Tommy Wood weight loss transcript

Written by Christopher Kelly

Aug. 31, 2017

[0:00:00]

Christopher:    Hello and welcome to the Nourish Balance Thrive Podcast. My name is Christopher Kelly and today my very special guest is Dr. Tommy Wood.

Tommy:    Hello.

Christopher:    We are in San Jose at the moment. We've been recording for the Mind Pump Podcast and we thought we'd record another podcast since we were together in person and it's just something that doesn't happen very often. We are outside on the grass with our outdoor broadcast mike. I hope this is sounding good to you. We are going to talk about the most reliable way to lose weight. How about that, Tommy? How do you feel about that topic?

Tommy:    I feel both good and nervous about that topic.

Christopher:    Okay. I wanted to start by being really specific about who we are going to address this problem for. I think it's very important to be very specific about who we're going to talk about. And we've got three different types of examples that we're going to talk about today. The first is a very competitive elite athlete, and then the second is myself and some of the adventures I've been on with weight gain and weight loss recently, and then the third is another female but this is a very different sort of female that's got maybe a little bit more weight to lose. In fact, she definitely has more weight to lose. She's got maybe 35 or 40 pounds to lose.

    And so we see all of these people quite regularly. I don't want to single anyone out specifically but at the same time if I'm not specific enough, I think that we're talking to no one.

Tommy:    But it's like a set of patterns that we see regularly.

Christopher:    A set of the common patterns that we see regularly. So, why don't we start by just a general discussion of problem solving? I think this is super duper important. Any time you go to solve a problem you have to understand what caused the problem. If your problem is unwanted weight gain, the first thing you have to understand is--

Tommy:    What caused the weight gain in the first place?

Christopher:    What caused the weight gain in the first place? And so I just talked about this nice example that, I think, the cyclist will understand and I talked about that on the Mind Pump Podcast. But let's say you're a cyclist and your tire goes flat and you suspect there may be a thorn stuck in the tire. Well, you can't just rip out the inner tube and shove a new one in and hope for the best. Because the chances are, that thorn is still stuck in the carcass of the tire somewhere and it's just going to give you another flat 200 yards down the road and you then won't have a spare inner tube and then you'd really be screwed and you'd be phoning Julie looking for a ride home.

    And that's true. There's many, many examples of this in life, that if you do not understand what caused the problem then it's just going to happen again. Maybe you'd find some way to hack your environment temporarily or your diet temporarily and that will give you some weight loss. But it's not going to work in the long time. Whatever you do, tell me to agree, it has to be sustainable.

Tommy:    Yeah, definitely. And we know lots of people and there's loads of success stories, anybody can find them out in the internet, in terms of applying some training program, applying some diet and you get short term weight loss, and that's been shown very, very well. But it's creating something that's sustainable, that is what most people want. So, maybe you want to look a certain way in three months because it's beach season, but that's different from trying to find the weight loss and the health that's going to continue into the future.

    In order to do that, you need to understand what it was that caused the problem in the first place so you can put a short term Band aid on it and you get maybe the results that you want for the short term. But for anything that's going to be sustainable you have to look under the hood and figure out what it was that was the issue.

Christopher:    Super important. Okay. So, let's dive into our somewhat specific type of example and that is of the elite female runner who is flirting with disaster with her current body composition but she's not pushed it so hard that she knows it can't go any further. So, let's say she maybe is even of a world class level. Her body fat percentage is somewhere in the range of 15% to 20%. She's seeing other girls at races who seem, in her mind, to be skinnier and she's wondering if she pushes things a little bit further would she be a more competitive athlete? Okay. I'll stop talking. What do you think about this, Tommy?

Tommy:    Yeah. So, this is coming into the point where we're talking about, sort of on the borderline of something like a true relative energy like deficit where you don't have all the nutrients you need to do all the functions that you want. So, something that we used to call or used to be called female athlete triad. And we know you can see something similar in men. They'll maybe stop menstruating and they'll lose bone mass. Those are the two things that you'd really see in kind of a female athlete who's sort of flirting with that very low level body fat and that kind of caloric deficit.

    And the real problem that we get into is the fact that we know of many people who, so, say, females, once they get their body fat into the single digit range, that's when they perform their best. They lost their period. Maybe they had some other things. You could measure their hormones and they're absolutely in the tank. But that's when they were going fastest.

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    And this becomes a real issue because if you're an athlete who is having to pay the bills and the sport pays the bills your performance is what means that you can still eat, right? Then you're working very hard for a specific performance goal but that doesn't necessarily mean that in the long term that's not going to cause some real issues. The first thing you have to do is think about is my performance so important that I'm willing to sacrifice my long term health? And many people will do that and that's just an important decision that they have to make. But when people are saying should I be losing more body fat to get better performance, that's where you really have to stop.

Christopher:    Yeah, it's really important. So, let's say this person is making money running but they still have their periods. Do they go the extra mile to get down to ten or maybe even sub 10% body fat in order to be a more competitive runner? Would you be willing to help someone achieve that goal?

Tommy:    Yes, but it requires the conversation up front. Because there's two parts of it. You could lose the extra body fat. You've lost the extra weight. If we're looking at power to weight ratio, that may well increase if you manage to maintain your strength or speed or power at the lower body fat percentage. And so, yeah, you may well go faster. But equally, you may not because you may get to a point where you trash your body so hard or you've reached a certain point where you're not getting the performance gains maybe because you've lost the extra body fats. So, you're not getting those benefits.

    You have to start with that conversation up front. It's like, yes, there's a possibility you may get better for it but you may also get worse. But if somebody turned up and said, "In the short term, it's really important to me that I achieve this goal so that I can potentially go faster so I can potentially have the income that I can set myself up for in the future, I'm willing to take that risk," then fine.

Christopher:    Short term sacrifice.

Tommy:    Yeah, short term. But you have to know that up front. You have to have that conversation.

Christopher:    Right. Know what you're getting into there.

Tommy:    Yeah, absolutely. I mean, you can probably achieve it and there's certain ways you can sort of overcome some of the body's potential adaptations that sort of tries to fight that weight loss, you can do some of that stuff, but you just need to be frank with that conversation up front. If that's something that somebody wants to do and they're willing to take that risk, then you can probably help them do it as safely as possible and see what happens. But you never know what the long term risk is going to be.

Christopher:    Right. And I'm talking about it like it's certainly going to be a performance advantage but I don't know that with certainty.

Tommy:    No. You just don't know that. I mean, you can definitely look at -- This is the problem. You're comparing two different people. Genetically, they're different. Environmentally, they're different. They may have slightly different body compositions. That doesn't mean if you got one person to the body composition of the other person they would then perform better. You can't know that with any certainty.

Christopher:    Right. And then so how do we do it then? Let's say that we've made the decision that my running is paying the electricity bill and I really need to bump up my performance, my body fat is somewhere in the region 15% to 20%, I think I can get it lower, let's say I'm already eating minimally processed real foods diet. It's a mixed diet that includes both carbohydrates and fat and an adequate amount of protein.

    Say I'm sleeping well at night. I'm doing resistance training. I'm ticking all of the boxes that we've been talking about on the podcast over the last four years. Where do you stop pushing this to the point where it could be detrimental but maybe has some performance gains?

Tommy:    So, one thing that you're going to have to, particularly in this kind of person who is going to be training really hard, one thing you have to overcome is that loss of non-exercise activity. Thermogenesis, right? If you're, or NEAT as some people call it.

Christopher:    Yes, you better explain that before you go further.

Tommy:    Yeah. They've done some nice modeling in this recently. They basically show that after a certain point of exercise activity, if you burn more calories, and I do that with air quotes, if you burn more calories then your body will adapt by burning less later. And it's often stuff like the subconscious movements you don't know about. So, could be tapping your toes, just moving around. You just don't feel like moving as much so maybe you sit still for longer periods of time. It does that to try and maintain some kind of caloric balance.

    So, you can overcome that slightly if you're very conscious about it. So, continuously moving, walking frequently. So, you don't need to be exercising extra but you could always add in that barrier to staying still is going to give you, like prevent some of that auto regulation, which means you move around less.

Christopher:    Right. That's a real tough one. I must admit that I wasn't terribly aware of this until quite recently. But, I think, most endurance athletes, they're listening to this podcast, will recognize it.

Tommy:    You go out and you crash yourself on the bike, say, for three hours and you get home and then you just sit.

Christopher:    Motionless.

Tommy:    Yeah. Completely motionless for the next 21 hours of the day because your body is just trying to conserve as much of that energy as possible.

Christopher:    Yeah. I've always wondered. A lot of guys go out on Saturday, and girls, go out on Saturday mornings because maybe that's a convenient time to get a ride in before the rest of the family are up. It's the classic Saturday morning thing [0:10:07] [Indiscernible] before it's even light out.

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    And then you go crash yourself for three or four hours. And then I wonder what exactly those people are doing with their family after they get back from this soul crashing ride.

Tommy:    They're completely comatose for the rest of the day. They're barely present.

Christopher:    Exactly. Yeah. So, they're sort of there in body but not really there in mind. This is a tricky one. So, we talked about anything that you do need to be sustainable. And I'm not sure this is sustainable because you're using conscious willpower to move your body when some part of your brain is telling you to do the opposite.

Tommy:    Yeah. I mean, again, this is the point where we're going outside of, say, normal physiology. And, I guess, it's protective. So, if you do all the stuff that you're doing in terms of like ensuring adequate circadian rhythm, sleep quality, food quality, all that kind of stuff, making sure gut health is good, that's something we talk about a lot. If you're doing all of that stuff, you're obviously sort of protecting yourself better from some of the maybe non-physiological things that you're trying to do.

    But you can also build this in as -- It just needs to be a habit forming. You need to create these habits. So, if you need this to be sustainable, if we're talking about the elite athlete trying to gain short term performance for just like a year or two, maybe because of their job they're willing to use conscious willpower for that length of period of time to just get it done. But finding ways to move more frequently throughout the day.

    So, I mean, it could just be taking stairs, walking all the time. It could be sort of like greasing the groove in terms of exercise. There's people who are like every hour they just like do a couple of push-ups or whatever. Like Robb Wolf has a dead lift bar in his garage. He just goes out and does like one dead lift every hour or a couple of pull ups. Neither is particularly taxing and none of it is actually truly forcing body [0:11:45] [Indiscernible] but you're continuously moving. You can build those habits in and then it becomes -- If you can get to the point where you don't need to use willpower that's definitely going to be less taxing on the brain because we know that willpower is--

Christopher:    Limited resource.

Tommy:    Yeah, it's a finite resource. If you're using all your willpower to make sure you're moving all the time to try and maintain this caloric deficit that you're trying to create in order to lose this weight then you're going to have less willpower in the rest of your life and that could be in terms of your food choices or in terms of like how you deal with other people in your life and other stresses in your life.

Christopher:    Or your professional life.

Tommy:    Yeah, absolutely. And so then you could -- Those stresses come in elsewhere. So, if you're somebody who can, as a professional athlete, everything--

Christopher:    [0:12:25] [Indiscernible] This is your profession.

Tommy:    This is your profession. Everything you do is dedicated to that goal. So then that's fine. But if you're just an average person, you have a family and a job and all this stuff then creating the habits such that you don't have to use willpower is going to be much more important.

Christopher:    Okay. And would you bother counting calories?

Tommy:    At this point, I probably would. Yeah, I would. And I think -- Especially if we're going do it over -- Try and do it more gradually over a long period of time. I would definitely cycle calories up and down. So, maybe there's a period, a couple of days where you create more of a deficit and then you allow some more to come back so then you're not going to get this dramatic -- Because as we know, we talk about turning down the thermostat, right?

    So, if you're not eating enough calories or enough food, just to cover all the work that you're doing, eventually the body just adapts by turning down metabolism. We see that in a drop in terms of TSH. And thyroid hormones. And then also some of the anabolic hormones because we know that you're just not going to invest those building projects because you just haven't got the energy.

    So, if you cycle calories up and down, you're going to prevent some of that. You're going to prevent some of that adaptation. You could come back to like the fasting and feasting can still be important. And you still want, occasionally want those anabolic signals. You want to recover better from some hard training sessions. So then you kind of have more calories and then you can bring deficit back down and then you can still get the benefit of those. If you're constantly restricting, your body's going to adapt to that.

    And you can do it. People could just be in a caloric deficit every day and just push, push, push. For some people, that works as well. But if you're going to do it, hopefully, a slightly more sustainable period then the cycling calories up and down. At this point, your diet is going to be fixed. You know what you're eating and then you know that you can eat less of it. At that point, if you know, if your diet doesn't change, if you eat less of it you're going to have fewer calories, so then you cycle up and down.

Christopher:    Okay. Could you be any more specific about percentage of calories that you would cut over time or anything like that?

Tommy:    Not really because it will sort of depend on the person. But, I guess, we're talking maybe like 10%.

Christopher:    Okay, 10% to 20%.

Tommy:    10% to 20%, and then maybe that comes back up 10% to 20% the other side for a couple of days.

Christopher:    Right. And we can't really know. I mean, so you've talked about this before but it's worth reiterating because it's such an important point that we cannot know exactly how many calories are in the food that we take.

Tommy:    Yeah, absolutely. You cannot rely on the calories that says on the back of the packet or the calories that it says on MyFitnessPal or whatever because the way that those are calculated are just so inaccurate. But if you have a fixed diet and a lot of athletes by the time you get to where you are you know exactly what you're eating and how much of it because there's a certain type of diet that's supporting your performance in the way that you want to perform, and then you know you can manipulate up and down from there.

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    So, even though you don't know exactly how many calories are in there you can still manipulate up and down just because you know how much you're eating already, if that makes sense.

Christopher:    Okay. And then are there any other hacks you can think of that you would use to try and to push this process?

Tommy:    I think, if you have your fixed training, everything else is fixed and then you're preventing down regulation of NEAT and you're manipulating calories, that's probably all you need to do. Because if you're going to do anything more than that then you're kind of getting into pharmacological. You could prevent the decrease in thyroid hormone by supplementing. You can prevent sort of the decrease in sex hormones by supplementing. And then we're into kind of like the doping realms and we don't really want to touch it.

Christopher:    Yeah. No. That's not really…

Tommy:    That's not something I'm -- In reality, that's not something I'm going to help you with.

Christopher:    No. Exactly.

Tommy:    You have to find another coach.

Christopher:    Yeah, of course. And then if you're a professional athlete you're not doing that anyway. So, that was the stated case.

Tommy:    Supposedly. That's what we like to think.

Christopher:    And I don't want to imply that any different, we have any other information, because we absolutely do not.

Tommy:    No, no. There are people who could help you do that stuff but we wouldn't help you do that stuff.

Christopher:    Well, that's good. All right. So, I'm still a mountain biker. I'm still really active. I'm still racing my bike on a regular basis. I'm still racing pretty much at the highest level. I raced mountain bike races at the beginning season as an age grouper because I was bored of getting beaten up in the pro ranks and I finished fourth in the age group. If I had entered into the pro category, I still would have been fourth. So, I thought I could beat up on the age groupers and maybe cheer myself up a bit. That, of course, didn't work. What else have I done? I've done some really long gravel grinder events and--

Tommy:    What does that mean?

Christopher:    Gravel grinder. I'll explain that. It's like a mixture of road and off road. So, you ride a cyclo-cross, I rode a cyclo-cross bike that's got wide tires on it. They're actually mountain bike wheels, cross country mountain bike wheels on there. It's got disc brakes. It's actually a Santa Cruz Stigmata, really good bike. And then this was -- A race in particular I'm thinking of was the Belgian Waffle Ride. It was really a good fun actually. Really, really good fun.

    The road is in Southern California, did not know how to handle dirt and I really enjoyed that. The first section, it was like the opening scene of Saving Private Ryan. There was like bottles and people and bikes just exploding going everywhere. It was really fun. So, yeah, definitely not earning a living from riding my bike but I still care about performance and my body composition.

    My story is that I've been 152 pounds for most of my adult life. I think I was a bit heavier when I was around 18, when I was doing a lot more weight training. And then I kind of backed off on that and just returned to 152 pounds. That's where I've been my whole life. And then I went on to the keto diet and I lost a shit ton of weight and with it a bunch of my power. And so that wasn't a performance advantage. I dropped down as low as 138 pounds and I was like super skinny but really quite Froome, which is maybe a good rider.

Tommy:    He literally did just win the Tour de France.

Christopher:    Yeah. So, maybe that's a good thing, I don't know, to be Froome. So, yeah. But I lost a lot of power. I don't think it was very good. It didn't look very healthy. I didn't look very good. And then without changing my diet, I started to put the weight back on. And then eventually, I overshot where I originally began and got all the way up to 162, maybe even 164 pounds, without changing my diet or exercise or anything else that I really knew about.

    And now recently it's spontaneously gone back to 152. Maybe it's not spontaneous, right? So, we said at the beginning, solving any problem requires that you understand what caused it. Maybe I won't get to know what caused it. That sometimes happens, right? You get a flat tire in your bike and you just have to, "Okay, I don't know why this happens. I'm just going to shove a tube in and see that hopefully it's okay." Maybe that's the same situation here. I have a number of ideas of what might have changed. So, one thing that changed was my diet. I reintroduced carbohydrates into my diet. Do you think that might have had an effect on my weight at all?

Tommy:    I mean, it definitely could have done it. It's surprising that -- So, you add in back some carbs and then actually lost some weight, right? You lost about ten pounds.

Christopher:    Yeah. So, that's I'm right back to 152 pounds again.

Tommy:    There's definitely some projects that could potentially require some carbohydrate. Maybe you needed that a little bit for gut health, for thyroid regulation. Your thyroid has been all over the shop.

Christopher:    Oh, yeah. It's been a little wonky. On keto, it didn't look good.

Tommy:    Some insulin can definitely help with regulating thyroid conversion. So, it could potentially be that your thyroid health is better with some carbohydrates. And [0:19:37] [Indiscernible] to play that. So, if people have autoimmune thyroid conditions, sometimes they do better on low carbohydrate diet. But going all the way down to keto, some people thrive and their thyroid looks great. But yours definitely looked a bit--

Christopher:    On paper, really wonky. In real life, I didn't have any symptoms. But I think I have done in the past. So, one of the reasons I gave up kiteboarding was, A, I had SIBO.

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    Like try putting -- You wear this harness when you're kiteboarding. It's like this big belt that you put around you. And then you have to really cinch it down tight because you're attaching the kite to that. And when you've got a belly full of gas that does not feel good. When you're in a wet suit and you're worried you might shit your pants and like there's no bathroom and you couldn't even get the wetsuit off in time even if you want to.

    So, that was one reason why I think I started kiteboarding less or it became less fun, at least. And then another one was here in Santa Cruz, the Pacific Ocean is very cold. And even with a 5-mm wetsuit I'd be freezing after even 30 minutes. And other people, they'd be just fine all day long out there in the Pacific Ocean. I'm sure that was due to some thyroid abnormalities that since went away.

    Okay. So, I reintroduced some carbohydrates. But other than that, I didn't change my diet. And if you want to know what I'm eating, it's available on our website, actually. You can come to either the front page, scroll all the way to the bottom, or you can come to the show notes for this episode and there's a little box on the right hand side and you can download a PDF ebook that Julie put together in 2014 that describes, in pictures mostly, there is some writing, what we're eating. And really, that's [0:21:10] [Indiscernible].

    Yeah, we went from a whole foods, mostly plant based Paleo type diet, no gluten, no dairy. We are eating some seeds, nuts, nightshades, quite a lot of fat but not crazy, some carbs in the form of sweet potatoes, other root vegetables, and that is the exact same diet we're going back to. And Julie wasn't very happy about it at first because cooking sweet potatoes when it's 100 degrees outside in the oven is like really not much fun.

Tommy:    But, I think, this comes back to like the really, really crucial point and it's something -- I may have said it a few times. Maybe we should say it some more times. It's that when you're talking about just average body fat loss, if you have excess body fat and you're trying to lose that body fat, one of the most important things is to get back to something that allows you to maintain normal appetite regulation and normal caloric control.

    Your hypothalamus and [0:22:00] [Indiscernible] but some other areas of the brain, they are there as well as various other physiological processes in the body, but one of the things it measures is basically caloric and energy balance. That's what -- It detects and then adjusts accordingly, intake versus output. If you are doing lots of stuff that's confusing that and that could be some kind of systemic inflammatory process, it could be the types of food that you're eating, it could be any number of things, if you're outside of that environment, and this is where we go back to the root causes, if you put your body back in an environment where it's able to control its hunger cues properly and actually have access to real food we call them like you're eating, it would just happen naturally.

    So, one of those things is you've gone back to putting your body into an environment which it is enjoying such that it can regulate calorie intake and then all of a sudden you spontaneously reduce those ten pounds you just lost because you're not confusing it, if we want to call it that, with something which removes it or removes the ability for it to--

Christopher:    Self regulate.

Tommy:    To self regulate. Exactly.

Christopher:    You're just reminding me that, that we should also talk about where this fat is. So, back in the day when I was really quite sick and I was incredibly lean according to skin calipers, I could remember my coach trying to take a pinch of skin on my arm and there being literally nothing. It was like tissue paper. There was literally nothing there to measure. And he just said, "I don't know." It's below threshold at which calipers could measure.

    And these extra ten pounds, I definitely had, I could get hold of a roll on my belly and it was, I don't know, maybe an inch and a half thick. I don't know. My point here is that it was visible subcutaneous fat. Can you talk about the differences between visceral and subcutaneous fat and the risks that they confer?

Tommy:    Yeah. So, there's broadly two kinds of depos of fat that we have in the body. So, the subcutaneous, which is that's what covers up the six pack, right, essentially. That's how you know. Or what might around your sort of ass and thighs depending on your body shape. And that's the stuff that visibly people don't like but actually it's fairly benign.

    If you are somebody who is able to put on some subcutaneous fat that may actually be a good thing. It's probably going to be protecting you from some degree of insulin resistance because you have this depo that can expand and contract based on needs and caloric intake and other things. And actually having the ability to do those is actually very good for you especially for your long term metabolic health. This is part of the reason why I think they call it the obesity paradox or whatever, that some people who have a slightly higher BMI have either greater longevity or better blood sugar control.

    I think it's just because their body is able to have that buffer which then means you don't have excess glucose or fatty acids circulating in the blood which is what actually causes a lot of the disease process. If you can use that store as it's meant to be used to expand when you need it to expand and contract when you need it to contract then actually that's a very healthy thing to have. Whereas the other one is visceral fat. And you probably think of a guy's beer gut. Right?

Christopher:    Yeah. And it's surprising. When a guy lifts shirt, you're like, holy shit, where was that?

[0:25:01]

Tommy:    And it's just like kind of this big dense -- If you poke it, it's hard. So, subcutaneous fat, you poke it and it's soft because it's right there under the skin. The visceral fat is underneath the abdominal muscles. It's inside the abdominal cavity. So, there's muscle on top of it. So, if you poke it, it's hard. And that's the really dangerous stuff for a number of reasons, and one of them being that it's not very good at holding fat in. And I mean, there's a high fatty acid turnover. So, it's constantly exposing the liver particularly to these fatty acid breakdown products which are then kind of forced into something like gluconeogenesis and then you have raised fasting blood sugar and then you're on your way to pre diabetes and [0:25:36] [Indiscernible].

Christopher:    Right. Inappropriate lipolysis.

Tommy:    Yeah, exactly. And so this fat which is usually associated with a lot of inflammation, it's usually very inflammatory, it's got this high turnover and it's insulin resistant and it's not storing fat nicely and keeping it nice and locked up. It's kind of continuously turning it over.

Christopher:    Recycling it.

Tommy:    Continuously recycling it, and then you're exposing the liver to that and that's going to be a lot of issues.

Christopher:    Sorry. I was just going to say that does make a lot of sense in my case. So, I remember the first time around I became diabetic, basically, consistently having a fasting blood sugar of 120 milligrams per deciliter. This time I didn't have any, okay, it's only ten pounds but I definitely didn't have a blood sugar problem.

Tommy:    I often worry about people who are trying to -- So, if you're very obese and you have, say, hundreds of pounds of extra fat that you need to lose, getting rid of those fat cells is probably going to be a good thing. You don't necessarily want those extra cells there. But I often worry about people who are already fairly lean, fairly healthy talking about killing fat cells. You talk about trying to get your fat cells to disappear and doing various things like thermogenesis techniques or other things you think of just trying to get rid of those fat cells.

    But actually, you want those fat cells. So, actually I kind of have this theory. I don't really have too much science to back it up. But having a subcutaneous fat store that is able to expand is actually going to be a good thing in the long term. Again, we go back to the example of lipodystrophy which is a genetic disease where you cannot store subcutaneous fat. And these people become insulin resistant very, very early because they cannot store anything extra. They just have no capacity for it.

    So, there is definitely some benefit of getting rid of excess fat even excess subcutaneous fat depending on how much, but having the ability to have fat, particularly subcutaneous fat, is actually probably pretty good for you.

Christopher:    Okay. That's really good information. Okay. So, the next thing that could be affecting this equation is my gut health which has not been stellar over the last year, if I'm honest. I did the BC Bike Race last summer and that was 700 guys from all over the world, chemical toilets, obviously a lot of racing, suppressed immune system from the racing, living out of a van. You can imagine this is like a pretty good place for something to go wrong.

    And it was actually okay at that time. I had a really good time at the race. No problems there. And then my digestion just sort of start getting a little bit iffy after that. And so I did some stool testing and I found Blastocystis hominis, which is controversial. And the reason I say that is because there's some researchers that are looking at its role in both health and disease. So, I'm not sure. When I say controversial, it really depends on the context, right? So, iffy digestion, you did a stool test and you found Blastocystis hominis, I probably would treat that. If it's iffy, you went looking and you found something.

Tommy:    If you found it in a healthy person, it's probably part of their gut flora and you [0:28:18] [Indiscernible].

Christopher:    Yeah, exactly. I've looked through some studies. They're screening people in an airport and they're finding a surprisingly high percentage of people just have this thing as a commensal. Well, would you treat that in someone when you just screened them in an airport?

Tommy:    No.

Christopher:    Probably not. No. The other thing I found was Cyclospora, which is a lot less controversial. And you can go to the CDC website and look this up. It's just you need to go to your doctor and get some antibiotics, probably. And so I have been taking some herbal supplements to remedy that. And I've done a couple of stool tests. The first time I was unsuccessful in treating Blastocystis but that might have been because I self treated with some supplements that were not our standard protocol. I don't know why I did that. I'm an idiot.

Tommy:    Yeah. Because I remember we've talked -- I was talking about this and I was like, "What have you done? Have you done this?" Like our standard protocol. "Oh, yeah, no. I never really did that."

Christopher:    No. I just thought I'd try this other thing because it was kind of new and shiny and that's the thing that we use every day that works all the time. Let's try something else to see if that -- Why? I don't know why I did that. So, I did the standard protocol and my digestive symptoms were completely gone. And it's so weird to track these things because when you don't have a problem you don't think about it.

    When was the last time you thought about not having something in your eye? You just don't. You know what I mean? It really is like that. I sat here with my legs crossed up against my chest right now and I feel fine. And maybe when this was at its worst I wouldn't have been able to do that. I would have taken a position more open hip because you've got like gas and stuff in there and it hurts when you compress it. You just don't think about it when everything is okay.

    But I wanted you to talk about how this, some plausible mechanisms that may have led to some weight gain. And then in particular, we already said that maybe this was subcutaneous fat. So, perhaps it's just one of the less plausible of the explanations. Why don't you talk about some of the potential connections there?

[0:30:11]

Tommy:    Yeah. So, I guess, you had, the weight that you lost in this period of time, like part of it was subcutaneous. We don't know if you're losing it.

Christopher:    No. So, we don't know. I didn't do a DEXA scan. So, I don't know.

Tommy:    You didn't do a DEXA scan or anything like that? So, my guess would be that potentially it was a bit of both. I think part of it comes down to if you have some kind of chronic inflammatory process going on particularly in the gut and if you're irritating the gut then other things can come in that can then cause problems themselves. We know that if you're getting fully digested food products, you got increase in gut permeability or something like that. You may get some other things that are causing, coming through causing issues too cause you're not digesting completely or you're not keeping things out that you want to keep out.

    Then, I think some low grade inflammation. And this is kind of on the tissue level. We know a few things, and it's very similar to what [0:30:56] [Indiscernible] talks about in terms of inflammation from exercise and associate with atrial fibrillation is this inflammation is happening like, probably happening at the tissue level. So, if you measure it in your blood, you measure your CRP, it probably didn't go up, right?

Christopher:    Yeah, no. Not much.

Tommy:    And so, in like the general population, we know that having an elevated CRP is definitely associated with all kinds of cardiovascular diseases.

Christopher:    But we never see that.

Tommy:    But it's not something we see very frequently because it's this much lower grade kind of tissue level stuff. Or at least we're assuming that it's on a tissue level because we know that if we fix it we see the problems that, we see the problem reverse. So, we know that there was something going on there but it wasn't, at least on something like a CRP, maybe if we tested some other cytokines, something like that, then the testing is really expensive and maybe we could have tested for it. But we know what the issue is and we know we could fix it and then we see that it's better afterwards. So, this is kind of the balance of what you have just--

Christopher:    I try to correct myself there, that we do sometimes see elevated CRP. And then it's like high -- We were talking about this yesterday, right? High fives. When you see somebody with a CRP of eight--

Tommy:    You know you can fix that.

Christopher:    Oh god. It means they're still eating something they're really sensitive too. Or it's like something blaringly obvious that we can fix in two weeks. So, that's a testimonial on its way two weeks, you know what I mean? It's quite rare for us to see that.

Tommy:    But then there's some other stuff. So, one of the most plausible mechanisms in my mind is something like leptin resistance. So, leptin insensitivity. So, we know if you have some kind of inflammatory process going on then you're less sensitive to insulin, you're less sensitive to leptin. So, you're less able to regulate like those hunger and satiety signals.

Christopher:    Right. So, explain what leptin is.

Tommy:    Yeah. So, leptin, it's another hormone that's mainly released by body fat. It's the longer term. So, if you think you have two main hormones that regulates or tell your body how much energy you have around, insulin would maybe be the short term one and leptin is the longer term one. So, it's released by body fat stores. So, as your body fat stores expand then you have more and more leptin that tells the brain that, actually, we have plenty of energy we probably don't need to eat too much. That's kind of part of the longer term weight regulation mechanism.

    And they discovered it by some -- There's some people who had genetically caused obesity and then they're either, because they didn't have any leptin. So then you replace the leptin and they lost weight because they weren't hungry all the time. It's that slightly longer term regulation of satiety and body weight.

Christopher:    So, just explain that. Just summarize that. So, how does the inflammation interfere with leptin signaling?

Tommy:    Most probably like within on the cellular level and we see it because it's crossed out between the insulin and leptin signaling pathways. We know they're kind of -- They augment one another. So, part of insulin is to improve the signaling effect from leptin. There's sort of this kind of some cross talk so the two work together. And if you have some inflammation you seem to cause, basically, resistance within the cell. The activation of the pathway just delved down essentially.

    So, if you have some kind of inflammation there's some speculation that things like gluten antibodies or some antibodies against food intolerances or some peptide breakdown products, something like gluten, I think gluten is the one they focused on the most, that they can actually interfere with the leptin receptor. So, that may actually cause overeating. I think they've only showed that in vitro.

    So, they've shown that, say, some gliadin breakdown products can interfere with the leptin receptor and so if you are somebody who isn't digesting that properly and you have gut permeability and it gets across the gut, gets into the blood, then it's probably going to cross the blood brain barrier and get into the brain. So, the theory is that that could be causing some degree of leptin resistance too. Obviously, that wasn't in you and it hasn't been proven but there's a theory that there are other things in the diet, there are some reactions or some things that you absorb because you haven't digested them properly or whatever, that could also interfere directly with leptin signaling.

Christopher:    Okay. Yeah, I mean, it's definitely possible. I've been contaminated. I went away for a long snowboarding trip, do you remember, for Low Carb Breckenridge. That was challenging. Some of the little towns in Silverton you're going to, when you've got nothing else to eat. Actually, Paleo On The Go were lifesavers then. Paleo On The Go is this company where you can just order your meals online and they pack it on dry ice and it turns up via FedEx and they do deliver to hotel. It's fantastic. And if you got hotel with a microwave and you've got a Pyrex dish with you--

[0:35:00]

Tommy:    [0:35:00] [Indiscernible] microwave in a plastic.

Christopher:    Yeah. No. I carried a Pyrex dish so that I wouldn't have to do that. But, yeah, it was either that or be totally destroyed by the food at a local restaurant. But, obviously, I didn't go back to eating bread or anything like that. It was really, really hard to try and not be exposed. Okay. So, that's another plausible mechanism.

Tommy:    And so then the other side of that, so it could be a central thing. And then if you did have some visceral fat, there's definitely very plausible theory that when you have some kind of inflammatory process in the gut that the generation of visceral fats is partly there to try and plug the holes. So, if you imagine, we know -- So, say, in western populations who have some kind of insulin resistance, they also have greater levels of particularly both fasting but then particularly postprandial endotoxemia. So, the endotoxins from protobacteria in the gut which then activate various inflammatory pathways which then can also lead to insulin resistance themselves.

Christopher:    Okay. You better stop and explain that a bit more carefully because you used a lot of complicated words.

Tommy:    I used a lot of complicated words.

Christopher:    So, you said endotoxin. Explain an endotoxin.

Tommy:    An endotoxin sits within the outer wall of a gram, or the outer membrane of a gram-negative bacteria. People might have heard of gram negative, gram positive, and that's basically what color turns on a gram strain based on what the walls--

Christopher:    That's all it means.

Tommy:    That's all it means, based on how the outer wall and membrane of the bacteria is structured. And these endotoxins, and we talk particularly about e-coli because e-coli endotoxin is used experimentally to activate these pathways and to model sepsis and things like that. So, we inject endotoxin to people and it makes them really sick because you're activating the immune system and you can get exactly, it would look exactly the same as having a really bad bacterial infection because you've sort of activated those same pathways.

    Which goes to the point of when you're sick it's not the bug that made you sick. You feel sick because it's the immune system doing its job essentially. And so these endotoxins, they are almost certainly a big part of metabolic disease. And if you cause dysbiosis, you've got more of these endotoxins coming across the gut barrier associated with insulin resistance, type II diabetes, also obesity. And one potential theory is that if you've got more of this stuff coming across the gut wall and so every time you eat you're exposing yourself to this outside environment which is essentially within the gut. And so if the body is trying to sort of pack fat around the intestines, that's where visceral fat is, because it's kind of like there's this bad shit coming from the gut--

Christopher:    So, let's firewall this.

Tommy:    Let's try and put up a firewall. It doesn't really work. But one of the theories is that that's sort of parted the process, just trying to wall off some those bacteria. Again, I'm not really sure I have -- I couldn't give you a study that sort of proves this. But if you look at chronic low grade endotoxemia, experimentally you inject to mice or humans, you get a very similar pictures you would get in metabolic disease and you can create that kind of fat that you see, visceral fat you see in metabolic disease. It's all connected. And if you had some kind of chronic infection in the gut and it could be parasitic and you're causing other issues then it could be, again, you're sort of having -- It's enough to register a couple of kilos on the scale.

Christopher:    Right. It's so funny.

Tommy:    Even if [0:38:12] [Indiscernible].

Christopher:    I know. But isn't it funny how that's the one thing that everybody is concerned about? "Oh, I've put on four pounds." You hear an endurance athlete say that, "Oh, an extra four pounds I need to lose before that race." And really, I mean, the stuff that you've been talking about, who gives a shit about the extra four pounds on the scale? The potential harm that could be done from endotoxemia is--

Tommy:    Is much, much greater, yeah.

Christopher:    It's so funny the things that people worry about.

Tommy:    So, that might be the other side of it. If you have a little bit of visceral fat that was part of an inflammatory process in the gut and then that settled down, they're not--

Christopher:    It still weighs something.

Tommy:    That could have gone too. But there was definitely less of a problem than it was for you before because, again, you didn't look more insulin resistant again and that's what you would get with more of sort of visceral fat type picture. So, it could have been any balance of that. That may not have been the actual issue that you had, and it was more of a subcutaneous one.

Christopher:    But it's worth people knowing about.

Tommy:    Yes, definitely worth people knowing about because if you have insulin resistance, it's been shown very well that you have more endotoxins circulating. So, that doesn't mean it's fully causative but there is some interaction with your gut and you have a greater number of these inflammatory toxins floating around essentially and especially after a meal. And so if you are somebody who's still struggling with metabolic health despite fixing all those other stuff, maybe that's something you need to look at.

Christopher:    Yes. So, you're just reminding me of some of the guys I see riding around in Santa Cruz and they seem to be in really good shape. They keep up going up the hills. They're doing really well. And then you see them lift their shirt to dry their face off or something like that and then, "Holy fucking shit, this guy has gut like a proper big gut. Like where did that even come from?" It's really surprising. And so for those people they've probably got a fucked up gut. Like not just it looks fucked up. It's actually fucked up inside, endotoxemia, firewalled off, inflammation. Yeah. Super interesting. Okay.

[0:39:59]

    All right. So, that's the possible connection with the gut. Another thing that I thought was worth talking about loops back to what you were saying about the non-exercise associated thermogenesis, which is NEAT. So, there's this thing where you stop moving after you've done a heavy workout. And one of the things I've done in this time that I've lost weight is get a dog and the dog doesn't really allow you to do that.

    I've conditioned the thing already. Every time I push my laptop away, he like comes running across, nuzzling into my leg like, "Okay, now it's time to go out. Here's my ball. What are we going to do now?" And so, really, what's happened there is my environment has changed in such a way that the reduction in NEAT is less likely. It's very difficult to resist the dog when it's like wanting to do something and you don't really -- It's just a way to break that vicious cycle in a way.

Tommy:    Yeah. And it's definitely -- And it comes back, we kind of fight the calories in-calories out model because it's just cognitively it's very difficult to kind of do that in a sustainable way and in a healthy way. But in reality, that's exactly what happened. If you burn however many, you do have much exercise on the bike and then your body adapts the rest of the time to kind of balance out the energy expenditure, but if you have the dog then you can't do that. That's one way to kind of build that back in. So, that may have been part of it too.

    And what's interesting, actually, and this goes back to -- I wrote a short, a very short blog post about this that we can link to in the show notes -- but part of it was is the calculator created by [0:41:31] [Indiscernible] and sort of looking at calorie needs based on the macronutrient content of your diet. So, just assuming you need the same calories -- again, calories in air quotes -- even if your macronutrient balance is the same is actually incorrect because there is something called the food quotient which basically tells you the amount of energy you could produce for a given calorie, that changes based on macronutrient balance.

    So, if you're eating the same calorie level but eating a very high fat ketogenic diet, you may actually end up being in energy excess. And so we talk about the fact that the ketogenic diet is satiating enough when people spontaneously lose weight because they eat less. But for you, it could have been you got to a point where actually you were chronically slightly overeating on the ketogenic diet because at the same calorie level, if most of your calorie is coming from fat, you can actually end up in a slight -- And they see this. They're obviously like low carb keto guys and they've actually -- And Alex works with a lot of athletes and they see it sort of in keto athletes. They almost end up in chronic over nutrition because they know that they need to eat more because they're on a ketogenic diet so they fight the satiety thing and actually then they end up overeating.

Christopher:    You're kind of playing a dangerous game there by trying to second guess--

Tommy:    Yeah. It's super tricky. And that's the thing, is you almost can't second guess it.

Christopher:    You've got to rely on--

Tommy:    Yeah. But then the problem comes when -- and we see this all the time, is that people just -- So, they exercise at a certain amount, they're on a certain diet, they're just not hungry and they end up chronic -- They end up spontaneously restricting calories. For most people like out there in the real world who just want to lose weight then fixing all this other stuff that we talked about like fixing diet quality and moving some more and fixing the circadian rhythm and making sure you don't have any macronutrition deficiency and all that kind of stuff, that's what they need.

    And that maybe like timer-restricted eating so that it is eating less of the time or they're manipulating their macronutrition slightly so that they've got less refined carbohydrate, whatever. That's what the world needs. But then the people who end up coming to us are almost going the other direction. So, it's one really important thing, is knowing who you are in this scenario and where do you fit.

Christopher:    I know. So, that's what I thought. It's so important to be specific about who we're talking about.

Tommy:    So, just talking about weight loss--

Christopher:    Is meaningless.

Tommy:    It's completely meaningless unless you know who you're working with and who you are. So, the person listening to this, you need to know who you are and where you are on that scale. Are you just somebody who needs--

Christopher:    You have to identify.

Tommy:    Yeah. Are you just somebody who needs to eat a better quality diet and that's it? Maybe that's all you need to do.

Christopher:    I think most people listening to this, they already did that.

Tommy:    They've already done that, yeah, exactly.

Christopher:    It's kind of the first thing--

Tommy:    Yeah, yeah, absolutely.

Christopher:    That people try. There may actually be a circadian rhythm piece linked in with me getting a dog and that's because now the first [0:44:07] [Indiscernible] -- Yeah, like the first thing I do at dawn, I roll out of bed, I grab the dog and we go for a walk for 20 minutes. And I'm walking 20 minutes a day three times a day now. I mean, I suppose in theory that could be some contribution to--

Tommy:    In terms of like overall--

Christopher:    [0:44:23] [Indiscernible].

Tommy:    Yeah, maybe. Maybe like a couple hundred calories or something. Maybe that's also enough. You never know.

Christopher:    Yeah. Who knows? There might be the circadian [0:44:32] [Indiscernible].

Tommy:    That's one of the best bits of having a dog, is you wake up first thing in the morning and you have to go out.

Christopher:    Yeah.

Tommy:    The dog has to go out. You've got no option.

Christopher:    Yeah. Definitely. Okay. So, there's some plausible explanations might of what had been going on for me. Hopefully that's helpful to other people listening to this. If you're a masters endurance athlete--

Tommy:    And you've kind of -- So, say, two or three different things, the problems that you could identify in you and then those are the problems that were fixed. So, that's the important thing. I mean, you're doing this restrospectively now because it sort of spontaneously happened as you fixed some other stuff.

[0:45:04]

Christopher:    I was not actually that bothered about it, like the extra ten. I didn't really know. so, the other thing I'd been doing more of is weight training with Mike T. Nelson as my coach programming strength training plan. So, for all I knew, and I didn't do a DEXA scan, maybe I just put on ten pound of muscle, who knows? It's plausible.

Tommy:    Yeah. And lost it.

Christopher:    And lost it since. I don't think so. I've continued to get stronger. I've continued to progress on this program. I certainly wasn't noticing anything different with the way that my clothes are fitting or anything like that. So, it's pretty minimal. I think that's typical of the endurance athletes that I speak to, that quite often they're looking for just a few pounds. And when you think about it, if you try and do that in carb and fiber, it's about $1000 per pound of weight that you'd lose by spending it on carb and fiber.

Tommy:    So, if you just lost it from your body, that's much cheaper.

Christopher:    Right. Oh, yeah, then it's so much -- Obviously, it's free. So, yeah, that could be a big deal if you are competitive enough. So, yeah, I hope that helps people. All right. Let's move into our third type of example. I don't want to pick on the girls too much here but the reason I'm bringing this up is just because this is just the most recent, some of the most recent examples that I've just been working with recently.

    Okay. So, a woman in her 30s who's eating a whole foods diet, maybe it's a Weston A. Price style, so really good quality food and their sleep is pretty good, and they're moving like 8,000, 10,000 steps a day maybe on some days but definitely not sedentary but not lifting weights or anything. They don't really know how many calories they're eating. They've not really checked. And they've got 35 pounds to lose. So, where would they start? You can pull things together now, right? So, you did explain a lot of different tools and techniques.

Tommy:    So, I think, one of the things that kind of ties across a lot of this, and maybe we didn't specifically mention it in the first example, in the elite athlete, but looking for any of the obvious issues, right? If you're going to do this kind of severe manipulation in that scenario, making sure that you don't have any deficiencies, you don't have any underlying gut issues, you don't have anything else. That's going to make it much easier. That would be the same scenario here. So, one thing is -- So, you can look at the diet. We talk about diet quality, and that's really good. But it is very easy to say you overeat a lot of nuts, a lot of high fat dairy, and that stuff is really good.

Christopher:    Certainly not coming out on the food dairy though. So, Julie is looking over everyone's food diary. And if anything, she's suspicious that they're under eating. And then maybe we see something in the blood chemistry, that thyroid pattern where TSH is pretty normal but everything else looks kind of hypo.

Tommy:    Yeah. And this is something that we've seen plenty of times, is you sort of thought to add back calories and actually then weight loss starts to happen because you're allowing the body to turn their thermostat back up. It's that kind of preservation. If we're chronically under eating, then you might try and retain some of that body fat more so that you're going to have it for a rainy day, whatever.

    That worked with plenty of people who when they actually started to add back calories, then their weight loss starts to happen. But the part of the thyroid problem could be that if you have some high levels of cortisol, high levels of peripheral inflammation, you get this discordance in where your thyroid hormone is going. So, in the periphery, you're not maybe getting enough thyroid hormone to support metabolism but in the brain because of the differences of the expression of the enzymes it convert T4 to T3, the brain actually sees enough T3 so TSH looks about the same.

Christopher:    Right. Okay.

Tommy:    And I think there's definitely a pattern that we see fairly frequently. And so then it's hunting down whatever it is that's causing that sort of inflammation peripherally. And the gut is always a great place to start but it could be -- We've had some people with chronic viral infection, say, and it's going to be something that is causing that discordant. So, if somebody's looking fairly hypothyroid then there's something out there that you need to fix especially if TSH is elevated. There's going to be some kind of peripheral inflammatory process that you need to identify so that those thyroid hormones levels can start to come back up and then the metabolism improves and then that's going to--

Christopher:    Spontaneously, don't need to do anything.

Tommy:    Spontaneous. They don't need to do anything. If you fix that process then you allow the thyroid hormone to do what it's supposed to do then that metabolism is going to come back and you'll probably lose that weight.

Christopher:    Right. It's just super difficult message to communicate and for people to understand. When you're on a client call and they're almost saying, "Wait. So, okay, I get this. So, we're going to fix my gut. My digestion is a bit iffy. I understand why we're doing that. I'm willing to do that. But the reason I'm here is because I want to lose some weight. So, what are we going to do to help me lose some weight?" And you're like, you end up talking in circles. Like, "Yeah, I know, but shouldn't I be--" They're expecting something that you would classically associate with weight loss like calorie restriction or something. But what you're saying here is that you don't need to do that.

Tommy:    No. So, again, it comes back to whatever it is that stopped the body being able to normally regulate [0:49:55] [Indiscernible] you need to find the root cause. And if you fix, it should happen naturally. And then maybe you need to do some manipulation, sort of get over the hump.

[0:50:02]

Christopher:    Right.

Tommy:    And that's actually pretty rare. If you get the body back in a healthy state where it can actually regulate energy balance properly then it's going to happen naturally.

Christopher:    Okay. So, what about the role of resistance training especially for women with a weight loss goal?

Tommy:    I think that that's, and this is something that people listening to us, because we'll release the Mind Podcast and this podcast too, that's something that they talk about a lot. I think it's super, super important because you're actually -- For a number of reasons. It's really important for longevity, being strong. Having a level of strength that is in the top half or top third of the population is very strongly related to longevity because you're not falling over, breaking hips, all this kind of stuff. It's also related to cancer survival and all this kind of stuff.

Christopher:    It's super hard to sell that to people before it goes wrong--

Tommy:    So right now, when you're in your 30s, and I'm telling you, well, if you weight train now and you're stronger you won't break your hip in 50 years.

Christopher:    I can't even tell that to my dad. And it's like it's going to happen to him any day if he's not careful. So, super hard thing to sell.

Tommy:    But equally, if you have more muscle mass, it's more metabolically active and your overall kind of requirements are going to be greater. And then if you maintain everything else in a healthy sort of balanced way you will start to lose that body fat because you're going to need it to run like your base metabolic rate. And it's nothing huge. And we're definitely not talking about building huge amounts of muscle. We know a lot of people who are like, "Well, I don't want to lift weights because I don't want--"

Christopher:    I'm already big, right? I don't want to get any bigger. That's the opposite of [0:51:31] [Indiscernible].

Tommy:    Yeah. I don't want to get bulky with a lot of muscle. Actually, if you speak to guys who've tried really hard at the gym to get bulky, it is not easy to put on a lot of muscles. And it's even harder as a woman. It's just how things are. What you tend to see is that the weight may stay very similar but you'll start to change over body composition but you'll be happier with the way you look. Like the weight on the scale is just a number where you think that's how good you will look.

Christopher:     I mean, it is totally. That might be -- So, Jason Seib, we're a huge fan of. He's created a number of excellent resources especially on body image. I mean, he's been talking about throwing away the bathroom scale since long before I had anything to do with the health and fitness industry. It's true. He says that nobody cares about the force that you exert on the earth due to gravity.

Tommy:    Which is essentially all your weight is.

Christopher:    Yes.

Tommy:    But it's something in your head and you kind of figure that. So that, at 35 pounds less I'm going to look this good. Actually, maybe you do need to lose a little bit. But what will happen, particularly if you do some appropriate weight training and you kind of fix all this other stuff, is you will re-proportion that same body weight and you will feel much better. You'll look more how you want to look in the mirror but maybe the weight didn't drop that much. So, the weight on the scale is not what you should be focusing on. It should be on body composition.

Christopher:    Right. So, what's the easiest way then? And people who do -- So, I've seen online now, certainly in the Bay Area here, you can get a DEXA scan done very inexpensively.

Tommy:    It's at $100, I think.

Christopher:    Yeah. Maybe even less. So, you can go visit one of these mobile trucks or something. Maybe that's not everyone's cup of tea. So, is there something that you prefer to that, like maybe waist to hop or…

Tommy:    Yeah. You can do something like waist-hip ratio and that's also good. I mean, a lot of people at least who want deeper data then something like a DEXA scan is going to be great. But waist-hip ratio is also much better than something like BMI for predicting cardiovascular disease and stuff like that. It is definitely -- It does definitely tell you something.

    But where I always come back to is like how do you look and how do you feel? So, just ignore what the scale says. If you look in the mirror and you feel pretty good then, great. You're going in the right direction. And if you don't, well, there's two potential parts. One is you still need to keep going. And the other one is do you have realistic goals about how your body should look? That's a whole lot can of worms that we're not really [0:53:53] [Indiscernible] conversation. But that's a huge part of it, right?

Christopher:    Of course. Of course. And then there's the real danger -- this actually did come up in Mind Podcast as well -- is that I'll be happy when. And it never happens. I'll be happy when I get that new bike. I'll be happy when I lose that extra ten pounds.

Tommy:    And then when you lose that ten pounds, actually, you won't be any -- You probably won't be any happier because it's not the ten pounds that was making you unhappy.

Christopher:    No, no. So, it's kind of a fool's errand in a way. But is there anything else? Any other tips and tricks? You mentioned time restricted eating very briefly there. Can you elaborate on that any further? Because, I think, that may be an important change as well that's emerging in the scientific literature and, in fact, you've got Satchi Panda presenting at the Icelandic Health Symposium.

Tommy:    Yeah. And so he's probably the real proponent on this and he's done loads of studies in mice where he basically manipulated every possible combination of time feeding versus time fasting in mice. And then now he's done some studies in humans. And what you're basically seeing is that, yes, you need time to eat but you also need time to not eat.

[0:55:00]

    And he does a huge host of stuff like sensitizing your body to the food that's going to come in, timing your circadian rhythm to the sun outside, so we hopefully eat when there's light outside and not eat when it's dark. There's an interesting difference between humans and mice, actually. This is something that Satchi Panda says, which is that if you have a mouse and you give it a certain amount of time to eat, so say eight or nine hours during the day, and that's probably around the point when people start to really see benefit is just eating eight to nine hours a day and then fasting the other, whatever it is, 16 hours a day, something like that.

    If you give a mouse eight hours a day to eat, it will eat the same number of calories in those eight hours as it would if you just gave as much food as it wanted throughout the 24 hours but it will still have much better metabolic health and it will still, if it's overweight, it will lose weight. Humans actually spontaneously restrict calories because they just don't eat as much in that same period of time. And he's done this using like an app where he tracks people. He tells them, "You only eat during this period of time," and they like take photos of their food so he can like--

Christopher:    With the time stamps, so you know when they had--

Tommy:    Yeah, so he can figure out how much they're eating. So, there tends to be -- So, part of the benefit is a spontaneous restriction in the amount of food that you're eating. But the other part is that your timing your food intake to circadian rhythm. There's over 600 genes that are regulated throughout the day that follows circadian pattern. Your circadian rhythm determines how you respond to the food that you eat.

    So, you want to time the food that you eat to your circadian rhythm. You want to eat when your body is expecting to eat. And you can see this really nicely in things like -- I often go back to the studies of people in intensive care units because when you're in an intensive care unit you often -- So, say, if you've had some massive traumatic experience or you have some sepsis or something you require a lot of calories because it's a very intensive process to heal the body, so in order to get those calories in, or maybe these people can't eat, is they give them a nasogastric tube.

    So, basically have a tube that runs into the stomach and it's like liquid food that sort of goes through continuously. And they've actually shown really nicely that -- And for convenience, you tend to feed people overnight. They're asleep, you just sort of feed them overnight. And actually, that results in a much worse metabolic pattern. You're much more likely to go to glucose intolerance and insulin resistance because you're feeding the body when it should be asleep, when it should be fasting.

    And so you've created this dyssynchrony between when you're eating and when your body expects to it. That's a really nice case of it, is that you're eating when you don't want to eat. So, if you're timing food to when the body expects it, to when the genes and the proteins are ready to digest and accept food at the right period of time during the day, and then also you're telling your body when it is day time and you're going outside or whatever, getting the right light at the right time. That seems to spontaneously help reduction in body weight because that's just your giving your body the cues it needs to better regulate intake.

Christopher:    So that the simplest takeaway I can come up with from all of that is just eat when it's light outside. Is it dark out? You shouldn't be eating.

Tommy:    Yeah, which is the exact opposite of carb backloading which is, is it dark outside then eat some carbs. We don't really have time to go into all that. But it's just, is it light outside? Then, yes, you can eat. That's basically the place to start. And then if you're in Iceland in the middle of summer and it's light 24 hours a day then maybe that rule doesn't quite apply. I mean, in broad strokes, that's a really good way to do it.

    And actually, that's also what you probably naturally would have done because we know that, say, our carbohydrate intake should fluctuate through the seasons when those carbohydrates are available. So, in longer light cycles, it's a longer day, maybe you have a longer feeding period, you're eating more carbohydrates, that's normal. But then the winter, particularly above a certain latitude, it's dark, you're not going to have as many accessible carbohydrates, you're eating more of a low carb ketogenic style diet, getting more protein or fat from whatever animals you can get or whatever is available at that time, and actually you'll eat it in a shorter time window too.

    So, we talk about something that we try to regulate right now but maybe this is actually something that we should be being regulated over like a season and a year or many years. And actually this stuff is supposed to fluctuate much more naturally, feasting and fasting, over those kinds of time scale. So, when you try and manipulate something in a very short period of time, again, you're taking it away from what we would naturally want to do.

Christopher:    I love this because it works great for me. I love that it works well for me. This is exactly what I did. I get up first thing in the morning, take the dog for a walk. It's only 20 minutes. Come back, immediately have breakfast. Eating is [0:59:21] [Indiscernible] giver of time. So, I've been training my circadian rhythm. And then I do eat lunch if it's quite early. And then my last meal of the day is 4:00 p.m. usually. So, I eat with Julie and Ivy at 4:00 p.m.

Tommy:    And that's it?

Christopher:    And then that's it. That's certainly it for me. Ivy tends go get a bit hungry again later on. She's only three.

Tommy:    Which is fine. She's growing.

Christopher:    Exactly.

Tommy:    There's absolutely no problem with that whatsoever. But there's an increasing number of papers and studies coming out showing that particularly if you already have some kind of metabolic disease, eating more of your calories in the morning and having a greater space between meals are much better for overall metabolic health. And that's just what you should be used to and that kind of continuous eating all day every day is part of what got us to the problem that we're having at the moment.

[1:00:04]

Christopher:    Okay. Well, I hope this has been helpful for people. It's certainly been helpful for me. This podcast is my continuing education. And it is the information that we use for our clients of the elite performance program. If you're interested in having us investigate your situation -- and I would suggest that you try some of the things that we talked about on this podcast before you come forward to work with us.

    I would suggest that the best way to start is come through nourishbalancethrive.com, find the show notes for this particular episode. I am going to link to my new seven-minute analysis, which is 51 radio buttons that you can click on and then I'm going to use my machine learning algorithms to predict the results of some of the testing that we do in our practice. I think those algorithms can give you a really good idea of the things that you need to focus on.

    So, we talk about circadian rhythm. We talk about hormone imbalance. We talk about blood sugar dysregulation. We talk about gut health. We talk about low hemoglobin. And wow, we had -- we launched it this week. I guess, I'm making this podcast a bit sort of timely and I don't know when I'm going to release it. But in the week that we re-launched the analysis, 700 people did it in two days.

Tommy:    That's awesome.

Christopher:    So, it's quite exciting. We're very excited about it. And then, okay, so you're going to do the analysis and then we're going to have a ton of information for you and then you're going to watch the videos. And you're going to have to think about some of the things that maybe you could be doing. And then I'm going to follow up with an email link that you can use to book a free elite performance program starter session.

    So, you can talk to either me or Julie, who is my wife, about how we can take a deeper look at your particular situation and how we can use the testing and the lifestyle modification and the supplements that we use to meet your weight loss goal. And, yeah, that's about it. Was there anything else you wanted to say, Tommy?

Tommy:    No. I don't think so. That was good.

Christopher:    Cool. All right. Well, if you have any questions, the only thing you can do is leave a comment for us in the comment section on the show notes. If you're having a particular problem that you think that we haven't addressed in this episode, then you can leave a comment for us and I'll be sure to get that answered either in a future episode of the podcast or maybe some other way. But we will get you an answer. So, leave us a comment in the comment section on the show notes for this podcast. And thanks so much for listening.

Tommy:    Thanks.

[1:02:27]    End of Audio

 
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