Written by Christopher Kelly
Jan. 20, 2017
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Christopher: Hello, and welcome to the Nourish Balance Thrive podcast. My name is Christopher Kelly, and today I have, not one, but two very special guests. The first is Chris Masterjohn, PhD. Chris received his PhD in Nutritional Science in 2012 from the University of Connecticut. He served as a postdoctoral research associate from 2012 to 2014 where he studied the interactions between vitamins A, D, and K. He has authored or co-authored ten peer-reviewed publications. He writes a blog, The Daily Lipid, and produces a podcast by the same name. You can also follow his professional work on Facebook, Twitter and Instagram, YouTube and Snapchat. I will of course link to all of those things in the show notes for this episode. His home for everything is chrismasterjohnphd.com.
My second guest is Dr. Tommy Wood. He is a UK-trained medical doctor. He just finished his PhD in Physiology and Neonatal Brain Metabolism. He’s currently working as a visiting scientist at the University of Washington. Previously, he completed an undergraduate degree in Biochemistry from the University of Cambridge before going onto graduate as a medical doctor from the University of Oxford. Guys, thank you so much for joining me today.
Chris M: Excited to be here.
Tommy: Yeah, me too.
Christopher: I wanted to start this round table conversation by getting a general feel for what both of you thought were the general causes of obesity or over-fatness, if it’s possible to name a few. Why don’t we start with you, Chris. Do you think it’s possible to explain why anyone in particular becomes overly fat or obese?
Chris M: Well you can explain that at a few levels, and I think there’s one level at which it’s super, super easy to explain it and that is that people become obese when their long-term energy status is in positive balance, so they’re consuming more calories than they’re spending. That doesn’t have a lot of explanatory power about what to do about that, but I think it has to be the starting point before assessing any of the practical implications. Now I think that has been twisted in ways that haven’t been very practically helpful for a long time, to say that the solution is to eat less and exercise more. We know that that advice isn’t all that helpful because when you eat less, the normal physiological response to that is to get hungrier so that you eat more. When you exercise more, the normal physiological response to that is to make you want to rest and eat more. So I don’t think that the practical implications are obviously straightforward, and I don’t think there’s simply exerting your will to eat less and exercise more. However I do think that both of those things do play a role. We have physical environments and lifestyle trends and social environments that facilitate us eating more and exercising less. The one that’s most relevant right now is that we have a lot of holiday eating. I think it’s well-documented that people that do progressively get fatter tend to gain a lot of that weight between Thanksgiving and New Year’s because of all the holiday eating. Normally when you would eat, say, in the wild, it would be on the basis of what’s available and how hungry you are, but when you impose on that social conventions around eating then you eat more than what your body is homeostatically regulating. So that’s one thing.
Many of us, we may have different jobs but we work in sedentary jobs for the most part. This is starting to change but for a long time, the buildings that we work in, go to school in, were built in ways that didn’t facilitate any activities. For example, particularly with buildings that were built, at least in the United States, between probably in the ‘80s and ‘90s, I’m sure someone who works in this field could better pinpoint the dates than I can, but there was an era where convenience was the only thing that was incorporated into architecture. The elevators were front and center, and it was really difficult to find the stairs even if you wanted to take them. I think you can see that in most modern hotels, not only are the elevators front and center and the stairways in the sides, but the stairways are literally ugly. So you go into the elevator, and everything is beautiful outside the elevator, it’s beautiful inside the elevator. If you can accidentally find the stairs or walk around for half an hour before you find them, everything is gray. There are no decorations. There are maybe some cigarette butts there even though they don’t allow smoking, because no one bothers to clean them. It literally feels like it’s not even part of the hotel.
[0:05:25]
These things are what we would call the built environment, and our built environment has tended to facilitate non-activity for various reasons that partly include lack of consciousness but also include people who make money off these things trying to make more money. We tend to -- like if you go into a grocery store, the things that you would snack on or eat because they look cool are right by the cash register to make you buy more of them and go, ooh, I could snack on that right now, and buy it. There are areas where we can improve that. The grocery story is probably always going to want to make money off those things, but there are plenty of studies of eating habits in, for example, cafeterias just by putting healthier foods in a more convenient place. So I think that there’s a lot about our environment, our social environment and our physical environment, that facilitates bad habits around these things. Sure, there are lots of other things that we could talk about, but if we don’t construct our lifestyles in ways that allow us to create and sustain healthy habits then we’re shooting ourselves on the foot from the very beginning. That’s for us who are conscious about this. Most other people aren’t thinking about it, and they are largely acting on auto pilot, not really thinking about these things and so they are, in that sense, largely victims of their environment where they’re not even at the point where they would start thinking about how to construct their own social and physical environments. They’re just going to be immersed in whatever they happen to be in by default then. So I think that’s really the starting point.
Christopher: Interesting, okay. Tommy, what would you give your answer to the same question?
Tommy: I’ll just start by saying that Chris has made a really good point there which is, basically anybody who has listened to this podcast is already so much further ahead than the majority of the population in terms of how cognizant they are of the issues and then how much they are willing to change their environment in order to create long-term health. I think that that’s actually, in the broadest scheme of things, that’s actually quite rare. Obviously the people who probably listen to this are in a slightly different scenario compared to the general population. But I think, obviously, over all, calorie balance does matter absolutely. One of the reasons why I wanted to have this conversation or to talk to Chris particularly about this and topics around this, is because I think there are a lot of things that we’re doing in the environment that will upset this balance.
I think the first thing that is really important is the food and the kind of food that we have access to and probably how frequently we have access to that food, also the specific composition and makeup of that food. There’s a number of different ways that we can get into it if you want to, in terms of the composition of the Western diet and how that pretty much gears us up to both overeat and then make us more likely to store body fat or the fat that’s contained in that food and then allow us to expand our body fat stores based on the composition of that food, the macronutrient composition of the food. But going past that, there are a number of things that Chris was talking about in terms of, say, holiday eating. If all of your homeostatic mechanisms are working correctly then, yes, you have a few days where you overeat but then the body realizes that and then puts into place practices for you to then eat less over the next, however long, so you then come down to whatever your set point is, but there are all the things that we do that upset that set point.
We know that sleep deprivation or poor sleep increases hunger and reduces our ability to regulate our energy homeostasis. We also know that things like going past sleep, the circadian rhythm, so light at the wrong time, too much light, too little light is really important in terms of both setting our circadian rhythm but also our hunger cues. Eating in time with those cues is also really important. Then there are all these other stuff. We talk about stress, information, particularly what’s going on in our gut or whatever other inflammatory things that we’re being exposed to; they can really cause both to increase hunger directly, and that’s probably because it can affect the hormonal signaling basically within the brain, so we’re talking about things like insulin, leptin. You can cause resistance to those hormones within the brain, and those are really important for hunger. So if you have some kind of ongoing inflammatory process, that can affect our ability to sense hunger cues from the peripheral body and let it know how much energy we have and how much energy we should be taking in.
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So I think it’s a combination of the type of food that we have access to but then also the environment that we place ourselves in which is basically built to make us hungrier and have us ignore the normal cues so that we can’t follow normal set points and then we can’t just overeat for a short period of time or undereat for a short period of time and then come back to whatever our baseline is because we’ve constructed an environment that’s basically forcing us always, making it so that we can’t listen to the cues that we should be getting from our body and from the environment.
Christopher: Okay, well this is interesting. I’ve asked you both what makes people over-fat, and everybody knows that low carbohydrate diets are great for weight loss. Yet none of you, neither of you mentioned macronutrients. Tommy, why do you think that low carbohydrate diets work so well for weight loss?
Tommy: The standard answer is insulin. That’s what we always come back to. I think insulin has almost become a bit of a dirty word in terms of the weight loss or the health communities particularly in the clinical setting. That reminds me of this recent paper that Ray Cronise just brought out that was basically talking about oxidative priorities so basically the macronutrients that go into your mouth and then the ones that metabolize, that fully metabolize your own body fat. Basically anything you eat isn’t going to be metabolized before you metabolize body fat, but carbohydrates come at the top of the list. They didn’t want to talk about hormones because that complicates things, but basically what happens is if you eat carbohydrates then your insulin goes up. What insulin is actually really good at doing -- people talk about insulin being important for blood sugar control, and actually pushing blood sugar into cells is the least important thing that insulin does. What it’s really good at doing and what its most important job is, is regulating when and where you story body fat.
If you are keeping insulin high, particularly if you have a high fat intake at the same time, that fat that you eat is going to end up in your body fat stores. We know that if you sample the body fat from people, the composition of the body fat is very similar to the composition of the fat in their diet, so most of the fat that you store is the fat that you eat. One of the main reasons that you store that is because insulin tells that fat to be stored rather than burned. You can gain that system by reducing carbohydrate intake which is going to reduce your total insulin load which is going to make it more likely that the fat that you do eat will get burned rather than stored. At the same time, we also know that low carbohydrate diets tend to lead to a reduction in overall calorie intake so then you get back to that calorie balance because it increases satiety. People just eat less overall. So those are the two reasons, broadly, why a low carbohydrate diet tends to work for that.
Chris M: I agree with everything that you said leading up to the conclusion, but I don’t actually think that that actually has anything to do with obesity. It’s definitely true that insulin is a fat storer to hormone and that insulin will store fat in proportion to the amount of total insulin signaling, and the best way to do that is to add more and more carbohydrate to the meal. But insulin also proportionally increases carbohydrate oxidation. That’s why no matter what you’re eating, most of the fat in your adipose tissue is the fat that you eat because if you eat, say, pasta topped in butter, if the pasta is enough to meet your current needs, you’ll preferentially burn the pasta for fuel and put the butter in your adipose tissue. If that pasta is not enough to meet your needs then you’re going to burn more of the butter. All that really indicates is that carbohydrate is preferentially burned for energy, over fat, and the role of insulin is to make you burn more carbohydrate and less fat when there’s more carbohydrate present. In that case, it’s not necessarily altering the net caloric balance at all. So the fact that you mostly store the fat that you eat in your adipose tissue, doesn’t necessarily have any bearing on the total amount of adipose tissue that you have.
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Tommy: The point is that if you’re eating a highly insulinogenic diet, which the Western diet is, which also includes a high proportion of fat, then you de facto -- are we going to state that pretty much all of the fat that you eat is going to end up being stored because of the insulinogenic nature of the diet and then just because of the pure -- the fact or the way that the insulin works, that body fat is going to be stored.
Chris M: I 100% agree with that. What I don’t agree with is that that has any bearing on obesity. Absolutely true that the composition of your fat is going to largely reflect the composition of the fat in your diet under most circumstances and that’s largely because carbohydrate present in the diet is shifting that fat towards storage, but that’s proportional to the amount of the carbohydrate load. That same proportion is the proportion to which you’ll preferentially burn that carbohydrate for energy. If that carbohydrate weren’t there to be burned for energy, that fat would be. If you were to eat a high fat, high carbohydrate meal, if everything is working properly, if you then fast for 16 hours then the fat that you ate in the diet that the insulin put into your adipose tissue should come out and be burned for energy later. So it still comes down to the overall caloric balance rather than -- like, insulin, yes, is causing fat to be stored and carbohydrate to be burned but if it’s decreasing fat oxidation and increasing carbohydrate oxidation, it isn’t necessarily affecting total energy expenditure.
Tommy: I think my response was largely aimed at Chris asking about why a low carbohydrate diet can help people lose weight. I don’t actually disagree with anything you said, but I think there’s a difference between the acute scenario and what’s happening chronically because what we’re tending to see is the number of ways in which we process the food and the diet can increase the insulinogenic response to that food despite having exactly the same overall macronutrient composition. What’s going to happen is you’re going to get larger swings in both energy availability and insulin-signaling. Over a long time, those very large peaks in insulin-signaling are probably going to cause some degree of insulin-resistance, both peripherally and centrally, which is going to change hunger and hunger cues and is then going to potentially drive overeating as well as driving a larger portion of the consumed dietary fat into the fat stores. So while that’s correct, while I completely agree with you in the acute setting, I think in the chronic setting, particularly with the type of food that we’re eating, is then going to drive some degree of insulin-resistance which can change hunger cues particularly and then can lead to increase in total caloric consumption.
Christopher: Chris, how then would you design a body recomposition program then? Say that I’ve been eating too much over Thanksgiving and Christmas, and I’ve got a few pounds of fat to lose. Let’s just say, for example, I have a friend with this problem. How then would you design --
Chris M: I’ve got a friend too.
Christopher: I’m sure other people listening to this podcast will also know someone that might be able to benefit from such a program.
Chris M: Pretty much I’ve got that friend right now.
Christopher: So how would you design a program then? Would you care that much about the diet then? Is it just about slightly restricting calories and moving more? How would you design that program?
Chris M: I think that’s highly individualized. That’s not to say there’s nothing to say but if we are to say things, I think what we need to do is bring out several of the most common archetypes of the typical person experiencing this. Just briefly I would say, my -- I think we all agree and most people would agree that low carbohydrate diets can be an important tool for weight loss. My view of why that is the case is much less, if at all, insulin-centric. I don’t see insulin as having, even in the chronic sense, a net effect on caloric balance, but it’s definitely the case, for example, if you have someone with low blood sugar control that is putting themselves in reactive hyperglycemia, for example, I think that’s going to stimulate hunger cues for sure. That can be a problem for some people. But I think that low fat diets and vegan diets and Paleo diets and ketogenic diets and the South Beach diet and the Zone diet, I think there’s at least a dozen different dietary tools that are shown to have some degree of efficacy for weight loss. I really do think that for a low carbohydrate diet, the main utility is that whenever you simplify a diet and you restrict variety, first of all, you are reducing the reward value of the diet that your brain is sensing, and you’re going to have a spontaneous decrease in caloric intake.
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Also, if you look at what most people eat, most people don’t eat very good carbohydrate foods. The theory-based person or the highly motivated nutrition person can say, “Well you can eat lots of carbohydrates but they should be lentils and germinated brown rice and lots and lots of low calorie vegetables and things like that.” But low carbohydrate is, for a lot of people, a very simple cue that helps them get rid of things like pizza and ice cream and white bread and sugar, sweetened beverages and things like that. I think that the utility of low carbohydrate for people who are highly motivated who aren’t eating those junk foods, is largely a means of simplifying the diet and causing a spontaneous caloric decrease. I think in the general population, it has huge utility just as a very simple and intuitive tool to get rid of junk food.
But to answer your question, if someone is just eating a lot more on the Holidays and that is the specific reason why they’ve gained weight, they can probably just return to their old habits and that weight will be lost soon after. The average person is gaining a lot of weight during the Holidays and then only -- maybe they have a New Year’s resolution and they lose a little bit of it but then they don’t lose all of it and then they have a much smaller positive gain of weight over the next six to nine months and then they get into another Holiday season and they repeat that, I think in that case it’s a matter of not finding the forms of habits that are actually sustainable for you. So if you find that a low carbohydrate diet is a sustainable way of life that allows you to keep weight off for longer then probably that’s what you should go with.
For me, I lost 30 pounds by tracking my calories with MyFitnessPal. What I did was, my personal limiting factor for losing weight or even for avoiding a chronic energy gain is that I can’t sleep well if I haven’t eaten enough total calories, and my own barometer of appetite is not precise enough to allow me to find the exact amount of calories that I need to fall asleep well. So for me, if I err on the side of eating less, I’m really likely to have insomnia; and if I err on the side of eating more, I’m really likely to gain weight because I wind up eating 2 or 300 calories more than I need to sleep well at night. So for me, tracking calories really helped me, but it would drive other people crazy. So I think a huge issue is the person’s psychological profile. A lot of people like working with a lot of data, and tracking calories can work really well for them, but most people I think are probably going to benefit a lot more from having 1, 2, 3 simple and intuitive rules that can allow them to make sustainable habits that lead to a spontaneous caloric deficit. I think a low carbohydrate diet is great for a lot of people. It doesn’t work well for me because of the type of exercise that I engage in. If someone does a lot of high intensity exercise, they’re probably going to benefit more from a lower fat-higher carbohydrate approach if they’re trying to lose weight.
Christopher: Can you just clarify for me, it sounded like you were creating a caloric deficit but at the same time you said you didn’t sleep well if you did that, so what exactly did you do? Did you just restrict periodically or?
Chris M: Actually this goes back to something that we were talking about earlier that I think we could have talked more about, which is if you have someone who is stressed from not sleeping or from emotional stress and work stress, all of these things tend to promote body fat gain. I actually am skeptical that that’s a true disregulation. I have a friend who is very up on the sleep research, and I’ve talked with him about this. I do believe it’s an open question, but I think we can all agree that if you sleep for three hours instead of eight, you are going to eat more calorically dense junk food the next day. I don’t know if that’s because your appetite is disregulated or because the higher caloric food is actually helping your body accommodate the stresses of sleep deprivation.
[0:25:47]
I feel, from my own experience, that the reason I had 30 pounds to lose in the first place is because I was chronically stressed in multiple ways, sleeping three or four hours a night, feeling over-stressed, being very psychologically and emotionally stressed all at the same time. I gained that 30 pounds and five to seven inches on my waist in a matter of a few months being in that type of stress, and I really wasn’t able to sustain a caloric deficit that could allow me to lose it without causing other problems like sleep problems until I spent a year working on proper destressing. I really feel that the only reason I was able to achieve that caloric deficit in the first place is because I focused on destressing first and on losing body fat second. I think that it’s probably generalizable to most people that they would benefit from taking a similar approach if they’re gaining fat because they’re not sleeping, or they don’t like their job, or they have family problems. I see this as a way of your body not knowing whether things are going to be okay and that extra fat paddage as a way of you telling your body that, yes, everything is going to be okay. Because I think that we’re hardwired to believe -- I say believe, I’ll put that in air quotes -- our bodies are hardwired to feel stressful times require lots of energy. So if your body is subject to chronic stress, I think it’s a natural adaptation to that, to increase fat storage because that fat storage is what is going to guarantee that you have -- if all the signals are telling your body that that stress is chronic, that extra fat storage is telling your body that over the long term, you have enough energy reserves that you’ll be able to get through whatever that stressful period will be.
I feel like, for me, spending a year destressing was a way of telling my body that it was okay to let go of that extra weight because that period of stress was over. I don’t think that I could have just gone right into a caloric deficit like that and not have really negative consequences on my sleep had I not spent that time destressing. But it’s also a matter of precision. So for me, even after that destressing period, I found that eating 1900 calories a day was guaranteed to give me chronic insomnia. Whereas eating 2150 calories a day, give or take 50, I never had insomnia and I would consistently lose one or two pounds a week. So for me, it was locating the amount of caloric deficit that was tolerable, and with tracking calories, I was able to locate that much more precisely than I was if I were just trying to guess. I think it’s pretty easy to eat until you’re full and you know when you’re full, but to eat a little bit less than that, it’s really hard to gauge how much less than that you’re eating when you just go with your intuitive appetite signals.
Christopher: So it seems like the solution then is not a general recommendation, everybody should try and follow this plan, it’s more you have to be mindful of your situation and assess it and then really feel out, maybe do some quantification and figure out what’s going to work for you at that time.
Chris M: Absolutely, but some people would prefer a more intuitive approach. I don’t think you have to start with all that data, but that data can be really helpful if you start with something that doesn’t work. For me, I started with other ideas that weren’t working for me. I think if a low carbohydrate diet or a ketogenic diet or something else like that that’s really intuitive for you leads to a sustained weight loss that allows you to achieve your goals, hey, if it ain’t broke, don’t fix it. But no matter whether it’s counting calories or Weight Watchers or low carbohydrate diets or low fat diets or whatever it is, and this isn’t just for weight loss, but for any health goal, you always need to stop and evaluate and say, “Is this working the way that I expected it to? Is this giving me the progress that I’m making towards my goals?” If it’s making you worse or you’re not getting better at all, then it doesn’t matter what the textbook says or what your consultant said or what your health coach said or what your doctor said, it matters that whatever your plan was, it’s either working partly or it’s not working at all or it’s making you worse; and you reevaluate and readjust accordingly.
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Christopher: That sounds like common sense, but I don’t think you believe how often that doesn’t happen. People say, “Oh, you’re not doing it right. You’re not measuring ketones. Did you measure ketones?”
Chris M: It’s not common sense at all because think about it, common sense with food is your appetite so if you’re reading about nutrition, you’ve exited common sense.
Christopher: Right, right, it’s true. Tommy, you know our clients really, really well. You know that we work with a lot of endurance athletes. We have quite a few strength-based people too, a lot of people engaging in glycolytic stuff like Chris, the CrossFit and Olympic weightlifting. What would you do at this time of year if you had somebody like one of our clients that has a body composition goal? Say they’ve lost sight of the veins that they could once see in their thighs, for example, for example.
Tommy: I've had that in the past and that was really tough to deal with.
Christopher: I know.
Tommy: I think we’re finally getting towards the point of the conversation that I actually wanted to have with Chris, and he has brought us back around to it, which is really important. I kind of blame you, Chris Kelly, because you basically -- because you have a low carb bent, you started off by getting us to defend the low carb diet. What I actually wanted to talk about was people who are inappropriately using low carb diets or are continuously restricting carbohydrates or particularly in going further into ketosis or trying to drive themselves further in that direction because they’re failing to meet their goals and the low carb diet isn’t working, and whether they’re starting to restrict more and more and more or feel the need to restrict more and more and more because they haven’t fixed these other stuff, say, stress, like Chris was talking about. I think the really important thing that I end up talking about all the time is actually you need, A, to look at the environment and, B, actually fuel for what it is that you’re trying to do. He’s absolutely right.
We’ve recently talked about a lot of our high intensity athletes who try and perform well at obstacle course racing or CrossFit whilst eating a low carb ketogenic diet, and that just does not work for most, the majority of people. For some people it might work, but that just does not work because you are not fueling for what it is that you’re trying to achieve. So then, absolutely, eating more carbohydrates is incredibly important both for the performance in the sport at a metabolic level but also in terms of hormone signaling and all that other stuff that we see, thyroid hormone, intestinal strain, all that stuff just ends up on the floor because they’re just not fueling correctly.
So to come back to your question, if we had somebody who was some kind of power or glycolytic-type-sport athlete who was trying to then improve their body composition, I think there are a number of things that I would do. Where I would probably start absolutely is start by fixing the environment. With the talk of calories and macronutrients, we really leave behind what’s probably more important which is fixing the environment, so setting a proper circadian rhythm, making sure you’re not eating late at night, making sure that you’re fueling the right time around workouts, working out the right time of day, making sure you’re having some kind of period of feasting and fasting during the day and that’s appropriate to the amount of calories that you have to eat, and then again, addressing sleep, stress-issues. When we see a lot of people who have issues in the gut, so addressing that. We can talk loads about the microbiota and their effect on the peripheral body. The circadian rhythm, we’re not yet entirely sure how much we truly understand that. We think we have a rough idea but in reality we might be kidding ourselves there. But we know that if we treat certain infections that we see then people improve.
In terms of what you eat, particularly if you’re somebody who is doing one of those kinds of sports then I don’t think restricting carbohydrates overall is a good idea, but I do think that keeping them around workout time, so before and after workouts, is really good. Usually you basically cycle on a day or across the week. In terms of the actual composition of the diet, just lots of whole food is really important. We talk about all the things that can affect our ability to sense our macronutrients and sense our hunger, and that comes when we start to strip away the fiber or the other stuff, the cells and the water and the connected tissue that comes with the food that we eat. So if you’re eating whole real food, and it doesn’t have to be Paleo but it could be, but I also like beans, and I like dairy. All of that stuff is fine in certain scenarios. So just eating real whole food, maybe cycling carbohydrates or macronutrients. You could even cycle calories a little bit, depending on when your activity is, but actually just eating real food. There are a number of studies which suggest that that’s probably going to be enough for a lot of people just because you’re increasing both the nutrient density but also reducing the caloric density of the food, and that’s going to be enough to help your regulate your appetite. If you do that within a normal circadian rhythm and you’re addressing all the other environmental factors then I think, and this is something that I want to talk about, then I think the actual composition of the diet probably starts to matter a lot less.
[0:36:24]
Christopher: Okay. I’m sure there are lots of people listening to this who are already eating a whole foods diet. What do you do then? You could say that’s true with me as well. If I wanted to improve my body composition, it’s not like I’m eating white flour and sugar. I’m eating all whole foods but maybe I’m still not losing weight.
Tommy: Then what I would do and probably what a lot of people would do is I would stop looking at the diet and I would start looking at everything else. Are you looking after your sleep hygiene? Are you eating especially when it’s light? Are you eating at the right times of day? Are you addressing any other stressors? Have you got any chronic infection or chronic exposure that you need to deal with? Do you hate your job and your family? For a lot of people there are going to be these huge stressors in their lives that they just accept and deal with but maybe they’ve gotten to a point where they’ve fixed the diet, they’ve fixed the movement, they’re doing all that stuff and there’s still going to be this big roadblock. Can I tell you that you need to quit your job? Very difficult for me to do with a client but it might be that you actually need to spend some time being mindful of what it is in your life that’s causing that roadblock and what you can do to fix it.
If somebody comes to us and they have, say, a body composition goal and they tell us about their exercise, they tell us about their diet and well that sounds pretty good, then it’s going to be the environment that’s the issue, and probably stressing about the exact number of calories that goes into your mouth is probably going to then detract from the overall goal because then it becomes a stressor in its own right, for some people, not for everybody, just like Chris is talking about. That’s something that I would put aside and I would focus on the environment.
Christopher: So what in particular in the environment then? You’re talking about just taking the stairs more than the escalator, as Chris mentioned earlier.
Tommy: Actually, no. There’s a lot of really interesting data that’s coming out, both human studies and mouse studies, which are kind of starting to suggest that when you’re on the track to obesity or overweight and particularly when you’re eating those -- so in mice, they have their high fat diets which is like this killer combination of sugar and lard that makes it really good at creating gut permeability and causing weight gain, but what tends to happen is you change some of the signaling in the brain to almost reduce spontaneous activity or reduce resting energy expenditure, at least in the animal data, so -- they haven’t done this as well in humans, but it’s starting to look like reduced activity in obesity is almost a consequence but not a cause. Actually there are some signaling changes in the brain that then causes you to reduce the amount of activity you do, so you can sort of expand that out and be like, the person just doesn’t feel like moving. But then a lot of the calories that we burn are just sitting, moving your fingers, tapping your feet, all that kind of stuff. That just stops happening, and that’s not something you have conscious control over. That could actually be a downstream consequence of obesity rather than being a cause in its own right.
When we’re talking about the environment and things that you can fix then it goes back to [0:39:46] [Indiscernible] I don’t think that taking the stairs rather than taking the elevator is going to be the difference in what allows you to have long-term fat loss which is essentially what we’re looking for. I think it’s going to be addressing sleep hygiene, it’s going to be external stressors, it’s going to be addressing the circadian rhythm, and where that becomes really important is with the amount of time that we’re eating over the day and the cues that we’re giving our body to eat over the day. When we look at things like the amount of light that we’re exposed to, if we look at broad, broad strokes, we’re basically designed to eat large amounts of food when it’s abundant so, say, during long light cycles in the summer. What happens is you would want to store some of that so that you can then use up during the winter or during periods of time when food is less available.
[0:40:44]
When we are continuously exposed to artificial light late into the night and then early in the morning, you’re basically telling your body that the light cycle is long. It’s summer all day long. That light actually helps drive hunger and helps to drive caloric intake. So when you’re basically exposing yourself to these very long days, you are telling your body that it’s time to eat during that period of time because that’s basically one of the functions of light in the circadian clock. So when people restrict the time they eat, they spontaneously reduce calories but they also time correctly the nutrient intake to what the body is expecting. So reducing the period of your day, so not having lights on late at night or not being exposed to lights late at night, and then restricting the amount of time that you’re eating will also spontaneously reduce the number of calories that you’re eating. There’s a stress that’s caused by being exposed to light outside of the times that you’re supposed to be exposed to them. I know that Chris has talked about some of the things that you really need to get good sleep, and one of those is absolute dark at night. That’s not something that the people are being exposed to.
One of the main things I think, there’s some really interesting data coming out of Satchidananda Panda’s lab about time-restricted feeding, is that basically the quality of the diet matters much less than the period of time when you eat. That works in humans even as well-- he has done most of his work on mice but that data is starting to be realized in humans as well. So that’s one thing that I think people talk about but they don’t necessarily look after as well as they could do.
Chris M: I want to say that for light, I think it’s important to point out that our light perceptions are largely driven by the differential between the light and dark periods. On an absolute level, we’re not at all overexposed to light. We’re massively underexposed to light. That’s because the lights that we have indoors during the daytime are, orders of magnitude, less light than it is outside even on a cloudy day. We don’t notice that difference because our eyes adjust to it. If you go out on a cloudy day, from being inside, you’ll probably notice that it takes a few seconds for your eyes to adjust. What’s happening during that adjustment period is that the cells in your retina that are sensing how light it is, are, number one, telling your eyes to adjust to the brightness so you don’t notice it, and, number two, telling your brain that it’s daytime now.
People are definitely overexposed to light at night because simply -- I mean, forget about screens and stuff like that, just having a typical incandescent light bulb at night is vastly more light than it is out at, say, twilight or on a starry night or moonlight or something like that. But most people go through a day without getting really any meaningful sunlight. So in the morning, I make a habit of going for a walk, a half-hour walk around the same period of time each morning where my peak sunlight is basically happening, like in the first couple of hours of my day. That light exposure is thousands of times what I’d be getting if I just carried on indoors, in an indoor work environment. So I think it’s a combination of not enough light in the day and too much light at night rather than having too much or not enough light altogether. What we need to do is not simply constrain the light period but actually try to increase that differential between night and day as much as possible.
[0:45:04]
Tommy: Yeah, I completely agree. I’m sorry I didn’t make that clear earlier. Chris is absolutely right, being exposed to dim light all day is part of the problem. If you have a bright light exposure earlier in the day then that actually reduces the negative effects of being exposed to low level light later at night. That’s the really important thing. So, absolutely, we focus all the time on not having lights at night when in reality what we really need to do is go out and get sunlight during the day, yeah, completely agree.
Chris M: Yeah, and also there’s a time delay in the effect of darkness where the few hour -- so, really, the beginning of the day and the end of the day are the most important for setting your circadian rhythm. What happens in between might be important to how you’re feeling at that time, but the critical periods are getting really intense sunlight in the morning. The two to four hours before you go to bed is also important for blue light exposure. I think people can get the doorway into thinking about this by thinking about making their room darker at night. Having a completely dark room, for me, was always necessary but not sufficient for sleep. I really didn’t start consistently sleeping well until I started practicing blue light avoidance in the two to four hours before I go to bed and getting sunshine in the morning.
Tommy: Yes.
Christopher: Is getting sunshine in the morning going to work for anyone anywhere in the world? If not, what should you do instead?
Chris M: It’s going to be better than not getting sunshine in the morning.
Christopher: Well I’m saying, I remember when I worked in London this time of year, you go to work and it would be dark when you went to work and it will be dark when you left the office at 5 pm.
Chris M: I think that in those cases the best thing you can do is get the brightest indoor lights that you can find. There’s also some, I’m not very familiar with it but there’s some -- Ben Greenfield, on his podcast, frequently talks about some light therapy technology that he has where it hits photoreceptors in your ears and goes into his nose and his eyes and whatever. If you really have that problem I think that the best thing you can do is just focus on getting really, really bright lights that you can be exposed to. There are lights available that you can use as a desk lamp, for example, that makes your work situation much brighter, but it really is that early part of the day that’s important. For me, I have overhead lights in my house that are as bright as I can get them, and I turn them all on when I wake up. I don’t necessarily keep them on the rest of the day, but I try to create a ritual around very robust and reliable light exposure in the day. Sometimes it’s dark and it’s stormy out and I’m not going to get any sunshine by going outside. On those days, I have enough of an effect from the light at home. But I think to the extent that you’re able, you should try to get outdoors rather than replicating it inside, if you can.
Christopher: Did you have something to add to that, Tommy?
Tommy: Yes, I think the technology that Chris is talking about, I think the HumanCharger is the one that you can look up. They get light therapy in the ears to try and help set the -- but I think it’s particularly used for jet lag. I think the important thing still is to get outside. Yes, you can get lights that are like 10,000 lux, little light pads that can go on your desk and give you the amount of light that you might get similar to, say, an overcast day outside if you get some of the really strong ones. You can use that, but even then, even when it’s not sunny, you’re going to get much more light just by going outside. That’s very separate from getting the wavelengths or the amount of light or type of lights that’s going to cause [0:49:22] [Indiscernible] or anything like that, but it will be enough to set the circadian rhythm and it’s going to be better to get it outside. So if you’re somebody who, say, works and goes to work when it’s dark and goes home when it’s dark, everybody is allowed a coffee break or a cigarette break, if you can do that, 11:00, 12:00, even for 15, 20 minutes, get outside, that should be enough to help set the rhythm.
Christopher: I can’t believe you said cigarette break.
Tommy: The thing is that people who smoke cigarettes, they’re allowed breaks to go outside. There’s this really interesting study that just came out of Sweden that basically showed that those people who smoked but get maximum sun exposure have the same overall mortality as people who don’t smoke but don’t get any sunlight. So maybe those people who are going outside and smoking are offsetting the bad things about smoking because they’re getting some sunlight at the same time.
[0:50:21]
Chris M: So I think the solution is that you have to socialize with the people who are taking the smoke breaks.
Tommy: Yeah, but have some kind of filter or something, some kind of --
Chris M: Go, chew gum outside with the smokers.
Tommy: Yeah.
Christopher: Nicotine gum. Well this is really interesting because I can certainly think of my own situation. There are a couple of things that you’ve mentioned that are certainly not perfect. I do sleep really well and definitely the whole food diet, but it’s difficult -- Chris, you’re probably about to discover this as an entrepreneur. The movement when you’re working from home is something that doesn’t come naturally. You’re really going to have to put some effort into building it into your day. Sometimes it’s frightening. My phone records the number of steps I do. I can get through a whole day with about 200 steps so certainly not doing very much movement other than the time I spend in my bike which is probably not quite the same. Then getting outside first thing in the morning also becomes challenging. There’s no reason to go outside. You’re not going to work anymore so maybe just spend the whole day inside, sedentary. So you’ve certainly given me some things to think about. Do you really, honestly promise, the both of you, that these things, moving more and getting more sunlight during the day and destressing and sleep, are really going to help me with my body composition goal as opposed to just restricting more food or restricting a macronutrient of some sort?
Chris M: No, I don’t promise that. Whenever you’re solving a problem, the thing that’s going to have the biggest payoff is whatever the weakest link in your chain is. I don’t think that these approaches are going to help someone unless that’s their limiting factor, but there’s a real high probability that this is the limiting factor because most of us, because of modern lifestyles, as Tommy was saying, have disregulated circadian rhythms. So it’s one of the low-hanging fruits that most people get institute and get help from, but I don’t think that necessarily causes weight loss. I think what it does is it removes one of the most important impediments to you losing weight or one of the causes of you continually gaining weight, but it doesn’t necessarily -- I think it is necessary to address that but not sufficient for long-term weight loss. I don’t think it’s even necessary for short-term weight loss.
The problem is that, and I’m sure both of you probably see this more than I do simply because of the volume of people that you interact with, but I frequently get questions like, “I tried restricting calories, I tried doing this diet, that diet; and every time I lose weight I get really hungry, I get really irritable, my sleep suffers, my this and that suffers, my libido crashes, et cetera, et cetera, et cetera.” That person asks, “How can I lose the next five pounds?” Well that archetype of person, the answer to that is your body is telling you a thousand different ways to not lose that last five pounds, stop trying to lose it. Eventually that has to be the goal, but that’s your body telling you that there are other much bigger priorities that need to be addressed so what you need to do is listen to that overwhelming voice telling you and figure out what those other priorities to address are. So for that person, it may be the case that setting their circadian rhythm is one of the primary higher priorities that their body has. Once that’s checked off the list, so to speak, that may enable that person to then implement habits that will sustainably lose weight. Sometimes that person will spontaneously lose 10 or 15 pounds, but what you’re really trying to do is not cause the weight loss, per se, but address the underlying foundational issues that need to be addressed before the weight loss can be consciously addressed itself.
Christopher: Tommy, do you have a checklist in mind? We’ve worked with hundreds of people now who have lost weight after doing some testing and fixing the problems that they find there. Do you have a checklist in mind? Are you really doing everything before you then get into the testing?
[0:54:54]
Tommy: That’s a good question. A lot of people will, they’ll dive into the testing earlier just because having some data is a really good way to create some accountability or to create some reason to drive change. The problem is that that potentially or definitely comes with a cost attached to it. I would say that if you are somebody who, say, has listened to this podcast and there’s anything that we’ve mentioned that you’re, like, “Well, yeah, I probably don’t do that well enough,” I absolutely think that it’s worth investing the time to create those habits before you then start spending money. But if you get to a point where you’re pretty sure you’ve got those things nailed down or, equally, if you’re starting out with some real symptoms of, it could be insomnia, poor libido, brain fog, whatever, it could be any of those things, or if you’ve seen a dramatic change recently, then it’s likely there’s something underlying that needs to be addressed and those other environmental factors probably aren’t going to be the low-hanging fruit. If you’re honest with yourself and you think these others things that you could change first then I definitely think you should try that. You should try that first.
So it would depend on how long things have been going on for and what you have managed to change already, whether there are any really recent changes that you don’t think you can put down to just not addressing your circadian rhythm or not dealing with your stresses in your life and things like that. You will be somebody who knows yourself. You should know yourself quite well. Certainly the protest of trying to either lose weight or improve performance, one of the biggest, most important things is learning more about yourself so that you can be more mindful about what it is that’s going on, how you feel, what you can do, what you change and how that makes you feel. I think getting into that process before you start diving into testing -- there are a lot of people who just focus on the data rather than actually focus on listening to their body, which is, over your lifetime, is going to be what’s infinitely more important. So just take that time to be honest with yourself and ask yourself those questions and then you should have a rough idea of what you need to do next.
Christopher: I’m certainly one of those guys that when I see something messed up on a lab result then it becomes real and I really want to fix it. I’ll give you an example. You see a disrupted circadian rhythm on the results of a urinary hormone panel that measures cortisol, it suddenly becomes real. I guess I really do need to put the laptop to sleep at 7 pm or something. I maybe wouldn’t have done that until I had the test result. That’s stupid really. I should have been able to know that without doing the $400 test.
Tommy: Yeah, and then it becomes a big problem where there’s one or two or three -- if you do a panel of, we end up with 400 markers for each person or something and then two or three of them are out of the normal range and then you obsess about what you can do to fix those. That is not what you should be focusing on. You should be focusing on how you’re feeling and performing. If that’s all good then please don’t worry about it.
Christopher: Okay, sounds good.
Chris M: Yeah, I think there are two roles of the test; one is to give you the picture of what’s happening metabolically and physiologically so you can try to understand what needs to be fixed, and the other is to motivate you to change. That’s not what the purpose of the test should be, but I think that it is what it often is. Chris, maybe if you consistently and reliably find that you need to see it on a piece of paper in order to implement the change then maybe that’s just one piece of the self-knowledge that you need to be able to instruct your habits in a productive way.
Christopher: Well I think this is a nice place to end it. Chris, can you tell us about what you’ve got going on over at chrismasterjohnphd.com? I’ve really been enjoying your podcast. Can you tell us about what you’ve been doing recently?
Chris M: For sure, yeah. I have been gearing up for what has happened over the last day which is now I’m devoting my efforts, full-time, to everything for which the home is, chrismasterjohnphd.com. I have my own podcast called “The Daily Lipid.” That podcast you can find in a podcast app, if that’s how you use it, but you can also go to my website and click on ‘Podcast’ and find it there. I have brought up my blogging to a new level. I’ve just released the Ultimate Vitamin K2 Resource. That’s at chrismasterjohnphd.com/K2. I plan on doing more of these. Basically this has -- it reaches people at multiple levels, depending on what they need. So if you just go to the article, you basically get everything practical you would want to know about K2 so for example, what does it do, what are the benefits, how much should you get, how do you get that from food, If you can’t get it from food, what supplements should you use, what are the few best supplements and so on.
[1:00:24]
It also has infographics that are designed to be really cute and fun but explain the practical principles. Even if you want to get into it, some cute, fun infographics to explain the biochemistry, in a way that I think a lot of people can meet in the middle. For example, if you don’t really have much of a science background, you can probably improve your science understanding with these infographics just because they’re fun and cartoonified in a way where you can understand something where your eyes would have just glossed over it if I had written a paragraph of text because it just wasn’t fun enough. Also, for the advanced user, you just click open a little button at the end of each section that says, “Click here for more detailed explanation.” It gives you this encyclopedic tome on that topic with full references and everything like that. I got a phenomenal response to this and what I’m planning on doing, going forward -- to be honest, this costs hundreds of hours and probably a thousand dollars to produce and so on, and it’s totally free. What I’m going to try to do is alternate between making these resources along this model for other nutrients, and alternate my efforts with some products that will be available for purchase that try to put together a model where I can use one to sustain the other and to be able to produce an epic amount of really awesome free content for people.
The other thing that I’ve just released as we’re speaking today is I’ve been offering consultations for a year or two now, and I’m going to start offering consultation packages where people can get something much more long-term and strategic if they want to work with me in that way. One other thing that will probably be released by the time this comes out but isn’t quite ready yet, so this will be happening in February through March, is I’m actually going to be recruiting for a human study that people can get involved in but due to the nature of the regulations, I should not say much more about it there. I’m sure with a little bit of searching people will be able to find out about it. So those are some of the big things I’ve got right now going on chrismasterjohnphd.com.
Christopher: Do you have any thoughts about how is the best way for you to maximize the number of people that you help? I always wonder about people like you. Should you be doing one-on-one sessions with people like me, or should you be teaching doctors, or should you be teaching nutritionists, or should you just be continuing to be teaching en masse like you do through the podcast? How do you think that should be best done?
Chris M: Sure. I think what I’m doing right now is I’m blocking all of my one-on-one work to Mondays, so I’ve expanded my availability across the day well beyond a typical workday so that, no matter what people’s schedule are, they’ll probably be able to fit in there. That basically leaves most of my workweek for other things. What I think that does is, when I work one-on-one with people, I get a much more intimate sense of the kind of things that I should scale. In other words, I could just work on information products that I’m selling or free blog posts that are funded by affiliate revenue or something like that but then I’m operating in my own head and I’m just guessing at what people need. When I talk to people one-on-one, not only am I able to give close help to those people on issues that I haven’t been able to scale yet, but I also find out what are those issues that people really need solved. I get their perspective about what their problems are, and I get my perspective on what their problems are and what the best solutions are, so that feeds into what I can do for other people. I totally agree that, yeah, I need to be teaching on a number of different levels, including doctors and including people who are just interested in health and wellness, but basically what I want to do is have a model -- do you follow Gary Vaynerchuk at all?
[1:05:22]
Christopher: Oh, no, I don’t, but I will now.
Chris M: Okay, so Gary Vaynerchuk is not in the health world at all. He got his start in the online wine business. Anyway, he does a lot of content on entrepreneurship. Anyway, he said that it is a lot more fun to put yourself out of business than to have someone else do it for you. That instantaneously resonated with me because that’s the way that I think about one-on-one consulting. When I do a lot of one-on-one consulting and I find that there are repeated problems, patterns that emerge from that, what I want to do is I want to put that part of my consulting out of business. There are a lot of things where people come to me with the same problem, over and over again, that is proof positive that that help could be scaled and isn’t. So what I want to do is find those patterns and then translate them into models that do scale so that it’s really easy for people to find the answers to those problems and fix those problems. Of course in order to sustain that, I need to find a way to monetize that, but if you can make it more affordable to a broader audience and what you do is you help more people and the volume helps sustain the same level or a greater level of monetization and then the people who wanted your one-on-one help for those things don’t want your help anymore because you’ve made it easier for them, plus, for each one of them, a thousand other people. But then the people who want your help are the next level of people who have the next level of problems that are harder to solve, so that brings in a whole new level of, what are the new patterns and what are the new things that need to be and aren’t scaled and how can we scale them and so on.
Christopher: The other thing I wondered about for you was whether you’d be involved in developing any tests, especially for the fat-soluble vitamins or maybe magnesium or K2 perhaps. Have you any plans of that sort?
Chris M: To a degree. Right now, I’m getting my feet wet with how do I navigate doing independent research? The study that I mentioned I’m leading is an independent contractor, and that’s helping me navigate the legal and regulatory and financial and practical aspects of that. I don’t know if I’m really, necessarily going to be on the front of developing tests right now. I’m not sure if that’s necessarily where my skill is most applicable, but certainly there are new and emerging tests where I could organize studies to see how -- I just talked about vitamin K2, right? That’s one area where there really aren’t any good tests.
Christopher: Exactly.
Chris M: There is osteocalcin and undercarboxylated osteocalcin offered by different companies. They would be good but subject to a lot of caveats if they were offered by the same company, but they’re worthless when offered by different ones. So I think the people who are really doing innovative work on that front is VitaK in the Netherlands, but there are a lot of unanswered questions where my insights would be really useful. For example, I have my own take on what forms of vitamin K should be taken to be doing different things, and it would be great to put a study together where I could test some of those hypotheses just by having people in my audience take a certain vitamin K supplement and use those tools that VitaK is developing to see how does that impact vitamin K status in different tissues and come up with things like that. So I think that’s really where I should be putting my efforts right now. Definitely, down the line, it can emerge from that, maybe I notice specific gaps in the testing and have ideas for that. At that time maybe that’s where I branch out into.
Christopher: Very exciting, chrismasterjohnphd.com. I will of course link to everything in the show notes. Tommy, would you like to talk about your plans for the future or anything else you’d like to add?
[1:09:57]
Tommy: In the next few months, I’ll move from working as a research scientist to working for Nourish Balance Thrive, full-time, so that we can both work directly with more people, one-on-one, but then also improve our ability to use the data that we have to apply that to a broader number of people. We want to do exactly the same thing. We want to be able to scale what we know and what we do, to more people and make it more affordable and easier to use for as many people as possible. We have a load of really interesting data and also models that we can maybe use to predict outcomes and predict responses to treatments so that you can get access to that without having to actually pay for my time or your time. That’s something that we’ll be doing over the next few years hopefully, as well as maybe doing some practitioner training courses and stuff like that. So lots of really interesting stuff that we’ll be doing and people will be able to get more access to me, more of my time, if they’re interested in working with me or with us. That’s something that I’m really looking forward to.
We’ve done one of our own studies. We’ll be doing some of our own studies as well. Hopefully, maybe with Chris, we can share what we know and what we’ve learned so far to try and make sure that we can both individually -- where we can individually do that better because I think that that’s something that’s really important, is people who are out there working with people in the real world, outside of a traditional academic or medical system, they have all this knowledge, they have all this data, but it’s not getting out there so the people who are in the traditional academic or medical worlds can access it and understand it and see what’s being done. I think that that’s restricting our ability to do things better in both worlds. So I’m really passionate about trying to increase that, increase publishing of data or studies from outside of those more traditional spheres so that everybody can learn more about what it takes to make people healthier, and maybe bring some of those ideas into the more traditional worlds, which is what we really desperately need.
Christopher: Yeah, absolutely. When I think about some of the people out there that must be sitting on mountains of data, there is so much valuable knowledge. We have a lot of data now, but there must be people out there that have even more.
Tommy: Yeah, absolutely.
Christopher: It will be amazing if we could join up all those islands of data. It’s really interesting to hear Chris mention Gary V. Also Pedro Domingos who is a professor of Computer Science, who was on my podcast recently and he said, “Automate your job before somebody else does.” It’s exactly the same message. I think that’s what we should all be focused on. For people who are wondering, Tommy is the architect of the program that we run for athletes, and our goal is to improve performance and also resilience and longevity. You can come to the front page of my website, nourishbalancethrive.com, and book a free consultation. You can talk to either the registered nurse I employ, Amelia, she’s quite wonderful, and then also my wife who is of course wonderful also. She’s a food scientist. We can talk about how our program might be able to fit your goals. Thank you very much for joining me, guys. It has been an absolute pressure.
Tommy: It has been great. Thanks, Chris.
Chris M: Awesome, thanks so much for having us.
Christopher: Thank you.
[1:13:15] End of Audio
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