Written by Christopher Kelly
Feb. 25, 2016
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Christopher: Hello and welcome to the Nourish Balance Thrive podcast. My name is Christopher Kelly. Today I'm joined by Dr. Tommy Woods who you know, and Guðmundur who you do not know, from the Icelandic Health Symposium. Hi, Guðmundur.
Guðmundur: Hi.
Christopher: Hi. Tommy, how are you doing?
Tommy: I'm good. Thanks. People are probably wondering why you can't find any other guests.
Christopher: It's because you're so good, that's why. Why settle for second best when I can have you?
Tommy: Well, we've got Guðmundur as well today, so I think that's going to be good.
Christopher: Even better. I'm super duper excited, and Julie is even more excited than I am because we're going to Iceland to a conference to meet Tim Noakes and Gary Taubes and you and a whole bunch of other amazing experts to talk about food.
Guðmundur: Great. We look forward to seeing you.
Christopher: I am genuinely very, very excited about this. Guðmundur, tell me about yourself. How did you get interested in food in the first place?
Guðmundur: I'm a doctor working in Iceland. I did my medical training in Sweden and internal medicine and emergency medicine. I always had a keen interest in nutrition and metabolism and a little bit in endocrinology all throughout my training. So this is something that escalated for the past maybe five years or so.
When I was doing my medical training in Sweden I had problem with being a little bit overweight. I started to think more about why I was putting on so much weight. Slowly but surely I started to figure out that it was more about the content of what I was eating more than just about the calories. It was more about the carbohydrates I didn't seem to tolerate.
So I slowly started to cut out the carbs more and more and then slowly started to lose weight. So that was my kind of aha moment that it was more than just about the calories.
Christopher: Right. So you did your medical training in Sweden. How did you ever come to eat that many carbohydrates in the first place? Because I visited Sweden several times. One thing I thought was interesting about those people was that they certainly do not have fear of fat. I didn't think that they ate a lot of carbohydrates in the first place. Do you think your diet was different from the other Swedish people?
Guðmundur: Yeah. I'm Icelandic. For the past 20-30 years, like everybody else, we started to consume a lot more carbs than we used to previously. So I had become accustomed to eating a lot more carbs maybe than I was supposed to. I loved pasta and bread and stuff. That is like a drug to me.
Christopher: Yeah. Me too actually. Okay. So you figured this out that maybe you were eating too many carbohydrates. Then you become a medical doctor. So tell me about your practice in Iceland now. So you're actually practicing as a doctor now.
Guðmundur: Yeah. I work mainly as an emergency physician in Iceland. So I meet a lot of people in the ER who are at the end stage of their diseases, chronic illnesses like cardiovascular disease and kidney disease and diabetes and so forth. It's kind of frustrating when you're working at that end of the healthcare system. You're aware that with certain lifestyle changes these conditions could've been prevented.
I also have done a bit of work in primary healthcare, working with people, and helping them a little bit with their lifestyle. I've seen dramatic changes in people who have health problems with diabetes and being overweight. So I really understand it's a long process.
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It's a process that we can easily step into and reverse the problems if we give the people the right tools and the right information to take their health into their own hands so to speak.
Christopher: Yeah. I know. I think that's fantastic. That reminds me actually. I employ a registered nurse. Her name is Amelia. Hi, Amelia. She does fantastic work. Her motivation was very similar. She treats people in a hospital. Again, she's seeing the final progressions of a problem rather than the beginning of it. Her thought was "Well, this is completely backasswards. What I really need to do is talk to these people before they become obese, while there's something that can still be done for them." That's what motivated her. Yeah. I know. That's super cool that you've taken this initiative to do that.
Guðmundur: It's so much more costly to treat their diseases when they are already there instead of doing stuff to prevent them. It's a long process. For example, if you take diabetes, if you take a person from the beginning where he started to be insulin resistant and until he reaches the stage where he has type II diabetes that requires insulin there's a lot of time and there are a lot of opportunities to reverse that process without costly treatments.
Christopher: Yeah. I know. Absolutely. Tommy, tell me about your connection to Iceland because I think this is quite interesting.
Tommy: My mom is Icelandic. I've never really lived there but I usually go multiple times a year. I have a lot of family there. So I have a very close personal tie to Iceland. I feel very at home there. I very much enjoy going and spending time with my family there, spending time in the countryside there. Yeah. It's always been a big part of my life even though [0:07:15] [Indiscernible].
Christopher: The medical system there, is it different from what I'm familiar with in the UK and in the US or is it similar?
Tommy: Guðmundur might have some technical details but I see it as very similar to the NHS. It's a largely nationalized healthcare system though they have some options whereby you can sort of pay extra to get things that aren't available. Most of the stuff you need is available free and from taxpayer money like in the NHS.
Christopher: Right. Okay. Guðmundur, a general practitioner or a GP, would they ever sit down with someone who obviously has difficulty choosing the appropriate foods and talk to them about their diet? I'm not sure that that would really ever happen in the UK or in the US at least.
Guðmundur: No. Traditionally Icelandic doctors, as most doctors, are not trained in nutrition or nutritional biochemistry or exercises physiology or any of that stuff. It's not part of our basic medical training to look into it. I feel that more and more doctors are adapting this information. With social media, with Twitter and Facebook, doctors are seeing that information from all over the place and talking to each other about it and helping each other out.
For example, we started a Facebook group earlier last year for Icelandic doctors who want to learn more about the affects of nutrition on chronic illness. That group has grown to 220 or something right now. So it's definitely there.
Tommy: It's worth remembering that when you're talking about 200 doctors in Iceland that's a significant proportion of doctors in Iceland.
Guðmundur: Yeah. I think all of the Icelandic doctors are on Facebook, I think, in one group. There are about 1,400. So 220 is quite a significant percentage of that group. I think we are adding number each day. So hopefully, in the end we'll have all of them in. The interest is definitely there especially among the younger colleagues who want to learn more about this.
Christopher: This is really interesting. I wonder why this is happening uniquely in Iceland. Maybe somebody listening to this can let me know if this is happening elsewhere in the world. That's certainly not what we're seeing in the US where you have a plague of primary care doctors suddenly deciding to take an interest in nutrition and conferences happening. That's certainly not what's happening at all.
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Guðmundur: I don't know why it is. There are so few of us. News travels fast. We all know each other more or less because we're not that many. I think it's not that difficult to get information across everyone if we want to.
Christopher: The Icelandic Health Symposium and the Foodloose conference, where did the idea come from?
Guðmundur: The idea actually came last year. I was reading Gary Taubes' book, Good Calories, Bad Calories. As I was reading through the book it struck me that when we're talking about diet and chronic illness I don't think just cardiovascular disease and diabetes seems to be a lot more of western diseases or the chronic illness we see are related to our diet than most of us realize. I was also had been looking a little bit into low carbohydrate diets. A few weeks after I started thinking about it, it would be cool to have a conference here in Iceland.
I talked to my brother-in-law about it. It was just a pipe dream at that time. He really believed in this idea. So what he did is he took the initiative to send out emails to Gary Taubes and Tim Noakes and a few others. The snowball just started rolling after that.
Christopher: Wow! So that's how it went down then. I know these people. Tim Noakes has been in my podcast. It took me probably, I don't know, at least a year of asking to get him to come to the podcast. In the end I couldn't believe he agreed to it. He's obviously such a busy guy. It's really just that simple.
What is it? How did you do that? I kind of want to see what was in that email, what you said to him. "Hey, will come to my conference in Iceland?" Do you think it's just like everybody wants to go on holiday in Iceland?
Guðmundur: Yeah. I think that's probably it. Maybe Iceland has such a draw. I don't know. Maybe they sensed that we were serious about what we were doing and they replied. I was just as surprised as you are that they answered us. Here we are.
Christopher: Yeah. I know. That's fantastic. That's right. So you've got some fairly unique things going on here. You've got a large network or a large percentage of all the doctors in Iceland who are on board with this and communicating and thinking critically.
Guðmundur: That's a big thing part of the discussion. I don't know if they all are on board with low carb diets or that stuff but at least they are showing interest in how nutrition affects chronic illness.
Christopher: We got Gary Taubes. We got Tim Noakes. Who else is on board that's going to be speaking at the conference?
Guðmundur: Yeah. Tommy obviously is going to speak, and Axel Sigurdsson, the Icelandic cardiologist who has the blog site docsopinion.com, and Aseem Malhotra, the British cardiologist will be there as well, and Denise Minger, I hope I pronounced her name right, as well as Maryanne Demasi will be there as the moderator from the Catalyst program in ABC in Australia.
Christopher: That's fantastic. So how is it going to work then? Is it going to be like a seminar or these people are just going to be giving presentations?
Guðmundur: The idea is that they're going to give presentations and then we'll give the audience a chance to do a Q&A with them and Maryanne after each session. So they can ask a little bit more about each individual presentation, and then to have a panel discussion in the end.
Christopher: Tommy, who are you most excited about meeting at this conference? Is there anyone that you've met before?
Tommy: I've met Aseem Malhotra. We've spoken together and been on panels together at a conference in the UK, and Axel Sigurdsson obviously. Guðmundur and I have sort of done some with him. We're actually publishing a paper together very soon. Other than that, I'm really excited to meet Tim Noakes.
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Christopher: Awesome. So what will you be talking about, Tommy? Have we decided yet?
Tommy: Yeah. So the other guys are going to talk about, obviously, things that they're very passionate about and that they have been bringing up in the public debates recently. So Gary Taubes is obviously going to be talking about his view of the carbohydrate-insulin hypothesis and also some stuff about [0:15:51] [Indiscernible] policy and things like that which he's very vocal about. Aseem Malhotra, I think he's going to be talking about sugar and some other things that he's sort of working really hard particularly in the UK but also increasingly worldwide.
Axel Sigurdsson is going to talk about diet and heart disease which he's very knowledgeable about. I actually suggested to Guðmundur: that we bring in Denise Minger because she's going to bring -- you and I have talked about her on the podcast before. She's going to bring an opposing view point because the other guys are going to be focusing very much on low carb, real food, increasing fat. She's going to bring in the data which shows why that's not necessary always what you need to reverse metabolic health just to kind of get a discussion going at least.
Christopher: Right. I think that's really interesting. It's not just going to be all sugar, sugar, more sugar in your coffee. You're going to like to stick Denise Minger in the middle of that to play devil's advocate and restore some balance to all the high fat guys.
Guðmundur: The whole idea with bringing Denise to the conference is also for people to realize that nutrition is more about context that anything else. You can eat a lot of sugar, fruit juice and all that stuff without it having metabolic consequences or it could even be beneficial.
Christopher: Right. Yeah. It's true. I actively encourage my daughter, as I said, she's two, to eat carbs. She won't. I guess she just copies us. I'm not practically forcing banana chips down her throat. If anything, just to make her a bit hungrier. She doesn't seem as hungry as I'd expect a kid that runs around as much to be. I'm kind of a bit worried. Maybe I'm wrong about how much food we really need. Yeah. Absolutely, the context is really important.
Tommy: Yeah. I think it's really important because she has some really interesting things to say. She's dug up some really interesting data. A lot of times I'm banging my heads against very strict reductionist orthodox thinking from every corner like traditional medical world but also the less traditional medical world because they have their own thing. That's what they think is going to fix everybody. I don't think that's always necessarily the case.
Christopher: Yeah. I know. She is interesting. There are certain individuals who seem to have painted themselves into a bit of a corner. Denise Minger is almost the opposite. She's always displaying devil's advocate and trying to say, "Well, let's suppose the opposite is true. What would happen then?"
Tommy: Yeah. Exactly. So you could kind of think of it as she's playing devil's advocate almost for the fun for it. Maybe there's a part of that. She's clearly very clever and she's done a lot of digging. I think any model that we have of disease has to explain all the data. That's something that I try and say a lot because I think that's important. So she's going to present data that is different.
Everybody else is going to talk about food. So I'm going to talk about the other stuff, all the other things that I think are very important in terms of what we need to do to be healthy. That's going to be movement, sleep, stress, spending time with family. How I'll put that across, I haven't quite done it yet but I think it's going to be quite different from previous talks I've given just to kind of bring things together. It's important to remember that we shouldn't be just focusing on what we eat because there are so many other things that come into play.
Christopher: I know. It's so annoying, isn't it? It was the first thing that I found and I think it's the first thing that most people find is the food. They find the Paleo Diet or they find a high fat, low card, moderate protein diet and they get results with it. It's really tempting to think that's it, like that's what we need to worry about. And then you hit a plateau and you think "Wait. Maybe I was wrong about the diet." It's really not. It's something else that unfortunately you're going to have to think about too. Frequently or at least amongst the people that I talked to, those other pieces are actually more important than the diet piece at that stage.
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Tommy: Yeah. Absolutely.
Christopher: So you're going to get super technical with some biochemistry for us?
Tommy: No. I don't think so. There's going to be some stuff on the second day which Guðmundur can give us more information about. I'll be there. If people want to dive into some biochemistry with me then they'll be very welcome to do it.
Christopher: So May the 26th is the main day. Guðmundur, tell us about the workshops that are going to happen on the 27th.
Guðmundur: The day after the conference we're just going to have a small culinary workshop for 20 participants, for those who really want to dive into these kinds of things and also want to meet with the speakers. So it's a mixture of cooking class where the focus will be mainly on LCHF or Paleo. And then we'll have discussions and more in depth lectures about nutrition or more specific topics. So I think it's going to be interesting for those who are really into this kind of stuff or want to meet up with the speakers and talk to them.
Christopher: I think everybody is going to be there the next day at the workshop, honestly. If you're passionately enough to go all the way to Iceland for a conference like this then surely you're going to be there the next day. That'll be quite exciting. Maybe I can get Professor Tim Noakes to teach Julie how to make an omelet. That'll be fun.
Guðmundur: It will be good fun to have as an extra to the conference.
Christopher: Right. Tell me about what else people should do in Iceland. Is there anything that people must do whilst they're staying?
Guðmundur: Well, that really depends on what your interests are. Iceland is all about nature. You don't go there for the weather because you can't depend on that. We have some fantastic nature in Iceland. It's like having a sample from all corners of the world actually. It really depends on what you want to do. You want to go hiking or you want to go kayaking or you want to go biking. Outdoor activities are definitely things to do in Iceland.
Christopher: What about you, Tommy, what will you be doing whilst you're in Iceland?
Tommy: Obviously, I'll go and visit family and things like that that I don't get to do as often as I'd like that. So that's always a priority. I know you'll be there so maybe we'll go and do some tourist stuff. Iceland has become very popular with tourists recently. So there are certain things all tourists go and do but equally I think if you're a tourist in Iceland for one time only you should go and do them too. I think that's important.
There's something called the Golden Circle where you can go and see the glaciers. So you have that hot water coming out of the ground. You have the big waterfall, Gullfoss. You can go and see the first parliament in the world which is in Iceland. Then there are things like the Blue Lagoon which is like this natural -- well, it's not natural. It's wastewater from a geothermal power plant which basically accumulated in a lava field. It looks like this kind of eerie blue color. Even though it started as waste they were like "Oh, if we built a hut and charge people [0:24:02] [Indiscernible] then we'll be rich." That's exactly what happened. I think people should go to the Blue Lagoon because I think it's nice. It's also a traditional thing.
If people are only there for a short period of time you can do daytrips and go hike up glaciers and things like that which really aren't that far away. So that's also definitely worth considering. Those are things you can do in a short period of time and not that far from Reykjavik and do daytrips and things.
Christopher: That's awesome. My little blonde haired, blue eyes California baby, she's two now. She's not going to know what hit her. She's never left California, really. We're going to take her somewhere. How cold will it be in May?
Guðmundur: If you're going to Iceland you have to be prepared for everything. It's somewhere around 10°C usually that time of the year. So you have to make sure that you bring warm clothes with you just to make sure. It doesn't bother me too much though. As long as you're probably dressed you won't mind the cold.
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Tommy: Yeah. So expect blazing sunshine, sort of like maybe 60°F, and hail and snow and rain. My daughter used to say the difference between summer and winter in Iceland is that in summer you can see [0:25:31] [Indiscernible] but you could say the same thing about England. The weather is exceptionally changeable. It's amazing. So expect all seasons in a very short period of time.
Christopher: That's awesome. I think it's important as well to leave California before you become too soft, so you got to get out there. That's fantastic. Did we miss anything? Is there anything else you want to say about that conference? I'm certainly very excited about it. I know that Julie is too. If you're listening to this podcast and you're planning on going, then please do email me. My email address is chris@nourishbalancethrive.com . I'll be sure to take you out for lunch or go for a hike or something with you. So it'll be great to connect. Did I miss anything? Is there anything else you wanted to say, Guðmundur?
Guðmundur: No. I think we've covered at least all the big parts. If people are interested or want to get ideas for trips and stuff to do in Iceland they can also go through the footloose.is webpage because the travel agency who's organizing the conference with us have put in a few ideas for people to do while over there. So I would definitely check that out if you would need idea.
Christopher: Tommy, I wanted to talk to you a little bit about what's been going on in Concierge Clinical Coaching group on Facebook. So for those of you that don't know, Tommy and I have set up a private membership site that athletes can use to ask questions and to kind of figure out what might be the best strategy for them to get faster, stronger, think more clearly, get better sleep. It's been quite exciting actually.
My main goal with this group was to give people, everybody else, the same education that I've been enjoying through Tommy. So typically I'll say to Tommy "Hey, what's the best type of resveratrol to take?" and Tommy will scour the literature and then send me six scientific studies that answer my question basically, and then he'll give me the executive summary, and then I'll spend some time reading. It's a really fun learning process. Now with this private membership site we have the ability to open that up to more people. It's quite a small group. We only have five members.
Why don't you tell us about the presentation that you gave recently that you posted in the group, Tommy?
Tommy: Yeah. So this is something that's kind of growing every day. I think the more people put into it the more they're getting out of it. So these are people that we've worked with before so we have some background. The more they share the more they ask. I've been posting studies every day recently and my sort of initial thoughts and kind of encouraging people to ask questions and discuss it. I think that's something that will hopefully build up. So there's a community. There's been some interaction just between other people asking questions. You and I almost didn't have to say anything because people had their own information and knowledge to share.
I recently gave a talk about insulin resistance to a group of doctors in Arizona. The group is called Physicians for Ancestral Health. It's basically a group of MDs and DOs from around the world now. Guðmundur has joined recently. There's increasingly a number of doctors that people recognize from the community that we exist in. I gave a talk about modeling insulin resistant.
That's actually also something that I've been doing with Guðmundur because I have some previous experience modeling chronic disease from my work with multiple sclerosis but then I got very interested in insulin resistance particularly as kind of an underpinning of a lot of chronic modern disease. I kind of feel that people are dismissing certain aspects that are important in terms of developing and treating insulin resistance especially just being overly reductionist in their thinking, not even fully understanding or explaining the basis of how insulin works. That's something that we talked about last time when I was on the podcast.
So I kind of brought that altogether in some kind of ways that people should maybe be thinking about it. Guðmundur particularly was really important to that because I've done this modeling but there's a huge amount of data that needs to come together. So it started with another member of that group, the Physician for Ancestral Health group, a guy called Bob Hansen. He sent me a huge amount of information I started to put together and then Guðmundur has fed in a lot as well.
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I'll leave my computer for two hours and Guðmundur would send me 10 references to stick into my model. So it's been a really interesting group effort. I can't say that we've got it perfect yet but I think that we're sort of putting together something that would maybe give us more of a holistic picture about how we should be treating these kinds of chronic metabolic diseases.
So at the moment it's private. It will go public at some point. It's going to go on that website. As soon as I've done it it went up into the group. I think people enjoyed it.
Christopher: Yeah. I know. I definitely enjoyed it. I enjoy the complexity. I'm like one of those guys that enjoy the complexity of the systems analysis model from the chemical engineering world. It makes a lot of sense to me. You know it's not as simple as just restricting carbohydrate otherwise everybody who does that would solve all their problems, and we know that doesn't happen. So something is going on here.
It's not just a full out list either. It's not like I can just say diet, rest, exercise, stress reduction. All of these things are interconnected and feed forward into each other. So the only you can do then is create this model, and that's exactly what you've done by digesting these scientific studies and then putting them into a hopper, turning the wheel and out pops this model at the other end. Yeah. Super exciting. I think you're doing some really fantastic work.
Yeah. We talked about another couple of studies as well. The wasting is saving I thought was really interesting as well.
Tommy: Yeah. So that was an analysis from a couple of guys in the UK, one at Cambridge and one at UCL in London, basically looking at how the body adapts to altitude. We know that when you're adapting to altitude you tend to lose both fat and muscle mass. Part of that is probably a beneficial adaptation for two reasons. The one that they talked about is ketogenesis, how you are giving a more oxygen efficient fuel for the mitochondria because compared to fat and glucose, you get the most ATP per oxygen molecule by burning ketones.
Actually when you're wasting muscle, when you're taking muscle and burning it up, some of those aminoacids are ketogenics so they can help provide ketones as kind of fat as you break that down. But then also if you have a large amount -- and this is something that we talked about afterwards which wasn't necessarily entirely obvious on the paper, but I think that if you want to perform really well in altitude there's definitely something to be said for not having too much muscle mass because it's very metabolically expensive.
I spend most of my time talking about how everybody should have more muscle mass because it's so important for long term health but if you're looking for optimal adaptation altitude, then actually less but very functional muscle is probably the best thing to aim for.
People are asking about adaptogens and how to fuel for -- we have a guy who's diabetic, so fueling for long endurance races and things like that. So we're kind of all over the shop but it's been really interesting so far.
Christopher: Yeah. I know. Fantastic. I really want to get more people involved. I think we can go a bit bigger than five, maybe not too big because I don't want to dilute the experience too much. Yeah. I know. It's exciting. For me, I would've given my right arm to have the ability to ask a good doctor a question. It seems so difficult to even find one let alone -- so you've got this question. You call up the office and they say, "Oh, yeah. We can talk to you in three months time." You're like "Ah, I just have one question. I'm not even sure you can answer it." I think it's also a whole bunch of problems at the same time.
Tommy: Yeah. Hopefully. It will evolve as people figure out what they need and what we can try and help them with.
Christopher: Excellent. Conciergeclinicalcoaching.com is the link. I will put that in the show notes for this episode. I think that's about it. Did I miss anything, guys? Is there anything else you want to say?
Guðmundur: No. Just thanks for having me on the show.
Christopher: It's my pleasure. I'm very much looking forward to meeting you in May in Iceland.
Tommy: Yeah. I really hope people can take the opportunity to come. One of the things I haven't said is that I just know it's going to be really good. I know it's going to be really good because from the second that Guðmundur contacted me and asked me to speak, within a couple of months he'd gotten all these amazing speakers, international superstars at talking. He had the first lady of Iceland as the patron. The organization is going behind it. It's just unlike anything I've seen before. So I'm really looking forward to it.
Christopher: Yeah. I know. I'm super excited too. Yeah. It didn't take me long to book my ticket as soon as I found out about it. So I'm hoping other people listening to this podcast do the same. Excellent. Thanks very much for joining me today, guys. Yeah. We'll see you in Iceland.
Tommy: Yeah. See you there.
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