The KEY SIGNS You're Not Healthy In Life & How To FIX IT! | Casey Means & Lewis Howes

it's not working right we're getting sicker every single year we're getting sicker we're getting fatter and we're getting more depressed as a country and i think the key problem with this is that i think you gotta have a dream the school of greatness really yeah please welcome you went from i guess being a doctor to saying well how can i help people in a holistic approach to preventing chronic illness and disease and i'm hearing you say that it starts with metabolic health is that correct yes so what is metabolic health then for people and how can they optimize this yeah so well first of all i think you hit the nail on the head there is a movement and a tribe of doctors who are sort of waking up and realizing that we are missing the elephant in the room of modern american health care and the elephant in the room is that first of all the vast majority of things that are killing americans today are conditions based in our dietary and lifestyle choices over the course of our lifetime which means that we have huge amount of agency in changing our fate in terms of these diseases how many diseases would you say are caused by food and nutrition alone or a diet nine of the ten leading causes of death in the united states are either not only just caused by food and lifestyle but are directly attributable to dysfunctional blood sugar or are worsened by elevated blood sugar nine of the ten what's the what's the tenth one oh well to go through the ones that were like what we're talking about so we're looking at things like um alzheimer's dementia which is now being called called type three diabetes because it's so related to blood sugar heart disease type 2 diabetes cancer is very much driven by blood sugar chronic kidney disease which is very much a problem of the small vessels in the kidney becoming narrowed in part because of metabolic dysfunction and erratic blood sugar control chronic lower respiratory infections of one of the leading causes of death and we know that people with unstable elevated blood sugar have much higher mortality even with something like influenza or pneumonia having high blood sugar actually can get into the fluid of the lung and feed the bacteria that leads to some of these issues and of course with covid we've known now since the very beginning of the pandemic that having metabolic dysfunction diabetes is a key accelerator and driver of mortality and morbidity there's some odd ones on there too for instance suicide is actually on the top 10 list of killers united states and people with with diabetes or metabolic dysfunction actually have higher risk of suicidality really so it's all across the board um and and so what's really fascinating is is the way in which um these these dietary and lifestyle factors are essentially linking so many of the conditions that are killing americans today and the way we've approached it is we've looked at these as all isolated silos we think of them as all different things like huh we wouldn't treat diabetes the same way we treat cancer or kidney disease the same way we treat alzheimer's but when we look at these through the root cause approach that you talked about and sort of the fancy term for this medicine is systems and network of biology what is the network between diseases rather than how are they all different when we treat it that level it's so much more efficient and we can actually generate good health in the body as opposed to just reacting to symptoms and managing conditions so i think that's what a lot of doctors are waking up to they're sick and tired of being reactive practicing sick care practicing you know this end-of-the-line medicine and they want to help generate health in people's bodies and that's just a totally um different different way of practicing right yeah that's inspiring and so what i'm hearing you say is blood sugar management or control is one of the key factors of either being healthy or potentially linking to one of these other i guess diseases is that right that's right yeah and and what it really comes down to which kind of gets your question of what is metabolism metabolism is fundamentally the way that we make energy in the body so we eat food and you know food has um you know fat and glucose in it and either fat or glucose glucose sugar can be used to convert into a type of energy that our cells can use which is called atp so we take in this substrate but we have to convert it through our mitochondria in our cells to a form of energy we can use the currency that our body understands and can use that process of conversion is metabolism and this is happening in every single one of the 37 trillion cells in our body and it has to work properly so break it down for me then fat or glucose uh or i guess carbohydrates enters the body through the foods we're eating right what happens after that how is it processed in the body through the cells through the mitochondria how is it processed yeah so looking at carbohydrates for instance they go into our digestive tract they're broken down and absorbed into the bloodstream broken down into simple sugars like glucose and fructose these go into the bloodstream and let's say we're talking about glucose which is blood sugar this signals to the body um it's particularly an organ called the pancreas to release insulin which is a hormone that hormone allows you to take that sugar out of the bloodstream through the cell membrane into the cell once it's inside the cell um it's broken down even further and then goes into the mitochondria to be go through a chemical processing that then creates atp which is this molecule that can be then used to essentially power all the millions of cellular processes that are happening every second so yeah atp is the power is the fuel it's the fuel it's the battery in our body okay and so the way it's processed is it based on the foods we eat whether it be fat or sugar that comes through does that determine how the quality of the energy or what does that mean within is it all equally the same when it converts an atp or well i think the way to think about it is to really focus on the mitochondria this is the energy factor of the cell this is the powerhouse of the cell and the thing that people really need to understand is that our diet and our lifestyle in the modern western world so past 50 to 100 years so much of it is actually damaging the mitochondria of our cell and creating problems in that conversion process so for instance when we eat too much sugar okay and these days the average american is eating a lot of sugar like a hundred times more than we were like a hundred years ago into the rest of human history it's like this massive overload of this substrate what that does is it causes stress on the mitochondria and creates damage and one analogy i sometimes use is like imagine you had a factory that was making something like like cheese and like all of a sudden you get like a hundred times more of like the raw product like milk delivered to the factory the workers would be like we don't know where to put this we can't work like they go on strike there's nowhere to store it there's no refrigerators it would all go bad all of a sudden you actually produce less cheese even though you have more substrate you know and so it's like we are giving so much of the substrate to the body that it's gumming up the system it's breaking down the factory and creating problems and the molecular way this is happening is that each time you have these glucose spikes from eating these refined products or added sugars your body's releasing more of that insulin it's saying okay more glucose in the bloodstream so we have to produce more insulin to get it out of the bloodstream and over time the body sees all this insulin circulating and it's like we can't bring more of this into the cell there's too much and so it actually puts up a block which is called insulin resistance which is that cellular process that leads you towards problems like diabetes and so what's happening now is the body and that's why you're storing fat or you're storing other dead cells that you don't need to keep in the body i guess right right because insulin is the signal saying tons of glucose around for energy so we don't need to burn fat for energy so insulin is also a block on fat burning so it's this chemical signal saying too much glucose around blocking it from getting into the cell and also telling the body not to burn fat so of course for people who are dealing with trouble losing weight insulin is the hormone we hormone we really really need to be um thinking about and so we we reduce our insulin sensitivity um now we have lots of uh glucose circulating in the bloodstream but it's not able to efficiently get into the cell and um and then you've got all these other things that can hurt our mitochondria and and really a mitochondria energy-centric view of health can really help us some other things that can hurt the mitochondria are oxidative stress so i know you talked about this a little bit on the podcast with david perlmutter but um aside from glucose eating too much fructose so this comes with like sodas or fruit juice or things that have really high concentration of fructose it's not going to actually stimulate insulin in the way that glucose does but what it does is it goes into the cell and it's converted into something called uric acid and that uric acid creates oxidative stress which is sort of this sort of damaging reactive molecule in the mitochondria and creates mitochondrial damage so now again you've got more trouble processing energy than mitochondria environmental toxins are actually a huge problem as well they can directly damage the machinery or the mitochondria so we're thinking about things like pesticides and a lot of the fragrances in our personal care products and a lot of the you know fragrances and chemicals in our home care products these things actually go into our bodies damage our mitochondria make it difficult to produce energy effectively chronic stress can damage our mitochondria through cortisol and through our stress hormones so it's it's interesting to think about how all these different aspects of modern life fundamentally feed down into damaging this precious part of our cell that creates energy and when we have the mitochondria the mitochondria and when we have problems creating energy in our body this can happen in any cell type again 37 trillion cells you know dozens of organs in the body where this is showing up most prominently in the body is where you're gonna see symptoms and this is why metabolic dysfunction and blood sugar dysregulation can look like so many different things it can masquerade as so many different symptoms and in the conventional system we see those all as separate but when we think about it as this is actually just where a fundamental core problem is showing up in different cell types and so if you can address that you can potentially kind of melt a lot of things away so just as some concrete examples if metabolic dysfunction is showing up in the blood vessels well if it's sort of most prominently showing up in the penis that could look like erectile dysfunction if it's happening in the heart it could look like you know heart disease um if it's happening the liver it could look like fatty liver disease if it's happening in the ovaries it could look like polycystic ovarian syndrome which is the leading cause of infertility in the united states which is a metabolic problem um and if it's happening in the brain it could like like alzheimer's dementia and so it's got all these different faces but fundamentally is rooted in a core dysfunction in how our body is converting food to energy and and a lot of that has to do with this chronic over nutrition overloading ourselves with too much to process gumming up these systems and then the many other lifestyle factors like toxins stress sleep deprivation and sedentary behavior that can also hurt the mitochondria right so blood sugar management and metabolism management is that right so the main things we just think about how does blood sugar and metabolism work together yeah so so the way that those sort of things link up is that if your blood sugar is quite erratic like let's say it's going up and down in big spikes every day yeah you're having lots of sugar you're yeah you're just eating poorly you're stressed you're overwhelmed yeah and and the majority of foods on the shelves in our grocery stores now have added sugar like well over 60 so it's not unusual for an american to be on that blood sugar roller coaster up down up down up down and that's called glycemic variability and that process of glycemic variability is very damaging to our metabolism through the through the mechanisms you know we spoke about of causing insulin resistance by stressing the body to make too much insulin over and over but that those high blood sugar spikes in their own right can cause damage as well when your blood sugar acutely goes really high like after eating a pop-tart or eating a pastry or something like that or a big bowl of pasta that spike can lead to inflammation it can lead to oxidative stress because of the way that it's overwhelming our systems and creating free radicals it can also cause a process called glycation which is where sugar sticks to things in the body um and so if you can imagine if your concentration of blood sugar is really high it's kind of going to just stick to things more like your blood vessels and proteins and that's not good that that's like a signal for the body that something's wrong and so um all of these things kind of coalesce to just creating problems so the more that we can minimize our glycemic variability and go from spikes and valleys to more gentle rolling hills the better we are the better we're going to basically be treating our cells and it's not just um it's not just the sort of like cellular optimization we're trying to do it's also the way you you feel i think a lot of us have had that experience where we have a really high carb meal a big dessert and we feel like we kind of have a crash afterwards it's like that post-meal crash we feel lethargic like we may need to have another cup of coffee or or even feel jittery after it like a big high carb meal um that's we really understand how that works the body sees a huge load of glucose from a high carb meal the body then surges out that insulin over compensate soaks up all that glucose and you crash and in that crash state is when we feel fatigue there's potentially some anxiety and it's when people usually feel cravings so by learning more when you watch more to bring yourself back up because you've kind of crashed and i think the majority of american bodies are on that cycle because you think about what we eat it's like breakfast it's cereal juice toast pop-tarts pastries you know sweetened coffee beverages that's all refined sugar and refined grains then you go to lunch and it's bread tortillas wraps chips you know all of that stuff and then you go to dinner pasta potatoes whatever and then it's and then it's dessert and it's like if you're not if you're just going along the normal american cultural treadmill of what's normal to eat you're on a glucose roller coaster and that means that your day might be highly labile in terms of the energy mood performance cravings and so learning just simple ways to to balance out that glucose roller coaster can be an amazing life hack and really a super power for essentially getting your day under better control making you feel better in the moment yes and of course creating the cellular conditions to set you up for long term right longevity and health and prevent that whole downstream insulin resistance cascade that we know is related to so many causes of sure death in the united states so let's let's speak to people that are listening or watching who maybe have active lifestyles they like to work out so they need energy for working out they're driven they're passionate in their careers or entrepreneurship they have a lot of friends and activities like to go to say they need energy throughout the day how can they get the energy without the glucose roller coaster happening what are the best foods to be eating throughout the day how many times should we be eating and does it really matter or does it really depend on each individual's body type [Music] yeah so i think for the type of person you're describing the key concept we want to think about is achieving metabolic flexibility okay so metabolic flexibility means that we are able to use different forms of energy to make you know atp based on what's available and what i mean by that is if there's sugar around we can efficiently burn sugar to make atp but if there's not the body's fine it's like cool we've got fat to use for energy the average person is not metabolically flexible and the reason is because they've been on the glucose roller coaster their body is so used to seeing glucose that those pathways are super active um and they're constantly on that sort of like craving hit they want more of it they haven't really given their because glucose is the preferential fuel the body will use it's the first thing it's going to grab it's kind of like that easier thing to um to use it will never go and burn fat if there's glucose or it will not burn significant amounts of fat if there's glucose readily available so something that we can do it essentially train our bodies is to give it opportunities to burn fat so this is where you start thinking about things like time restricted feeding or fasting or potentially doing a fasted workout where you're actually kind of intentionally keeping your blood sugar levels in the low normal range signaling to and of course the downstream effect of that it's going to be insulin will be low because if you're not having a glucose spike then insulin will be low and that insulin being low takes away that signal to not burn fat so now your body's like cool insulin's low glucose is low i'm going to tap into my fat store so that's when it starts to burn the fat exactly exactly so if you work out for in the morning without eating you're more likely to be burning fat is that what i'm hearing you saying that's right and there's actually a lot of athletes that are using this type of metabolic science to their advantage there's a whole community of endurance athletes now that are doing low carb training and the purpose of that is that they don't want to be super dependent on glucose during their event where they're just like every half hour having to take a goo or a bar or an energy drink or something like that and have these big spikes throughout their event instead they've actually trained their bodies to use fat during an endurance workout and there are literally marathoners now who will run the entire thing fasted because they can so efficiently burn fat but that's not that those pathways have to be kind of worked and developed to be able to do that and that's metabolic flexibility so how do you train metabolic flexibility for yourself i would say the key thing is to minimize these excessive glucose spikes to give your body an opportunity to be more in the stable healthy low range for more time of the day to keep insulin in a lower and healthy range so that your body knows to burn fat one way that you can do this you know is of course with a continuous glucose monitor you can which are becoming popular now wear it see what spikes your glucose modify it and and try and get to a more stable range interesting or measure your ketones which a lot of people are doing now and this is um a finger prick device or there are breath monitors you can also check in your urine and ketones are a byproduct of fat burning so if your ketones are super low or zero it means you're not burning really any fat and if your ketones are higher like above 0.5 or up into the ones and twos you are proving to yourself that you have gotten to a state where your glucose and insulin are essentially stable enough that you're burning fat for energy and so something i like to see if i'm tracking these things is okay if i've kept my glucose quite stable and low for a couple days based on the choices i'm making around diet and lifestyle i start to see ketones rising up and that to me is proof of metabolic flexibility and i can test things like okay if i do the peloton ride first thing in the morning after not eating does it increase my ketones later in the day and start to do some experiments um like that and another thing that people can do is ask their doctor to do a fasting insulin test um it's not a test that's normally done on a regular yearly panel but it's a really powerful test because again if insulin is quite elevated it's going to be kind of that block on fat burning and if insulin is a low and healthy range it's a signal that your body is probably likely very insulin sensitive you're not far down that insulin resistance pathway i like to see it between about two and six and shockingly the reference range in a lot of labs will say that like anything under 25 is normal but that would be very very very elevated so you want it to be tight and low to know that you're just giving your body that opportunity to to burn fat and to work those different pathways so many people are talking about fasting or intermittent fasting these days is it different for men and women on the ways to fast in order to burn fat or is it the same for both you know i would say it's different for every single person even you know and definitely for for different genders but um it's it's different day to day you know i think intermittent fasting and time restricted feeding is a stress it can be a stress on the body you know and so i i tend to think of it as you know we've got a certain capacity within the body to manage different stressors and we know that certain stressors can be helpful in building adaptations in the body to help us improve so like cold exposure heat exposure fasting um high intensity interval training um but there's also stressors in our life that or maybe someone out of our control like work stress or family stress or things like that um and we don't want to overload our body and so you know if a woman is potentially in a part of her cycle for instance where her body's also already quite taxed um you want to do it then you wouldn't do it then and on a day that i'm i don't have as much sleep on a day that you know i might be doing a big podcast or something like that like today you know i'm probably not gonna add you know um i'm gonna be thinking very deeply about food though because you also don't want to be eating a big meal and then crashing right during that time when you have to perform so it's more about keeping things keeping things really stable and not being highly fluctuate you know fluctuating so i think about it more that way i think that fasting is great if you're otherwise very well resourced with sleep with resilient psychological resilience not putting your body probably under intense physical stress during that time i tend to do more like zone two workouts you know sort of low intensity during fast um so as not to add too much stress the body and ultimately too much stress can lead to breakdown and so kind of like bringing those things just thinking of everything in a really holistic picture if you stress the body too much does the blood sugar go up or what does that do to blood sugar and metabolism yeah stress is has a fascinating relationship with blood sugar so psychological or physical stress can both cause blood sugar to acutely go up even if you're fasted even in the absence of any glucose and the reason for this is that any stress signal to the body will release stress hormones like cortisol and catecholamine like noradrenaline epinephrine things like that these signal to the body that there's a threat and the body has trouble interpreting the difference between a physical or a psychological threat and so it's going to produce the same stress hormones so if there's an event that happens in life let's call it something we witness or something we see or something we hear or experience we think of a thing that causes a stress hormone to go to the body is that what i'm hearing you say there's a thought that we have associated with the event or the stressful or the thing that we think is stressful and then that causes a stress hormone yes to enter the body does it go throughout the entire body does it go to the heart what it what happens and then does it just spike the blood sugar up exactly so it it goes to the whole body and i would say simply put in many ways our mind has huge control over our metabolism what it sounds like yes and because we can think of thought and stress ourselves out and have high blood sugar just based on thought alone you can think your way into metabolic dysfunction i think can you think your way out of it too in in some ways you can and it should be a part of our strategy for optimal metabolic health so the way it works is that um these stress hormones they travel throughout the body and they actually tell the liver we've got a threat there's a lion chasing us we need to run we need to have fuel for our muscles so that we can flee you know it's fight or flight so the liver actually stores about two hours of really quickly accessible glucose in the form of something called glycogen it's change of glucose and it's it's like our debit account it's short-term it's ready to go but it's only a couple hours worth okay so you've got your circulating and then you've got your stored glucose stored in the liver like all the time all the time yeah unless you burn it for those two hours then it's exactly depletes and you deplete your liver glycogen so that hormone says dump it so you flood this the bloodstream with blood sugar to feed the muscles and you can imagine if you are doing a high intensity interval training workout and go to 90 your vo2 max in like five seconds that is a stress signal but you're gonna use that glucose your body's actually so you're gonna see that rapid spike and it's actually fascinating to see on a continuous glucose monitor like i will do a sprint workout or you know a crossfit workout and it's like within two minutes my glucose is going up and it can look like a big food spike but the muscles are there using it and the really cool thing about muscle is that it's one of the only cell types in the body that doesn't need insulin to take up glucose so it actually can just take it up from the contraction so it's not like it's really feeding into that pathway of insulin resistance like we were talking about like it's a sink for that glucose so there's a supply um sort of use match which is good but when you think about psychological stress you're literally just like you're sitting in your chair you're on your computer you get an email that's stressful and you're like how reacting to it your body has that spike but you're not moving isn't that crazy yeah you're not using those muscles it's just sitting there causing damage and you can think about like we're doing this probably 100 times a day in our regular life or ruminating on something from the past or stressing about something in the future or reacting to you know the news or whatever it might be that we can react to that how much of the psychological aspect is related to the disease in our life versus just the straight food itself without the psychological i guess thoughts that come with it you know i think it's so multifactorial i always really say i think that food is the foundation you know food is the substrate food is both what physically builds our bodies and it's also the molecular information that tells our body how to function we eat about one metric ton of food per year two to three pounds per day this is just straight up chemical information that builds our body and tells our body what to do you know we're turning over constantly the body we have today is not the same body we have in a week from a physical atomic perspective we're shape-shifters we're constantly changing so food is it's incredible it's magical it's this incredible thing that we're just constantly transmuting into ourselves and so it's it's got we've got to get that right but while it's necessary it's not sufficient for optimal health you still got to dial in the other the other factors and when i really think about the pillars i'm thinking about seven things i'm thinking about food i'm thinking about stress management exercise sleep our micronutrient status so not just like the macros we're getting but what are the actual micronutrients vitamins minerals and antioxidants our microbiome how that's doing and then our exposure environmental toxins so yes while food is the foundation you've really you know got to get those other things dialed in any one of those things can shift you off course she said food stress exercise sleep macronutrients micronutrients micronutrients which we often overlook okay what are those this is all the vitamins minerals and antioxidants that come from whole foods so like things we don't often think about like manganese and selenium and vitamin c and polyphenols and all you know trace minerals like chromium um that actually you know they come from whole foods and unfortunately because our soils are becoming super depleted now because of our industrial agriculture practices and because of overuse of pesticides that are really hurting our soils the nutrient composition of our food is declining and we're eating less whole foods but when we think about metabolism and the mitochondria again so your mitochondria is filled with all these little enzymes these little protein enzymes that are essentially doing the work they are the they are the um factory line that's taking that food and converting it to atp and every single one of those amazing little protein machines needs these micronutrients to actually work and the way to think about it is they are lock and keys that bind into little pockets of these enzymes and create tiny tiny structural changes that actually make it work so if we're deficient in selenium or magnesium or manganese or zinc or whatever it is these aren't working properly and the majority of americans are deficient in at least one critical micronutrient because we're just we're not eating real food right um and because stress can actually deplete a lot of these chemicals so you know i really think about it all goes back to thinking about those molecular machines that are converting food to energy and what they need to function properly and micronutrients is a big one i've also heard examples of people who let's say eat perfectly but still have challenges maybe their relationships are off and they're in a stressful environment in their relationship or their marriage or whatever it might be or they just react poorly they worry often to things they see and experience they're a warrior and so every time they worry there's a i guess the stress hormone is spiking right and sending hormones to the body which is spiking blood levels is that right yeah blood sugar so it sounds like the psychological side of things is also extremely important to understand and that every time you're on you're allowing your body or your mind to ruminate on a consistent basis it's sending a signal to the body in a negative way which is helpful if there's a real life threat but not when it's on a repeat every day is that right that's exactly right it's that chronic low-grade stretch that can be really damaging and there's you know something that's been really fun to experiment with is you know there's now heart rate variability monitors um like aura ring or whoop or leaf therapeutics and what these do is ra variability is a metric that you can track that looks at actually the time between each heartbeat and oddly enough we want the time between each heartbeat to actually not be consistent like a metronome we want it to have some variability yeah like maybe 0.7 seconds and then one point i'm sorry 0.7 seconds 1.1 second 0.9 seconds that's variability why do we want that it really is a symbol of a dynamic system you know you want elasticity in the system and that can sometimes have some irregularity to it um sort of the way i kind of think about it is like a stiffer system is going to be a little bit more more regular and there's sort of that and it's these are subtle you know it's not like you can feel it in your pulse if you just feel your pulse but you can pick it up and so we want more heart rate variability and usually less lower heart rate variability is an objective measure of stress and i've worn these things and been giving a talk on zoom or something like that and i'm looking at my data afterwards and my heart variability plummeted during the talk or i'm processing email my heart rate variability goes down so using and then of course glucose may go up and so you see these things happening together and the immediate thing i think is this is where our tools come in this is where the deep diaphragmatic breath where the mindfulness where having awareness of this happening and then there are so many things we can do to modify that stress response even telling your body you're safe you know everything is actually okay can have a huge difference so really dialing into awareness and then where can i apply the tool so i would say i take about 100 times more diaphragmatic breaths now than i did a couple years ago because i realized wow if this is happening all the time throughout the day without my awareness that's going to add up over the next 30 40 50 years and have a huge impact but it's not actually just the chronic low-grade stress there's been a lot of research showing that acute traumatic events um like you know loss of a loved one or divorce or childhood events so adverse childhood events which are usually there's an acronym in aces people who have many of these tend to actually have worse metabolic health and this actually may be related to changes in the brain that affect metabolism so really changing sort of our set point for stress thresholds early on in life and so so sometimes we'll have that patient like you talked about who's doing everything right they're eating really healthy but they're just really not quite making that progress towards driving they want and a lot of those patients i'm thinking about what is like the deep core wounds and the what's the set point that's causing you to feel that this world is not a safe place that is causing you to be inherently hyper vigilant um and doing that work even on myself has been so positive because i think what you start to unpack as you go down that journey is that your perception of the world and whether it's safe is very much dictated by your lifetime of experience and i think for those of us who have been on a journey of like therapy and now people are very interested in of course how psychedelics can fit into this and then you know other modalities um you know long-term meditation you know the meditation events and things like this that can really unwind some of those kind of amygdala-based fear-based responses in the brain i think there's huge potential there for that to potentially like unlock a new level of health because what it's doing is changing the fundamental way you see the world as a place of threat or a place of safety and unfortunately i think in our modern world fear has become a currency that we've used to to profit in a lot of ways if we can get people to to be fearful we can get them coming back for information that assuages that fear and we see that with social media we see it with the news you know there was that undercover uh reporting of of one of the uh cnn executives who who said you know was recorded saying if it bleeds it leads you know that we need to get people fearful for them to come back and watch and what that's doing to our stress hormones to our brain set point to our desire to have dopamine stimulation to kind of get some pleasure in the face of all this fear the way that's affecting our cellular biology is profound and so you know i think all of this movement that we're seeing right now towards helping people towards normalizing mental health care normalizing you know psychedelic abuse is not an end-all be-all but i think it's interesting how that's now being talked about as a way to really help help people unlock some of this chronic um you know fear i think it's going to have you know it could have positive impacts on the body because if we're living with chronic fear our bodies are not functioning properly and many of us are did you live with chronic fear for a while i think that the the health care system the conventional health care system unfortunately uses fear as a way to to control patients in a lot of ways we you think about a conversation between a physician and a patient and it's like you know your cholesterol is a little high you need to take a statin and the patient might say well can i have some time to like work on diet and lifestyle well i mean it's your choice i mean i'd recommend the statin right now because obviously i don't want you to have a heart attack but like you know sure if you want to try a diet and lifestyle like that's the type of thing that's happening every day like where this fear of bad outcomes um is i think driving very much a pharmaceutical and invasive intervention type of strategy um and i think i think that that really was unsavory to me because it's very disempowered it's like if i can drive fear in a patient then i can essentially get them to do whatever any whatever intervention i recommend and as a surgeon medicines procedures anything right exactly you know oh well if we if we don't treat this ear infection with antibiotics then it could travel to the brain and create a brain infection and it's like most ear infections resolve on their own without antibiotics an overuse of antibiotics is causing huge huge problems with our gut which then leads to mental health issues and metabolic problems and it's like but if people are scared of the potential you know outcome that may be very rare then of course you can kind of get them to do stuff and and i think that i don't think that doctors are intentionally doing this i think we have an incentive system in western healthcare that really drives people towards intervention um but i think that you know i i also think that with kovid we saw this happen where you know this fear of you know anyone you know being harmed from covet or you know that we you know kind of got people to do anything and everything and and we're kind of losing this um we're losing kind of that rational sense of of the risk that is inherent in living you know we get in a car every day and like there is risk involved in that but we choose to do it and i think that um you know there's just a lot of a lot of sort of fear-based thinking that happens in the health care system that unfortunately disempowers patients and pushes them to do interventions more quickly when i think that there is so much opportunity to help coach them with diet and lifestyle which takes longer it's harder but ultimately it generates health rather than just putting a band-aid on disease there's no medication that actually generates health only diet and lifestyle strategies generate health and so that should obviously be the foundation of our of our medical system but unfortunately we're not very well trained as physicians to know that information or to coach on it um but yeah to answer your question i think a large part of my personal journey has been trying to overcome fear um personal fear personal fear i think one of the biggest examples of this is my mom just passed away and about a year ago from cancer and just as any normal person i spent my life fearing my parents mortality like it's like oh this is going to be horrible and devastating and i think a lot of people worry about premature loss of a parent and you know i think going through that experience and it actually being a very beautiful transformational experience um see it was a very it was sort of a surprise and um she had two weeks between her diagnosis and her death oh man we had this beautiful time together as a family she was actually very much on the same page about sort of holistic health as me and and knew in her heart that she was dying very rapidly she chose to stay at home be with the family we were all together had this spectacular two weeks the hospital system through every possible medium was trying to pull her into the system you know it was pancreatic cancer so it's like you know liver sting you need a liver biopsy you need a blood transfusion you need to be at start chemo immediately and the reality was she knew i'm dying like right now she ended up dying in two weeks none of the interventions would have helped we wouldn't even had a um you know what if it lasted maybe a few more months or a few more weeks maybe you don't know i actually don't think at all i think that um might cause more stress and more well and it was coveted so she would have been in the hospital and we could have not visited her oh that'd be tough so anyways that experience of seeing her approach um seeing her pure joy in the face she was just ended her last two weeks very joyfully was very at peace we had that time together um she was not just like locked in the hospital doing interventions that would not have helped very much i realized oh something i've been fearing my entire life happened was the most transformational growth experience i've ever had i still feel way more connected to my mom than i ever could have imagined no one can tell you oh you're gonna still feel connected until you maybe experienced that and it kind of made me realize fear is kind of not useful so i think that something like that and i think it probably a lot of people have their own examples just kind of makes you realize the futility of living in in fear and you know what does it do it damages your body it doesn't really change the outcome a little bit of healthy fear is useful of course like you don't want to cross the street without looking um but the the idea that um we should be fearful all the time like that's going to protect us is such a fallacy so turning to stoic philosophers turning to you know some sort of eastern text uh buddhist and taoist texts like sort of looking into traditions that have thought this way has been a really useful part of my journey and i think needs to be a part of how the health care system reforms because we weaponize fear of death as a way to control patients into doing anything we want and i think fundamentally overcoming your fear of mortality which is the the the only thing we can be certain of in this world um and really approaching that with a sense of awe and a sense of curiosity and a sense of what can this teach us about how to live i think is an absolute foundational part of what we need to do as individuals but also the health care system because otherwise we're just using fear as this thing fear of death is this thing to just wrangle people into as many interventions and um and as pharmaceuticals as possible with the off chance that people think it's going to somewhat reduce their chance of mortality so what i heard you saying there was that there is no medicine that can actually make you healthier is that correct or that that could actually solve the issue on the medicine itself the vast majority of all medications i probably wouldn't say all on a record but i would say the vast majority most do not generate health in the body they manage they don't cure the disease you take away a diabetes medication from someone their diabetes is not gone it's right back there where it was um whereas if you get someone to really foundationally improve their cellular function which can only be done through consistent dietary and lifestyle habits they can truly reverse their disease but there's no medication that reverses diabetes there's no medication that reverses heart disease there's no medication that reverses alzheimer's dementia um they just kind of manage the symptoms they manage the symptoms you know and maybe maybe some relief a little here and there relief um you know life extension for some of them um but but they do not create health and what health is health is optimal cellular functioning we are just a big you know bag of cells and each cell needs to be functioning properly for us to have health what is a symptom what is disease that is cellular dysfunction happening on the individual level happening in a you know if that's happening in mass that might be tissue dysfunction if that's happening uh you know in a bigger way it's organ dysfunction and that's when we see symptoms and disease so we have to really zoom in on what's happening in the cell and what is a a cell is being getting its information from what you're eating what it's being built from which is your food what stress hormones it's seeing binding to its little cell membrane um you know what's happening with your hormones which of course is dictated by stress and by sleep and by exercise and by food it's the super complex milieu that can only be optimized by the choices that we're making every day day in and day out consistently even by the sunlight we're exposing ourselves to in the morning and um you know andrew huberman talks about this all the time but literally the consistent exposure of sunlight first thing in the morning is chemical information to your body through the sunlight's energy to tell your cells how to function you can't put that in a pill you know it has to happen through these millions of years of evolutionary evolved processes and so yes like medications can't with their you know one pathway that they might be intervening on truly generate foundational cellular health which is what we need to achieve they don't they don't bring uh wholeness back to the cell yeah i guess there's what some creams or something that might help you heal a cut or something like that but we're talking about like a chronic illness medication right there's yeah but even if you think about a cut you know i mean a cut is like it seems so simple but it's actually so complex it's like for cut if you think about people with disease like diabetes for instance one of one of the reasons that people with type 2 diabetes die is because of chronic wounds they have wounds that won't heal interesting oh yeah and i don't know internal ones or external external wounds people can get um something that happens with people with diabetes is they often have nerve damage um because of the way the blood sugar is affecting the nerves so then their feet become numb and then they might get a cut on their foot they don't feel it and then that festers and because of their high blood sugar their immune cells don't work so they can't heal the wound um and then they die from the wound and then they get a huge systemic infection that might lead to death or an amputation so the the majority of lower limb amputations are caused by diabetes diabetic ulcers that are like wounds people have type 2 diabetes in the u.s do we know the number oh yeah well there's 128 million americans with pre-diabetes or type 2 diabetes of those 30 million have full-on type 2 diabetes 30 million of the what 300 and what is that 300 something yeah it's about 13 of the population has type 2 diabetes yeah and it was less than one percent in the 50s and 60s and pre-diabetic you're saying a hundred million yep what is that what does pre-diabetic mean who is who is someone who might be pre-diabetic well it actually can be quite surprising there are lots of young healthy people walking around who look otherwise fit who have pre-diabetes and don't know it 90 of people with pre-diabetes do not know that they have it how do you know if you have it well the easiest way to do it is through a blood test um so you basically get a fasting blood sugar test from your doctor and if it's between 100 and 125 milligrams stress liter of fasting glucose um that's considered pre-diabetes 100-125 100 what do you want to be at what's a healthy range so what's considered normal is 100 or below 100 below but i would say that that is way too lenient at a range because what we've figured out is that people in the low end of normal are much less likely to develop long-term problems with like heart disease stroke or diabetes so even if you're in the high normal range and your doctor says to you oh you're you're fasting blood sugar is 97 you're great you're normal that's very close to how you see that as a huge red flag you are metabolically dysfunctional if that's the case um and so really where you want to shoot for is about 70 to 85 milligrams per deciliter people get a test that they can order and do this themselves or you have to go through what they're called glucometers um so you can just they're like literally 20 on amazon there's keto mojo just prick your your finger and then it'll tell you right away in a few minutes five seconds yeah so then it just tells you what your level's at what it is and it's cool to check it actually um day to day like for a few weeks because one thing you'll find is that let's say you have one poor night of sleep like let's say you had a big work thing do and you got six hours instead of eight hours your blood sugar in the morning might be ten points higher come on oh for sure yeah or let's say you had a really late meal the night before your blood sugar might be higher the next morning so when it starts putting together for you is this is very dynamic and if i did these activities day after day year after year for my whole life i'm building so figure out what allows you to be in that 70 to 85 range maybe it's like a really awesome workout in the middle of the day prior and getting to bed a little bit earlier and getting morning sunlight exposure and doing some deep breathing in the morning and all of a sudden you're like oh cool my blood sugar is 72 milligrams liter you know or fasting for you know 16 hours or something like that but figuring out what works for you to stay in that low range and then dial it in for as many days of the week as possible um as you can the other really interesting thing about fasting blood sugar as a test is that you know the body like we were talking about with the insulin resistance it's very adaptable and when the body starts becoming insulin resistant so it's saying we're seeing too much glucose around we're producing like we're going to create an insulin block what the body does is it's like well we've got to get this glucose out of the bloodstream so it starts producing more insulin so your your insulin levels will actually start rising as you become insulin resistant to push more of that glucose into the cells and so a study in the lancet a big medical journey journal showed that you can actually keep your blood sugar levels normal for like 13 years prior to them elevating and all the while insulin is rising but it's compensating to keep glucose low unfortunately because we don't check fasting insulin in this country we're missing that window where people are clearly becoming insulin resistant but their glucose still looks normal in their yearly check so to just make this concrete you and i could both go to the primary care doctor and have a fasting glucose of 80 milligrams per deciliter and so the doctor says to both of us you're both in perfect health if i'm really insulin resistant because i'm on that glucose roller coaster and i'm getting poor sleep and i'm chronically stressed and not managing it and i have childhood trauma that i haven't addressed blah blah all that stuff i could be at 80 but i'm doing that by my insulin being elevated to like 35 or 40 and your insulin might be two so your body's not working hard at all to keep your insulin at 80 and my body is having to produce so much insulin so i am clearly on the path towards metabolic disease diabetes and all the associated conditions heart disease stroke cancer alzheimer's dimensional fatty liver disease gout infertility right total dysfunction blah blah blah and you're in the clear but our doctor tells us that we're the same so this is why i recommend that every patient ask their doctor for a fasting insulin check because you you have a sense of what's actually happening under the hood and if you're in that early range and of course this is talking about people who are in the normal range that's not that's not even included in 128 million americans who actually have a diagnosis of pre-diabetes so this is like people in the normal who still may be on their route to problems so it's now becoming like the majority of the country is dealing wow with a fundamental problem in how they make energy in the body which is a core process that allows every cell to function so and you're saying there's seven factors to this but what would you say the main couple is it food and lack of exercise or what i would say the four like most important pillars are food sleep deprivation and interruption in sleep you know just the beeping and the buzzing and um the blue light late at night um that interrupts our sleep quality the chronic low-grade stress and the fear that so many people are dealing with and then the sedentary behavior the fact that most americans are sitting more than eight hours a day and that is just sitting creates inflammation in the body it creates it keeps that glucose in your bloodstream and not going into the muscles um and and the exercise one i think a really empowering um just a tip for people it doesn't have to be like go out and you know run five miles or do a high intensity animal training workout or do a crossfit workout it literally is as simple as walking maybe walk 15 minutes after a meal especially if a high carb meal and even walking for two minutes every half hour has been shown to statistically significantly reduce insulin and glucose levels throughout the day it's actually the study was a minute and 40 seconds so it was looking at for people who just walked for 30 minutes in one chunk of the day but otherwise sat during the day versus people who walked for 30 minutes but broke it up into one minute and 40 seconds every 30 minutes throughout the waking day those people that moved more frequently but the same quantity um had much lower glucose and insulin and i think the reason is because if you think about sitting all day and then walking for 30 minutes you've basically just like been atrophying your muscles all day like you're just like you know blob sitting there versus the continuous of it like constantly yeah and again thinking back to the cells you're activating these pathways it's all just information to this activate the pathways get them moving you know get the glute clear the glucose every 30 minutes you know and so it's not like this is a lot of stuff you have to do a simple walk makes a big difference but i think one of the from looking at all this literature one of the biggest takeaways i've realized is that moving more frequently even if it's low intensity is key it can't just be that one chunk yeah maybe if you're in an office or something or you're not walking or have the ability to walk maybe you can do some air squats or push-ups or just anything when you're moving your body some split squats whatever it might be um just bodyweight stuff for a minute minute 40 seconds do do lift your knees up in the water or something yeah whatever yeah exactly i love that that's interesting yeah some high knees yeah yeah wow this is fascinating so thirteen percent that we said has type 2 diabetes in the us is type 2 diabetes reversible absolutely yeah i mean but beyond that it's not reversible is that right well type 2 diabetes is sort of the that's like once you get into that range of type 2 diabetes of course there's a spectrum of how how bad it is right and it's always easier to reverse these things earlier on the type 2 diabetes is the fault there's another there's not a type 3 or type four okay no type two diabetes so basically what does that mean when you have type 2 diabetes so it means based on our criteria it just means you meet a particular threshold of blood sugar levels so if you're if you're first thing in the morning fasting blood sugar your you know you go to the doctor they take your blood if it's below 100 um non-diabetic 100 to 125 pre-diabetes 126 or above type 2 diabetes wow and you can reverse that the earlier you catch it back to the pre-diabetic or to the 100 to 125 and hopefully below that yeah with nutrition and lifestyle absolutely yeah and there's actually been studies showing i mean virta health sarah hall said she's an amazing this company is showing reversal of type 2 diabetes with a low carb high fat diet and coaching i mean it's not even an exercise intervention it's just diet and they showed that in 12 weeks coaching just a nutritional coaching are you doing this every day just checking accountability exactly they're not even including exercise like it's that simple um and they are showing amazing reversal of diabetes to the extent where the american diabetes association they did not actually recognize reversal of diabetes as something that's possible until this past year they're actually calling it remission which i think is a funny term like it's it's basically reversal i mean you're changing cellular function you're becoming more insulin sensitive you're lowering your circulating glucose levels and you know the reason why you want to get on top of this early though is because the longer you have diabetes again coming back to the mitochondria the more damage you're doing to those cellular structures so you want it's harder and harder to reverse hair it's harder how big of a business is type 2 diabetes in the u.s alone oh a year incalculable um so how much money is spent on the management of type 2 diabetes you'll see lots of different numbers usually somewhere between like 200 and 600 billion but 200 to 600 billion yeah just for type 2 diabetes well our health care costs are 4 trillion dollars per year about 17 percent of our gdp we spend more than of course any other country in the entire world 70 you said how much 17. 17 17 um four trillion healthcare in the usa yeah what is canada i don't know okay but if you look at the curve it's like all these little dots down in the lower left corner and there's like the u.s up here in terms of cost and 200 to 600 billion of that is in the type 2 diabetes metabolic management management yeah holy cow and on top of this our life expectancy is going down so what's what's ironic about the american health care and for three years our life expectancy has been going down you would you would think right like like this is this is sort of what perplexes me about physicians right now is that you know you're as a physician you're really like a steward of the system like you are the person sort of calling the shots and doing the treatment you look at this system and okay every single year we're increasing healthcare costs every single year it's an increasing part of our gdp we're now spending four trillion dollars on health care we're literally throwing money at it and outcomes are getting worse every single year wow if if you're not stopping and thinking what is going on what are you doing with your time you know it's like it's not working right we're getting sicker every single year we're getting sicker we're getting fatter and we're getting more depressed as a country and just throwing money at it and i think the key problem with this is that you know the modern american healthcare system has produced miracles literally we have yeah a hundred years ago first today if you transported someone from 1900 to today and they looked at what you know life expectancy and infant mortality and and what happens when we get an acute illness they would they would be shocked it's unbelievable but that's because we are very good at managing acute illnesses so if you have an infection you know something like childbirth if you break your arm if you're in a car accident we can manage these things whereas before we weren't good at that and some people would die or have massive complications with those absolutely yeah and so that's great like if like we can manage that but chronic disease is where we are abjectly failing and chronic diseases are 90 of our health care costs they are the things that are killing americans and they are based in diet and lifestyle and those are the things that we are doing having this is worse outcomes the more money we spend so ninety percent of the four trillion is out of this goes towards chronic diseases chronic diseases which is what else besides type 2 diabetes these are the diseases that are like long term are considered to be um develop over time and are generally rooted in diet and heart disease heart disease alzheimer's dementia chronic respiratory illnesses chronic kidney disease chronic liver disease um you know there's like depression anxiety chronic pain chronic fatigue syndrome gout they're things that don't just like come and go like a cold or it's not overnight yeah come and go 90 of these of the money is going towards chronic disease and illness that's right and what i'm hearing you say is chronic disease and illness can be prevented with nutrition and lifestyle or reversed or reversed in many cases of course not all most most of the cases i'm assuming a lot of the cases right i think a huge burden of that disease could be prevented or reversed obviously there's going to be cancers that you can't reverse with diet and lifestyle but a lot of the cancer we're seeing today could likely be prevented but we're not trained on how to do that effectively as physicians or any practitioner how much money could we save if we just invested in the prevention and the lifestyle nutrition training and coaching versus just spending money on these things that are masking and not solving the problem i think trillions of dollars yeah and the funny thing is is that you know what taxpayers don't realize is that they're paying for this like four times over it's crazy we are paying taxpayer money to of course fund you know healthcare medicare medicaid all these things we are then going to the doctor and paying our co-pays we're paying our insurance premiums we're paying for that service we are also paying taxpayer money for the farm bills and for the food subsidies that are making all the disease promoting foods cheaper for americans so we spend 31 billion dollars on our farm bills which directly subsidize the foods that cause disease making them artificially cheaper so this is corn sugar soy wheat um and other foods like that does not go towards the vegetables and the fruits which are actually part of a separate very small horticulture bill which is like not even like a fraction 10 million or something yeah so small it's a tiny little amount so they're paying for those that then make us sick and then of course we're paying for the environmental damage of those terrible farming practices of the foods that make us sick that are then ruining our topsoil and creating horrible runoff in our rivers and oceans so literally like you walk into the store and you grab you know skittles um or you grab wonder bread and i think what people don't realize is that if that had a real price tag on it it would be like a hundred and fifty dollars you know because it's the health care costs it's the cost of the food it's the cost of the taxpayer money for health care for others it's the cost of the environmental damage and the cost of the farm bills we're paying all that that's crazy and yet it's three dollars yeah yeah what i think what's cool what you're doing and a lot of other of your peers are doing is trying to give people information and access to take back control of their own health and prevent a lot of these things from happening by just making better choices every day having the information the education of what makes you sick and what keeps you healthy with all these different factors we've talked about and also just staying on track with it you know staying on track uh consistently to to prevent and stay healthy as long as possible the challenge is there's so much temptation in the world there's so much temptation and so much available at all the times to make poor choices whether it becomes nutrition diet sugar all these different things processed foods it's it's very challenging for a lot of people even myself i want to consider a healthy person active i just ran a marathon three days ago for my first marathon congratulations thank you but i still feel like oh but i still i'm not in the best shape that i could be in right because of the nutritional aspect i can go months of eating super clean and healthy and then other months from like i feel great let me just have some sugar every day now um so it's the it's the accountability it's the structure it's the the uh accessibility there's so much processed foods which i think is challenging for a lot of people and i think that's what's one of the hardest things is just the discipline it takes yeah the personal discipline yeah so how do you manage it personally knowing all this information do you still eat a lot of sugar are you kind of like cut sugar out of your life now yeah well first of all i think the points you made are so important like it is hard and and that's why that is why i'm excited about technology that helps people eat better because like like continuous glucose monitoring and of course what we've started with levels is because it's not like i want to walk around and see everyone being a cyborg with technology on their arm i'm actually a very like crunchy granola person i'm not the most tech savvy person and like i want to just like be in the back country unplugged you know like that is my ideal however the cards are stacked against us so monumentally in the way we've talked about the past 50 to 100 years the human body has had to be bombarded with all these external signals that it's never had to deal with in you know the tens of thousands hundreds of thousands of years of evolution and it's breaking our bodies we have broken bodies by and large in america as evidenced by the fact that six in ten american adults have at least one chronic disease we're breaking and so those cards are sort of stacked against us of course there's governmental factors there's all this stuff there's food marketing our school lunches for kids are awful and so in the face of that modern reality tools to empower ourselves to make decisions that are better i think are very important and ideally you know you could use these tools to gain awareness to gain learning to gain knowledge of how to eat and live in a way that keeps your blood sugar more stable that keeps your metabolic health on point and then maybe you don't have to use it anymore right you know maybe it's just allowing you to help you know i'm not wearing one right now i've been at this for three years and i can go months now without wearing one i mean it can be very helpful for accountability at this point but but you know what works what doesn't work now yeah yes and it's a nuanced balance and so that's what i'm so excited about is empowerment i think that is the key word because your doctor might say to you um oatmeals you've got high cholesterol so eat oatmeal like this is a heart-healthy whole grain that might be not bad for you well put your blood sugar blood sugar monitor on you know on your arm and and eat the oatmeal and see what happens and maybe for you your blood sugar stays quite stable and you don't have a big spike but for me because i've tested this one serving of quaker rolled oats caused me an 80 point glucose rise and crash which is about four times higher than the highest i want to go i want to go up like 20 points after you want to stay like here not here exactly so for my body terrible metabolic choice for yours maybe it's okay but the fact that the doctor's saying it sort of works for everyone that's where we can kind of get into trouble because every single body is different we are so biochemically individual and what works for you and me might be very different in terms of what causes the blood glucose spike and it can also be different day to day sure like again if i'm sleep deprived it might hit me a lot harder than on the day that i'm not so knowing what those variables are can be really useful information so for me like when i started wearing um continuous glucose monitors when we started levels i was almost 100 plant-based and what i learned super quickly was that before the monitor you were plant-based and i'm still like 93 plant-based but like i'll eat a little bit of really thoughtfully sourced animal protein now but what it did for me was make me realize that within my plant-based diet there were certain foods that were causing really big spikes and how i could modify plant foods and balance them with adding fat protein and fiber to my carbohydrates to keep the spikes much interesting less so because you could be plant-based and be unhealthy absolutely oh my gosh you'd be having sugar all day long and be spiking left and right still you can just be you know trashing your health that way and i think that one of the things i'm most excited about with this personal biofeedback data about nutrition is that i think it's going to pull the rug out from diet wars and from all these really so show the proof here's the evidence yeah because like i can look you know some someone who's carnivore and this has happened can can be ripping on vegans on social media and if i can come out and say here are my blood sugar curves they're flat uh my insulin is three my cholesterol is xyz my inflammation markers are this my vitamin d is this and my omega-3 levels are this like how can you fight with me like this is working healthy for me and it might actually look identical to their lab work because the body is such a complex system there are many different redundant pathways to kind of getting to the same outcomes but the key is you have to be so thoughtful about how you're doing it the the run-of-the-mill vegan diet is probably not going to be great for people carnivore diet yeah and so just having insight into that but i think it's again it's like the proof is in the pudding and um and that's where i'm i'm excited to see like more data helping to quell some of the debate and what's better because each body is different and um you know that's interesting so tell me about levels then what is what are you guys doing at levels with this con it's called constant glucose monitors what it's called continuous glucose yeah cgm where you put on you essentially put on a monitor in your skin right for two weeks though it is and then it monitors your blood levels for 24 7 for two weeks yeah anything you consume or don't consume it man it tells you what's happening you have an app that shows you and tracks it yeah so why is this essential for someone to be curious about and to be potentially want to try this out yeah the reason why it's something that i think is relevant to pretty much everyone is because of the rates of what we're seeing in our country like if you're just living your life standard american diet more likely than not you're gonna end up with a metabolic disease that's just now common reality and so having some information to both see what the trajectory is over time have a real sense of ownership over what's going on metabolically in your body i think that's really empowering like right now you kind of get crumbs of information from your doctor once a year but imagine if like you know you could really have ownership over that foundational aspect of your health so that's one thing is just like the awareness and then the the bigger piece is to have this closed-loop biofeedback on everything you're eating and everything you're doing to to keep glucose more stable because we want to get off that those ups and down swings not only to improve our day-to-day functioning and the subjective experience of our days the energy the mood the cravings um the fatigue um but also to set us up for like the long-term avoidance of sort of the glucose-related metabolic diseases and so that's really the reason to use it and what i love about it is like just like with the oatmeal example try a food see what happens the cool thing is like even if you do spike it doesn't necessarily mean you have to get rid of that food forever it means that you can potentially modify it and work with it so let's take the oatmeal example for instance if you love oatmeal like you're just like i do not want to live without oatmeal that's fine one thing we've seen in our data set so we've had about close to 25 000 people go through our program we have over 50 million glucose data points so we have a lot of information here people who eat like rolled oats like instant oats which are fairly processed spike higher than people who eat less processed forms of oats like steel cut oats or growths which are kind of like a chewy very whole food form of oats so eat one of the less processed ones potentially or add fat protein and fiber to that carb the carb alone if you're eating what i call like a naked carb essentially a meal that's just like dominant carbs yeah no fat protein yeah like two bananas or oatmeal or skittles like you think about some candies like skittles are basically just like sugar whereas like a snickers bar actually has some peanut butter peanut butter chocolate and chocolate and crazily enough skittles have an over 80 point glucose spike in our data set and snickers is like 35 or something so it's like half and because skittles are more of a naked car um and so skittles are actually the highest spiking food in our entire data set yeah just a straight sugar ball straight sugar ball skittles candy corn milk duds it's like they're all very similar jelly beans yeah it's like sugar coated on sugar with more sugar that's crazy so um so yeah so you want to avoid that naked carb situation so i see oatmeal with chia seeds which has tons of fiber and protein a little bit of almond butter which has fat protein and fiber add a few maybe low glycemic berries like a couple blueberries or raspberries or whatever which have a good amount of fiber and antioxidants maybe some flax seeds on top which is going to be fiber and fat mix it all together and like you're going to probably absorb the glucose slower it's going to slow digestion the fiber can actually block the amount of glucose that gets into the bloodstream the fiber also has the effect of feeding the microbiome which has downstream positive effects on metabolic health so it's like keep the oatmeal but modify it and if you're not wedded to oatmeal then start experimenting with other breakfast so for me i'm like i couldn't care less about oatmeal so if i i saw that it spiked me and i think i never ate it again i'm like i don't even like this i just thought it was healthy so like you cut it out for me that's gone um and if you look in our data set at what some of the best scoring breakfasts are we see things logged like eggs and avocado eggs and greens we see frittata we see chia pudding we see actually one that we see is like green some some there's a particular smoothie that we actually see logged a lot it's called the fab four smoothie it's popularized by kelly lavaca yeah she's great she's amazing and she it basically is a really well balanced smoothie that's low sugar high protein and fiber and healthy fats and there's some vegetables in there as well and a lot of our community logs that and so it's actually got a very low glucose spike so what you can see from all from this amazing data set is that there's all these options that have like less than 20 point glucose spike um so choose those choose those options as opposed to interesting so someone signs up for this i guess there's a waiting list right now but when they what does it do for them does it coach them on the foods to eat does it tell them oh you know you just ate this and it's not good for your system right now add this to it if you want to keep eating it it kind of coaches you for those two weeks or what's it do yeah it does everything that you just said basically so the the so a levels member will actually use it for a full month to start um so it's the sensors are on the arm for two weeks so the first month of levels is two sensors so you put one on for two weeks you peel it off you put a new one on and so it's 28 days total and throughout that process it's doing exactly what you're saying you log your food you take a photo of it and then you get a score for each of those meals so the score is essentially a one to ten zone score is what it's called that tells you about the glucose impact of that meal so you're shooting for tens and one is like lower so interesting for example i could eat sushi which of course has white rice and sometimes the white rice has sugar actually added to it um and for me like sushi usually scores like a two or three like i have a very very high spike um and you want it to be a one you wanted to be a ten ten you wanted to be in ten so that's like a pretty like that would look like a big sharp stocking crash so what i learned and what the types of things that we talk about in the levels app is like okay well based on what other people have logged if you log sashimi you're probably gonna score like a 10. right a nine or a ten because that's of course just like straight fish people are now logging cauliflower rice sushi which is kind of interesting which has like almost no glucose spike and there's actually restaurants offering this now or i mean i think like me there's some people who just don't want to give up sushi like that's not like oatmeal like for me i'm like i'm not giving up sushi so there's other things that i'll suggest like for instance add pre-load your meal with before the sushi have a salad with protein and fat because there's been research that's shown that if you eat like again fiber fat and protein before carbohydrate if you sequence the meal differently you actually have a lower glucose response so you can eat the exact same sushi but if there's some other stuff in your stomach first um you there's processing and it's processing it differently and it's changing the hormonal response to the food or it will say take you're going up your glucose is going up take a 10 to 15 minute walk right now no way and it'll bring it right down oh yeah for sure i mean it can definitely bring it in just tell you like live data is it's like okay you need to add this or you need to go walk or it's telling you um in pretty close succession yeah and and helping you if it sees a spike it's going to say when you're in this range go take a walk or add this or eliminate that yeah and actually if you have a spike and you haven't logged anything like we'll say to you um hey like what happened here what did you do interesting and some people will see spikes if they're exercising like we talked about because of the stress response usually if someone's going above about 70 to 80 percent of their max heart rate they're going to see a spike which is actually the stress response type thing and we can people will be able to exclude that from their scores because we know it's not a food induced spike it's not like a the same as sort of a potentially damaging food induced spike so this is fascinating yeah it gives you information on your body yeah and then we'll give the people tons of swap options like for instance if they log a tortilla like let's say they log tacos and they have a really big spike we have a ton of content on like here's 10 other tortilla alternatives that we don't know don't spike as much so for instance like jicama tortillas from trader joe's there's now there's keto tortillas like i just got to la yesterday first stop erwin got their almond flour keto i'm like in love with them spent 70 on those yeah oh yeah they're like you know forty dollars of cheese but i love those tacos butter lettuce is great um you know so there's different different options so we'll give people those resources give them costco shopping lists that's pretty cool yeah okay now i'm excited to try this okay um what do people need to do if they want to get on the wait list or or sign up to be a part of this so they just go to levelshealth.com and put your email address in and you'll be in the loop about about the waitlist and getting off it cause you're kind of like rolling it out like every few months to new people right yeah exactly yeah and then that'll also sign people up for the newsletter which has just like a ton of amazing information about a lot of stuff we talked about today and a lot more tips and you know there's certainly people don't need a continuous glucose monitor to apply these metabolic health strategies you know you can you can learn from what people in the program have learned and apply that to yourself and so we try and put as much of that on the blog as possible so that people can learn um this fascinating stuff are you on social media a lot yourself too i'm on social media at dr casey's kitchen so dr casey's kitchen um and then levels is at levels um okay cool and we post a lot of experiments that our members are doing it's cool yeah and so get some some fun ideas for people to try how many people are using it at one time do you know because you said 25 000 people have done it over the last couple years but how many people are on it right now do you know that's a good question is it hundreds is it a thousand a couple thousand yeah i'm not i don't know the exact number for sure but around that so interesting yeah really cool stuff i've heard a lot of great things about it so i'm gonna have to try it myself um and i guess we'll be wearing a patch for a couple weeks right for a month but it'll be cool to see the uh the research on myself um really cool so guys go to levelshealth.com check it out dr casey's kitchen if you want to see more about uh casey as well what else should we be thinking about or how else can we be support to you or or levels oh my gosh well i think the best thing you're doing is just having these fabulous people on your podcast you've had so many wonderful people in the levels community on and i think just spreading the word about holistic health and metabolic health i mean it's amazing how i think podcasts like yours and you know andrew human david sinclair dr perlmutter's podcast like mark hyman's podcast drew pruitt like these things are becoming the thing that people look to to figure out how to actually create health in their lives because they're not necessarily getting it from their doctor and so i think it's a really exciting time that we're in i'm very grateful for like for the work that you do that's cool yeah i appreciate it casey all right this is a question i ask everyone at the end called three truths i think you know it's coming um imagine it's the last day on earth for you and you've lived an incredible life done everything you want to do but for whatever reason you've got to take all of your work with you to the next place so no one has access to this conversation or your blogs or content or anything you've ever done but you get to share three lessons you've learned from life with the world and that's all we have left to kind of be remembered by you what would you say are those three lessons or three truths um i think one of the biggest ones for me in terms of what brings joy and satisfaction to my life is to focus on the little things and just true awe in all the amazing things going around us i think if you just step back for like one second you know and look at what's going on around us we're in this incredible cosmic journey you know we're hurling through space we're made of trillions of cells innumerable atoms we're we're constantly you know it's like every time we eat we're literally taking in matter from the universe and converting into our body and like shifting our shape every day it's just it's at you know we're part of this incredible just continuum of of energy and matter and like you know i think it's just so awe inspiring so just like step back look at the ah you know the fact that the sun is shining and telling your brain you know what to do it's fascinating so i think like focusing on the little things and just having a sense of awe and reverence for everything around you like brings me just such intense joy every single day and can help elevate you from some of the day-to-day stresses um so aw live with awe and focus on the little things and of course that loops into being in the present moment because you have to stop and pause to see things um i think the second thing would be really we talked about a little bit earlier that like really focus on death you know examine it think about it be curious about it i think you know one of my favorite quotes steve jobs talked about death as life's greatest invention and i think that's so true when we overcome our fear of mortality and have a good relationship with with death and see it as not an end but a part of the process that's very natural um think about the the way that energy cycles through generations and we're a part of that um i think it's incredibly liberating like you know and again getting back to the question of fear like if you can not be fearful of death like you have a lot of power to make your own decisions and not be controlled by external forces and so um there's a lot we can learn from it so i would say on a practical level like yeah read some of the stoics read some of the you know buddhists or zen thinkers um you know read some mary oliver poetry you know there's people who are grappling with this and it can really make life i think more joyful um ironically and then i think the third thing would be just never stop asking why um and really if anything is conventional wisdom or is being kind of spouted by the large majority in a loud way or anyone's having to be coerced to believe something is true or manipulated or like ask why and think about the bigger picture when you keep asking why it just makes life so much fun so for me like looking at the healthcare system and being like we're spending more money people are getting sicker why why that was the best question of my life and led me to lead the surgical world get into functional medicine ultimately start levels and realize this incredible world of metabolic health and how things are connected rather than how things are separate and i think that i just you know hope that doing that at every stage um will continue to just open up whole worlds of new opportunities so i would say ask why and challenge conventional wisdom and think for yourself that's beautiful one of the reasons i keep asking questions on this show after nine years i'm still curious and i want to learn more so i think those are great um i want to acknowledge you casey for taking the for asking why many years ago and taking a shift in your career and your mission from being i guess in the practice of surgeries and and prescriptions now into prevention and reversal of these i guess diseases for people and really helping people shift their thinking from having personal power personal knowledge and information on their health so acknowledge you for taking the shift it's a big change i guess for it probably feels like a big change for a lot of people in the medical world to think differently than what they've been taught for so long so i acknowledge you for seeing things and allowing yourself to reinvent an identity that you once held on to probably for a long time and shifted into a different part of your identity so i really acknowledge you for the process and all the great information you're giving people with levels it's really inspiring to see what you guys are building so congrats on that as well final question casey what's your definition of greatness my definition of greatness is being able to achieve and embody sort of thriving in this world and to be able to enact your purpose and fundamentally you know be able to go out there and really really live your purpose and shine your personal light that really requires us being healthy and so that is what drives me as a physician and as a health tech entrepreneur is if we can help create more function in people's bodies they can go out and share their light which is you know their greatness make their minds healthy help make their bodies healthy help empower them to take control of their health and and so that's really just um how i think about how i think about greatness being able to shine our light and embody our purpose love it casey thanks so much appreciate it yeah the two fastest ways to not recover from trauma are to compare yourself to others and to minimize your pain it sounds crazy but the mo and i you know believe me i went through i could tell just horrible experiences of going through kind of this this

Channel: Lewis Howes

Views: 606,236

Keywords: Lewis Howes, Lewis Howes interview, school of greatness, self help, self improvement, self development, personal development, success habits, success, wealth, motivation, inspiration, inspirational video, motivational video, success principles, millionaire success habits, how to become successful, success motivation

Id: sS_MNw9QYoI

Length: 89min 24sec (5364 seconds)

Published: Mon Apr 18 2022