Tommy Wood IHS 2017 Recap transcript

Written by Christopher Kelly

Sept. 30, 2017

[0:00:00]

Christopher:    Hello. And welcome to the Nourish Balance Thrive podcast. My name is Christopher Kelly. And today, I’m joining you with my chief medical officer, Dr. Tommy Woods. How are you doing, Tommy?

Tommy:    I’m good. Thanks.

Christopher:    We are here in Iceland in person recording. The last 2 days, we’ve been attending the Icelandic Health Symposium. And we thought that we’d do a recap for all of the listeners of the podcast. How does that sound, Tommy?

Tommy:    Sounds great.

Christopher:    Tell us a little bit about the conference. You were the host this year. I know you were involved in the organization of the conference. Tell us about it.

Tommy:    So, the idea of the whole Icelandic Health Symposium came out mainly from a guy called Gudmundur Johannsson who is the CEO of the board of the symposium. And he initially e-mailed me after he heard me speaking in Iceland about multiple sclerosis about 3 years ago now. And he wanted to create a conference and he was particularly— Back then, he was a low carb kind of guy and he’s sort of expanded out from there since then. So, he was excited about Gary Taubes, Tim Noakes and he reached out to them and managed to get them to come and give a conference here in Iceland last year. And I spoke then and we also did a podcast last year where we summarized. Very similar to this. And then this year, we wanted to focus on longevity. And so, we had— Well, my role essentially was to help find and contact the speakers that I thought would be good to speak in this area. So, we had a wide range of guys come and talk and then I decided that we had— So, Ben Greenfield came. He’s one of the speakers. He did a workshop. We have Mark who’s gonna come. He’s doing a running workshop today. And then we had also a practitioner workshop where we have Bryan Walsh, Mark, Deborah Gordon who’s also been on the podcast. So, everybody, they’ve all been on this podcast before, come and talked to practitioners, give a slightly more clinically oriented days. We did that the day after the main conference. So, the idea is both to help the public and the medical professionals in Iceland, those particularly who are interested, to sort of better understand lifestyle approaches to health, disease, and to obviously empower their patient or the person before they become a patient to look after their own health, but then also help healthcare practitioners better understand how they can use these other things as well as traditional medicine to improve health. So, that was the goal of the Icelandic Health Symposium. And there’s more work to do to get more people in the door to listen to the speakers. Hopefully, that will continue over the years, but it was very well-received. I think we had about 250 people on the main day. And some of the speakers and organizers were on the TV, have been in the paper since. So, it’s sort of had a bit of momentum and all the feedback was great.

Christopher:    What do you think the divide was like with the audience? Most of the people that I saw and talked to, they seemed like they were either health and fitness professionals of some sort or rather doctors. It didn’t seem to be a lot of the lay public present.

Tommy:    I think the opposite.

Christopher:    Oh really?

Tommy:    I think there’s quite a lot of the lay public.

Christopher:    Interesting. Just the people I spoke to probably.

Tommy:    Yeah. Probably. I think there was a good mix actually. I mean, down the front, you had all the Icelandic Crossfit royalty and they have some of the best Crossfits in the world. You know, they showed up and they were there on the front. So, you would consider them— They’re not the lay public, but they aren’t the public or they’re not healthcare practitioners.

Christopher:    Advanced users.

Tommy:    Yeah. Advanced users. And so, you had advanced users. You had less advanced users and then you had some healthcare professionals. And so, I think there was a good mix and then the idea was that we gave a broad range of information, but then also details. So, you would hopefully speak to different people on their own level throughout the day. And I think, yeah, we got pretty close to striking a right balance.

Christopher:    It’s a great location. Iceland. It’s so accessible from both the U.S. and Europe.

Tommy:    And equally if you’re trying to get somebody to come and talk at a conference telling them that you’ve given them a free trip to Iceland is actually a really good sell. So, there are so many of the speakers that we had both last year and this year, the first thing they say is “Oh, I’ve always wanted to go to Iceland.” So, that’s a really easy way to get top drawer speakers because they’re excited to come visit the country. So, that’s good too.

Christopher:    And Dr. McGuff brought his whole family and he—

Tommy:    And he loved it. He is here for a week and they were traveling around and did all these various things. And he was talking about how much he enjoys like traveling around first. So, that was really good.

Christopher:    And I’m here with my co-founder, Jamie Kendall-Weed. And her husband is a professional mountain biker that makes videos. I’ll link to some of Jeff’s videos in the show notes for this episode. And he’s here with a filming crew. So, they’re gonna be making a video over the next several days and he’s brought all of his bikes. And luckily, he managed to get me a bike. So, I’m gonna be able to ride here in Iceland as well, which is super cool. It is a fantastic place. We always enjoy coming here. We spent the morning doing more of the hot-cold immersion therapy, which is fantastic. Really good fun. Let’s talk about the speakers then. Rangan.

Tommy:    Yeah. So, the first guy we had in the bill was Rangan Chatterjee who people in the U.K. will probably know of as the Doctor in the House. He’s at a BBC series where he goes and shows what you can do if you actually spend a lot of time with your patients and really connect to them and figure out what’s really going on with their health and then consult with these chronic conditions that are supposedly incurable.

[0:05:08]

    You know, he’s this great traditionally trained doctor. He’s a GP in the U.K., but he’s also done some of the Institute of Functional Medicine stuff. He’s done the Bredesen Protocol training for Alzheimer’s. And he just sort of has this great overview of health and all the different things that you can and should do. And he’s also very good at making it accessible for people and just incredibly enthusiastic and just such a nice guy as well. so, he talked about— So, he just written a book, which I think will come out soon, based on his 4 pillars of health, which people listening to this may not be surprised, but they comprise of food, movement, sleep, and stress. And actually, I’ve got a question on Twitter to him about whether he thought there should be a 5th pillar which was sort of love, and social connection, and relationships. He didn’t get a chance to sort of talk about whether it’s gonna fit in, but that’s obviously and important thing too. And he did sort of touch upon it, but those sort of 4 things are where he really focuses with his patients. And then, you know, we talked a lot about food, about maybe people aren’t thinking as much about the movement or if they’re doing the movement, they may be not doing the right movement or, you know, the sleep and the stress are other things. And particularly for people who haven’t really thought about this stuff before, then maybe we kind of sold that it’s so important that we have so much to do and you have to look after the kids, and work, and all this stuff and we’ll cut short our sleep and maybe that’s— You know, we realize the implications of that. So, how we handle stress particularly for people who are just getting into this kind of stuff, I think those messages are really important and those all be equal, right? Food is not just the most important thing necessarily particularly depending on the person. So, give a really good grounding of all the things that are important for long-term health. So, that was a really great way to sort of quick things off.

Christopher:    I was sitting next to Jamie in the audience as he was giving his presentation. And one point, he says, “I see 45 patients a day.” And Jamie just looked at me and went “How the heck does he have the time and energy to do this when he is seeing 45 patients a day?” And do you remember he was talking about how he integrates movement into his work by taking the time to walk from his office to the waiting room rather than using the Tannoy. And Jamie is liking putting the hands “What the heck? Who is this guy and how does he get this done?”

Tommy:    I think it’s just because he knows it’s important and he loves doing it. I mean, he did say that in the structure— ‘cause she asked him that question and he says the traditional structure is that you book 20 patients in a day. But by the time you’ve done any emergency consultations of you’ve gone to— you do like a house visit in your lunch break and then you do some like follow-up calls, so then the number of patients you have spoken to, interacted within the day is close to 50 and to sort of keep up the emergency and enthusiasm. And then, you know, go home, write your book, also spend time with your kids, spend time with your wife.

Christopher:    Amazing.

Tommy:    His energy and passion is just incredible.

Christopher:    Insurmountable.

Tommy:    It’s just because he knows how important it is and he loves doing it. So, it’s amazing to see him in action.

Christopher:    Truly someone who has found their purpose in life, which we’ll get to a bit later. My question is why is this not the standard of care in the U.K., you know? Like there’s nothing earth shattering in his presentation, why is this not the standard of care? He’s this celebrity GP that people are making television programs about because he’s doing something different and getting great results. Why are people not noticing and this becoming the standard of care in the U.K.?

Tommy:    Having spoken to some GPs and medical students, I think they are noticing. It’s just stuff takes a lot of time to change. And I know there are a lot of GPs in the U.K. and I’m sure it’s the case everywhere where just because of access to information— This is something that Rangan talks about himself, you know. With the internet and the access that we have to people doing the kind of stuff that he is doing, it’s much easier to see this and think “Hang on a second. You know, this makes perfect sense. You know, why aren’t we doing it?” And I think there’s a thirst for knowledge amongst the doctors who see the same patients coming back again, and again, and again. You know, you just change medications, try something new. It doesn’t help. They get sicker, you know, and you become frustrated because what you want to do is actually help your patient. So, when you first see the traditional model was not getting the results that you wanted to get, not helping the patients as much as you would hope to help them and then you see these alternatives and yeah— I mean, it’s TV. So, they make it look amazing and they start with— They only show the complex cases when actually you could have an even bigger impact potentially for some of the simpler cases, but they don’t make it. Rangan was talking to us about how he had some simple cases where he sort of just like happened to fix something just on the side, which wasn’t really intentional, but because he was changing diet. You know, these health problems that have been around in people for years just suddenly disappeared and the TV producers were like “Oh, that was too easy. We don’t wanna put that on TV.” The ability to do that, you know, I think the people are seeing that and starting to ask questions. And that’s where you can really ask for at this point, you know, when we are sort of stuck in the quiet mark that we are stuck in.

[0:10:02]

    If you can just put this information out there and get people to start asking questions and thinking about it themselves. A lot of the speakers talked about that actually. It was not just “Here’s a prescription. This is what you need to go out and do. It’s, you know, I want you to think about this. And if you think about it and you think it’s important, then maybe that’s gonna stimulate some change either in yourself or your practice.” I think that’s the best way to get people started.

Christopher:    I know his TV series will be available on the BBC iPlayer. I’m not sure how accessible that will be in the U.S. Maybe we can find some of his TV. The reason I think that might be important is this might be a good entry point for somebody who is listening to this podcast. Could you send “hey, dad, watch this on the iPlayer”? And it’s TV. It’s mainstream TV. So, it’s entertaining. And at the same time, there’s this message in there that may nudge the— You’ve been talking a lot about what I’ve been talking about. Pre-contemplators and contemplators after interviewing Simon Marshall and maybe it would nudge the pre-contemplator into the contemplator zone. And that could be important. Maybe not for the people listening to this podcast directly, but for people that they know and love.

Tommy:    Yeah. Absolutely. And on that point exactly, Rangan did say that the second series has managed to hang around on YouTube. So, the first series, somebody put it up and it was immediately taken down.

Christopher:    Okay.

Tommy:    So, I would say look for it. It might be. You might find it.

Christopher:    Yeah. Poke around on the internet.

Tommy:    On the internet.

Christopher:    Okay. Well, moving on, I can’t pronounce. Lilja.

[Talk Out of Context]

Tommy:    Lilja Kjalarsdóttir.

Christopher:    Okay. Talk about that. So, there was a change of speakers. It was gonna be Dominic. Can you talk about why Dom wasn’t there? You’re not allowed to do that?

Tommy:    I’m not sure I can.

Christopher:    All right. We’ll cut that out.

Tommy:    I mean, we can’t say the— So, Dom D’Agostino was gonna be on the bill, but then he had a very good reason (work-related reason) for why he couldn’t come. He tried very hard to be here and he couldn’t be here. I think some people were very excited to hear him talk, but he’s definitely very keen to the future event. So, watch this space and come to Iceland and listen to Dom talk, but then we’ve got a great replacement. And it’s nice to have some homegrown talent. I think it’s really important if you have a mainly Icelandic audience. And we did have some people come from abroad, but you’ve got mainly Icelandic audience. And I think it’s important to have an Icelander tell them the same stuff.

Christopher:    Yeah. There’s a real danger of U.S. endemic, right? All these Americans coming here and telling us— The Icelandic people are sick of that anyway because the Americans came and they set up an airbase where the airport now is and that terrible food.

Tommy:    All that food.

Christopher:    The rubbish cars.

Tommy:    Yeah. But then there’s also a little bit of— I know some people have said, “Wow. The problems are so much worse in America like is it as much of a problem here? Should we be listening to the Americans because we don’t have as much of a problem?” I think certainly in some respects Iceland is one the same trajectory. Just 20 years behind. So, there’s definitely the risk of getting there, so maybe we can intervene earlier. But yeah, hearing that from somebody who is from Iceland and works in Iceland— And she did her PhD in the U.S., but she’s come back and she’s working in research here now.

Christopher:    And also a former professional athlete as well. Her bio is very impressive.

Tommy:    Yeah. Professional soccer player. Fitness competition competitor. So, that’s in the area of body building, but more sort of fitness related. She’s been a soccer coach and a couple of other sports. An impressive athlete too, which I think helps speak to—

Christopher:    Ridiculously impressive human around and an incredible physical specimen. How can this one person be good at all of these things? That doesn’t seem fair. Aren’t you supposed to be a bit sort of skinny or overweight if you’re gonna be a nerd? But apparently, for her not. So, talk about her presentation.

Tommy:    She talked about two broad things that she has direct research experience in and the first one was largely to do with metabolic flexibility. So, the requirement to have healthy mitochondria and then the ability to be able to both burn carbohydrates and fat at a required time.

Christopher:    I know we talked about this a lot on the podcast before, but I’m starting to realize it’s important to mention things more than once in order to have things sink in. So, let’s define metabolic flexibility again because the danger is that people think it means to only burn fat, but that’s only half truth. Right?

Tommy:    Yeah. And that’s kind of— I think that’s part of the problem that we’ve had with low carbon ketosis world is that everybody wants to become fattened up and a fat burner, but then they don’t realize that this is potential and it may be not as much of a risk as some of the anti-keto people say it is, but there’s the potential that you focus on the other end of the equation so that you just burn fat rather than thinking about your ability to burn carbohydrate or have that available in certain scenarios depending on what it is you’re trying to achieve. And in reality, you just wanna be able to do both, right? You have systems that burn or utilize different energy substrates for different types of work and you want to be able to do all of those things. And where it came up and it came up in multiple talks actually was the ability to burn fat, but mainly just because at nighttime you’re supposed to not be eating and there are periods of time when you will be relying on stored energy. You know, after some period of time, that’s gonna have to be fat. And you rely on that to stay alive. Right? And you should be able to do that. and being able to do that and spending time doing that even if it’s just a few hours a day is actually directly linked to metabolic health and longevity.

[0:15:06]

    So, being able to switch from one to the other so immediately after a meal. Say you’ll burn the carbohydrates. You know, insulin goes up and increases rates of glycolysis. That becomes the primary fuel source. So, you store whatever is extra. And in between meals, you shouldn’t be hungry. You shouldn’t be necessarily hungry. You have all this stored fat that you could use and then you just go the other way and that’s what you use. And it’s the same if you’re doing some kind of aerobic exercise. You know, you should be able to use those stores rather than constantly require to throw down extra fuel down the hat. So, she basically just gave this overview of why you should be able to do both and why that’s important and the importance sort of went down into the cell and, you know, talked about what a mitochondria is and why it’s important to have healthy mitochondria and how when you’re insulin resistant or you have metabolic disease you basically have fewer mitochondria and they are crappier mitochondrias. So, they’re worse at doing the job that you want them to do and then why it’s important to think about improving those. And she particularly talked about exercise. She talked about healthy diet. She didn’t really give her own parameters for that, but then she also talked about carnitine because that’s something she’s specifically done research in. It’s the requirement of carnitine both to get energy into the mitochondria, but then also to get excess metabolites out of the mitochondria. You need both as a shuttle. So, that was something that she has directly done research on. So, those were her 3 key takeaways, were probably a carnitine deficiency in many people particularly those who get hungry, get sort of energy dips between meals, and then exercise and just a better diet. So, you’re not shoving the wrong fuel in the whole time.

Christopher:    And so, where’s the carnitine coming from?

Tommy:    Red meat.

Christopher:    Okay.

Tommy:    That’s where it should come from.

Christopher:    Right. And so, it’s not necessarily about supplements.

Tommy:    No. And I think she said based on the work that she has done that if somebody’s been deficient for a long period of time, then you should supplement to get over the hump and then you can maybe continue to get it from diet. So, she did recommend supplements, but only in people who had metabolic issues. Not necessarily for everybody. It was if you’re trying to improve your metabolic health, maybe start with some carnitine that can help buffer some of the issues that you’re having and then long-term you obviously don’t need it.

Christopher:    I feel like we’ve been seeing less of the carnitine deficiency on our organic acids test as people have gone off their keto craze. So, if you were eat ketogenic diet, you probably should be supplemented with carnitine because there’s always certainly going to be a deficiency. Presumably that’s just because you’re shuttling more fatty acids into the mitochondria or perhaps the carnitine supply can’t keep up with the demand perhaps.

Tommy:    That’s what it seems to be.

Christopher:    So, the prescription is L-carnitine or a few more carbs in your diet and you can fix the problem.

Tommy:    Yeah. Well, I think if you’re somebody who is purely going to be relying on those fats as the main energy source, then, you know, making sure that that system is optimized is gonna be really important. And I think it’s also the thing that people who go on to a ketogenic diet and then take some time and they struggle, it may be that they were carnitine deficient before that time. So then part of requirement that you’re seeing is a previous deficiency being translated over to a diet where the requirement is higher and then you sort of need to get over that hump that maybe in the long term they don’t need either, but that’s sort of— We would see people in the middle period and then that’s definitely when they did need carnitine.

Christopher:    Someone should do keto in a box like the starter pack that’s got their keto mojo meter in. We just found out about this new meter that does glucose, and ketones, and hemoglobin, which I thought was very cool. Can you imagine a starter pack with that? Maybe some electrolytes and then the L-carnitine as well will be pretty cool.

Tommy:    Yeah. That’s probably all you need to get started.

Christopher:    Yeah.

Tommy:    Yeah. Like extra salt with some potassium, magnesium, a little bit of selenium like a nice sort of mineral supplement. So, anybody entrepreneur, that’s an idea.  

Christopher:    Yeah. That’s a product for you. Talk about shuttling the fatty acids in and out the mitochondria and the movement of acetyl groups ‘cause I sort of have forgotten about that. You think about carnitine bringing the fatty acid into the mitochondria, but something interesting comes out and that’s important.

Tommy:    Yeah. There’s this whole concept of protein acetylation that people probably heard of because they may have heard of histone acetylation, histone deacetylase inhibitors, so things like a butyrate can do it. Resveratrol can do it. They sort of— The acetylation, which is basically the adding of acetyl group on to a protein which can control gene expression, but a lot of acetylation happens by mass action. So, if you have a lot of energy, excess energy in the cell and we’ve talked about sort of excess or energy overload within the cell and one of the downstream effects of that is lots of acetyl-CoA and then you have all these acetyl groups and then what they do is they end up just like sticking themselves to proteins. And that can almost happen indiscriminately. And one of the potential benefits of fasting is actually you’re removing those acetyl groups. So, actually, you can sort of undo some of that damage. And then at the same time, when you fast, you activate these histone deacetylase and you inhibit histone deacetylases.

[0:20:03]

    So, you specifically keep certain acetyl groups. They’re important and then you’re activating those pathways that we talked about. They’re important for longevity. So, maybe mitochondrial biogenesis or [0:20:13][Inaudible] pathways or something.

Christopher:    So, it’s part of sensing that low energy state.

Tommy:    Exactly. But what Lilja’s research particularly shows is that in that scenario where you have this excess acetyl groups and over nutrition— This is in mice where they do the high fact diet. So, it’s high fat, high sugar like a Western diet equivalent. If you have enough carnitine, you can help get some of those extra acetyl groups out of the mitochondria. But otherwise, it sorts of hang around inside the mitochondria and then they just like tag themselves to all the proteins and it reduces mitochondrial function. So, the carnitine is important to get fatty acids in, but it’s also important to sort of get out some of those extra acetyl groups if they’re there, which can then sort of be tagging themselves to proteins and decreasing their function.

Christopher:    Very interesting. And Lilja did a fantastic job with her presentation. She said at the beginning that she was a bit nervous ‘cause she was used to giving presentations to other academics and hadn’t really talked the lay public before. And I think she did a really good job, didn’t you?

Tommy:    She did a great job. And the second thing that she talked about was bone health ‘cause that’s something that— There’s a company. She was chief scientific officer of a biotech company here that was developing some bone health supplements based on some of the marine resources that you have in Iceland. And so, the main thing she talked about was the load on bone. So, if you remove mechanical load, then you lose bone structure. And why that’s so important for bone health is to walk, or lift weights, or somehow apply stress to your bones so you get improved bone health sort of came at the end and that sort of tied into her recommendations to do exercise ‘cause it’s important for your mitochondria, but it’s also important for your bone health and both of those are very important for long-term health.

Christopher:    I think that’s a good segue into Dr. Doug McGuff’s talk about the importance of strength training.

Tommy:    Yeah. So, the reason why I invited Doug is because he is the— The populations that he works in, they tend to be very sick. So, he has two jobs, right? His day job is he is fighting fires in the emergency department and then the hobby is that he’s helping people improve their long-term health or reduce the likelihood that he’s gonna see them in the emergency room mainly through high intensity exercise training. And the way that he does that is through like super slow protocols where you fatigue the slow twitch muscles and then you end up activating the fast twitch muscles, which is the ones that you lose as you get older and you get sarcopenia, but he does it in a way that you don’t have to do it with very heavy weights or high intensity because, obviously, if you’re somebody with multiple sclerosis, or Parkinson’s disease, or severe osteoporosis, or severe sarcopenia, you know, put them on 100 pounds in a squat, I mean, you’re just asking for injury. But if you do very low weight, but extended sets which eventually become very intense, then you activate those large muscle fibers. That’s what you want to keep to keep you upright, stop you from falling over and breaking your hip. That sort of allows you to get the activation without having to do it under very high loads, which can potentially cause injury.

Christopher:    So, I’m just wondering how relevant this is for everybody who is listening, their parents, right? So, I’m definitely thinking about my parents and the fact that they’ve never really done any strength training. And as Doug said in his presentation, you’re one fall away from death. And they’re not really expecting you to die if you’re to slip in the bathroom right there and then. It’s what happens once you get into the medical system, once you’re in hospital, the chances of you picking up a pneumonia or something like that. That could be deadly to someone in their 70s or 80s.

Tommy:    Yeah. When you’re in your 70s or 80s and you fall and break a hip, I mean that obviously gets worse than the other things that you’ve got going on. Some pre-morbidities and other diseases. But at that age, if you fall and break your hip, your mortality within a year is around 50%. So, you fall and break your hip, you have 50% chance of dying within the next year because of all these other things. Some feedback that I got from my mom who is sitting in a corner listening to us talking right now, I think the problem with Doug’s talk is he assumed I think that there were lots of— it was mainly practitioners in the audience. So, what he did is he gave all the science behind why strength training is important, but he didn’t tell us about his protocol so that my mom is like “Well, this is all very nice and good, but what do I do?” So then—

Christopher:    Should we be telling Doug this in private right now?

Tommy:    Maybe we should be telling him, but— So, I really enjoyed the talk—

Christopher:    I did too—  

Tommy:    …‘cause he was talking—

Christopher:    …and I already know what to do. Right?

Tommy:    Yeah. Exactly. ‘Cause he was. He thought he was talking to people like us.

Christopher:    Right.

Tommy:    But maybe we did a bad job of telling him who was in the audience.

Christopher:    So hard. Isn’t it? I mean, even when you’re there in person giving the presentation, you still don’t really know who you’re talking to. And that’s obviously one of the greatest problems with the podcast as well. We don’t know who is listening to this. You may not understand Doug’s context, right?

[0:25:00]

    He’s not really training budding young athletes. He’s dealing with an older population.

Tommy:    And seeing fabulous results.

Christopher:    Fabulous results. Yes. Never too old to see benefit. I think Doug did a really good job of correcting that in the panel afterwards and he showed us one exercise in particular. Do you wanna describe the exercise? I thought it was really good.

Tommy:    Yes. So, I asked him how you can generate— ‘cause Rangan had also talked about like a kitchen workout. People doing like calf raises and presses against the table and I think that’s good and some lunges. I think that’s good, but I don’t think you’d get that intensity that activates those muscles that you are losing that you didn’t know.

Christopher:    My problem with that was that he was talking about doing calf raises in the kitchen and he was talking about doing dips. You know, you can have a surface behind you and actually lower your body weight behind you like a dip, but those are teeny tiny muscles, right, like the triceps and the calf. It’s like two of the smallest muscles we’ve got. It can’t actually do anything like that.

Tommy:    I mean, I think it’s good to get people going, but maybe if you are going for something that’s optimal, I’m not sure you’re getting the intensity that you require and that’s because— And it’s because the muscle fibers that you lose as you get older are the ones that require that intensity to be activated. So, it’s just the nature of the—

Christopher:    So, those are the stabilizing muscles. When I slip and nearly fall, it’s the fast twitch fibers that prevent me from falling.

Tommy:    Yeah. Absolutely. So, we all start to kind of show— Sorry. If you don’t have any equipment or know how to generate this intensity at home, so he whipped his belt and he showed 3 exercises. And the first one was like the chest exercise where you basically— And his protocol is you start 20 seconds at 50% effort, 20 seconds at 75% effort, 20 seconds at 95% effort, and 20 seconds at 100% effort or what you count as 100% effort. And then what you do is you gradually fatigue the type 1 fibers, the endurance fibers first. And then by the end, you’re just taxing the fast fibers, but you’re doing it symmetrically. So, you’re not actually moving at all. So like the chest exercise is just by pressing your hands together. If you press your hands together right now, you could feel you activate the chest muscles.

Christopher:    Right.

Tommy:    So, you do that. You just press 50%, 75%, 95%, 100%. He did like a shoulder-based exercise where he took his belt off and he just— He sort of gripped it in front of him, held it in his hands, and then just like try to pull the belt apart.

Christopher:    So, the force was coming from his hands. Maybe I was doing that wrong. I tried that the next day with a towel, right? So, this is maybe a great thing that you can do if you’re away traveling.

Tommy:    You can do it with a towel. Yeah.

Christopher:    Just do it with a towel. But I was treating it like a deadlift. I was like trying to generate the force—

Tommy:    So, that’s the other one.

Christopher:    Okay.

Tommy:    So, the first one he did was the shoulder based one.

Christopher:    Oh sorry.

Tommy:    And then afterwards, he held one end of the belt in each hand and then he looped it under his feet like he was coming down for a deadlift. I’m doing it right now. I’m not sure why ‘cause I don’t have a belt in my hand.

Christopher:    People can’t see you.

Tommy:    People can’t see me, but I’ve looked on his hand and he was kind of in sort of like half deadlift, half squat position. The idea is you just try and stand up at 50%, 75%, 95%, 100%.

Christopher:    Same principle. So, you’re fatiguing those slow twitch muscle fibers first and then you move on to the fast twitches, which is what we’re aiming for.

Tommy:    And to be honest, if you did only one thing, that exercise would let you do all of it because you’ve done all the back, glutes, quads. And you’re also doing your grip and grip strength ‘cause you’re having to grip on to the belt and grip strength is one of the best predictors of all cause of mortality. And it also applies to everybody. You can’t necessarily test— So, leg strength is another one, but you can’t test leg strength in somebody who is bed bound or has really bad arthritis or has some other comorbidities, but you can test how hard they can squeeze. Grip strength exercises are also helpful for those people. And if grip is anything that they can test, you know, you can just squeeze a ball and even that will improve health outcomes. So, the grip is something that’s applicable to everybody. But if you’re training your grip, back, glutes, and quads, I mean you never need anything else. You only need one exercise. You could do just that and you’d do pretty well.

Christopher:    Brilliant. It’s very practical, very important work.

Tommy:    And requires nothing except for something you can loop on your feet and grip on to like a towel. A towel would be fine or a belt.

Christopher:    Exactly. You can find that anywhere you are. Really awesome. Let’s talk about Satchi Panda. I really, really enjoyed Satchi Panda.

Tommy:    He was one of the first people that I thought of when we were talking about this conference actually. I just watched a YouTube video of his describing his work and he’s just such a humble, clever, nice, engaging guy. He’s been doing this stuff for so long and like finally people are— I guess finally people are listening.

Christopher:    Listening to him—

Tommy:    He’s amazing. And you know, one thing that I think everybody noticed and Bryan Walsh was sitting next to me and like halfway through like just saying how professional like his slides were. Like everything was a custom graphic that showed you exactly what it was he was talking about, but also it made perfect sense. It was just something, you know, for the visual learners. It wasn’t like loads of extra test or anything like that. It was just sort of—

Christopher:    Oh yeah, there was barely any words.

Tommy:    No words, whatsoever. It was all like very visual and Bryan was like “Oh, this guy is such a badass.”

[0:30:00]

    And he’s like “The slides were just amazing.”

Christopher:    Is that a result of him being a senior academic that’s done a lot of important work and he has people that produce beautiful presentations for him now?

Tommy:    Well, I don’t know ‘cause most senior academics who’ve done a lot of important work couldn’t make a PowerPoint presentation if it like would save their lives.

Christopher:    Maybe he didn’t produce that is what I’m saying.

Tommy:    I mean, some places have like a graphics department where somebody—  That quality of presentation I think is still fairly rare.

Christopher:    Okay. Okay. People think of him as the time restricted eating guy, but really he’s the circadian rhythm guy.

Tommy:    Yeah. But he has focused on food because he did talk about sleep and he talked about light. His point was the reason why the focus is on food is because the light environment that most people were exposed to, which they can’t change, it’s hard to change. Maybe that’s something that’s more difficult to intervene and then also sleep if you’re stressed in your family and job and worst if night shift workers or whatever. It’s also hard to change sleeping patterns or in some people it’s hard to change sleeping patterns. But when you eat, it’s something that everybody should have control over. So, he focused on the easiest intervention point. So, that’s where he’s done most of his research. I mean, he definitely said that all of it was important, but he’s focused on food just because that’s something that he knows most people are most likely to be able to change.

Christopher:    Uh-huh. And he’s done some really clever experiments where they’re using an app so they can work with humans remotely rather than trying to bring them into a metabolic vault or anything completely expensive and bunkers like that. And so, he talked about some of the experiments he’s done.

Tommy:    I guess it all started in mice where he’s done like every permutation of different quality of diet from— You know, I think they’ve done low carb, high carb, standard chow, western diet, all these different things and then looked at the effect of just shortening the feeding window. He’s done it like literally whether your eat for 9 hours a day, 10 hours a day, 11 hours a day, 12 hours a day.

Christopher:    What’s the shortest window he’s looked at?

Tommy:    8 hours I think.

Christopher:    Okay. And is there any reason he hasn’t gone shorter?

Tommy:    I don’t know. You’d have to ask him. I haven’t seen him. That’s where they’ve seen the most benefit. I don’t know if they’ve tried shorter and just not seen any extra benefit. That’s perfectly possible. I don’t know. But if you look at some of the human research, it does suggest that if you like have just one meal a day, that may actually not be as good as having a couple, or two, or three in terms of like blood sugar control or insulin.

Christopher:    Right.

Tommy:    Blood sugar or insulin responses to a meal tend to be exacerbated or maybe worsened depending on how many meals a day you’re having and what time of day.

Christopher:    It’s probably going to end up being extreme calorie restriction is my guess. Most people can’t eat 2,000 calories in one sitting unless you’re using something that’s very, very good at delivering calories like a liquid perhaps.

Tommy:    And then you’re not getting any of the nutrition that you need. So, I think part of it is practical application, right? So, most people don’t want to just eat one meal a day, right, or they don’t— You know? So, he’s sort of creating stuff that’s gonna be the most applicable to the most people. And so then, what comes out of it is the— in mice and also in humans regardless of what you eat if you can shorten the eating window, then metabolic health improves and weight decreases. In the mice, they eat the same amount of calories in a short time period and they gain less weight and they live longer. But in humans, if you restrict their feeding window, they automatically restrict their calorie intake because it’s just hard to eat that many calories in a short period of time. And the way he’s done that— So, his app, you basically take a photo of your food and then it gets sent to a central server and actually deletes it from your phone. So, you can’t go back and look back at what you ate and think “Oh God, I ate terribly today.” You just send it. It disappears. You don’t think about it again, but then it tags the time that you ate it. And then they later on calculate calories and all that kind of stuff for you so you don’t have to do it. But what you see is that after sort of 6 p.m., that’s when people eat their most calorie dense foods. So, it’s sort of the late night eating, which they’re getting rid of, is also—

Christopher:    The worst type of eating.

Tommy:    …the worst type of eating.

Christopher:    You run out of willpower. At the end of the day, you’re kind of tired. You can’t be asked to cook anything. There’s some Pringles there in the cupboard and a pint of ice cream in the freezer. I’m gonna sit down and watch TV and eat all of this stuff. And people lie, right, when you ask them about what did you eat and when did you eat it. The quality of their diet is very poor. But when you do the app, the quality is very, very good. Right? You can’t really like about what time you took a photograph.

Tommy:    Yeah. I think that’s one of the reasons why it’s so applicable to the average person. If you just say “well, I’m gonna stop eating at 6 p.m.”, then you’ve removed that time period where you’re most likely to say “oh, I’ll just have a bowl of ice cream”, or “you know, I’ll just eat those Pringles in the cupboard”, or “you know, I’ll have a couple of glasses of wine.” And so, you automatically improve the quality of their diet and you reduce that sort of calorie dense nutrient-free component of their diet and then you add the circadian time and component. Literally all you’ve done is tell them to eat their calories in a shorter part of the day. Right? So, you give one piece of advice and you’ve already improved 3 to 4 different things.

[0:35:00]

Christopher:    That’s awesome. That’s awesome. And Katie Compton who was on the podcast recently talked about using the app. And she’s had really great results with it and continues to use it even though she may not be part of the experiment anymore. So, I’ll link to the app in the show notes. I make comprehensive show notes for each episode and there’s a time map, time stamped list of things that I’ll mention in the podcast and so you can find the links in the show notes. Okay. So, moving on—

Tommy:    Oh, I’m not gonna move on yet because there are two really important things that Satchi said that I think—

Christopher:    Oh, I’m sorry. Yeah.

Tommy:    …are really worth talking about.

Christopher:    Yeah. I’m sorry.

Tommy:    So, the first one is that in the absence of good light cues and he made a great point, which is during the day we’re not exposed to enough light and at night we’re exposed to too much light and we’ve talked about that on the podcast before and he has— Actually, he has an app called MyLux. And so, you’re iPhone can measure how many lux you’ve been exposed to. And so, we were sitting in this hole and it was brightly lit and there was a big screen and all this stuff and it was like 20 lux in the middle of the day when what you need to be exposed to is 10,000 lux. So like you think “Oh, there’s actually plenty of light in here.” But compared to what you need to set your rhythm, it’s actually—

Christopher:    You need to go outside.

Tommy:    You’ve got to get outside. So, in the absence of proper light cues, food timing becomes that much more important. So, for everybody again in the Western world, if you create a circadian food rhythm, then some of the absence of real lighting cues, light and dark potentially become less important obviously. If you had both, that would be great, but I think it’s most important for the people that he’s working with. He’s working with people with obesity who are in this sort of modern lights environment. Then if you can create that circadian component, you’ve automatically made again so many more things better because you’re helping to train their clocks when they’ve sort of been lost. So, in people, you have circadian rhythm issues, then food becomes really important and we were talking about, you know, separately and hypothesize that maybe people with things like seasonal affective disorder who really are affected by light, you know, maybe for them if they could create a stronger circadian cue from their food, you know, maybe that will help combat some of those symptoms and that was our own sort of hypothesis. I don’t know whether it’s true, but that’s definitely a possibility. And then the other thing that he said, which I thought was really interesting, is about caloric restriction and all the caloric restriction studies. You know, they still debate about— Well, there should be debate. And some people say, well, it’s definite. You know, caloric restriction make us live longer and we should just all be restricting our calories and then we’d all be happier and healthier for longer, which if you look at the way the studies are done, there are lots of potential issues. The one he pointed out was that if you’re trying to create a caloric restriction, you automatically include or you create a circadian timing component because they’ll say you want a mouse running. You send him out food. You just give it that food. You know, they eat all that food and won’t go and then there’s no food left. So, you’ve created a restricted feeding window.

Christopher:    Right.

Tommy:    And it’s the same thing in humans if they’re told to calorically restrict. So, something like the calorie trial in humans or some of the trials with monkeys. If you have less food to eat, it’s gonna take you less time to eat it. You’re not gonna just like—

Christopher:    You run out of food in the evening.

Tommy:    Yeah. You run out of food in the evening or you skip a meal because, you know, you only have so much food. And so, you’ve already created a circadian timing component. So, he’s like “Well, maybe it’s not the caloric restriction. Maybe it’s because you’ve created a circadian component for their diet.” It’s like “Oh, this is amazing.” So, I thought that was really an insight that I haven’t thought about before.

Christopher:    Yeah. That’s incredible. We’ve been traveling around Europe for the last few weeks and I’ve seen almost no environment that is in concordance with Satchi’s work. Right? Everybody has got the super bright spotlights imbedded in their ceiling. And then as soon as it gets dark, the lights come on. So, Satchi mentioned this that they end up changing building codes. Right? So, when you build a new building, you’re acquired to put a certain amount of glass in. Glass can be used as a structural component of a building now. So, we could put more glass in, get more light into the space during the day. And then of course, if we can come up with a device like the iPhone 7, can we come up with a switch that when you flick it, it changes the temperature of the light according to the time of day? And of course, that will be completely trivial.

Tommy:    Yeah. You can—

Christopher:    We will start up opportunities. Who is doing this? You know of a company that’s doing this?

Tommy:    So, there are some lighting companies, but I think it’s mainly just the temperature of the bulb is different and you use different temperatures in different rooms. Ben Greenfield talked about this, how he has like the red bulb in his bedroom and then he has the white bulbs that have more of a blue component.

Christopher:    Yeah. We do this at home. Yeah. You can definitely engineer. You can hack it. I mean, the orange bulbs are available on amazon.com and pretty much anywhere where they sell light bulbs.

Tommy:    What you need is just F lux for your house. Right?

Christopher:    Yeah.

Tommy:    It like we use this any time of day and then regardless of what you want. It makes everything go orange.

Christopher:    Yeah. Exactly. Orange glasses, but they’re so dorky and I’m not sure they were— Like the ones I’ve got, I think a lot of light comes around the sides. I look like an idiot on them.

Tommy:    Which ones are they?

Christopher:    I don’t know. I just got them from sunglasseswarehouse.com or something.

[0:40:02]    

    It cost $9, so maybe not the best. But yeah, really, really important work. And I really wished I had said a lot to Satchi now and asked him to come on to the podcast to clear up some of these things. And I should have told him about the fact that Katie Compton 13 times National Cyclocross Champion is using his app.

Tommy:    I mean, I e-mailed him to get into the conference first. I e-mailed him cold and he replied directly to me. So, I’m sure we can arrange that.

Christopher:    That is still a vice mine. How is it I could be the first person to say hello and go out to walk the dog and talk to a total stranger? But when I get the opportunity to talk to someone like Satchi, I let it slip. I don’t know why I do that. Let’s talk about Ben Greenfield then. I think he did a really good job of trying to condense down— Anyone that listens to the Ben Greenfield podcast, I’m sure there’s lots of people that listen to this podcast that they will know that it’s a fire hose of information. Each episode is so many things. How could you possibly be doing it all? And I think recently I’ve decided that really Ben’s audience, they’re about novelty. Right? He’s an ideas guy. Like listen to the Ben Greenfield. And people love novelty, right? That’s a really good strategy in business. Novelty is something that people seek out. And so, lots of novelty. Lots of new things each week. You can’t possibly do it all. You really need to prioritize and decide which are the most important things. And then for Ben to stand up on stage and do that after doing however many— Probably near 1,000 episodes of the Ben Greenfield podcast at this point. So, what do you talk about, you know, after all these years and so many episodes? I think he did a really good job of condensing it down.

Tommy:    I think the way that he did it and I think it has to be the way to do it is the stuff that he basically told us about the stuff that he does.

Christopher:    Right. Right.

Tommy:    Even for him, there’s only so many things that a man can do. And yes, some of the stuff that he talked about in terms of electrical shielding from Wi-Fi and structuring his water and stuff, I’m sure like most of the— The audience, their eyes— Their eyes just glaze over and they ignored him. But you know, he started with movement and some of the protocols. You know, based on the research, they’re doing something high intensity, some strength training, some aerobic training. Doing those once a week like he gave some sort of simple structured advice of how people could do those things and that sort of movement. So, you cover everything in a week, you know. So, that was kind of pretty nice and simple. You know? And then he talked about nutrient-dense food and how there’s lots of different things we could do. So like he mentioned everything from vegan diet to Paleo diet. All these other iterations. He was like I’m completely agnostic about diet. I thought that was pretty good ‘cause he was just like here are the principles. Some of the things he focuses on are, you know, whether it’s digestible and whether it’s nutrient dense. If it’s nutrient dense, but not digestible, maybe there’s a way to make it digestible. If it’s digestible, but not nutrient dense, then you are into the realm of the western foods that maybe we should be avoiding. So, I thought the rules were fairly easy to understand and that sort of gave people good grounding and that was sort of— Again, going back to the pillars that Rangan was talking about sort of tied right back into those. And they largely agree. So, I think that was kind of like a nice— gave a little bit more detail or gave the message in a slightly different way that people could maybe understand or they would identify with.

Christopher:    I really enjoyed the idea of a dumb home. But now, when I think about it, we don’t really need to— So, when Ben said the dumb home, it means I’ve got no Wi-Fi, you know, there’s not technology that—

Tommy:    There’s no Elexa or—

Christopher:    Right. No Bluetooth. You can’t order more toilet roll by Bluetooth and all of that, but that is hilarious. I don’t believe it.

Tommy:    There’s no Elexa.

Christopher:    There isn’t Elexa in the room as we’re recording this podcast. And when I said that, the Elexa started speaking.

Tommy:    Elexa, turn yourself off.

Christopher:    That’s amazing. Tommy just unplugged it. Nice. Very funny. But yeah, we don’t really need a dumb home. What we really need is the science interpreting and implemented correctly, right? So, the feature I just talked about where the color of the lighting is changing according to the time of day, I mean, that’s kind of smart features like smarter than a conventional light switch and a light bulb. It just needs to be done right. It doesn’t need to be dumb.

Tommy:    Yeah. Then he talked about the different lights he has in different rooms and that’s whereas if he was applying his true like stupid home principles he would have everything open air. He would get natural daylight through just windows during the day and then at night there’d be no lights ‘cause it would be dark. So, you know, I think you’re right that even he would be forced to admit that he does use the best of technology and that’s what he talks about. So, I think the idea is nice and it’s that you don’t need to automate or make everything in your home smart, but equally at the same time you could make things smarter that would create a more natural environment through the correct use of technology.

Christopher:    I do think he was in danger of creating more of that U.S. endemic, you know, it’s all very well for you, Ben, in your mansion in the—

[Crosstalk]

Tommy:    …however many millions of dollars or whatever.

[0:45:00]    

Christopher:    Yeah. You get to spend the whole day meditating and flipping tires whereas I’m an emergency room doctor and I work nightshift.

Tommy:    Yeah. I mean, he did sort of give some of the basic principles that I think helped. You can start wherever you want on this path and do the easier stuff first. And if you wanna do some of these other stuff, then sort of open the door to some of those things too.

Christopher:    Shall we talk about Bryan?

Tommy:    Yeah.

Christopher:    So, I think we’ve satisfied the criteria that no podcast shall be recorded without mentioning Bryan Walsh’s name and justifiably so too. Bryan’s fantastic. We love him to pieces. And he’s as good live as he is teaching via video or recording podcasts.

Tommy:    Well, I do actually think he’s better live.

Christopher:    Really?

Tommy:    Yeah. This is the first time I met him in person.

Christopher:    Okay.

Tommy:    That’s saying that he’s not good in the other formats. Enjoyed him in person even more. So, last year, when I gave a talk at the Icelandic Health Symposium, part of my talk— Last year, we focused largely on foods, then I talked about all the other stuff that’s important. And one of those things is social isolation and I stole Bryan’s story. And I won’t tell it here because if you haven’t heard it, you should go back—

Christopher:    Yeah. Yeah. I’ll link to the podcast of Bryan.

[Crosstalk]

Tommy:    Go and listen to him telling that story, but then I thought he would be a perfect person to come and—

Christopher:    Straight from the horse’s mouth.

Tommy:    Yeah. Exactly. And he went through several different things he wanted to talk about like why taking antioxidants doesn’t actually make you live longer and some other stuff, but then what he came up with was it was called thought driven. The science of thought-driven physiology, so how your thoughts can actually change what’s going on in your body. I mean, Ellen Langer has been on the podcast. He talked about Ellen Langer’s research. He has been talking about studies like the perceived time has an effect on glucose levels more than actual time that’s passed or how if you tell hotel chambermaids that, you know— By the way, did you know that when you spend all day walking up and down hotels changing beds hovering, you’re actually doing what we would consider good exercise? And then if you tell them that, they suddenly lose weight without changing anything else and their blood pressure improves and their blood glucose improves and all their stuff improves. And they’ve literally done nothing other than realize that actually, you know, I’m actually pretty active, you know, in good shape. And then there was another study where they took women with like a true amenorrhea. So, you know, their hypothalamus isn’t talking to their ovaries in the way to create a normal menstrual cycle and then they gave them cognitive behavioral therapy to change the way they think about their condition and then the cycles returned with changes in estrogen and progesterone. And all they did was get psychological therapy. So, just based on how your mind approaches things, you can actually change hormone levels in your body. And then he was like “Wait. What supplement did they take?”

Christopher:    Where was the medicine? So, they actually showed data, a time series mapping out the cycle. And you could actually see where the intervention was. You think it’s gonna be a drug because of the effect it has on estradiol and it’s not. It’s cognitive behavioral therapy.

Tommy:    It was just cognitive behavioral therapy. And then he talked about perceptions so like how you perceive things and your attitude towards them and then how that affects outcomes too. So, my favorite one was in people who think about aging as a positive thing, you know, it’s like I’m getting older, you know that’s actually not such a bad thing. You know, I’ve gained wisdom. You know, I’ve lived this great life and it’s okay to get older. They actually live longer and healthier than people who are scared of aging. And I thought that was really ironic because essentially the people there in the audience all figured out how to live longer probably because they don’t like the idea of aging, yet they’re being told that if they were thinking positively about aging, then they might actually age more slowly or live longer. So, it’s kind of like this strange reverse psychology or whatever. It is reverse through process. I thought that was really interesting. He was on stage like slightly fat, balding, wrinkly. I’m really happy about it. You know, I don’t care. And so like that was just like a really good example.

Christopher:    I think it was Ken Ford who is the first person I heard say this. Maybe the only person I’ve heard say this, is that aging is good because what’s the alternative?

Tommy:    Death.

Christopher:    Death. So yeah, why not be positive about it? It’s funny ‘cause some of what Bryan talked about and some of the research that he presents is intuitive. It seems like common sense like what you think is going to be the outcome will have an effect on the outcome, but then what’s surprising is when you show the physiological data and you see that hormones are going up and down and real things are changing in physiology. That’s the part that is surprising to me. I’d give you some examples actually. With restaurants now, if I think I’m gonna be glutenized, then just the stress of sitting there and thinking “I don’t think that chef is gonna use a separate pan for my burger” is gonna— I might as well not eat at that point because I’m gonna have a bad outcome whatever I think. And I’d been thinking about this as well for people that may be worried about chemicals they’re exposed to, you know, when they walk in to a new house and it sort of smells like new paint.

[0:50:02]    

    Oh, I don’t like the Wi-Fi in here and the most toxic environment of all is the exit through the Duty Free shop in the airport. Right? You look up and you see all these bundles of cables going through the metal cages. You’re basically inside of a Faraday cage with all these cables inside of the Faraday cage.

Tommy:    And then all of these chemicals off-casting from all of the things you’re walking past.

Christopher:    Extraordinary. Like we’ve gotten to the point now where we basically hold our nose and just sprint as we go through the Duty Free shop. You know, if you’ve got to the point when you’re expecting that to have a negative impact on your health, guess what? It will. And so, that’s why it doesn’t bother anyone else. It’s ‘cause they’re just not really noticing it in the same way.

Tommy:    So then you kind of wonder whether the fact that you spent all this time thinking and talking about this stuff is actually having— Maybe ignorance is bliss and you should just quit and go live in the woods.

Christopher:    So, I had a conversation with Bryan in the back of the car in the way to the speakers’ dinner at the Blue Lagoon. And he wants me to talk more about this. What is health? Like is what you’re doing at this point helping people by making them constantly thinking about how they can improve their health? Are you really still improving it or did they already achieve optimum health and now they just need to chill out and forget about it? You know, I’m perfect open to that idea.

Tommy:    I mean, I think that’s a huge part of the people that we interact with actually. They will probably be healthier and happier if they just stop worrying about it. I mean, it is something that I try and do myself because having a lot of not information can be a very dangerous thing and you know the people sort of obsess about all these details. I try and go the opposite way. So like I’ve informed myself. I know what the risks are. Like I know it’s probably not a great idea that I’m standing next to a Wi-Fi router right now, but I also know that worrying about it is gonna be a bigger problem than just standing next to it. So, I’ve acknowledged it, but there’s nothing I can do about it. So, I don’t really worry about it. I think definitely that last step is something that more people need to be doing. You know, you can educate yourself. You can modify the things that you can modify, are willing to modify, that you’re willing to get stressed about, willing to make a change. And then if there’s anything else that’s extra, worrying about it is— What you’re gonna be left with is worrying about it and that’s how you’re gonna make things worse, then just don’t worry about it. Don’t think about it. It’s not something you’re gonna change. It doesn’t mean you can’t change. So, it’s better to actually go the opposite way.

Christopher:    Yeah. Absolutely. I’ve become increasingly interested though in ways in which you can maybe harness the power of this positivity like how can I— Is there a button I can press and just have the correct mindset? Wouldn’t that be fantastic?

Tommy:    Well, that’s the next app you can create.

Christopher:    We should probably talk briefly about the difference between hedonism and eudemonia because that was a very interesting point that came up in Bryan’s presentation. I think I might have this down than he does honestly like he slide on that. I think it was a little bit difficult to understand it whereas in my mind it’s quite simple. So, hedonism is the pursuit of pleasure for one’s self and it happens very quickly. So, it’s instant gratification. So, a drug user snorting a line of cocaine is hedonism. Right? And then you’ve gotta do more to get that same effect whereas eudemonia is pleasure that’s complex and delayed and always achieved through something else. It doesn’t necessarily have to be someone else. You might achieve pleasure by looking after a plant or an animal or just something else. It’s not that instant gratification whereas his slide on that I thought was kind of confused. What did you think?

Tommy:    I mean, I did not actually even read his slide, but I thought his example was actually okay ‘cause he gave the example of himself going on stage and the hedonistic version is please let me be really clever today and say all the right stuff. And the eudemonic version is please let the audience get what they need to have in this talk. Right? And the end goal, what happens may be exactly the same thing, but that’s the way you approach it. I can’t remember the slide because I didn’t pay attention to it ‘cause I was just listening to what he was talking about.

Christopher:    So, especially eudemonia, it’s a very nebulous concept. The more you speak, the less clearer it becomes. And so, adding more bubbles like more bullet points under the eudemonia column, it doesn’t necessarily make it any clear. But yeah, the example you just gave I think illustrates the point perfectly. And so, I talked about why it might be important.

Tommy:    I mean, that particular comparison goes back again to some of the stuff that he touches on in the social isolation podcast, but it’s basically to do with— It’s to do with having a purpose for the great good and that’s what a lot of his talk on the day and then also the day after when he spoke at the practitioner event. He came down, you know, talking about the science of purpose and the effect that has on health. And so, even if you are a socially isolated smoker with multiple diseases, if you have a purpose in life, your mortality actually, your long-term health is— when you die, you will live longer just through the act of having a purpose despite the fact that all these other things go against you. So, even if you are socially isolated, if you have a purpose, you actually protect it. And there are all these other things that he has now built into his clinic.

[0:55:00]    

    You know, asking people why do you wake up in the morning. And his example is if I smacked you across the face in the middle of the night and woke you up and said “what’s your purpose”, would you have an answer? And I guess it’s really difficult to tell whether I would have an answer.

Christopher:    Yeah.

[Crosstalk]

Tommy:    If you did that to me, I’d just punch you and go to sleep.

Christopher:    Which is what Bryan said most people would do. They don’t have a purpose. Are you trying to tell me that you don’t have a purpose?

Tommy:    No, I do have a purpose.

Christopher:    What is your purpose?

Tommy:    I think I was actually asked this. I was having this conversation with Elizabeth the other day and the only way I could boil it down is to say that I want to make as many people as healthy as possible. I couldn’t tell you in 5 years’ time how I’ll be doing that. Maybe Nourish Balance Thrive won’t exist anymore. Maybe I would have an argument and you’re off telling people to eat a vegan diet and we’ve reached artistic differences. It’s perfectly possible and then I’ll hopefully find another way to do it, but sort of that’s essentially what it boils down to. And how I do that I think will probably change a few times along the way.

Christopher:    Yeah. I think the right biology answer is we’re all here to reproduce. Don’t we? I’ve just gotta pass my DNA and then I’m done. And Bryan did say that too. His purpose is really his family, but that’s kind of a cheating answer, isn’t it, like of course your purpose is your family and I would give the same answer, although my wife is in this room and would probably gonna rush up and say I’m gonna disagree with you there and say that the things that you find on the laptop are far more important than anything that’s happening with our daughter. Yeah, I disagree. But yeah, my purpose I think is even more generic than health. I just love solving problems. That’s the most gratifying thing for me, is solving a problem. So, you know, that may be something in computer science. It may be something— At the moment, it’s all about health, then it seems like some of the most interesting problems that we could solve are in health at the moment like who really cares about what’s going on in finance, or in social media, or some of the industry. All the interesting problems are in health in my opinion. So yeah, for me, it’s what purpose—

[Crosstalk]

Tommy:    …going and fixing social media.

Christopher:    I think I’m gonna be long dead and married before they’ve solved all the problems in health. I think we’ve got our work out there. Okay. Oh yes, Bryan was great. The next day, while we’re talking about Bryan, he came to the practitioner workshop that happened the next day and then he met Greenfield, didn’t he? He hit him with the fire hose. He started with the levels of organization and he talked about the importance of cellular function and he built the whole thing up from first principles. He talked about the periodic table and then he talked about the importance of all the different micronutrients that are required as co-factors to make all these enzymes work. And without those, we’re all completely screwed and everything is drawn towards all these fancy supplements these days. The standing joke that ran throughout his talk was goji berry. Does this guy have a goji berry deficiency? No, it’s B6. That’s the thing that you really need.

Tommy:    Or does he have a hormone T deficiency?

Christopher:    Hormone T deficiency. Yes, he does. First thing in the morning, I do have a hormone T deficiency. That’s why I reach for the hormone T every morning. I totally agree with him.

Tommy:    So, his principles were that every disease is just based on the dysfunction of a cell. A certain type of cell in a certain tissue. And then what then cause a cellular dysfunction are what you need to ensure optimal cellular function and it often comes down to that cell’s ability to produce the energy that it needs to do the job that it wants to do. So, in order to optimize that, you need to give the cell everything it needs to do to perform that job. You need to remove anything that might damage that cell. And you need to put that cell in the right environment. And you know, that obviously makes perfect sense, so then you need to give it all the right micronutrients. You need to deliver it with glucose. Particularly glucose is very important and the inability to do that causes real problems. It needs to be able to get that glucose in and utilize it and everything associated with that, but then you also need to remove anything that could be some kind of chronic infection, or a heavy metal, or a xenobiotic, something else that might be disrupting the function of that cell and then you need to put it in the right environment. So, you need to optimize the pH and you talked about the vast number of things that your body does to buffer pH to make sure that stays the same. And the reason you do that is to maintain enzyme function because those are very strict, the range that they work in optimally. And then you also need to have those cells surrounded by other cells of the same type and have them be able to communicate with one another. And then that’s where sort of the communication of the purpose, you know, the cell has a purpose. And then also, the human has a purpose and then population has a purpose. And you’re sort of like well, maybe, if you lack purpose as a human, then your cells kind of read that and then they lack purpose.

Christopher:    Yeah. We actually see this in the literature. You’ve talked about this in the highlight series. If you don’t know about our highlight series, come to nourishbalancethrive.com/highlights and we’ll send you this narrative on some studies that have been done with testosterone and your partner’s level of testosterone. That has got in to the highlight series.

Tommy:    Yeah.

Christopher:    Or they have to go in now that I’ve said it?

Tommy:    No. No.

[1:00:00]

    Are you talking about the study whereby men who are in committed relationships have low—

Christopher:    Yeah. Exactly.

Tommy:    …testosterone because that makes them—

Christopher:    It is.

Tommy:    …better able— You know, so then they’re less likely to be aggressive and out there competing and fighting and they’re more likely to be caring towards their family. So, you know, we have all these people who are like everything is gonna be terrible until my testosterone is 1,000. Well, what’s gonna happen when your testosterone is 1,000? You know, why does it need to be that high? Do you realize that actually there is some benefits to maybe it not being that high?

Christopher:    The trouble with testosterone. That is absolutely fascinating stuff, but what I was referring to is that nothing kills the moment like your partner not wanting it. So, it’s not just about your levels of testosterone that’s gonna lead to increased sexual performance say, but also the other people who are in that same equation, right, like that’s important too. And so, it’s not just the level of self-organization. It’s not just about the cell and then the tissue, and the organ, and the body system, and the whole organism. It stems beyond that to other organisms and then populations and communities, or tribes, or whatever you wanna call it. It’s super interesting the way things work.

Tommy:    I guess the way we describe it maybe it sounded like Bryan was being sort of a little bit woo-woo. But actually, you know, I have a number of papers that kind of show how each of these happens at each level and maybe because we know that thoughts can drive physiology. And if you don’t have a reason for your body to be there to do something in the wider community, maybe the body inside in the cellular level is like “Wow, fuck it. You know, we don’t need to perform our job as well as we could do because what are we performing that job for? Not that we know.”  

Christopher:    Yeah. Absolutely. Bryan is extremely evidence driven and he’s always giving us tons of studies to look at. It’s kind of his favorite thing at the moment, isn’t it? It’s just to sit in the cupboard for 6 months and immerse with all these studies that come out with this grand picture that’s very, very important. And he did a really good job of introducing people to blood chemistry. I agree with Bryan actually that blood chemistry is the most important test. It’s the one that everybody has access to. It’s relatively inexpensive. Whether or not you can afford to do our 8,500-dollar program is neither here nor there. You should have access to blood chemistry no matter where you are. And there’s some really, really important information on there that perhaps is being overlooked. People are not extracting as much information as they possibly could. And I’m working on it. We’re gonna produce some software, but it’s interesting because you could actually uncover some nutritional deficiencies. They’re very fixable with inexpensive supplements or changes to your diet just from doing a CBC, right, just looking at the immunopanel like diagnosing the cause of an anemia could easily reveal the nutritional deficiency.

Tommy:    And maybe you need to start with the fact that it’s not even an anemia. So, by the time you’re in the bottom half of the normal range, you know, so you start with the fact that people whose— The optimal ranges that we use of men above 14 and women above 12.5, right? So, the normal range from the lab extend lower than that. But if you look at the literature and you look at say all-cause mortality, all-cause mortality and some disease risks starts to increase as you go below say 14 in men, right, so then you know that the optimal range is probably gonna be close to 14. So then if you start with that, anything below that is potential issue. And then if you look at all the different patterns in the iron studies and the size of the red blood cell, the variability of the size of the red blood cells, and various other factors, you can identify 5 or 6 different basic nutritional deficiencies. It could be iron, zinc, copper, B6. And just from that, you know, for like a blood test that cost a few dollars, a few pounds wherever you are, you can get it from your GP in the U.K. They’ll run you like a whole blood count, you know. If it looks like you have an iron deficiency anemia, but your neutrophils are low, maybe it’s actually a copper deficiency and then you can actually access the iron that you’re eating because you need copper to activate the enzymes, to activate the iron. You absorb it and use it properly. So, we can extract so much more data from that.

Christopher:    Right. But you need the software in order to do it, right? So, I feel like I’ve just had some clarity of what I need to do with this software and it’s like they made me panel. I think that’s what it is and it’s a decision table. When you look at Bryan’s work, there’s matrix of markets in one column and then there’s the up and down arrows that form the cells of the matrix. But really, we don’t wanna make it binary. We wanna put ranges in the decision table and then we can relate that to what we’ve seen in the epidemiological data. Is epidemiological where—

Tommy:    Yeah. Most of it is epidemiological.

Christopher:    Exactly. So, they’re looking at all-cause mortality based on the—

Tommy:    So, it’s difficult to like— You can’t do it. It’s difficult to do. I mean, some of it is perspective too. So, you mentioned somebody’s ranges and then see how long they live, but you can’t just like make somebody slightly anemic for a long period of time and see whether they die soon.

Christopher:    Right. Right. Right.

[1:05:00]

Tommy:    So, a lot of it has to come from population-based states rather than controlled trials, but that’s just the nature of the beast.

Christopher:    Awesome. And I’ll link to Bryan’s new course on glucose, which is very good. I finished it a couple of weeks ago and it’s excellent. And Bryan is working on level 2 of metabolic fitness pro. We are in no way financially affiliated with it.

Tommy:    No. We just love him.

Christopher:    You know, we just love him and that’s the only reason.

Tommy:    Yeah. I told him that on stage. He said it’s really important to tell people you love them. So, I was like— At that moment in time, I was very much in love with Bryan. Well, I guess I am a lot of the time.

Christopher:    So, this one last, but not the least, Diana Rodgers.

Tommy:    Yeah. I really did envy her because she had to come on stage after Bryan and he was just so enthusiastic and so—

Christopher:    Had a stage presence.

Tommy:    He had such a stage presence and that doesn’t detract from the job that she did, which was great, but it was just— I felt he’s just a hard act to follow I guess.

Christopher:    Right. Like Gary Taubes.

Tommy:    Yeah.

Christopher:    He spoke for an hour and a half without breathing.

Tommy:    Yeah. Last year. And so, she talked about— which is something that is incredibly important, which is if we’re arrogant enough to believe that we can halt the process of aging to keep people alive for much longer and we have the population of the earth that we currently have and the way we are currently approaching the planet’s resources, is there any way to sustainably keep this many people alive healthily on the planet? I don’t think the answer— I don’t think we can. So, part of the puzzle of longevity is sustainability and finding a way. So, if you keep all these people alive for you to feed them, then what’s the most sustainable way for to feed them? And obviously, Diana Rodgers is big in the Paleo community. She works on a farm. She’s a nutritionist and she looks into sustainability issues of plant-based versus animal based agriculture. And you know, she showed quite nicely— I think because of the recent— There’s been this, you know, recent interest in lab growing meat. So, if you grow meat in the lab, it’s not associated with the ethical problems, potential ethical problems of raising animals. And she did say upfront, you know, “I don’t believe in factory farming. I believe our animals should be outside roaming the land that they’re designed to roam on.” And a big part of that is the fact that 70% of the world’s land mass is unsuitable for the growth of crops. So, you come to Iceland, how much wheat can you grow on lava fields and moss? Very little. How many sheep can you grow? A lot. And so, those sheep take food plants that humans can’t eat and on land where humans couldn’t grow something else and they turn it into food. And there’s this big debate about how we should just be farming soy and grains and, you know, that’s gonna be better for the environment and that’s bad for animals. But actually, there’s only so much of the world where you can actually do that. And in terms of their natural resources, if you have animals grazing on the land, the land actually is healthier because you’re keeping them under control. You’re keeping the plants under control and then you also have something to keep the animals under control so that they don’t overeat the plants and the things keeping the livestock under control could be us as well as other things that you need in an ecosystem. And so then, that area of land is healthier because it has animals grazing on it and then we keep those animals in check because we’re eating them, but then the resources that require to feed those animals are free. Free rain, free sunlight, which then creates free grass for them to eat. And if you do that properly and I guess a lot of that comes from work with— You know, Allan Savory is doing a lot of similar work and actually showing that if you do this properly and sustainably, you can then create this food is minimal impact on the environment compared to say monocropping with soy, which just completely destroys any diversity, destroys the soil. It requires continuous input of fossil fuel derived fertilizers and all these other things. And it’s actually something very similar for lab-based meat. You know, you wanna create lab-based meat on a scale. You know, the amount of energy and then the initial starting resources that you need to have the first products that then go in to create this meat, you know, all of that is so energy and resource intensive that actually considering you could get livestock from the land for free with free resources that are easily accessible and could benefit the land itself, you know, just I think the disparity there was very interesting. You sort of display that very nicely.

Christopher:    Yeah. I think there’s a Catch-22 here that people think I can’t have grass-fed beef because there’s no grass here, but the reason there’s no grass there is because there’s—

Tommy:    There’s no beef.

Christopher:    There’s no beef. And the importance of the ecosystem was something that I’ve not really thought much about before that you can’t— like a field of wheat is not a full ecosystem in the way that we quite think.

Tommy:    And to turn a field of wheat into a profitable resource, you need to actively sort of work against the ecosystem that would potentially exist there, right, because you get rid of the insects, and the pests, and the other diseases that could be affecting the crop, but they’re actually part of a normal ecosystem.

[1:10:10]

    So, if you create a food system whereby the ecosystem— the natural ecosystem is encouraged and maybe adapted such that it creates food for humans rather than trying to force a certain monocrop or single type of ecosystem, then actually you could end up with a healthier planet and healthier people obviously too because maybe some more meat for some people is actually a really good thing.

Christopher:    I saw the CEO of Compassionate World Farming present at River Cottage with Hugh Fearnley-Whittingstall on our travels. And the message there was that we should be eating less meat and better quality meat. And of course, who could disagree with the idea of—

Tommy:    Yeah. I mean, that’s absolutely true.

Christopher:    Well, there’s actually several ideas you could not disagree with and one was eating more plants. Another was eating better quality meat. But it emerged somewhere in his presentation that he was a vegan and that maybe this eating less meat thing was what this was really all about. The fundamental floor in his thinking was that all diets are equal to humans. Right? We know this is not true. We went to the Natural History Museum in London. We saw Guy, the Gorilla. And I learned about all the things that we learned about the diet a gorilla must eat while it’s in captivity. They put tremendous effort into learning about how to keep these animals alive in captivity. The modern gorillas in London Zoo now, their diet has— So much has been gone into like understanding what that animal needs to eat in order to thrive. And then when it comes to humans, oh no, they could just eat— they could eat lentils, pulses. It’s got protein in it. Right? That’s all the same. We just eat more refined carbs. That fine. We can just turn these things into cereal, and bread, and that’s all gonna be fine. We just need to eat less meat. I just can’t understand that like have you not looked elsewhere? It’s the danger of specializing. You need to zoom out and look at this problem that somebody else has solved and see how they solved it.

Tommy:    That kind of reminds of going back to the caloric restricting argument and I was thinking about this recently. I don’t know which will come out first, but I went on the STEM-Talk podcast and I was researching some of the calorie restriction stuff because I know Ken wanted to talk about some of that stuff. And talking about the calorie restriction studies in monkeys and whether those are relevant to humans. And if you look at the quality of the diet like they’re actually giving these monkeys like sugar and soybean oil and if you give them less of it, they live longer. So, that sounds a lot like a Western diet. And these monkeys, they’re also inside in a lab facility. And then I suddenly thought that so monkeys inside under artificial lights eating soybean and sugar and that just made me think of, well, that’s basically humanity right now. So actually, you know, then restricting calories might be a beneficial thing, but you’ve created so many artificial things along the way that it just doesn’t really make any sense anymore. And if you actually look out what it takes for a human to be optimally healthy, right, then you might come up with a completely different answer, but nobody’s really done that. So, nobody spent the time with the human as they did with the gorilla. So, calorie restriction works when you put the monkey in a cage inside and it’s not moving. It’s under artificial light. Right? But what if there’s something so much better which is the monkey is outside and he can eat whatever he’s supposed to be eating?

Christopher:    Right. But why is it difficult to understand why it’s not the obvious answer? Well, let’s just have a look at how the monkey is in the wild. There was pressure from the environment that shaped this animal into what it is today. Is it not the place you should start before you start— Can you not do that with humans? Isn’t that what Paleo is all about really?

Tommy:    Exactly. And Paleo gets a bad rep for— You know, some of it is deserved. You know, that’s the principle, right? The ancestral health principle that actually we evolved to be here. So, maybe if we actually looked at what involved could actually maybe inform us in terms of what we should do next.

Christopher:    Hunter/gatherers for the win is the tagline. What’s the future for the Icelandic Health Symposium? I was thinking that maybe this might be a good place to talk about. Now, Gudmundur is a fantastic guy that’s done a tremendous job with the event so far and he’s obviously incredibly passionate, but perhaps one of his passions is not event organization. And with a baby on the way, this is not gonna get any better. I wondered if you want to talk about whether there might be someone out there that’s passionate about health and organizing events that might be able to help you and your colleagues at the Icelandic Health Symposium in the future. Somewhat of a leading question.

Tommy:    So, I guess the answer is obvious. I mean, what we’ve learned over the last couples of years and I have been involved, but it’s largely been helping to arrange for speakers and I know that organization is not my strong suit and I also don’t have time to do that especially because I live abroad. So, that’s never gonna be my part of that organization and then the other people in the organization are also people who are health advocates or working in the health system. So, Gudmundur is an emergency physician, you know.

[1:15:00]

    So, he’s doing he’s doing nightshift half the time and he’s always fighting fires and then trying to organize a conference becomes very difficult. And I think, you know, he’s done a fantastic job the last couple of years, but I also know that they’ve nearly killed him. And whether it continues will be dependent on other people coming in to help. So, obviously, we would prefer people based in Iceland with a connection to Iceland. So, if you know any Icelanders or you are an Icelander and you’re interested in helping to organize, we would love to hear from you because we are not people with the skills in marketing organization. We are not people who have those skills. And we’d be very interested in bringing some more people onboard to make sure that this continues and gets the word out and, you know, maybe there could have been more people that knew about this conference than did and we could have had more people there and more people then helping other people. So, that’s something I think if it continues and I certainly hope it does continue ‘cause I think the message is important, then I think getting in more people to help organize and get the word out is gonna be important too. So, if there’s anybody listening who is interested in that, that would be great.

Christopher:    Cool. I’ll leave an e-mail address in the show notes. It’s support@nourishbalancethrive.com. If you come to the show notes, I’ll write that down so that you can find it. I think that’s about it. Slightly long one, but really good. Thank you, Tommy, for your time and thank you for organizing the event and hosting us here in Iceland. It’s been fantastic.

Tommy:    Oh, you’re welcome. It’s been great.

Christopher:    Thank you.

[1:16:22]    End of Audio

 
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