We were so fortunate and grateful to be able to sit down for a few minutes with master trainer, Bert Massey, of Austin's Adapt.Fitness. This chat was one of my favorite conversations on health that I've had in a long while. If you are ever in Austin, you need to swing by the location and get a workout session in with Mr. Massey. You won't regret it.

The trouble with travel

• Early mornings

Observations this morning

• People watching. What do we see? Obesity

What can you do?

• A little bit of pre planning (hard boiled eggs)

Why are we revisiting it? 

Why do we sleep? Why is it important to understand the role sleep plays?

• Takes a third of our lives.

Dr. Walker address sleep as it relates to cardiovascular disease, dementia, weight loss, fertility,  and gain, immune system and cancer.

4 pillars of sleep

1. Regularity-how consistent is your sleep schedule?
   1. Social Jet Lag

CARDIOVASCULAR DISEASE

Study: Healthy middle aged adults tracked for 5yr and tracked sleep (associational/longitudinal /prospective study)

• At start of study there were no signs of calcification of coronary arteries

DEMENTIA

Comparing 7hr sleep or less VS 7hr sleep or more (associational studies again in humans) Amyloid build up.

• After 1 night of sleep interruption (human studies) there is a significant build up of amyloid and tau circulation.

The mechanism that underlies that causal relationship between sleep and alzhiemers has been demonstrated in human studies and has been demonstrated acutely in a 24hr period.

IMMUNE SYSTEM AND CANCER

Cytotoxic T cell decreased after one night of under 4 hours of sleep

WHO and shift work as carcinogen

WEIGHT LOSS

We have touched upon this.

Many mechanisms by which less sleep leads to weight gain and makes it hard to lose weight

• Insulin Resistance

When you control for EVERYTHING else, people gain weight with sleep deprivation.

Studies show that when you are losing weight, if also sleep deprived you lose fat AND muscle versus more fat and preserved muscle when rested.

How Much Sleep Do you Need

• 7-9  (chronic disease risk increases below and above this number)

https://peterattiamd.com/matthewwalker1/

https://peterattiamd.com/matthewwalker2/

https://www.foundmyfitness.com/episodes/matthew-walker

What is Decision Fatigue

The more choices you make throughout the day, the harder each one becomes for your brain,

Eventually your brain looks for shortcuts,

1. act impulsively instead of expending the energy to first think through the consequences.

“Decision fatigue helps explain why ordinarily sensible people get angry at colleagues and families, splurge on clothes, buy junk food at the supermarket and can’t resist the dealer’s offer to rustproof their new car. No matter how rational and high-minded you try to be, you can’t make decision after decision without paying a biological price”

Why modern society has way too much of this?

Food choices, clothing choices, netflix choices, instagram, facebook,

selfies

What does this lead to?

• Eating too much (studies show variety leads to overeating)

How Do we counteract

• Acknowledge it

https://www.nytimes.com/2011/08/21/magazine/do-you-suffer-from-decision-fatigue.html?pagewanted=all

https://www.apa.org/helpcenter/willpower

https://www.nytimes.com/2016/11/01/health/americans-obesity-willpower-genetics-study.html

https://www.dietdoctor.com/losing-willpower-at-night

http://www.bariatricnews.net/?q=news/112687/usa-survey-obesity-due-lack-willpower

https://en.wikipedia.org/wiki/Ego_depletion

https://digest.bps.org.uk/2015/06/24/new-research-challenges-the-idea-that-willpower-is-a-limited-resource/

https://jamesclear.com/willpower-decision-fatigue

https://michaelhyatt.com/the-science-of-decision-fatigue/

Why?

• A Lot of misinformation out there

What Happens when you only do aerobic exercise?

• The human body is smart and adapts

Studies with the Hazda

The Hadza, or Hadzabe, are an indigenous ethnic group in north-central Tanzania, living around Lake Eyasi in the central Rift Valley and in the neighboring Serengeti Plateau

“Conventional wisdom holds that physically active people burn more calories than less active people do. But studies show that traditional hunter-gatherers, who lead physically hard lives, burn the same number of calories as people with access to modern conveniences.”

• Biggest Loser is another example

How is Resistance Training Different?

• Counteracts the significant decrease in RMR accompanied by weight loss

“The findings suggest that regular exercise training, in particular resistance training, is likely to reduce body weight and improve body composition of overweight inactive people by suppressing orexigenic hormones and stimulating the anorexigenic hormones”  

Ghrelin decreased

Increased PYY

Increased GLP-1

(https://www.ncbi.nlm.nih.gov/pubmed/301489730

This is actually true for vigorous aerobic activity too

https://knowledge.library.iup.edu/cgi/viewcontent.cgi?referer=https://www.google.com/&httpsredir=1&article=2104&context=etd

https://www.ncbi.nlm.nih.gov/pubmed/26609965

https://www.ncbi.nlm.nih.gov/pubmed/30888221

https://www.ncbi.nlm.nih.gov/pubmed/28903957

https://www.ncbi.nlm.nih.gov/pubmed/26956987

“While the lifestyle of late Pleistocene hunter-gatherers was no doubt highly active as seen in foragers today, our results suggest that their daily energy requirements were likely no different than current Western populations”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3405064/

https://exss.unc.edu/files/2018/09/Exercise-paradox-Pontzer-2017.pdf

“If you pair strength training with the traditional cardiovascular endurance exercise in a planned program, you can create an effective symbiotic relationship”

https://us.humankinetics.com/blogs/excerpt/training-to-improve-body-composition

https://www.physiology.org/doi/full/10.1152/ajpregu.90706.2008

http://www.drmcguff.com/

https://www.amazon.com/Body-Science-Research-Strength-Training/dp/0071597174

Who needs to listen to this episode

Everyone

Why are we talking about this?

• It’s something we all have stress talking about (very few of us feel comfortable bringing it up with our loved ones)

How to Start

• Ask to sit down with an agenda

Advance Directive

“This is called different things in different states (e.g., living will, health care power of attorney) but, regardless of the term, this describes a legal document you use to provide guidance about what types of treatments you may want to receive in case of a future, unknown medical emergency. It also is where you say who can speak for you to make medical treatment decisions when you cannot speak for yourself (called a "surrogate"). All adults should have an advance directive.” 

POLST

“This is called different things in different states (e.g., MOLST, MOST, POST—but, regardless of the term, a POLST form is a medical order for the specific medical treatments you want during a medical emergency. POLST forms are appropriate for individuals with a serious illness or advanced frailty near the end-of-life” 

Know the language

Full Code vs DNR/DNI

• Tell your family where this info is and give them copies

An Overview of Fats (The Breakdown)

• Saturated

Vegetable oils

100yrs ago we didn’t eat these oils.

In 2014 the average American now consumes (on average) about 50g/day, that’s about 11 teaspoons) equating to 450 calories/day or approx 20% of the average American diet. That’s 2x as much as 40yrs ago. No other source of caloric intake accounts for the rise in total calorie intake increase between 1970 and 2014.

Differentiating oils derived from nuts, fruit et al. (coconut, palm, olive) that have been a part of the human experience for thousands of years as opposed to oils derived from the entire plant.

The process to extract oils from plants is an industrial process:

• Seeds are crushed/flaked

All this must happen to create a product that is palatable to humans.

https://www.youtube.com/watch?v=omjWmLG0EAs

Half of the vegetable oils consumed in the US are from one crop (Soybeans)

Highly Refined

• Hexane is used to extract canola oil (See here)

Where Do we FIND vegetable oils

EVERY SINGLE PACKAGED FOOD LIKELY HAS IT

Vegan, Paleo, Keto or Standard American diet - READ the label

Salad dressings

Even at Maine General!

Baby and toddler food (along with sugar) - very disturbing

Packaged brands I have found that DON'T have veggie oils

Siete

Jackson Honest

https://www.dietdoctor.com/low-carb/vegetable-oils

https://www.dietdoctor.com/low-carb/vegetable-oils#How-they-are-made

https://podcastnotes.org/2018/07/03/attia-patrick/

https://chriskresser.com/the-diet-heart-myth-cholesterol-and-saturated-fat-are-not-the-enemy/

https://www.dietdoctor.com/stunning-saturated-fat-and-the-european-paradox/comment-page-1

https://www.maxlugavere.com/blog/chill-with-the-butter

Blue Zones – Places In the World Where People Live to 100 and Stay Healthy

1/5000 people in the US live to be 100

10% of longevity is due to genetics. 90% is due to our lifestyle

Caveats before we get started

• In general many of these things are things we talk about BUT

The five blue zones are as follows:

The Italian island of Sardinia

• Move all day (shepards), eat lots of plant, cheese that is grass-fed and high in omega 3 fatty acids, wine with 3x number of polyphenols

• If grains are eaten always whole grain

• No process food exists

• They treat older people with respect

Okinawa, Japan

• Community. When you are born you are put into a group of people who support you your whole life.

• Average american has 1.5 close friends.

• No one retires.

• Ikigai

• Eat lots of plants

• Fermented soy products

• They don’t overeat

• Eat on smaller eat. They don't serve family style (no seconds), They stop eating when their stomach is 80% full. They eat small

Loma Linda, California

Costa Rica’s isolated Nicoya Peninsula

Ikaria, an isolated Greek island

9 commonalities

• None of them exercise, they set their lives so that they are in constant physical activity

• Live in houses with stairs, walk everywhere, sit on the floor so they are getting up and down constantly.

• All garden

• They have language around “purpose”

• They have strategies about how to eat less. (till 80% full)

• They drink a little each day (wine)

• They eat lots of plants, some quality meat / cheese. They eat nuts and legumes. If grains, a little and always whole grains. NO processed food period. No veggie oils!

• They hang out with people who live the same way

• Community connection (often faith based)

• Family  / loved ones first (very close relationships between older and younger generation

• They all take daily time for mindfulness

I would like to take a moment to point out

The eat no processed food with fake sugar / chemicals

They don't eat vegetable oil

That requires quite the nasty production process

They eat a lot of healthy fats (olive oil, fish, grass fed meat/butter etc.) high in omega 3

The Happy Planet Index is similar

• Connect

• Be Active

• Take Notice

• Keep Learning

• Give

There is a difference between pleasure and happiness.

Pleasure is anything that increases that dopamine. Companies can sell you things that do this. Any shopping/food/drugs etc. They try to convince you that they are selling you happiness but this is not true. Studies show that happiness is more likely to come about by the above things not by stuff.

http://happyplanetindex.org/

https://www.ted.com/talks/dan_buettner_how_to_live_to_be_100

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Pete’s injured foot

Why do injuries happen?

Some common types of injury: Chronic vs. acute

• Sprains

What is the best way to treat a new injury?

Talk about The Brave Athlete “Approach your recovery the same way you are approaching your training. Learn about it. Ask questions. Treat recovery like its a job. (maybe more like having kids…. It’s  24/7 kinda thing.

Somethings that ‘get in our way’ when trying to recover?

• Life

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There is a pathway in the brain that promotes weight gain

• Orexigenic Pathway

And a pathway to promote weight loss

• Anorexigen Pathway

Your body sends signals that stimulate one of these pathways.

Hormones that Make that decrease your appetite

Insulin

• From the pancreas in response to food

Leptin

• Secreted by the fat cell

Serotonin

• We talked about this on another podcast

CCK (cholecystokinin)

• From your small bowel

*Weight Loss leads to CCK NOT elevating as much after food

BUT if in Ketosis, normal response of CCK after eating is maintained

GLP-1 (Glucagon-like peptide)

• Small bowel

Others from the small bowel:; PYY, OXM, etc.

Things that make you more hungry

• Ghrelin is the more powerful

Ketones (SIDE NOTE)

Ketones inhibit the rise in ghrelin that occurs with weight loss

The pathway that makes you hungry is inhibited by many of the hormones that make you full

Other side notes

• Fructose does not help your brain to register that it is full

So, How can you regulate your appetite

• When you do eat: Protein > Fat > carbohydrates

Mindfulness has its place but intuitive eating may not be a good approach if you have metabolic dysfunction

• Plan your day / meal times