Sport (RED-S); Podcast: How to Identify and Treat Relative Energy Deficiency in Sport (RED-S), with Nicky Keay.

[00:26:39] Therapists, dietitians as essential resources for bodybuilders.

[00:28:32] Non-linear dieting and it's efficacy.

[00:29:27] Time-restricted feeding, within-week intermittent caloric restriction, alternate-day fasting, 5:2 diet.

[00:30:38] Refeeds, diet breaks.

[00:36:25] Better retention of lean body mass with refeeds; Study: Campbell, Bill I., et al. "Intermittent Energy Restriction Attenuates the Loss of Fat Free Mass in Resistance Trained Individuals. A Randomized Controlled Trial." Journal of Functional Morphology and Kinesiology 5.1 (2020): 19.

[00:39:43] Prescribed breaks do not hamper weight loss efforts; Study: Wing, Rena R., and Robert W. Jeffery. "Prescribed "breaks" as a means to disrupt weight control efforts." Obesity research 11.2 (2003): 287-291.

[00:41:38] Flexible dieting.

[00:44:18] Black and white thinking towards food predicts stress and failure during weight loss; Study: Palascha, Aikaterini, Ellen Van Kleef, and Hans CM van Trijp. "How does thinking in Black and White terms relate to eating behavior and weight regain?." Journal of health psychology 20.5 (2015): 638-648.

[00:47:01] Lifting heavy things: the "repetitions in reserve" -based rating of perceived exertion.

[00:51:03] Exercise oncology; Study: Fairman, Ciaran M., et al. "A scientific rationale to improve resistance training prescription in exercise oncology." Sports Medicine 47.8 (2017): 1457-1465.

[00:54:48] Muscle and strength pyramids.

[00:57:18] Books by Eric Helms: The Muscle and Strength Pyramid: Training and The Muscle and Strength Pyramid: Nutrition.

[00:59:09] Best rap album of 2020.

[01:00:17] 3dmusclejourney.com.