Written by Christopher Kelly
Aug. 25, 2014
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Chris: Hi, this is Chris from Nourish Balance Thrive and I'm delighted to be joined today by Dr. Lynda Frassetto. Lynda is a Medical Doctor and Professor of Medicine and Nephrology at the University of California, San Francisco.
She is the Director of a Clinical Research Center, UCSF, supervises patient care at three of the university's hospitals and helps teach courses on improved communications and behavior stress modification techniques.
Hi, Lynda. Thanks for coming on.
Lynda: Yeah. Hey, Chris, thanks for inviting me.
Chris: I'd like to talk about the clinical study that you're planning. Hopefully it's going to prove the efficacy of a Paleo diet for treating PCOS.
Lynda: Which is Polycystic Ovarian Syndrome for those of us who don't know it.
Chris: Yeah. I thought it would be a good idea for you to start by explaining what PCOS is.
Lynda: Okay. So Polycystic ovarian syndrome, it's a syndrome which means it has a variety of different manifestations. So it's typically people tend to have very irregular menstrual cycles. There are a lot of reproductive hormone irregularities which help produce these irregular menstrual cycles. They tend to have very high androgen levels which means they don't to be, for example, hairy, and have a lot of acne. And we believe that the balance between the various hormones is one of the things that helps promote the irregular menstrual cycles and the abnormalities in the way that the eggs are produced in the kidneys.
In addition, there are other endocrine-needing hormone irregularities. So a lot of people with PCOS tend to be insulin-resistant and that's why we got interested in this because we're interested in studying Paleo diets on people who are insulin-resistant. And the insulin-resistance may also contribute to some of the other metabolic problems that they have, like being obese and having truncal obesity, and they tend to have high glucose levels and can develop diabetes or heart disease.
And so all of these things which are all related to these irregular hormones, we believe that specific kinds of diets that improve insulin resistance may help change the hormone environment in the body and therefore help regularize things and hopefully help fix all of those metabolic problems and improve the menstrual cycle regularity.
For women who have PCOS and want to get pregnant, these irregular menstrual cycles makes it difficult for them to get pregnant and so it's one of the things that we would hope is that we can improve the menstrual cycle regularity, then it would be easier to get pregnant.
Chris: Okay. It affects an extraordinary number of women. I found the statistic here up to eight million women in the US alone. Is that just the women that we know about? Is it likely that there are many more women out there that are affected by this but don't even know that they have the condition?
Lynda: I think that would be reasonable to say because I'm sure that not everybody manifests exactly the same way so I'm sure there's a spectrum of responses and so some people might be on the less manifestation part of the spectrum.
We also believe that it's one of these diseases of civilization and so it's not just the United States. I would think that this would actually be something that if we looked, say, in Europe, we would see exactly the same thing.
Chris: Right. Exactly, yeah.
So why did you choose PCOS in particular? I mean there's obviously lots of diseases that are classically-associated with hormone balance. Why did you choose PCOS?
Lynda: Well, really, we were looking for a syndrome or a disease where insulin resistance is one of the underlying problems. Our previous research shows where we looked at couch potatoes then we looked in people who have Type 2 diabetes. The people who are the most insulin-resistant are the ones who seem to respond the most to our study guides.
There's no one Paleo diet, there's no one environment on the planet so there couldn't possibly be one diet. Well, we fed people diets that were about 2/3 fruits and vegetables and 1/3 meat and fish and nuts. And with that kind of diet, what we found is that both the couch potatoes who were the most insulin-resistant and the Type 2 diabetics who were the most insulin-resistant, those were the ones who got the most better.
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And so what we're looking for in this study is we're looking for people who fall into the insulin resistant range and then we want to put them -- actually, we're doing two diets that lower insulin resistance. So one is a Paleo diet where we exclude specific food groups like grains and dairy products and processed foods, and then the other one would be considered to be a healthy American Diabetes Association diet where we recommend like whole grains and low-fat dairy.
And in our study with our Type 2 diabetics, both groups improved, so it wasn't just the Paleo group. I mean both groups got better on these diets. So they both work. and so that's what we're doing now is we're going to be randomizing people to one diet or the other and following them for a few months and then we're going to cross them over and see which diet works better.
Chris: Well, I was going to ask you about the design of the trial. How much control do you have over these people? Is it you're just going to be following them and they're going to be doing some coaching on what they should eat? You have no got control over them to the point where, say, they're living under your roof and you control every bite that they eat?
Lynda: Right. So in our previous studies, we had done them on the research center where we made all of the food and we brought people in every day and so we were following them very closely.
Now this is going to be an outpatient study. And so what we've done is we're designing a whole teaching and coaching system including -- and I'm very actually quite pleased to try this -- we're going to be trying to use both Twitter and these mobile phone apps in order to be able to contact people daily on a very, very quick basis like "Did you eat this today?" or "Did you eat that today?" On top of our coaching, we have some students from UC Berkeley from the Nutrition Department who are going to be our diet coaches for this study.
And so what we're trying to develop a scheme where we intensively teach people what it is we want them to do, and then we follow them over the course of the next couple of months regularly. And then we do a variety of food questionnaires and we check to see how they're -- we look at, we do ovarian ultrasounds and see how they're doing.
And then from my point of view, we do 24-hour urine collections because although you can lie to us about what you're eating, you can't actually lie to your kidneys about what you're eating --
Chris: Oh, interesting.
Lynda: No, you don't, you know. And so what's in the urine, the electrolyte composition of the urine can tell us whether or not you've been eating a low-sodium diet or a high-potassium diet or a low-acid diet or a high-acid diet. All of these things help tell us whether or not you actually did what you said you were doing.
Chris: Okay. And then how are you going to measure success with this? Are you going to be looking specifically for the ovarian cyst or are you going to be looking at other markers like sensitivity to insulin or something?
Lynda: Yeah. Actually so the primary outcome variable which means the first thing that we want to look at the most, is how many periods do they get? So before, like in the previous six months, how many periods did they get and while they're on the study diet, how many periods do they get? And we kind of look at the average of this as well as looking at ovarian size and the number of cysts and then how big they are, and then a variety of the hormonal and metabolic levels to see how they're doing.
And then the other really exciting thing about this study and I'm really pleased about this, too. UCSF has one of the Nobel Prize Winners, Elizabeth Blackburn, who won the prize for doing telomere research which are the things that attach to the ends of the DNA and give you an idea of how long you're going to live.
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And so they've agreed to allow us to draw the blood so that they can do the measurements of these markers. Because one of my beliefs is that if you improve insulin resistance, you improve cell health and presumably, cell life or organism life. And so this would actually be a really amazing way for us to try to see whether or not there was like a real physiologic important change in what we're doing with these diets. So I'm very, very pleased about that.
Chris: Excellent. And then do you think these diets, if they're successful, do you think they're actually reversing insulin resistance or do you think they're just managing it? Do you have any way of measuring the sensitivity, like the amount of hormone or the number of receptors on a cell? Is that possible or do you not know?
Lynda: If we were getting pieces of tissue, we could probably do that.
In our last study, what we did was we did what's considered to be the gold standard for measuring insulin sensitivity which is a euglycemic-hyperinsulinemic clamp which is a very complicated study where you're giving both IV glucose and IV insulin at the same time. And what you're trying to do is keep the glucose levels the same and you measure blood sugars every five minutes for a couple of hours. And how much insulin you need in order to be able to keep your blood sugar the same gives us a functional idea of how the cells are responding to the insulin.
So actually, that's what we did in our last study. And so the answer is yes, they're actually becoming more insulin-sensitive.
Chris: Wow. And that's true for both diets, both Paleo diet and the ADA diet?
Lynda: Yeah, it's true for both diets.
One of the things that we think is very helpful for this is because that's considered to be the gold standard, we really feel like this is actually doing something.
Chris: Excellent. And then how did you come to choose the Paleo diet rather than any diet? Why not the Mediterranean diet or the Atkins diet or something else?
Lynda: Yeah. So that has to do with the kind of research that I had originally started doing when I started working at UCSF as a researcher. My mentors, Dr. Tony Sebastian and Curtis Morris, who are interested in physiology, were actually looking at something called diet acid load.
What that means is that in all foods, when they're broken down in the body into their component parts, can be chemically turned into acids or neutral compounds or bases. If you eat an American diet or a Western diet, it tends to be very high in acids. In fact, all foods contain acid-containing compounds. But if you eat a diet that's very high in fruits and vegetables, you tend to eat a diet which, on top of having acids in it, also has chemicals that are turned into bases in the body which neutralize the acids.
And so we were really asking "Can we come up with a diet which is a low-acid diet?" And we were looking at this because in kidney failure, you can't get rid of the extra acids and the acid levels rise. And we can show in kidney failure that this causes all kinds of problems like your bones dissolve and your muscles break down. And so we were really asking, so in people who have relatively normal kidney function and as they get older, their kidneys don't work as well, can we show that a high-acid diet actually is causing some of the diseases which are now considered to be diseases of aging like osteoporosis and age-related muscle decline? And so we were looking for a low-acid diet.
That was about the time Loren Cordain wrote "The Paleo Diet". So Tony Sebastian was like, "Well, let's use the Paleo diet. It's a pretty high-fruit and vegetable diet." So that's what we did. We weren't planning on using a Paleo diet. That was just the diet that we decided to use.
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Chris: This is interesting. This is actually news to me when we first met. I was under the belief that you couldn't really alter your acidity based on the foods that you're eating. It was very tightly-regulated.
So what you're saying is that's false and the food that you eat definitely makes a difference to your overall acidity?
Lynda: Right. So most people don't really understand this. So when I, as a kidney doctor, talk about increased acid levels in the body were really in people with advanced kidney failure.
So this is beyond the range considered to be normal. There is a normal range, okay, and people with advanced kidney failure, they are outside that and they have what we would call a true metabolic acidosis because of the kidney failure.
But in healthy people, what we're really talking about is within the range of normal, are you regulating your blood acid levels on the high-end of normal or on the low-end of normal? And over decades, does it matter? Does it make a difference if you're always on a higher end or at a lower end? And there's a lot of controversy for this for the few people in the world who actually do research on this. This is actually divided into two camps. One camp which believes it does make a difference and the other camp which believes it doesn't make a difference and never the twain shall meet.
My personal belief is that there's probably -- I'm going to say what I think. So I think that if you have completely normal kidneys and you're eating a diet where which has an average diet acid load and your kidneys are working perfectly well, the chances are you can get rid of all the extra acid that you are in sort of acid balance and you won't have a problem. But as you get older, in general, your kidneys tend to fail and there are a lot of great people who actually do have kidney problems.
And so for older, frailer people who may have age-related declining kidney function which is most people, then I actually think that as you get older, you have more and more of a problem getting rid of the extra acid and it, over time, causes more and more problems.
Now it may be that some of the things that we're looking at are actually occurring at the tissue and the organ level and so it may be that really the people who are eating the high-acid load who have normal kidneys, really, they're able to stay in balance only at the expense of their tissues being more and more damaged by the acid load.
So Professor of Medicine at UC Texas Donald Wesson who's been doing this research, his research suggests that the kidneys are being damaged by even these sort of average acid loads and that if you give bicarbonate, his research shows that it seems to slow the declining kidney function in people who have mild kidney disease. So it may just be that we're not seeing the damage until finally it gets to the point where there's a problem.
So there's something that -- there's a lot of controversy about this, but just from a kidney failure doctor, kidney failure is a real problem. You really don't want to have kidney failure. So if there was something that you could do besides taking medicines, if there was something you could do to help prevent damage to the kidneys, do I think that that's a good idea? Yeah, I do.
And that's just looking at it from a kidney point of view. I mean if you actually see what's in a Paleo diet, there's lots of things, good things, that you get in a Paleo diet. You avoid a lot of extra sugar, you avoid a lot of chemicals. It's got a very high-fiber diet generally which is thought to be good for you. It's good all these trace minerals and antioxidants and…
So there's a lot of other things that happen when you eat sort of a Paleo diet as compared to when you eat a high-processed food diet. So I mean, it's not just one thing that's what I'm talking about, but I think there's a lot of other benefits from it, too.
Chris: Absolutely. And so the thing I wanted to ask you about was this connection between insulin resistance and high androgens in women. I see this all the time on the saliva test that we run. Women, quite consistently, have higher levels of free testosterone than some of their male counterparts and I'm sure the insulin resistance is somehow linked to this but I don't understand the mechanism.
Do you know anything about that how it happens?
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Lynda: You know, I don't, actually. Although if you say to yourself, what do cells have on their surface that allow them to interact with their environment? I mean, insulin receptors are found on many, many types of cells and they activate a lot of pathways inside the cells. So would it be surprising to me that inability to react with the insulin receptors on the surface would alter the way the various hormone cells work? No, I wouldn't be surprised at all.
Chris: Okay. And then I wanted to ask as well about some of the things that you can't control for in the study.
I found from personal experience and success of outcome-based measures working with other people, that diet is definitely important for most people. It starts with food but it doesn't really end there and there's things like sleep and stress reduction and exercise which are also really important variables.
How do you control for those in a study like yours?
Lynda: Right. So really, you can't.
In our research center studies, we don't allow people to lose weight. But here, I guess, I wouldn't be surprised if people also lose weight and certainly losing weight is one of the things that always improves insulin resistance. It's one of the complicating factors that you simply have to adjust for.
And there's some built-in bias and people who agree to be in research studies tend to be motivated. And so if you're motivated to follow a diet, maybe you'd be motivated to exercise more or motivated to get more sleep or motivated to try to work on some of your other problems. So it may simply be that the people that we're getting are people who are actually "It's okay." Like "I'm really fed up with this now 'm going to do something about my life."
So I can't say that there aren't going to be these other factors. Fortunately, I think that they apply to both arms of the study so that inasmuch as we can say, like one group is not going to be different from the other group, that's about as good as we can get with that.
Chris: Okay. Yeah. And then I've noticed it especially when something starts working. So when someone starts doing a diet and they start seeing improvement, that's definitely a motivating factor to try and find out what else might work. That person then might think "Oh, well, if this is possible, I wonder what I could do with meditation or another hour of sleep every night." And of course, all of these things lead in the right direction so it made the diet look better than it really is.
The crossover, the design should help with this, too, right, if you get the same people. Hopefully they're doing the same thing on both types of diet.
Lynda: Right, exactly. And so that's more or less what in order to be able to adjust for the things that we can adjust for, that's what we're doing.
Chris: Okay.
And then so, I wanted to ask about the actual diet itself. Who designed it? What are the macronutrient ratios? It's something that seems to be quite hot topic at the moment, people are asking about it all the time. Like "How much carbohydrate should I be eating, how much protein should I be eating?"
What are those numbers in your diet and who designed it and why?
Lynda: Right. So typically, in our research center diets, we just arbitrarily choose numbers. But in this, this is going to be an outpatient study where we're simply going to counsel people.
So it's not going to be specific amounts of carbohydrates or proteins or fats. We're going to be saying things like -- in one group, we're going to be saying, "Avoid these food groups." And then other group, we're going to be saying, "If you're going to be eating grains, try to eat whole grains as opposed to processed grains."
So we're not going to be able to control for that. The best we're going to be able to do is have people fill out food questionnaires and then we're going to be able to see what their averages are.
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Chris: Okay.
Lynda: I mean everybody does things differently. Some people might tend to eat more carbs and other people less carbs. Just like there's no one Paleo diet, I mean there's no one ADA diet, either. Mostly it just tells you what kinds of foods they want you to eat.
Chris: And then you're not asking… some of the, I think, probably one of the most important things I as people to do is check their blood glucose on a regular basis and then adjust the amount of carbohydrate that the eat based on the numbers they see on this little handheld meter you can buy from Amazon for seven bucks.
Are you doing anything like that? Are you just letting people eat whatever they choose?
Lynda: Right. So there's certainly people who follow low-carbohydrate diets can improve their blood glucose levels.
However, what we found is that for example, in our Paleo diet arm, even though people were eating -- like our diets were about 40%-50% carbohydrate so certainly not a low-carb diet. So even though the carbohydrate level was relatively high and actually the fructose content in our diet was higher than in our control diet, people's blood sugars were much better. For a couple of people, we actually looked at what happened to the fructose in the liver to see whether or not this was a difference and how the liver was handling fructose. The answer is there was no difference on what the liver was doing in terms of glucose and fructose breakdown.
And so the diabetes guys I work with, actually thought it was due to the fact that it was a much higher fiber content in the Paleo diet because we were giving them a lot of the fruits; in the form of fruit, not in the form of juice or whatnot, or high-fructose corn syrup.
So they actually thought maybe it's because the fiber is actually preventing the sugars from getting absorbed into the body. So it may be that the fiber content of the diet which is actually improving the blood sugar control.
So really, it makes me think that it's not the carb amount, it's where the carbs are coming from that makes a difference. You can limit your carb intake and that will lower your blood sugar but I don't think you should do that. At least that's not what our studies show.
So are we going to be measuring blood sugars? We're going to be measuring them at regular intervals but we're going to be doing it not by like finger stick blood job but we're going to actually have them come in and get blood drawn. At that point, we're going to measure blood sugar levels and blood insulin levels and a couple of other hormone levels.
So we're actually going to be storing all the blood up and then we're going to be measuring all of these.
Chris: Have you ever seen… how well do they correlate? Like just the cheap meters you can buy from any drugstore and the type of lab equipment that you use, are they even in the ballpark, in terms of accuracy?
Lynda: For blood sugar?
Chris: For blood sugar, yeah.
Lynda: Oh, yeah. No, they're very good. I mean our ability to measure blood sugar using simple assays is very good. So yeah, those little blood glucose meters, yeah, they would correlate with the lab.
Chris: Okay. That's good news. It still shocks me how easy it is to measure and I'm obviously not the only one because many people I talk to, I say to them, "Oh, you just buy one of these meters for seven bucks from Amazon", and they're like, "Really?"
Lynda: It's not the meter that's expensive, it's those little sticks --
Chris: Those strips, but even --
Lynda: Those strips are past a dollar. If you're a diabetic and you're doing all these blood tests, four, five, six times a day, the cost is outstanding.
Chris: Yeah. No, maybe that's just me. I didn't think they were particularly expensive but the ketone strips are definitely expensive. I agree with that. I thought the glucose ones were quite cheap.
Lynda: Well, I mean, each strip is about a dollar. So if you're measuring your blood sugar once a day, that's 30 bucks a month. But if you're measuring it frequently, like some diabetics need to, the costs for the strips alone is very, very high.
Chris: Okay, yeah. So I've got 20 bucks for a 100 here. It's not bad, is it? But yeah. Interesting.
So what's the grant's plan then? What would happen if the Paleo diet turns out to be a really good treatment for PCOS, how could you actually make that work for people in real life, like how's that going to help them?
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How'd you get the message out there is what I'm saying.
Lynda: How do you get the message out there?
The reason that we're doing this as a research project is because we really want to be able to publish in a medical literature with a really well-designed research study that in fact, we can show this. Because we need to be able to prove, not so much to lay people like scientists and other doctors, that this is a reasonable approach and the only way that scientists and doctors are going to believe us is if we do these well-designed research studies.
And if we can show this, then we actually have proof. Like we're not just saying, "Oh, I put somebody on this and they got better." We can say, "We tested it against the gold standard which is the diet that the American Diabetes Association believes is a good diet" which is sort of like this typical healthy ADA diet is very similar to a Mediterranean diet in many respects. That's the diet that most people feel is like really a good diet.
I actually believe that both groups are going to get better. My personal belief is the Paleo arm might do better. But in our last study, both groups got better. So it may simply be that if people were actually to follow a good diet, that would be really helpful. I have to say that following a good diet is really hard to do and that's actually why I started learning doing behavioral modification and learning stress reduction techniques and now we teach a course at the University to medical students and graduate students.
Because, really, everybody's life is really stressed out and if you're really stressed out, it is really hard to do something like follow a special diet or do your exercise. Really you want to do something that makes you comfortable and typically, following special diets are not going to make you comfortable. It's something that you have to work at.
And so we then get to the "This is what I tell you to do", and then the last part is "And here are some tools for helping you being able to manage your life a little better so you can do this."
Chris: Yeah. I think you can work it that way actually with a dialogue and I've seen and I've definitely experienced it myself. It can be quite stressful when you know that you should be eating certain foods and that you can't because you're in some environment, so travelling is a classic one. And actually, where we met at AHS was like quite a difficult three days for me. I'm still eating an even more restrictive subset of the Paleo diet called the [0:33:14] [Indiscernible]. I've added a couple of things back in.
When you couple that with the fact that I'm also trying to be in ketosis, that's a disaster for eating in a restaurant, right? There's practically nothing I can eat and I think that that in itself could be quite stressful, too. I think it's something maybe worth considering as well, like when you say to people, "Oh, you can only eat this" and that itself could be a stressor.
Lynda: Yeah, I completely agree with that.
So most of the time for most diets, when you do research studies, you help the people get 85% or 90% compliance with what they're doing. You'd wish for 100% but I think that's unrealistic. It's kind of like well, "If it's your birthday, can you have some chocolate cake?" Sure, if you want. A piece of chocolate cake is not going to destroy your diet. But that's not what we want you to eat all the time. So if you can do it most of the time, do I think that that's better than never doing it all? Yeah, yeah. Absolutely. I mean, for the real world, not so much for research studies when it's kind of like, "Yeah, you got to do this and you got to do that."
Chris: So tell me about your stress reduction techniques? I've become sort of mildly obsessed with the work of Robert Sapolsky and his ideas about stress. It makes so much sense to me and it's the one thing that I see in common with every single person that I talk to; they have too much stress. The thing that's really interesting about it is if you're a surgeon that's doing CrossFit, then you have lots of obvious stress. And if you're maybe a housewife whose kids have grown up with no financial worries, then the stress is less obvious but it still exists. You just invent new things like "I've got some visitors coming and the house isn't tidy." Humans are really good at self-imposing psychological stress.
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And so it's something that's in common with everyone and then so what you do for reducing stress? What are your favorite most effective techniques?
Lynda: So I work with a woman called Laurel Mellin who's a PhD Researcher at UCSF and she's developed something called Emotional Brain Training.
So it's kind of like mindfulness therapy but with more of an evolutionary component to it which says that you need to understand emotional responses in order to be able to better understand and get rid of or at least have more control over how you respond to things.
And what this basically says is that if you're in a really good state, you generally tend to work with the cortical part of the brain. And that's just the rational part, this is where you can make logical decisions, everything is great.
But if you are completely stressed out, you're not able to use that part of your brain. You actually respond to sort of like lower emotional-based levels. And so then, when you're completely stressed out, you can't deal with anything, like "I don't want to listen to his, I can't hear this, go away."
So at that level, you're not going to be able to say "Well, I guess I should go and eat, I should eat this much food, this or that." so the first thing you need to be able to do is deal with that "Ah!" state. Being able to get rid of the complete panic, sort of like you just got off the phone where your mother is like bothering you for the zillionth time about whatever it is she's bothering you about and you immediately are kind of like "Rrr", like you just can't deal with anything right now,
And so when you're like that, you need to also be able to deal with that level of stress. And then there's like levels in between. And so what Laurel has done with the help of a neurophysiologist named Igor Mitrovic who's also at UC, is they've developed these tools for handling different levels of stress with the idea being that if you can handle these different levels of stress so that you can actually get to the point where things are great.
And then the whole idea is try to spend more time in the "Things are great" range as opposed to the "I can't stand it anymore" range which was me. When I started this, it's like eight, nine years ago now, I was pretty much always in the really grumpy irritable stage. And so now, after a long time, I've managed to actually work up into the more or less "Things are okay" range, more of, which I consider to be an incredible improvement over where I was before.
Chris: Yeah, absolutely. I'm sure you'll live a longer and happy life first from what I've understood. I think it's important to remember that you haven't changed anything like outside, like you still have all these stresses that go on in your life. I don't know whether it's still people calling you up and annoying you or not, but you can't really change that stuff. It's the way you respond to it that's changed.
Lynda: Exactly, that's exactly what it is. It's not that the stresses has changed, it's that my ability to cope with them is changed, and the more you're able to cope with things, the more things you're actually able to do.
For example, this crowd funding thing. I mean years ago, I would never ever have been able to ask people for money to be able to help run our studies because if they said "No" I'd just be kind of like "Oh, they hate me. I can't do this."
So now I can at least say, "Well, it's not me that they hate. They just don't want to donate money" and that doesn't stress me out as much. I mean really it gives you a better idea of how to deal with your -- I mean, who are you or who am I and how do I cope with things? And even though these are my coping strategies and this is what I've used for all my life, like maybe that's not the optimal coping strategy, like maybe there's a better coping strategy.
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And so I'm very, very impressed with Laurel's work, Laurel and Igor. I mean they really came up with what I consider to be an amazing way of trying to help with that which incorporates a lot of other strategies, too. This is not a new strategy. This uses a lot of… well, Laurel can explain better than me. It uses attachment theory and cognitive behavioral modification to try to come up with a better way of learning about yourself and being able to handle, being able to recognize how you deal with stress and maybe coming up with a system that maybe is a little bit more effective in terms of actually dealing with the stress.
I don't really want to go into this in a lot of detail but I think a lot of people have problems in that they try not to deal with stress. They try to avoid it. At least I tried to avoid it all the time. And that is not a very effective thing to do because the stress is still there and now you spend all these time and effort trying to avoid it.
So it's more effective to be able to deal with it but in order to deal with it, you have to be able to get around all of the mechanisms that you're using to avoid dealing with it which is sometimes really hard to do.
And so if you can learn how to deal with things more effectively and make you a happier person, I mean that was sort of my goal -- well, it wasn't my goal when I started it. It's my goal now to kind of be a happier person for the rest of my life. And if I can do that, then I can also follow these diets a little bit better because I'm more motivated, I'm more able to do it. Not even motivated, I'm more capable of doing it.
Chris: Yeah, absolutely. I think it makes you more capable of doing a number of things, actually. So my interest in it was, as an athlete, reducing stress in the ways that we've just been talking about, gave me greater capacity to train. I could train harder. I see all of these things, they come out the same stress budget so anything you can do to lower it makes you a better athlete.
Lynda: You can do whatever it is that you want to do actually. I actually agree with that. But it's really hard to do stress modification just like it's hard to do a real diet, it's hard to do behavioral modification.
And diet modification, like really lifestyle diet modification is really, really difficult. I mean probably anybody could do anything for a week but if we're saying, "Well, this is the diet that I think you should eat for the rest of your life", you're kind of like "Ugh".
Chris: Yeah, definitely. I mean that's one of the beauties of the Paleo diet is… So my sister, my oldest sister is just having this revelation right now. She's tried a number of things in the past that worked for the period that which she did them but then of course, she goes right back to where she was and maybe then some as soon as the diet ends. It's almost this programmed failure. And then each time she goes into something, she's kind of reluctant because she knows it's not going to be that much fun. But I guess in the past she;s thought "Well, at least it's only for a short period of time."
And now she's just doing it's called the Whole 30 Program. It's another version of the Paleo diet, it's like a Paleo reset. It's quite strict for 30 days and I think it then relaxes some of the rules after that. The thing that she;s loving about it is that she;s realizing this is sustainable. This is not something I have to do for 30 days and then give up. Not only is it showing results but it's also like "This is something I could keep doing forever" which I think is really important.
Lynda: Well, I mean it's critical. If all you're doing is thinking to yourself, "God, I can't wait till this is over so I can eat some ice cream", you're doomed to fail. It can be very hard, you know.
Chris: Yeah, it is hard.
I wanted to ask you about this whole idea of crowd funding research which it was fairly new to me. I had not heard of it before when I saw your campaign. And I'm now starting to wonder when you think about the way the research is currently funded, I think a lot of it comes from huge companies that have a financial interest in the development of some molecule that they can hold a patent to which can make the money for N number of years. And obviously, with something like the Paleo diet or any of these lifestyle interventions, there is no molecule, there is no patent, there is no way that you can specifically make money off of this. Nobody's going to get rich writing books about the Paleo diet.
What do you think about this new way of funding in the future? Do you think this is going to be something we're going to be seeing more of?
Lynda: I'm sure we are because I don't know how much your listeners know about research funding. But really most research funding comes from the government and over the last decade, the government has been funding less and less research.
[0:45:08]
And so that only leaves the few other alternatives. So industry, okay, and you're right, they're not interested in funding diet research; or foundations like the American Heart Association. And as the government has funded less and less, these foundations are being more and more overwhelmed by people asking them for the money so it's getting harder and harder to get these foundation grants. Or you know somebody really rich like Bill Gates who's just going to give you the money to do the study.
And that was it up until just a few years ago. Those were the sources of funding for research. And so now this is this idea that -- I guess Ross Perot actually came up with it for political funding -- is to try to get money from lots of little sources as opposed to tens of thousands of dollars from one big source. So I think that this is going to be as the funding sources dry up or become more and more specialized like specific drugs or whatnot, you're going to see more and more people turning to crowd funding as a way to try to get money to do the study.
Chris: And do you think yours is likely to be successful in meeting the target and what would happen if it doesn't meet the target?
Lynda: Right. So I don't know if we're going to be able to meet our target or not but we're certainly hoping to get enough money to be able to start this study. And then hopefully, if we have money, we can actually apply for grants and say "We have some of the money, we just need a little bit more money to finish off the study."
So I don't know whether we're going to meet our goals or not. Fortunately, through UCSF, it's not like kickstarter where if you don't meet your goal, you don't get any of the money. Fortunately through UCSF, we get to keep whatever it is people have donated so far which is terrific so we're quite pleased about that.
Chris: Excellent.
Okay. Well, thank you so much for your time today. Can you tell me a bit about where can I go and find out the URL? Our link to this in the show notes. Where can I find out more about the study, is this on crowdfund.uscf.edu or is there anywhere else?
Lynda: So that would be the easiest way to do that or you can Google it if you do my name which is Frassetto and Paleo and PCOS, it should come up actually so…
Chris: Excellent! Okay. Well, thank you so much for your time today. I'm really hoping this is going to be successful. You're about a third of your target right now.
Lynda: About, yeah.
Chris: And it's not even that much money, is it? Not really when you think about it, $40,000. I mean you can't even buy a particularly nice car for that amount of money, can you? Yeah, this could be some quite profound life-changing research for many, many people. Eight million people we said were affected so yeah, this is huge.
So I really hope it works for you and I'm definitely rooting for you.
Lynda: Okay. Well, thanks a lot and thanks for asking me to do this podcast. We've been really, really pleased with people asking us to try to help get the word out so we really, really appreciate your doing this for us. I mean, it's really been terrific. So thank you so much.
Chris: Okay. Thank you.
Lynda: Okay!
Chris: Cheers then, Lynda. Thank you.
Lynda: Bye.
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