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wise athletes podcast
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September 29, 2024#145 | Food for Thought | William Li, MD Professional Grade Supplements for WiseAthletes
Food as medicine is an old idea...it's the original idea on how to be a healthy person dating back more than 2000 years, but can food be the way to achieve athletic longevity? Can wise athletes target certain foods to target faster recovery, better health, and longer life? Can it be done without extreme or highly restrictive diets?
Today on episode 145, I am joined by Dr William Li...a physician, scientist and author of "eat to beat disease" and "eat to beat your diet" to discuss his research on using plant and animal based foods to boost our 5 body defense systems to fend off the chronic diseases associated with aging. And, in particular, I asked Dr Li to talk about combating chronic inflammation and activating stem cells to rebuild our body.
All right, let's talk to Dr Li .
Bio: William Li, MD- William W. Li, MD, is a physician, scientist and author of the New York Times bestsellers “Eat to Beat Disease: The New Science of How Your Body Can Heal Itself” and “Eat to Beat Your Diet: Burn Fat, Heal Your Metabolism, and Live Longer.” His research has led to the development of more than 40 new medical treatments that impact care for more than 70 diseases including diabetes, blindness, heart disease and obesity. His TED Talk, “Can We Eat to Starve Cancer?” has been viewed more than 11 million times. He is President and Medical Director of the Angiogenesis Foundation, and he is leading global initiatives on food as medicine.
Bullet points:- Science shows many foods can prevent, halt or even reverse cancer, heart disease, diabetes, obesity, and other life-threatening chronic diseases.
- Over the past decade, the Angiogenesis Foundation has discovered and gathered evidence that fruits, vegetables, herbs, seafood, tea, coffee, and even chocolate contain natural substances — bioactives — that can prevent and intercept disease by influencing angiogenesis and other defense systems in the body.
- What we eat and drink is enormously impactful when it comes to preventing disease.
5 body defense systems -- key pillars- Each of these systems is influenced by diet. When you know what to eat, to support each system, you can then use your diet to maintain health and beat disease. The five defense systems are angiogenesis, regeneration, microbiome, DNA protection, and immunity.
- Angiogenesis: The process by which blood vessels are formed. Angiogenesis keeps the sixty thousand miles of blood vessels found in your body working to support health and fight disease. This is the common component in cancer tumors. Barley and mushrooms are good for growing blood vessels where you need them.
- Regeneration: The process of creating and renewing 750,000 stem cells that power our bodies. Stem cells maintain, repair and regenerate our bodies. Avoid too much salt, saturated fat, alcohol, smoking. Do eat dark chocolate, barley, mushrooms, fruit skins (apple, pear, peach, strawberry...also anti-inflammatory)...to get stem cells to come out to heal the body.
- Microbiome: The bacteria that is found within our bodies that act to defend our health.
- DNA Protection: This is our genetic blueprint. Foods can help repair damaged DNA caused by daily living, but can also help lengthen our telomeres, which protect DNA and slow aging.
- Immunity: Our immunity defends our health. Too much or too little of each of the above defense systems can cause problems in the body systems in fighting disease. When the angiogenesis function is out of control, it feeds cancer tumors. The key to keeping all of these systems in balance.
5 x 5 x 5 framework that supports the five defense systems.- In order to support the 5 defense systems you choose five health-supporting foods you already like to eat and then eat them up 5 times each day. There is overlap in foods that serve more than one defense system. The goal is to eat 5 different foods every day that support each system. Examples below:
- Angiogenesis: almonds, blackberries, chicken thighs, coffee, eggplant
- Regeneration: black/green tea, cranberries, EVOO, red wine, coffee
- Microbiome: tomatoes, dark chocolate, sourdough bread, cauliflower, broccoli
- DNA Protection: coffee, broccoli, grapefruit, kale, carrots
- Immunity: apples, mushrooms, spinach, broccoli, capers
Related info and episodes:- Episode 94 -- Phytonutrients w/ Dr Jed Fahey
- Episode 100 -- Practical Tips for Phytonutrients/ Dr Jed Fahey
- Episode 132 -- Measuring Metabolism w/Hari Mix PhD
More William Li info:- SOCIAL MEDIA:
- https://www.instagram.com/drwilliamli/
- https://www.facebook.com/drwilliamli/
- https://twitter.com/drwilliamli?lang=en
- https://www.youtube.com/c/DrWilliamLi
- BOOK LINKS:
- https://drwilliamli.com/etb-diet-book/
- https://drwilliamli.com/book-li/
Want to support the show?If you are enjoying WiseAthletes, please leave us a review. And, be sure to check out our FullScript supplements link to see the amazing prices on the best brands on the planet.
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...more September 08, 2024#144 | Muscle for Athletics & Healthspan | Mark Tarnopolsky MD, PhD, FRCP(C) Professional Grade Supplements for WiseAthletes
Mitochondria are the powerhouse of the cell....yes, but what does that mean? What can we do, as Wise Athletes, to have enough healthy mitochondria in our muscles and everywhere else powering our bodily functions for optimal brain power, energy levels, we well as muscle power and endurance?
These questions and more are addressed by Dr. Mark Tarnopolsky, neurologist, mitochondrial researcher, lifelong elite athlete. Mark is the real deal who knows both sides of the story....the science and the practice of building muscle and VO2Max for performance today and a long stay on the planet as a strong athlete.
All right, let's talk to Dr Tarnopolsky about the single best way to stay healthy and strong as we get older....exercise.
BIO: Mark Tarnopolsky, MD, PhD, FRCP(C)- Professor of Pediatrics and Medicine, CEO and CSO, Exerkine Corporation,
- Director of Neuromuscular and Neurometabolic Clinic,
- McMaster University Medical Center
Bullet points -- Muscle & Mitochondria- "We all are suffering from the mitochondrial disease called aging"
- "An ounce of prevention is worth a ton of cure"...Muscle loss prevention is ideal but it’s never too late to restart exercising; benefits accrue to everyone who starts exercising at any age.
- Aerobic training is very good, but we also need weight training. Exercise provides a modest 4-year lifespan extension but a 10-year healthspan extension as it lengthens the time in life we can be mobile and take care of ourselves.
- Do at least 30 minutes of exercise everyday
- VO2Max is a function of and delivery of oxygen (heart stroke volume and heart rate) and extraction of oxygen (capillarization of blood vessels into muscle and mitochondrial volume to use oxygen)
- Vo2max:
- At rest: 3.5 milliliters of oxygen per kg of body weight per minute
- Min. to live without assistance: 12 ml/kg/min
- Mark's VO2Max at his athletic peak: 88.2 ml/kg/min
- VO2Max falls from 25/30 yo but older athletes have higher vo2max than sedentary young people
- But VO2Max isn’t enough for longevity. We need 3x/week of endurance training for VO2Max and 2-3x week of resistance training to build and maintain muscle mass.
- Longevity metrics: VO2Max, leg strength, waist-to-hip circumference
- Elite athletes need 2x the protein of sedentary people
- Don’t train with futility: Get enough high quality protein (aim for 1.2g/kg), don’t be deficient in Vit D (take a supplement), get sufficient calcium in diet. Milk and egg whites are the best quality proteins. Collagen is low quality protein (used as the no-protein control in experiments)
- Running or cycling at 65% of VO2Max (approx. lactate threshold; top of zone 2) 3-5x per week for 30-60 minutes a day will increase mitochondria.
- Interval training will increase the pace and HR possible at a zone 2 (“all day pace” of work) by increasing the lactate threshold. Once lactate starts to accumulate, it is only a matter of time before exhaustion sets in.
- Weight training in untrained older people does build mitochondria, and there is a spill over into VO2Max development
- Weight training for endurance athletes is about building muscle mass for strength and healthspan
- Fast vs. Slow twitch:
- Slow are the endurance fibers that are full of mitochondria, can go all day without fatigue, can burn every fuel we have with oxygen, but are smaller (to allow better oxygen delivery) and slower to turn fuel into energy. These fibers and their mitochondria come from a demand (consistent exercise) for long, moderate effort of work.
- Fast are the stronger fibers that have some mitochondria but not as much, burn glucose with or with oxygen, are bigger and stronger but tire easily. These are the fibers we build lifting weights that usually does not stimulate mitochondrial biogenesis
Why do we lose muscle? What can we do to stop it?- Lack of use is the big one
- Loss of enervation…the nerve that connects the muscle fiber to the brain dies, and now the muscle cannot get any signal to move, so the muscle is lost. On average people lose 30% of the muscle nerves. This seems to occur more frequently in people who do not exercise. Nerve talks to muscle; muscle talks to nerve.
- Mitochondrial damage from oxidative stress. Antioxidants made by the body and in our diets can help. As we lose mitochondria, the remaining mitochondria make more reactive oxygen species which cause oxidative damage. And old mitochondria have accumulated more damage and make more ROS. Exercise stimulates mitophagy…the clearing out of old mitochondria. But the ROS is also a signal to make the cells stronger and more resilient, so some ROS is good while too much can cause extra damage.
- Taking antioxidants after moderate exercise is probably not helpful and might impede adaptation but antioxidants after very hard, perhaps excessive exercise can be helpful to minimize the damage
- Other things Mark takes: a multi-vitamin, Alpha Lipoic Acid (ALA), coQ10 because he exercises hard 7 days a week.
- Deficiencies are never good: get iron/ferritin levels checked, b12 is often low, check thyroid…low thyroid is bad for mitochondria, vit d, lipids,
- Anabolic resistance…older people have a lower level of muscle protein synthesis for a given level of stimulation (exercise or amino acids). Largely related to poorly functioning transporters that bring the amino acids into the muscle cell to use to make more muscle. Probably from oxidative stress, AGEs damaged proteins,
- 0.8 g/kg is not enough for trained athletes training very hard…cannot fully recover. When training 1.5-2 hours a day, athletes need almost double the protein (1.6-1.7g/kg per day).High quality protein is best at these minimum intakes.
- Older adults should aim for 1.2g/kg/day vs the RDA of 0.8-1.0 unless training heavily and then aim for 50% more than younger athletes training the same amount
- “humanized milk” = 60% casein & 40% whey
- Autophagy is increased by exercise, which is safer for older athletes than fasting or caloric restriction.
- To adapt to training you need to match calorie intake with calorie expenditure AND get enough protein. Eat a variety of colors (phytonutrients are important). Eat “close to nature”. Avoid simple sugars and highly processed foods. Antioxidants in food are always good.
- Chronic inflammation is a cause for reduced muscle mass and slower muscle building. Exercise lowers chronic inflammation. A healthy gut comes from a healthy diet. Avoid the highly processed food (i.e. peanut butter) with emulsifiers.
- Mitochondria are not just in the muscle…but exercise is good for mitochondria everywhere in the body. Exercise is the key to healthy aging as well as health today. Cataracts, hearing loss,
- Supplements:
- fish oil (best in fish) good for muscle and mitochondrial preservation during disuse, ALA and Vit E and creatine combined lowered oxygen-related stress, creative alone is useful for improved sleep and muscle strength and brain health
- TRIM7 -- Obesity supplement also is good for mitochondrial health: Coq10 ALA, Vit E, beet root extract, Green tea extract, green coffee bean extract and mint extract called Forskolin. Browning of white fat….helps people to lose weight without losing muscle.
- Urolithin A – poor evidence of efficacy.
- NAD+ boosters….may not be good and some evidence of problems from niacin and niacatinamide.
- MUSCLE5 – creative, humanized milk, vit D, calcium.
Related info and episodes:- Episode 128-mitochondrial-power-up-w-methylene-blue-scott-sherr-md/
- Episode 127-how-to-get-great-bones-dr-keith-mccormick/
More Tarnolpolsky info:- Mark's Supplement Company: Stay Above Nutrition: https://stayabovenutrition.ca
- Exerkine (Revolutionizing Medical Nutrition): https://www.exerkine.com/
Want to support the show?If you are enjoying WiseAthletes, please leave us a review. And, be sure to check out our FullScript supplements link to see the amazing prices on the best brands on the planet.
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...more August 28, 2024#143 | Heart, Lung & Brain Injury from Chronic Over-Breathing | George Dallam, PhD Professional Grade Supplements for WiseAthletes
We all want a healthy heart, lungs, and brain. Can you guess at the single behavior that connects the dots on solving: the ability to run or ride at the same speed using 25% less breathing, reducing the occurrence of the so called exercise induced asthma or bronchoconstriction (EIB), eliminating side stitches while running, avoiding frequent sinus infections and bronchitis, and even dodging aFib and dementia?...and what if it cost you nothing but your attention? Well, listen to this: The latest science is showing us that while breathing with an open mouth allows for an increase in ventilation, increases work capacity (think: vo2max), and actually feels more comfortable and normal, doing so also predisposes us to a variety of potential health problems over time. Right, today we are going to talk about nasal breathing.
while nasal breathing may have fallen off the internet talk circuit as a popular biohack, wise athletes should always pick the low hanging fruit.
so coming back to our show on episode 143, the one and only Dr George Dallam walks us through his personal benefits from adapting to nasal breathing nearly 20 years ago, and the latest research into the health and physical performance benefits available to us all...without ingesting any chemicals, or changing our diet, or buying a single thing. All you have to do is breath through your nose. Its a simple prescription; ....if only it was easy to learn.... i say since i have failed to fully adapt in the two years since i first spoke with dr dallam...
All right, let's talk to George Dallam, author of the just published book, the-nasal-breathing-paradox-during-exercise
George Dallam PhD
Dr. Dallam holds the rank of Distinguished Professor in the School of Health Science and Human Movement at Colorado State University - Pueblo (CSUP). Dr. Dallam has been involved in numerous research studies examining various aspects of triathlon performance and training, diabetes risk factor modification, and the effects of functional movement improvement on running. His primary research interest recently is focused on the capability of human beings to adapt to nasal only breathing during exercise as a way to improve both health and performance.
Dr. Dallam has received both the United States Olympic Committee's Doc Counsilman Science in Coaching award (2004) and the National Elite Coach of the Year award (2005) for triathlon. Finally, Dr. Dallam has been continuously training and competing in triathlon since 1981.
Bullet points -- The Nasal Breathing ParadoxBenefits of nasal breathing:- Better filtering of particles and viruses (less nasal infection, bronchitis). Filtering becomes even more important when exercising because we take in so much more air.
- Less water lost though breathing
- Less energy spent on breathing (more energy for locomotion); higher O2 extracted per breath (higher efficiency)
- Recovery from “EIB” exercise induced bronchoconstriction (exercise induced asthma)
- Provides a powerful training stimulus to improve fitness…make you faster even if you go back to mouth breathing in high intensity efforts, such as races
- Improved stress management
- Better sleep, and overall improved recovery from exercise (lower stress, avoidance of snoring)
- Better posture and movement ability with improved diaphragm activity
- Functional movement benefits —diaphragm is a major core muscle that is under strength when we mouth breathe.
- Avoids possible damage to the heart from over breathing (a hypothesis from Dr Dallam)
- Effect of nasal breathing during exercise on brain health (https://digitalcommons.wku.edu/ijesab/vol2/iss15/103/)
Myths about breathing:- I feel the need to breath faster when I need more oxygen — mostly false. It is the presence of higher than usual CO2 in the blood that causes the “air hunger”
- CO2 is bad, and needs to be removed as fast as possible — false; CO2 is necessary for normal bodily functions. Too much AND too little CO2 are bad for the body.
- Breathing faster brings in more oxygen (superoxygenation) — no; red blood cells are generally 95-98% oxygenated after passing by lungs. You don’t get more oxygen into red blood cells, you just lose more CO2 from blood plasma, which creates problems for the body
- Breathing doesn’t take much energy or use much oxygen to do — false. During exercise, breathing can use as much as 15% of the total energy burn of the body…15% of the oxygen being used. If we can save 25% of that by breathing more efficiently (less breathing for same oxygen), we’ll have more oxygen left over for other muscles to use.
- An athlete cannot get enough oxygen for exercise though just nasal breathing — false. It is easy to see why people would come to this conclusion after one attempt, but with adaptation, many elite athletes compete using just nasal breathing.
What does the nose do for us?- Conditioning of the air: humidifying the air and warming up the air. Reduce lung dehydration and related wheezing and breathing problems
- Filtering: particulates (dust, smoke), viruses are captured instead of putting in lungs. Avoid damaging lungs long-term (emphysema, cancer) and reduce infections impacting lungs.
- Increasing air resistance…forces a recruitment of the diaphragm which is the best muscle for efficient breathing. Breath through the nose, then you will breath diaphragmatically without thinking. You can stop trying to train yourself to “Belly Breath”.
- Calming. Reducing stress. Deep slower breathing vs. quicker shallow breathing activates the parasympathetic nervous system…lowers the stress level of the body. This is definitely true at rest. For athletics, peak performance comes of being able to relax into the effort..not by trying as hard as possible, so stress level might also play a role in athletic performance.
- More efficient breathing: breathe less to get the same amount of oxygen. 25% less breathing when nasal breathing. So the 15% of total energy expenditure being spent on breathing is lowered to 11.5%….a 3.5% point reduction in energy used for breathing that can now be used elsewhere. This is the same level of economy improvement that elite endurance athletes seek to obtain from using weight training…and this is just from breathing through your nose.
- Avoids the over breathing associated with mouth breathing. Over-breathing MAY be a cause of damage to the heart seen in endurance athletes as a higher incidence of AFib….lowering of CO2 in blood (from over breathing) results in blood flow restriction, which may be a cause to a lack of blood flow (a lack of oxygen) to the heart.
Related to Exercise Induced Asthma / Bronchial restriction (EIB)- The lungs are filled with alveoli … the little sacs that allow the body to exchange gases. Single cell thick, covered in a surfactant that allows the sacs to stay open even at low pressure.
- The lung environment is very liquid and very delicate.
- Imagine blowdrying wet tissue paper with a hairdryer…not good.
- When the air comes into lungs via the mouth, the air is not treated. Everyone has experienced coughing…the only way we have to get stuff out of our lungs that shouldn’t be there. It also is what happens when we have damaged our lungs, whether from breathing air that is too cold or too hot or too dry or too wet or filled with damaging particulates or just through over extertion.
- Our body creates “broncho constriction” to protect the lungs. If you ever had a wheeze at the end of your exhales, you’ve had this thing.
- This correlates very highly with mouth breathing athletes. Bronchio restriction is vey common among elite athletes…cycling, swimming, running. 20-50% of population vs. 5% among sedentary population. The more you breath, the more important it is to treat the air you breath and protect the lungs.
- The availability of broncho inhalers may just be serving to allow us to overcome our natural defense again damaging our lungs from mouth breathing.
HOW TO NASAL BREATHE?- The transition to nasal breathing is easier for some people. Some people feel a terrible air hunger while others get used to it very quickly. The path forward for everyone is to find your way to just the threshold point that your body can do it…with just a suggestion of air hunger…and then move higher over time.
- It takes 6 weeks to 6 months. Three key variables that impact time to adapt:
- Existing sensitivity to CO2. If low sensitivity, then short time to adapt.
- How well developed is the diaphragm muscle. The more you need to build, the longer it will take.
- How dedicated is the effort to adapt. The more you nasal breath, the faster you will adapt.
- What do you need to do to be able to nasal breathe all the time?
- Break / Start the Habit
- Break the habit of mouth breathing. Do it whenever you realize you are not nasal breathing. Set reminders. (See Episode 45 - Build Strong Habits )
- During exercise, put a little water in your mouth so you don’t have to think about nasal breathing.
- According to Dr. Dallam, “I also found that focusing on nasal breathing during exercise facilitated focusing on it throughout the rest of my life as well. While subjective at best, I consider that I am more relaxed, more thoughtful, sleeping better and happier as a direct result.”
- Once you can do your endurance & recovery workouts while nasal breathing, the adaptation will go very fast because that is most of your training. And, if you are nasal breathing outside of exercise as well, you are essentially always nasal breathing at this point.
- You’ll adapt even faster if you will take down the level of effort to match your ability to perform while nasal breathing, and only increase as your nasal breathing improves.
- Separately work toward nasal breathing during sleep. This is harder as you will be unconscious, but this will have a gigantic impact on your health and ability to recover from exercise. Look into mouth taping and breathing exercises to open nasal passages before sleeping.
Reduce CO2 sensitivity:- By nasal breathing more, you will have less CO2 in your blood. Your body will get used to that …meaning it will start to feel normal quickly (in days). Keep pushing on the edge of discomfort to keep lowering your sensitivity. Pushing too hard will backfire, so take your time. This is not the place to develop a psychological problem. And, this adaptation will happen faster than the muscle development so there is no payoff from pushing harder than just enough.
- “Breathe light” exercises: just breathe more slowly while resting…until you feel an urge to breath more….just experience the feeling (from Patrick McKeown)
- Do breath holds while moving (walk, light jog). Hold until the air hunger is strong. Recover your breath fully, then repeat (from Patrick McKeown)
- Do HIIT intervals breathing nasally...start short and build up longer and longer.
- Muscle development:
- Training the breathing muscles to get stronger. This happens simply by using nasal breathing. Just give the muscles some time to adapt. It’s like getting used to using a bigger gear on the bike….You can do it for a short time right away, and over time you will get more muscular endurance as you get stronger.
- The Diaphragm muscle has to adapt. At first, you won’t be strong enough to keep nasal breathing (i.e., pulling air through the nose and down into the bottom of the lungs) for a long time. But the diaphragm muscle will get stronger and eventually you will be able to breath diaphragmatically for as long as you need and train for. This might be the slowest part of the adaptation..
- The nose muscles have to adapt as well.
- Nasal passage recovery:
- If you haven’t been using your nasal passages in this way, you will have to get them adapted to this level of use.
- The most important thing is to just breathe through your nose as much as possible.
- It will probably help to start using a Neti pot or Neti bottle (there are many varieties). Use distilled or boiled water, not tap water. Remember to not blow your nose too hard after rising nasal passages with water…you may inadvertently push water into your ear tubes which may cause irritation. I do it first thing to let the water fully drain out before I sleep. The first few times will be unpleasantly reminiscent of getting water up your nose at the beach. But do you remember how amazingly good your nasal passages felt after a day in the surf? This is the same thing. After doing it for a week, you will never want to stop. And it will make nasal breathing so much easier
- Use BreathRight strips or the like to hold open the airways in your nose. George says his nose muscles got stronger after a while, so this may be a temporary thing. But it does make an enormous difference in the beginning. There are other nasal dilator devices to try if you like the idea of stuff up your nose. I don’t.
- Try the Buteyko (bu-tek-o) method for clearing mild nasal congestion
- Metrics:
- It can help to track improvement if you use metrics but you don’t have to do so because the goal is NOT to breathe less, it is to use nasal breathing. The rest comes naturally.
- HRV — your HRV level should start to increase, especially if you can nasal breath while sleeping
- HR — you may find your HR starts getting lower for the same power / speed. This doesn’t occur for everyone.
- Breaths per minute — monitor your natural breathing. Oura ring & Whoop strap do this for sleep, which is a good way to see if it is falling. You want to get to 14 or less breaths per minute. 10-14 breaths per minute is normal, according to Patrick McKewon.
- Length of time until air hunger — 5 normal breaths. Exhale. How long until impulse to breath? 25 seconds minimum. 40 seconds target.
- Maximum breathlessness test: normal breath in and out of nose. Exhale, then hold and see how many steps you can take. 60 steps is minimum for “good” CO2 sensitivity.
- How to get started with nasal breathing during exercise, According to George:
- Get on an indoor device you like to use: stationary bike, treadmill, etc.
- Get going at a pace that is lower than normal
- Breathe nasally.
- Every 3 minutes increasing the pace just a little, and rate how much the air hunger you feel.
- When you find the level at which you feel you cannot keep going, back off just a little so you can keep going. It will feel hard but not feel like you are suffocating. The effort should be in the challenge of pulling the air in and out, not in staying conscious or in dealing with the fear of suffocating. Another thing to watch is a rising HR…if your HR is higher than it should be for that level of power / pace, then you are struggling too much…just back down a little until the HR stabilizes
- The next workout, try to go a little harder while nasal breathing to see if you can do it. You will probably find you can go harder every time for a while. The early, beginner gains will be the easiest, as in most things.
- Continue the upward progression over time
- Feel free to mouth breathe once in a while if you want to go harder. It won’t be a set back, but it won’t help you progress toward 100% nasal breathing. Just don’t lose track of the behavior change you are trying to instill as a habit.
Related info and episodes:- breathing-well-is-a-skill-w-george-dallam-phd
- protecting-lung-health-meilan-k-han-md/
More Dallam info:- George Dallam CSU-Pueblo profile
- Book: the-nasal-breathing-paradox-during-exercise-george-dallam
Want to support the show?If you are enjoying WiseAthletes, please leave us a review. And, be sure to check out our FullScript supplements link to see the amazing prices on the best brands on the planet.
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...more August 17, 2024#142 | Fasting Mimicking to Balance Muscle & Longevity | Joseph Antoun, MD PhD Professional Grade Supplements & 5-Day FMD Kits for WiseAthletes
Like so many people, I have struggled to lose my visceral fat while I have continued to put on muscle.... but there is more to being a wise athlete than having maximum muscle. I also want to live LONG as a strong athlete. The prevailing wisdom says that when you fast or when you cut calories, you lose fat and muscle. So the challenge remains….how to thread the needle on losing the visceral fat while keeping my muscle. And what about the battle between the high protein for maximum muscle growth vs low protein for low IGF-1 and life extension? Is there any way to get the best of both worlds?
Today on episode 142 I am joined by Dr Joseph Antoun, a medical doctor who is now the CEO at L-Nutra, the company that makes Prolon, the 5-day FMD food kits (wwwprolonlife.com). Could fasting mimicking be the answer to losing visceral fat while retaining muscle and at the same time extending lifespan as a strong athlete? After talking to Dr Antoun, I am convinced it is…and as of today, I am on day 2 of my initial 5-day FMD.
Listen in to see if you come to the same conclusion.
And please forgive the inconsistent recording quality….but if you want to give the Prolon FMD a try, click on the link at the top of the show notes to get a great discount.
All right, let’s talk to Dr Joseph Antoun about fasting mimicking for athletes.
Joseph Antoun, MD, PhD, MPP
Joseph Antoun, MD, PhD is the CEO of L-Nutra, a Food as Medicine leader using Science to Nutrition research first to uncover what humans should eat to live healthier longer and second to help patients achieve better health outcomes.
Bullet pointsFood as medicine & muscular longevity
- Use your body's built-in system to renew and fine-tune cells. ProLon, a 5-day precision nutrition program, and Fast Mimicking Technology formulation, is designed to trigger your body's built-in system to renew and fine-tune cells - by mimicking a fast.
- Fasting mimicking (not fasting per se) to get the renewal signal without resource depletion (Joe's take: long water only fasts are the equivalent of overtraining…too much signal without enough recovery)
- Periodic fasting mimicking turns on cellular renewal without forcing the body into restructuring into a low resource phenotype
- GH is a stress hormone. In water only fasting the body doesn't have the resources to maintain muscle. With FMD the minimal resources provided are enough to work with GH to maintain muscle while getting fat loss and autophagy
- Eat the least protein necessary to build and maintain the body and lifestyle you want. Any more than the minimum is age accelerating without muscle benefit.
- The amino acid composition matters. Focus on plants with some fish protein. That’s good enough for muscle building when combined with FMD a few times a year. Eat 0.8-0.9 g/kg on average per day (less if you aren't an athlete). Perhaps cycle between higher and lower amounts of protein around resistance training.
- For me, that means i'm cutting back from 200g/day to an average of 100g/day (I'll adjust after seeing how my body reacts)... I already started.
- I'm on day 2....looking in the box I can tell you it would be hard to pull it together myself. For now I will buy the box to see if it really does work for me. It’s pricy but tolerable. And the Fast Bar is delicious.
- Prolon info
- Clinical studies have shown that the ProLon formulation can specifically target belly fat and promote safe and effective weight loss.
- Why not just fast? Despite the potential benefits, fasting is hard to do. Hard on the body.
Related info and episodes:- Episode 135 | What's Your Healthy Bodyfat %?
- Episode 132 | Measuring Metabolism
- Episode 137 | Healthy Fat Loss
More Prolon info:- prolonlife.com
- https://www.nature.com/articles/s41467-024-45260-9.pdf
- https://www.valterlongo.com/daily-longevity-diet-for-adults/
Want to support the show?If you are enjoying WiseAthletes, please leave us a review. And, be sure to check out our FullScript supplements link to see the amazing prices on the best brands on the planet.
Pro Level Supplements for WiseAthletes
...more July 28, 2024#141 | Your Blood Test Results May Vary | Austin Baraki MD Pro Level Supplements & At-Home Tests for WiseAthletes
"In science and engineering, convention dictates that unless a margin of error is explicitly stated, the number of significant figures used in the presentation of data should be limited to what is warranted by the precision of those data."
Why don't I see error bars on my blood test results...?
We love to say that what is measured, improves. It is a fine idea that applies to many walks of life including athletic performance. Starting with Inside Tracker in 2009, an industry has emerged to help wise athletes and longevity seekers alike to measure, track changes over time, and even optimize lifestyle behaviors, supplements and pharmaceuticals to target “low all cause mortality” levels for blood based bio markers. And since the human body relies on many organs and biological processes to survive and thrive, scientists have developed biological age calculators that combine a set of the actual vs optimal blood markers to assess overall health status relative to “normal” to calculate a biological age or rate of aging. In longevity circles, a biological age lower than chronological age is a badge of honor. And it’s a booming business.
But just how accurate are these blood tests that all of this science and my own blood test results are based on? It’s a question that has been haunting my thoughts over the last year as I have aggressively measured my blood markers and calculated my biological age every 3 months in an effort to fine tune my longevity interventions.
So, today on episode 141 I am joined by Dr Austin Baraki who argues that blood testing is an important but challenging area of medicine. He argues that people should not put too much faith in imprecise technology measuring indirect markers of biological function. False precision can lead to over confidence, and distract people from the lifestyle improvements that would really make a difference. And he also shares his tips on reducing the variability and error in your own blood test results.
British Medical Journal: your results may vary: the imprecision of medical measurements (20 February 2020)
Dr Austin Baraki BioDr. Austin Baraki is a practicing Internal Medicine Physician, competitive lifter, and strength coach located in San Antonio, Texas. Originally from Virginia Beach, Virginia, he completed his undergraduate degree in Chemistry at the College of William & Mary, his doctorate in medicine at Eastern Virginia Medical School, and Internal Medicine Residency at the University of Texas Health Science Center in San Antonio.
After a 15 year career as a competitive swimmer through the collegiate level, he discovered the barbell and began training for strength and competitive powerlifting. He also coaches individuals ranging from beginners of all ages to national and internationally competitive athletes.
His interests include the application of strength training in the context of complex medical conditions, sarcopenia, pain neuroscience & rehabilitation, as well as cognitive and sport psychology.
Related Episodes- Episode 35 Inside Tracker
More Dr Baraki info:- barbellmedicine.com
- Dr Baraki Article: Where-should-my-priorities-be-to-improve-my-health/
Your Results May Vary website...see if your blood test result variations are significant (click photo)
Want to support the show?If you are enjoying WiseAthletes, please leave us a review. And, be sure to check out our FullScript supplements link to see the amazing prices on the best brands on the planet.
...more July 20, 2024#140 | Solving Low Vitamin D | Grant E. Fraser MD Pro Level Supplements & At-Home Tests for WiseAthletes
Updated edition: we had to fix a few spots in the recording so this episode is the (slightly) revised one.
Vitamin D isn’t a vitamin but a hormone, and it plays an important role in our bodies including the building and repair of muscle.
Can you just take a vitamin D pill and forget about it? Do you have to get sunshine to get sufficient vitamin D? Can you be low on vitamin D despite getting lots of sunlight? How much vitamin D can you take before you are risking getting too much? 2k, 5k, 10k every day?
The big question: is low vitamin D a cause or an effect of poor health?
These questions and more get answered or at least discussed in detail in my followup chat with Dr Grant Fraser who is passionate advocate for vitamin D supplementation.
To be honest, I've been a vitamin D supplementation skeptic for a long time, in part based on scientific studies that say supplementation doesn’t affect outcomes. Dr Fraser says …not so fast, pal!
Well, one thing is clear, everyone should get their vitamin D levels tested to see where they stand. If yours is low, today’s talk can provide a path forward. Fortunately the at home test only costs $37…mine is already on the way.
Grant E. Fraser MD, ABAARM, DABFM, FRACGP, FACRRM, GEM
Grant E. Fraser, M.D. is Board Certified in Anti-Aging & Regenerative Medicine, and more and is passionate about helping patients improve their quality of life, reverse health conditions, and live longer and happier.
Related Episodes- Episode 139 Finding Your Iron Sweetspot w/Dr Grant Fraser
- Episode 105 UV Light Sweetspot (more than Vitamin D) w/Prof Prue Hart
More Dr Fraser info:- https://www.grantfrasermd.com/
- https://www.grantfrasermd.com/blog
Want to support the show?If you are enjoying WiseAthletes, please leave us a review. And, be sure to check out our FullScript supplements link to see the amazing prices on the best brands on the planet.
FullScript Site for WiseAthletes
...more July 14, 2024#139 | Finding your Iron Sweetspot for Performance and Health | Grant Fraser MD Pro Level Supplements & At-Home Tests for WiseAthletes
We’ve all heard about anemia and iron deficiencies hurting our athletic performance and our overall energy level. But the latest thing is iron overload and dumping iron. So is iron good or bad??…the answer is yes. Iron is both a toxin and a nutrient.
What I’ve learned for myself is the older athlete needs just enough iron but no more. So the right question is …how to tell where you are on iron storage in your body, and how can you help your body not hold too much iron while avoiding having too little.
We all need 3-5 grams or 3000-5000 mg of iron in our bodies every second of every day and we only can absorb 1-2mg of iron per day from our food and supplements…plus or minus a bit using various techniques to raise or lower iron.
Too little iron can mean chronic fatigue, brain fog, and breathlessness. Diets low in animal proteins, frequent hard workouts, low stomach acid, gut issues causing poor nutrient absorption, and of course bleeding can lead to lower iron.
Too much iron, unless dramatic, is harder to feel and more likely for older athletes. Without blood loss, iron tends to accumulates in organs during aging and leads to dementia, heart disease, T2D and much more, and is worsened by drinking alcohol.
Donating whole blood can lower iron but moves the needle very slowly as only 100-250mg of your total 3000-5000mg of iron is lost at each donation. That’s the equivalent effect of not absorbing iron from food for 3 months, so it’s something.
The key is to plan ahead.
So how to know if you are low or high? Or on the verge of being low or high? How to know if donating whole blood every 8 weeks is a good idea or a bad idea? How can you make donating blood less unpleasant? And what else can you do to stay in your iron sweetspot and to avoid both of these terrible outcomes for athletic performance, quality of life, and overall health?
To answer these questions and more today on episode 139 I am joined by Dr Grant Fraser who is board certified in the United States in anti-aging and regenerative medicine and in family medicine. Listen in while Dr Fraser helps me to sort out what is going on and how to plan ahead to get into the iron sweetspot.
Grant E. Fraser MD, ABAARM, DABFM, FRACGP, FACRRM, GEM
Grant E. Fraser, M.D. is Board Certified in Anti-Aging & Regenerative Medicine, and more and is passionate about helping patients improve their quality of life, reverse health conditions, and live longer and happier.
Bullet points- What is iron?
- Iron is a very common mineral on Earth
- It has a highly stable nucleus and is capable of accepting and donating electrons easily, which makes it react with water to form rust and is very useful for biological organisms.
- We use it to grab oxygen from air and carry it around the body, we use it in the chemical chain that makes ATP or energy the body uses to power itself, and iron is a necessary part of many proteins.
- Our bodies need iron every second of our lives, so we keep extra on board just in case… we have 3-5grams in our bodies and we absorb about 1-2mg a day. That’s 1-2 mg vs. 3000-5000mg…we can’t get much very fast. So mostly we recycle it, and we keep some stored away in protective cages that keep the reactive iron from damaging our cells.
- So it’s like calcium (stored in bones) and proteins (stored in muscle and elsewhere) that we scavenge when we need some. But iron is so reactive it will damage our cells, so we lock it away and convert it to less reactive forms?
- In addition, most bacteria that infects us needs our iron to grow, so our bodies react quickly to inflammation to stop absorbing more and stop releasing iron from storage.
- So where is the iron and how does it get moved around, and what is measured in understanding iron status in the body when we use blood samples?
- Hemoglobin: 2 g (men), 1.5 g (women) – our red blood cells to carry oxygen
- Ferritin: 1 g (men), 0.6 g (women) – mostly in cells around the body but some in blood plasma? Why is it in the blood?
- Hemosiderin: 300 mg -- ?
- Myoglobin: 200 mg – in muscles?
- Tissue enzymes (heme and nonheme): 150 mg
- Transport-iron compartment: 3 mg (transferrin?) – moving the iron to where it is needed…mostly bone marrow? Why so low?
- When the liver or brain or arteries have too much iron, how is that stored?
- So why do we measure iron from the blood? It’s the easiest to get at? Issues with using blood measurement? Getting the tail end of a process?
- What do we measure and what does it tell us? Do we want to be at the low end of the range…at the high end? What is best for longevity?
- Serum iron – includes what? Iron in transferrin being moved around the body?
- Ferritin – cage for iron…why in blood? Decreases with low iron and increases with high inflammation…if droppoing suddenly look into why
- Transferrin – increases when….can be low even when iron is needed because…
- Saturation? 30% is normal. Why measure it?
- TIBC – total iron binding capacity – measures the amount of transferrin. Why?
- Other?
- Red blood cell count & mass? – a check for anemia…a clue to sleep apnea?
- Hematocrit - what is it?
- RDW- why important? Increase if building fast…
- MCV – what does it tell us? Size of red blood cell…iron deficient blood makes small cells. 80-100…decrease iron def…going up vit 12 def
- MCHC – what does it tell us?
- It helps to look at iron in vs. iron out to get a handle on where problems might come from.
- Iron in – issues
- Plant based diets – low absorption of non-heme iron, plant compounds binding to iron to block absorption. Calcium, tea/coffee,
- Medicines – PPI, antihistamines,
- Under eating – RED-S in athletes and other
- Gut issues reducing absorption – IBS, celiac, crohns
- Inflammation reducing absorption – from infection, hard exercise (for 4-6 hours), metabolic disease
- Eating too many iron supplements
- Iron out – some issues here
- Bleeding: surgery, menstrual cycle, bowl cancer, ulcer, etc.
- Pregnancy – baby needs iron
- Growing – children need iron
- Sweating -- can lose iron in sweat
- Foot strike red blood cell breakdown
- Low iron is a problem for many people. The challenge in getting in iron is particularly important for people who are growing or bleeding regularly. It can also be an issue for people with chronic inflammation, such as in obesity or with metabolic illness or with chronic iron absorption issues. Athletes can have issues without bleeding causes due to overtraining, heavy sweating, eating iron close to exercise which limits absorption. And low iron can come from GI bleeds, bowel cancer, ulcers…so figuring out why iron is low is important…don’t just supplement iron
- Low iron appears slowly usually…here are the official “stages of low iron”
- Stage 1 - Ferritin low while hemoglobin normal - some depletion for energy intracellularly
- Stage 2 - lethargy starts - more effects on cellular energy as tries to take iron to preserve hemoglobin level
- Stage 3 - anemia: ferritin and hemoglobin low. Compromised function
- Now let’s talk about my main interest….high iron.
- High iron is mostly a problem for people with genetic issues related to reducing absorption but can also be a problem for older people who have been accumulating iron for a long time: eating a lot of iron, drinking alcohol, or maybe its just a breakdown of the normal homeostatic mechanisms like many other things that don’t the way they used to?
- I’ve heard about things we do that interfere with iron management and contribute to higher iron…
- Zinc over supplementation (copper)
- Copper deficiencies (copper vs. magnesium)
- Vit c with iron meals
- Supplementing with iron unnecessarily (multivitamins)
- Estrogen supplementation (increase absorption if iron)
- Alcohol
- High iron is associated with many illnesses. People with clearly high iron should take aggressive action to reduce it. But what about people like me: my iron biomarkers are all in the green. Could I have accumulated iron in my organs that doesn’t show up in my blood? If iron is associated with neurological disease, metabolic disease, heart disease and more, would I be crazy to actively knock down my iron if I am eat an iron rich diet?
- Donating blood regularly… I do it every 3 months (for the last year)…I haven’t seen any impact on my iron markers. I’ve stopped drinking alcohol almost entirely,
- What else makes sense to drive down iron
- Emla – reduce pain from needle pain from donating blood
More Dr Fraser info:- https://www.grantfrasermd.com/
- https://www.grantfrasermd.com/blog
Want to support the show?If you are enjoying WiseAthletes, please leave us a review. And, be sure to check out our FullScript supplements link to see the amazing prices on the best brands on the planet.
FullScript Site for WiseAthletes
...more July 06, 2024#138 | Internal Arts: More than Stress Management | Jeff Patterson, author of The Yielding Warrior Pro Level Supplements for WiseAthletes
Jeff Patterson….martial arts expert and author of The Yielding Warrior.
After teaching 25,000 students ni his martial arts academy and earning the equivalent of black belts in the martial arts of Brazilian Jiu-Jitsu, Eskrima, Tai Chi, Qigong, Muay Thai, and Kenpö, Jeff now shares personal experiences, age-old wisdom, and the philosophies of meditative arts with his readers.
In The Yielding Warrior, you will learn how to:
- attain a higher level of proficiency in any sport or physical activity
- enhance emotional control and sharpen intuition for increased happiness and self-acceptance
- deepen self-awareness and esteem through the benefits of yielding
- apply meditative practices to excel in interpersonal communication and business relationships
- improve your focus by applying the skills attained through yielding awareness
The Yielding Warrior is about the concept of yielding and how it can be applied to almost any area of life
--> "everyone should meditate for 20 minutes a day unless you are too busy, then you should meditate for an hour"
Related episodes:- Episode 121 | Brian Mackenzie of ShiftAdapt
- Episode 119 | HRV Biofeedback w/ Marco Altini
- Episode 110 | Mental Fitness w/ Kate Allgood
- Episode 70 | Healing Yourself w/Joe Taft
More Jeff Patterson info:- https://www.theyieldingwarrior.com/ - Jeff Patterson's website
Want to support the show?If you are enjoying WiseAthletes, please leave us a review. And, be sure to check out our FullScript supplements link to see the amazing prices on the best brands on the planet.
Pro Level Supplements for WiseAthletes
...more June 21, 2024#137 | The #1 Secret to Healthy Fat Loss | Vyvyane Loh MD Pro Level Supplements for WiseAthletes
As a followup to my chat with Dr Vyvyane Loh, Glen and I sat down with Dr Loh to get into the HOW of losing excess body fat without losing muscle. Dr Loh does not disappoint as she shares her tips on how she has helped so many people successfully navigate the changes needed to get to a healthy body fat level AND a healthy body muscle level...both are necessary for health and athletic performance.
Check out my own Dexa Scan at the bottom of the show notes that reveals the details we all need to know to assess bone and fat and muscle health status, and to set improvement goals. I used dexascan.com via a provider in my area. My scan showed that while my body fat % is only 16.3%, I still need to lower my visceral fat from 87.7 cm2 to 70.0 cm2. I'm working on it.
Episode #135 | What's Your Healthy Fat %
Dr Loh is board certified in internal and obesity medicine, and she runs a medical practice helping people of all shapes and sizes to solve metabolic health challenges.
Bullet pointsHow to lose excess fat while retaining or gaining muscle?
- Good Sleep #1 (to keep cortisol and sex hormones healthy; recovery)
- 8-9 hours of good sleep for athletes (consistent sleep schedule every day & avoid use of sleep drugs that interfere with sleep architecture (melatonin okay)…eye mask, noise protected, test for sleep apnea
- Circadian rhythm— set by light and eating. Be consistent everyday.
- Respecting the timing of meals: Eat breakfast (within an hour of waking) with protein to end catabolic state
- Protein: eat 30-35 grams of complete protein per meal, up to 5 meals per day. Everyday. Animal sources of protein allows for lower calorie burden to get the protein.
- Exercise
- Resistance training is key (3X/week)
- Work at end range (maximum range of motion under tension but be careful)
- Essentric (lengthening) movement better than concentric (shortening)
- Also isometrics (good during injury recovery)
- Cardio is good also (do after resistance training if on same day)
- HIIT 2x/week (20-45 minutes) targets visceral fat. Has to be really hard. Dread it.
- Diet:
- Higher percentage body fat — with a calorie deficit in diet doesn’t mean less availability of calories. Still need enough protein to hold onto muscle
- Near goal body fat — eat 5 times day and getting enough protein. Working out. No calorie deficit.
- If fat is okay but low muscle? Get extra protein everyday. Maybe extra protein before bed to reduce muscle loss.
- Low carbs to manage calories but need enough carbs. No keto. Low carb is good for calorie control. 80-100g of carbs. Need more carbs if alot of high intensity.
- Insulin is a growth factor. Extra protein to get extra insulin to stimulate muscle growth. And extra protein can be turned into glycogen
- The key is to be clear about goals.
- Changing lifestyle is hard. Start with identity and making it hard to cheat.
- Everyone is ready when they seek help. It’s after they’ve lost weight at people lose focus. “Just ….” means you are in trouble because you are rationalizing.
- Just a little…just this one time…etc. watch out.
- Moderation is a loser strategy. We’ve tried that experiment across the country. Now we are all obese. Rising metabolic disease.
- Either you are getting the results you want or you are not. Focus on results not on theory and what we want to be true.
- Other topics:
- Rising fat in body leads to falling blood flow to brain. Leads to shrinkage of brain. Brain can’t get more blood flow but it can get more sugar per volume of blood. Crave sugary foods. High blood sugar.
- Don’t make it hard for yourself. Don’t put those foods in your home.
- Declare your identify as a person that doesn’t eat that sort of thing.
- Over eaters are fine in front of other people if they have declared publicly that they don’t eat crap and over eat. But when they get home, all bets are off of the foods are in the house
- Drinking alcohol also interferes with healthy eating. Alcohol calories. Decrease in willpower
- What about pleasure in eating? “As I got bigger my world got smaller”. Let’s be accurate…if you are over weight you might be enjoying the few minutes of eating but you are not happy most of the day. Getting healthy can you a boatload of happiness. Plus, stop hiding from the real problem. The food isn’t really solving the problem.
- GLP-1 good? Look for Dr Loh’s paper. (Didn’t sound positive)
- Vyvyanelohmd.com
- Sign up for Dr Loh’s newsletter, and send email on website asking for link to fat-muscle-bone talk
Related info and episodes:- Episode 135 | What's Your Healthy Bodyfat %?
- Episode 132 | Measuring Metabolism
- Episode 120 | Recover from Food Madness
More Dr Loh info:- Vyvyanelohmd.com - Dr Loh's website
Want to support the show?If you are enjoying WiseAthletes, please leave us a review. And, be sure to check out our FullScript supplements link to see the amazing prices on the best brands on the planet.
Pro Level Supplements for WiseAthletes
...more June 09, 2024#136 | Live Long Strong; Dodge the #1 Killer (CVD) | Michael Twyman MD Pro Level Supplements for WiseAthletes
The USA declared war on heart disease in 1955. 70 years later it is still the leading cause of death. What about statins and all that medical progress we’ve had. Exactly, what about it?
Dr Michael Twyman is a board certified cardiologist who runs Apollo Cardiology, a clinic serving patients from all over the world. His approach is to understand cardiovascular health from a whole body perspective. Rather than focus on LDL and HDL and apoB, he says we need to look at the bigger picture of cardiovascular health….namely cardiovascular health as a marker of whole body health. He says plaques can start building early in life....stop the progression now to eliminate the need for dramatic interventions with significant side effect later in life.
We discuss specific behaviors and supplements and even medications to signal the body to stop building plaques. A statin is only one of many potential solutions. Since recording this episode, I have stopped taking my low-dose statin that was significantly reducing my muscle power, and replaced it with better tools.
- Stop damaging the Glycocalyx (the protective barrier to the lining of arteries)
- Stop making so many ApoB particles
- Make more receptors to remove more ApoB particles
- Lower reabsorption and absorption of cholesterol from food in gut
Bullet points- Damage to glycocalx
- Causes: high oxidative stress (mitochondrial disfunction), inflammation from any source: gut related, infection (COVID), smoking, high insulin, high glucose
- Signs: high BP, erectile dysfunction
- Supplements to consider
- Vit k2 - keep calcium in bone not arteries
- Garlic - support glyocalix health
- Berberine — increase LDL receptors (like a weak pcsk9)
- Bergomot - lower LDL production (like a weak statin)
- Ezetimibe (not supplement) — reabsorption of cholesterol
- Aspirin (81 mg) - complicated. Had an event? Aspirin for life. No event yet? Higher CAC? Aspirin. Unless high risk of bleeding.
- Blood markers review
- Homocysteine <10
- GGT high means low glutathione (high oxidative stress)
- Uric acid. High means poor metabolism. A marker of gout but also damaging to glycocalyx.
- Oxidized LDL — 5 alarm code
- hsCRP — good to know but if high doesn't point to the problem
- Myeloperoxidase (increase with infection) — HDL dysfunction
- Boston heart panel
Related info and episodes:- Episode 103 | Boosting Nitric Oxide
- Episode 105 | UV Light for Health
- Episode 112 | Simple Solutions for AGEs
More Dr Twyman info:- drtwyman.com - Dr Michael Twyman's website
Want to support the show?If you are enjoying WiseAthletes, please leave us a review. And, be sure to check out our FullScript supplements link to see the amazing prices on the best brands on the planet.
Pro Level Supplements for WiseAthletes
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