What You’re Getting Wrong About Metabolism (And How to Fix It) with Dr. Nick Norwitz

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The term nutrition carries a lot of baggage.
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If you were to ask me 10 years ago what I thought about quote unquote nutrition science, I would have thought, oh, we have it figured out as life would have it.
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My own medical journey kind of humbled me to that respect.
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And I was forced to really look into how much potential there is to truly heal the body.
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I was in a very desperate place.
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I tried all the standard diets to tell you for gut issues.
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The most remarkable thing about my story was that it is not at all unique.
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That there's this motif of people struggling with conventional approaches, getting desperate, bordering on hopelessness, trying things because they have nothing to lose, and then something works.
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And you're caught in a little bit of a catch-22.
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Like, why was I never told about that?
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And answering that question has become a little bit of a passion of mine.
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Dr.
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Nick Norwitz, welcome.
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Thank you for having me.
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I am so pumped.
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I, you know, we were talking offline about your academic pedigree, and I was kind of joking around, but the list is long.
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I mean, you're a valedictorian at Dartmouth for your undergrad, which is pretty damn impressive.
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PhD from Oxford in metabolism and nutrition.
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Brain metabolism.
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Brain metabolism and nutrition.
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And MD from Harvard University.
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I I think what's so cool, um, Nick, is just how you have emerged as quite the voice of reason as it relates to translating nutrition science.
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And I hope I can use the word nutrition.
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Metabolic name.
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Do whatever word you want.
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Or yeah, I mean I I just think I feel like nutrition, just the word kind of comes with a lot of baggage.
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And uh yeah, metabolic science might be a better way to describe the work that you do.
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But I think you're you're providing, I think, a very interesting um discourse among academia that is is super helpful.
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Uh and maybe if we can kind of start there.
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Yeah.
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Um why have you felt the need to create this kind of public persona?
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Yeah.
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There's a lot of places to start answering that question, but I actually want to unpack something that you just nailed, which is the term nutrition carries a lot of baggage.
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And if you were to ask me 10 years ago what I thought about quote unquote nutrition science, I would have thought, oh, we have it figured out.
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You know, eat your five a day, my plate, balanced diet, and there's a lot of platitudes.
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So if you were to ask me if this was something, this world, be it you call it nutrition or metabolic health sciences that I would have gotten into, I would have said, heck no.
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That wasn't really of interest to me.
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As life would have it, my own medical journey kind of humbled me to that respect.
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And I was forced to really look into the depths of what I would call, I guess, metabolic health science, to use another term, realizing how much potential there is to truly heal the body.
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I mean, I say that without hyperbole.
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That then framed how I finished my PhD and then how I looked at medicine and healthcare as I was going through medical school.
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Because I was kind of beset with this uncomfortable tension, which was, you know, you mentioned my academic pedagogy also at I came from a family of MD PhDs.
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So my mom and dad are both MD PhDs.
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The idea of going into medicine was like the default path.
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It's like, I like science, I don't want to help people, so like of course I'm gonna go into medicine.
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And I hold in highest esteem, like physicians who commit their lives to helping people.
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So I had this very glorified ideal of what medicine was.
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And then when I got really sick myself, a few things happened to me, but the worst of it was inflammatory bowel disease.
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Um, when I was finishing up college and then starting college.
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Finishing up college.
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Yeah, actually, we can get into my backstory a little bit.
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I don't want to go too down that rabbit hole, but um you mentioned I was validatory, and one of the worst days of my life was commencement.
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Um I was giving the validatory address, and I had just gotten diagnosed, but people didn't know how bad it was.
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So I was like most days having pretty bad bloody diarrhea 12 times a day.
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Oh my god.
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It was horrible.
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And the worst part about that, it's not the pain, it's not like the uncontrollable bloody diarrhea, it's like the confusion and the shame and the not knowing how to handle it.
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It's like the psychological torture of like, well, of course I'm not gonna date anybody, because imagine having that person over and being like, excuse me, I'm gonna go like violently poop blood for a minute.
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Oh my god.
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So then imagine I don't know how to control this.
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I've recently been diagnosed and I'm given the opportunity to give my commencement address.
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Like, what do you do in that situation?
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Because I'm like, I don't want this illness to take that opportunity away from me.
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However, there's a legitimate chance I walk up on stage and ship blood.
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And so I have watched that video back.
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You can actually see in the video if you look, my face is almost a little cushingoid because I was on um steroids, which kind of kind of makes your face bloat.
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So well, my body was kind of lead.
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I had this like this bloaty face.
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And the interesting thing about that is you can't tell I'm like dying with anxiety.
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And the day ended up going fine.
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But the reason I raised that, and I guess answer your question with that tangent, is that was the framework of my life for several years while I was going through conventional care.
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And it continued to fail me, and it continued to fail me.
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And ultimately something worked that I would call fringe.
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We can talk about what that is later.
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Yeah.
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I guess spoiler, it was a ketogenic diet.
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And and when that worked so potently for me, I was caught in this tension, which is I hold quote unquote evidence-based medicine in the highest esteem, but it didn't help me.
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So then I got desperate and had to try something that wasn't quote unquote evidence-based.
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Right.
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And it worked.
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So that is not a traditional therapeutic intervention for IBD?
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Traditionally, no.
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There are some exceptions, um, like fiber-free diets and pediatric resistance Crohn's disease, which they don't really teach you in med school, but there are reasons that are your doctor wasn't prescribing a ketogenic diet, is what you're saying.
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Aaron Ross Powell No, and you can't hold that against them because it's never been proven, quote unquote, evidence-based.
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But the point I'm getting to, and what I really struggled with going into med school, is this distinction between what is evidence-based and what is actually effective.
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Because evidence-based sounds nice, right?
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It does, yeah.
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It sounds good, but you need to understand it in the context of the business models and incentive structures we've built around medicine.
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Evidence-based really just means what have we asked and where have we checked the boxes?
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And so if there's something that is incredibly effective, let's say, for the sake of argument, it helps 100% of people and it cures them 100%, biologically speaking.
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If nobody's invested the money to do the$10 million definitive trial, it's not standard of care.
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So it's not evidence-based.
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So there's this discrepancy between what is evidence-based and what can truly help people.
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And you kind of have to grapple with that uncomfortable tension, especially now when we're living in an age with so much metabolic disease that the conventional system hasn't properly addressed.
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Right.
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And so I think the way to thread that needle, and this is what we'll talk about, is exploring health and metabolic health through your own N equals one personal journey, given the tools that are available, even if Western medicine hasn't sanctioned them yet.
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Aaron Powell We've already said metabolic health, I don't even know, a dozen times.
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How do you define that?
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Aaron Ross Powell That's a good question.
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Um I feel like it's one of those things like ultra-processed food, you know it when you see it, but it doesn't have a fantastic operationalized definition.
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The simplest way to look at it is, and this is gonna be like a definition by contradiction, is the absence of any signs of metabolic dysfunction or metabolic syndrome.
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So things like high blood sugar, um, high waste recurfants, so excess visceral fat, high triglycerides, low HDL, they kind of make a metabolic fingerprint collectively in terms of how well your body's hormonal and energy generating pathways are operating, is how I would define it.
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So if those markers are all aligned, it kind of gives you a good signature that the fundamental things like your body's mitochondria hormone, circadian rhythm, are probably operating better.
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You mentioned that you explored, I guess, the keto diet, um, and and that really worked as a therapy intervention.
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I guess how did that even come into your mind as something to try?
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And what was the progression?
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How how did it um impact the disease progression, I suppose?
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Aaron Powell Yeah.
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Before I answer that question, I just want to caveat.
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Anytime certain buzz terms come up, like keto, I think there's a tendency to think that one is beset in the way that that is the way.
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And I will tell you, when I tried keto, I was incredibly skeptical.
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And the impact it had on how I thought about nutrition might not be what people think.
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So we'll get to that in a minute.
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But I was in a very desperate place.
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So having tried a lot of different conventional medications that weren't working, I just started throwing spaghetti at the wall out of desperation, no expectation.
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So I tried all the standard diets they tell you for gut issues like low FOBMAP, specific carbohydrate diet, and then things like vegetarian, vegan, paleo, Mediterranean, and kind of at the bottom of my list, I'm like, all right, I heard about this keto thing.
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Right.
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Somebody said it's gonna be anti-inflammatory, I have nothing to lose.
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So high fat.
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High fat, very low carbohydrates.
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So about 80% of my calories were coming from fat, about 15% from protein, and then the residual from carbs.
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It really had a dramatic impact.
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As in, my symptoms went away within days.
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Bloody diarrhea stopped.
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My inflammation markers dropped, and then eventually I had another biopsy.
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So they do a colonoscopy, they take tissue from your colon to see is there inflamed disease activity?
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There was nothing.
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So the disease went into full biopsy-proven remission.
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I'm now not on any medications and I've been kind of healthy for um I guess it was June 1st, 2019, when I started.
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So it's been over seven years.
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That's incredible.
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So you have been on the keto diet for the Yeah.
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With only a couple exceptions where I tried to reintroduce carbs, and every time I've gotten flares.
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But not every time.
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Um every time it's been longer than a two-week stint, I should say, um, has been a flare.
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So there's something going on in me.
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And we could delve into why this worked mechanistically.
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So, for example, ketones, they don't just fuel your brain, they fuel the regeneration of stem cells in the gut, they're anti-inflammatory in the gut.
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It can change the microbiome in ways that could be protective in inflammatory bowel disease.
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It's again one of those situations where post hoc, after the fact, I can rationalize why this works and why this makes sense biologically, but at the same time, I cannot tell you there is the randomized control trial proving this works in inflammatory bowel disease patients because it's never been done.
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Right.
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Not because it's been done, it didn't work.
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And what I find most compelling about my story is as I wade it into the world of call it nutrition, call it metabolic health, what have you, the most unique thing about my story, sorry, the most remarkable thing about my story was that it is not at all unique.
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That there's this motif of people struggling with conventional approaches, getting desperate, bordering on hopelessness, trying things because they have nothing to lose, and then something works.
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And you're caught in a little bit of a catch-22, like, why was I never told about that?
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And answering that question has become a little bit of a passion of mine because it's like only certain things get investigated because of what there's a business model for.
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So, how can we empower people with the knowledge and tools to safely explore the options available to them, even if they're not quote-unquote evidence-based, in ways that can really transform lives.
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And the transformations I've seen, like when I think about them too hard, they bring tears to my eyes.
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The first person I ever worked with, this was uh a patient with Parkinson's disease.
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When I was in um Oxford doing my PhD, I was working in with in in Parkinson's patients, and there was a woman from my clinical trials.
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She was in her 60s and I used to be a dancer, so took a lot of pride in body movement, and then Parkinson's disease, obviously, is a disease of severe immobility.
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She also had um rheumatoid arthritis, so she she ended up being like confined, basically very sedentary.
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In fact, when we went to work on her nutrition for the first time, I had to put her in a shopping cart and push her around like a little kid because she couldn't move.
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We had a lot of fun.
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Anyway, she got her nutrition locked in, and then everything started to change in her life, her inflammation went down, her hip got better.
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And I got this text that I will never forget from her.
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For the sake of anonymity, let's call her husband Peter.
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Yeah.
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She sends me this text, she's like, Peter just came home from work, and he caught me dancing in the kitchen, and we started dancing together and crying because we never thought I'd be able to dance again.
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And I've heard stories like that again and again and again.
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I can't tell you it's quote evidence-based, but it worked for her, it worked for me, it's worked for thousands of other people.
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I'm not even saying keto diet, I'm saying the things that conventional medicine considers unproven infringe.
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Yeah.
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So how do you make what m some might call outlier stories the norm?
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Because there's a lot of sick people that could use that level of recovery.
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Right.
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So um that's my path, so to speak.
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And not not to get into policy, but you know, when you look at you know, when you think about a primary care provider, you know, they are not they don't have any latitude to experiment.
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No.
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So it's it's just it's so hard to recommend what feels like the fringe, but could actually maybe transform their life, you know, and and and how to help an individual.
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And that's why I think like what you're doing is so powerful.
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It's just this idea of you don't want to do harm, but you because there's so much individual variability, we have to do some type of experimentation to figure out what works, even as a healthy person, right?
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I'm I'm better with lower carbs.
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I just am.
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But my best friend is better with higher carbohydrate.
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You know, like it just seems there's so much intra, you know, individual variability, right?
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Well well, let's dig into that a little bit.
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Um we'll go back to the the doctors not being able to experiment with their their patients thing in a moment, because I think there's a nuance there.
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But think about how we've built medicine.
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On the on this idea of a hierarchy of evidence, the pinnacle of which is the human randomized control trial.
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You hear it all the time.
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Yeah.
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Like it's you know golden in the beacon of truth.
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But the fact of the matter is, what is a randomized control trial?
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But looking for signals between large, heterogeneous groups of people.
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Right.
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What that means, in effect, is you can have something that's evidence-based, proven in a randomized control trial, that when actually implemented in the real world, helps a minority of patients.
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In fact, by far, I think this is a statistic that's a little out of date, it's 2015 from a Nature article, but one statistic was the top 10 grossing drugs actually help between one in four and one in 25 people who take them.
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Only help one in four and between one and twenty-five.
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So again, how you define quote unquote help, I think there could be distinctions.
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Obviously, say GLP1s probably work on a large proportion of people to cause weight loss, but the point is just because something's evidence-based actually doesn't mean it's helping people to a large extent or helping most people.
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Right.
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So then the patient that gets prescribed the evidence-based medicine but has no improvement or even is harmed, how does medicine deal with that person?
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So you really do need the individualized approach, which brings me back to the other thing you said about doctors not able being able to experiment with their patients.
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You can't treat a patient like a guinea pig.
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Right.
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But I think where another place medicine's gone wrong, and this is more on us as a society, is putting the doctor on a pedestal as some like omniscient source of knowledge and truth.
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When in reality, what the role should be is a support, a partner, and a guide, which also means a lot of responsibility falls on the patient, which is why what we're doing here in in general with the transformation of access to scientific information is so important, because if you can give people the tools to go to their doctor and say, I want to try this thing and I want your set of questions.
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Yeah.
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How can you support me with this exploratory journey and the tools at my disposal, that is a different conversation.
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And doctors can help with that.
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Right, right.
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I think that's such an important um framework for folks to because I I do think we immediately I think assume a doctor is not really the person to guide us, you know, in in a way.
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And I think we don't even give them the chance, maybe, is what you're saying.
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You know, but if we were to come with to them with some ideas, they could maybe support us in ways that it's like having a conversation just with mutual respect and humility.
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They're gonna have insights that you don't have, and you're gonna have insights that they don't have.
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Right.
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And they should have a lot of people.
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They don't have your context and your constraints.
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Yeah.
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Or or the time you probably spent researching a topic that they weren't taught about in med school and they don't have time to learn about now because of their busy clinical load.
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So it really can be a partnership.
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We don't need to go into the rabbit hole of skills to approach your doctor.
00:16:22.480 --> 00:16:26.159
But the point is, I realize there's a lot of mistrust in conventional medicine right now.
00:16:26.399 --> 00:16:29.120
I dislike that because I think it has a lot of strengths.
00:16:29.200 --> 00:16:31.360
However, I understand it.
00:16:31.759 --> 00:16:39.279
I understand the frustration because given the way the medical system is built, sometimes you find yourself butting heads, let's just say.
00:16:39.519 --> 00:16:40.480
And I'll pause it there.
00:16:40.559 --> 00:16:41.919
I don't want to derail this conversation with that.
00:16:42.000 --> 00:16:43.120
I want to get into some more practicals.
00:16:43.279 --> 00:16:45.279
But I'm sure a lot of people listening know what I'm talking about.
00:16:45.360 --> 00:16:46.879
Aaron Powell I think there is a lot of distrust.
00:16:46.960 --> 00:16:48.480
I mean, I see it even just in my kids.
00:16:48.639 --> 00:16:58.320
You know, I I think the information that they're getting, you know, maybe online makes them feel as though their doctor wouldn't be the person to help them optimize their health.
00:16:58.559 --> 00:17:04.640
You know, like uh and and that's and clearly a medical doctor is generally trained to treat disease, right?
00:17:04.720 --> 00:17:10.720
They're not actually there to help you optimize your health, which maybe we can talk about that just for a second before we get into some myths.
00:17:10.960 --> 00:17:20.000
I just I just feel like this is is is a trend and it it's it's um misplaced in in many ways, and I and I but I'm not sure the best way to talk about it, but I bet you have a good idea.
00:17:20.079 --> 00:17:24.319
Aaron Ross Powell At a broad level, I'd frame it as like, what are we taught to do in medical school?
00:17:24.480 --> 00:17:30.960
We're taught to treat disease because I mean that's basically the job description as we think about it, not to optimize cells.
00:17:31.200 --> 00:17:35.920
Also, there are not a lot of studies on optimizing health and healthy people.
00:17:36.319 --> 00:17:43.279
It's can you reduce major adverse cardiovascular events in people with metabolic syndrome by giving them this lipid-lowering drug?
00:17:43.440 --> 00:17:49.039
Like that is the study on which our entire medical education system is based and what we learn to do.
00:17:49.279 --> 00:17:57.119
When you go to a doctor and ask them to help you with something that they were never trained to do, it doesn't mean they don't have the mental capability or the desire to help you in that.
00:17:57.200 --> 00:17:58.720
It just means it's a little bit out of their wheelhouse.
00:17:59.039 --> 00:17:59.279
Totally.
00:17:59.599 --> 00:18:00.880
And I think that's going to change.
00:18:01.039 --> 00:18:03.839
And I think it's going to change in a bottom-up process.
00:18:04.000 --> 00:18:08.799
I think there are enough people that feel empowered that it's going to kind of force medicine to shift the spotlight a little bit, which is awesome.
00:18:09.039 --> 00:18:09.599
Yeah, agreed.
00:18:09.839 --> 00:18:22.319
Um but I think that's where we are now with this like uncomfortable, let's call it, like, puberty of medicine 3.0, where medicine's looking like, okay, patients want things, they're demanding things, they also want to learn to optimize.
00:18:22.799 --> 00:18:27.519
And honestly, at the end of the day, medicine is a business and it's going to need to serve the population of patients.
00:18:27.920 --> 00:18:29.680
So the power starts with the patients.
00:18:29.759 --> 00:18:29.839
Yeah.
00:18:30.319 --> 00:18:30.720
Trevor Burrus, Jr.: Agreed.
00:18:30.880 --> 00:18:31.039
Yeah.
00:18:31.119 --> 00:18:36.400
And I think having the right expectations going in, knowing what, to your point, what they're trained to do, what they're not trained to do, you know.
00:18:36.480 --> 00:18:36.799
Trevor Burrus, Jr.: Yeah.
00:18:36.880 --> 00:18:38.480
Don't go in there looking for silver bullets.
00:18:38.559 --> 00:18:40.799
Try to find a partner and realize that it's a journey.
00:18:40.960 --> 00:18:43.519
I think the superpower is if you can find the fun in that journey.
00:18:44.160 --> 00:18:51.119
If you're a healthy individual, do you think kind of functional medicine is a better way to go than kind of traditional medicine?
00:18:52.079 --> 00:18:58.720
Um I wouldn't necessarily create like a I I guess there's like a Venn diagram, but I wouldn't create a full distinction.
00:18:58.799 --> 00:19:00.240
I mean, like say you're a healthy person.
00:19:00.400 --> 00:19:05.839
Do I think you should still get like a routine colonoscopy to, you know, as a prophylaxis, make sure you don't get colon cancer?
00:19:06.000 --> 00:19:06.319
Sure.
00:19:06.960 --> 00:19:15.039
But is it also potentially worth exploring other avenues that your primary care physician might not be expert in to help get you to the next level?
00:19:15.359 --> 00:19:16.079
I think also sure.
00:19:16.240 --> 00:19:16.400
Yeah.
00:19:17.359 --> 00:19:23.119
One of the things that we hear a ton is um is that your metabolism all of a sudden is is gonna crash.
00:19:23.359 --> 00:19:27.440
Um you know, at the age of 30 or 40 or 50.
00:19:27.519 --> 00:19:37.440
You know, we hear this a lot in the the female physiology or kind of female health space where, you know, as soon as you hit perimetopause, your metabolism like drops in some you know meaningful way.
00:19:37.920 --> 00:19:46.559
We actually, in our WHOP data um across you know millions of members, we estimated daily ex energy expenditure declines gradually with age.
00:19:46.880 --> 00:19:59.119
But when we normalize for body weight and matched day strain, which is essentially how much load you're putting on your body, and we kind of have a metric called strain that quantifies that, we see that it's roughly three to four percent per decade.
00:19:59.279 --> 00:20:02.960
And there are no dramatic cliffs across any age group.
00:20:03.359 --> 00:20:08.559
So, what's your kind of overall take on this myth that we hear that your metabolism crashes?
00:20:08.960 --> 00:20:11.519
I would say it's a myth with a grain of truth.
00:20:11.839 --> 00:20:20.400
The grain of truth is that quote unquote metabolism, and we can define what that means, but let's call it broadly energy expenditure can decline with age.
00:20:20.799 --> 00:20:22.559
Um, let's say if you let it.
00:20:22.720 --> 00:20:25.440
So there's obviously habitual factors like what happens in your 30s.
00:20:25.519 --> 00:20:32.960
You have kids, you might have a sedentary job, things get away from you, you're not sleeping well, so you're not exercising well, your muscle mass declines, your energy expenditure goes down.
00:20:33.200 --> 00:20:38.480
So there's the one bucket of at the population level, probably some truth to it due to habitual factors.
00:20:38.720 --> 00:20:38.880
Right.
00:20:39.119 --> 00:20:45.680
And then there's the when we look under the metabolic hood, are there things that are changing purely as a function of age?
00:20:45.920 --> 00:20:51.119
There's a lot of directions I could take this, but I want to talk about a paper that came out this week.
00:20:51.359 --> 00:20:53.119
We're recording this July 2026.
00:20:53.200 --> 00:20:55.680
This paper came out, Nature Aging July 2026.
00:20:55.839 --> 00:20:57.599
And I can give you the reference to put in the the notes.
00:20:57.920 --> 00:20:58.960
And this is the one that you just sent this morning.
00:20:59.200 --> 00:20:59.839
Oh yeah, no, yeah.
00:20:59.839 --> 00:21:02.240
I sent it to you this morning unfairly because I was reading it this morning.
00:21:02.480 --> 00:21:03.039
No, it's amazing.
00:21:03.279 --> 00:21:05.759
And I'm like, oh, this this seems like it could be a good point of conversation.
00:21:06.079 --> 00:21:09.680
So coincidence, it was it was in the question deck you want to talk about.
00:21:10.079 --> 00:21:16.559
But what they did was they took, I think it was 47 adults, young adults, and older adults.
00:21:16.799 --> 00:21:26.559
But the older adults were split into three groups trained, so fit, normal, so like you know, intermediate, and then largely sedentary or immobile.
00:21:26.960 --> 00:21:40.000
And what they did was advanced um testing to look at metabolites in the blood, fat levels in the blood, so different lipids, and over 24,000 different uh transcriptomics, basically.
00:21:40.079 --> 00:21:46.240
So you have your DNA, the DNA gets turned into blueprints for making proteins, those blueprints are called the transcriptome.
00:21:46.480 --> 00:21:54.480
So they looked at a huge swath of basically the metabolic blueprints of what makes you function, what determines your metabolism.
00:21:55.039 --> 00:21:59.680
And then, like I said, there was the young adults and the older adults split into groups, they said, what?
00:22:00.400 --> 00:22:01.599
Declines with age.
00:22:01.920 --> 00:22:10.160
And then what things that generally decline with age at a population level are stable and resistant if you're well trained.
00:22:10.400 --> 00:22:18.720
And it turned out that over 55% of the changes that tended to decline with age, the signature of aging in muscles, I should add, this is in muscles.
00:22:18.799 --> 00:22:20.079
They took muscle biopsies.
00:22:20.240 --> 00:22:20.640
Wow.
00:22:21.279 --> 00:22:25.279
Over 55% were completely stable if you were trained.
00:22:25.519 --> 00:22:32.480
So you could maintain the metabolism of youth effectively, at least 55% of it, let's say if you continued to exercise.
00:22:34.079 --> 00:22:35.039
Can you define trained?
00:22:35.200 --> 00:22:37.920
Because there's just a lot of ways to skin that cat.
00:22:38.319 --> 00:22:38.799
I forget.
00:22:38.960 --> 00:22:42.640
I I should remember it because I was reading this is more than optional.
00:22:42.880 --> 00:22:46.000
It wasn't like number of steps per day that was a little bit more controlled.
00:22:46.079 --> 00:22:48.319
It was, let's just say, degrees of physical fitness.
00:22:48.559 --> 00:22:48.720
Okay.
00:22:49.279 --> 00:22:52.960
So you can measure this more objectively, you know, with something like that.
00:22:53.119 --> 00:22:54.799
Did they have the VO2 max or okay?
00:22:55.200 --> 00:22:56.480
I don't know if they use that to operationalize.
00:22:56.799 --> 00:22:58.319
Like strength chat tests or okay.
00:22:58.640 --> 00:22:59.599
I forget the whole thing.
00:22:59.759 --> 00:23:00.559
I'm excited to read this paper.
00:23:01.359 --> 00:23:02.640
The way they operationalize strength.
00:23:03.119 --> 00:23:08.000
I was literally reading it like before I jumped in my car this morning, but like elements of the methodology that I didn't dig into yet.
00:23:08.160 --> 00:23:16.480
But the the punchline was a lot of the signature of aging could be prevented if you were fit and well trained.
00:23:16.960 --> 00:23:21.119
This 55% wasn't randomly distributed across a transcriptome.
00:23:21.200 --> 00:23:24.720
It was enriched in things that are essential to metabolism.
00:23:24.960 --> 00:23:35.599
So literally gene transcripts that are related to complexes in mitochondrial electron transport, so complexes one and four, which you wouldn't know what those are, those tend to decline with age.
00:23:35.680 --> 00:23:36.880
They didn't if you were trained.
00:23:37.039 --> 00:23:37.599
Things like that.
00:23:37.680 --> 00:23:42.799
Or NAD, another thing really important in aging, it's depleted in muscles and the brain as we age.
00:23:43.119 --> 00:23:44.000
Yeah, levels decline.
00:23:44.160 --> 00:23:45.039
Like levels decline.
00:23:45.359 --> 00:23:45.680
Significantly.
00:23:46.160 --> 00:23:52.880
There was a controversial paper about declining levels saying showing no decline recently, if people are really into it, but it was looking at blood levels specifically.
00:23:53.359 --> 00:23:58.079
So in the muscle in the brain and other critical organs, it declines, and it's a signature of chronic disease.
00:23:58.160 --> 00:24:03.759
So if you look in the brains of patients with Alzheimer's, in the brains, NAD levels are depleted.
00:24:03.839 --> 00:24:09.680
And if NAD levels are normal, typically people's brain function is fine, even if they have a ton of amyloids.
00:24:09.839 --> 00:24:14.160
So like these are the core currencies of metabolic function in the body.
00:24:14.319 --> 00:24:21.920
And basically, what this study is saying, in agreement with other studies, is if you exercise regularly, you can stave off these elements of aging.
00:24:22.079 --> 00:24:23.920
Not every element, but these elements.
00:24:24.079 --> 00:24:36.400
And if you actually look at things like we mentioned VO2 max or muscle mass and correlate it with levels of enzymes that produce things like NAD and energy molecules, they say they they're like, they're directly correlated.
00:24:36.480 --> 00:24:45.279
So the fitter you are, the higher these levels of core metabolic enzymes, proteins, molecules.
00:24:45.519 --> 00:24:47.920
And I know I'm throwing a lot of jargon out there.
00:24:48.240 --> 00:24:57.440
I want to boil it down with this image, which is if I said exercise is good for aging, I think everybody would be like, all right, sure, I buy.
00:24:57.759 --> 00:25:03.200
But the conception might be, well, if you build up muscle, it's kind of like a reservoir.
00:25:03.440 --> 00:25:07.759
Maybe you're gonna decay a little bit with age, but like you have more of a muscle reservoir to bank from.
00:25:08.160 --> 00:25:09.039
This is different.
00:25:09.519 --> 00:25:12.480
This isn't just, oh look, you worked out, so you have a bigger muscle.
00:25:12.640 --> 00:25:24.799
This is if I take the same little tiny cubic millimeter of muscle from a trained person and an untrained person, then look inside the cells, down to the mitochondrial level, say, are these mitochondria different?
00:25:25.119 --> 00:25:26.000
They're different.
00:25:26.319 --> 00:25:30.559
So the the the metabolic operating system itself is different, not just muscle mass.
00:25:30.799 --> 00:25:31.839
That is what is so cool.
00:25:32.240 --> 00:25:37.279
And so that's where I would say the myth is busted that metabolism slows as you age.
00:25:38.000 --> 00:25:39.039
Aging's hard.
00:25:39.279 --> 00:25:40.799
I'm not necessarily speaking from experience.
00:25:40.880 --> 00:25:50.720
I understand the irony of a 30-year-old saying this, but that aside, the the data suggests you can stave off a lot of the metabolic signs of aging if you take care of yourself.
00:25:50.960 --> 00:25:51.119
Yeah.
00:25:51.359 --> 00:25:58.880
Yeah, I think it's so encouraging that lifestyle can move you in in in such a powerful direction.
00:25:59.039 --> 00:26:00.240
You know, I mean it's really empowering.
00:26:00.720 --> 00:26:01.039
It is.
00:26:01.200 --> 00:26:10.559
And and it's one of those things that becomes super empowering when it like really gets internalized and hits you because it's not sexy, you don't feel it like the day of, you still have to go out there and do the work.
00:26:10.799 --> 00:26:22.960
But in terms of like the gains you can get over the decades, I mean, if you imagine two different 80-year-olds, you could have somebody who's completely like immobile, their mind isn't there, and somebody else is like can go on jogs, walk around Disney all day with their kid.
00:26:23.200 --> 00:26:24.559
And that isn't luck.
00:26:24.799 --> 00:26:28.960
That is something that isn't within within people's control to a large extent.
00:26:29.599 --> 00:26:48.000
What would you do you have a hierarchy in terms of what you from my, I guess, like a muscle well when you think about it from a metabolic perspective, strength training versus cardiovascular work versus it all kind of matters, I think, but do you have like a hierarchy that you subscribe to personally?
00:26:48.079 --> 00:26:49.359
Aaron Powell I think it all matters.
00:26:49.519 --> 00:26:52.400
I think you know, identify your weak point and work on that.
00:26:52.480 --> 00:26:54.000
Um and also do things that you enjoy.
00:26:54.160 --> 00:26:56.720
Like I used to be a runner and I just love running.
00:26:56.880 --> 00:26:58.079
So like running is good for you.
00:26:58.160 --> 00:27:00.160
Do it to an extent, don't injure yourself like I did.
00:27:01.839 --> 00:27:02.079
Yeah.
00:27:02.319 --> 00:27:04.319
Um you want functional muscle mass.
00:27:04.400 --> 00:27:09.279
So resistance train, I think at least two days per week, at least hitting all the major muscle groups.
00:27:09.359 --> 00:27:17.680
Um, and do some sort of cardiovascular training that doesn't need to be if you don't like steady state cardio, like you're gonna sit on a rower or go on a run, doesn't need to be that.
00:27:17.839 --> 00:27:19.680
You can work it into full body workouts.
00:27:19.759 --> 00:27:28.960
So I personally really like full body circuits, so it's like do jumping alternating lunges for a minute, then do 50 push-ups, then do some chin-ups, take a take a beat.
00:27:29.119 --> 00:27:31.039
Like that will give you a cardiovascular workout.
00:27:31.279 --> 00:27:36.000
So you can work strength training in cardiovascular fitness together, but I think all of it's important.
00:27:36.160 --> 00:27:38.240
Actually, one other sidebar, totally random fact.
00:27:38.319 --> 00:27:41.759
Sometimes I just go on, I call them stay curious side quests, the way I'm branding it.
00:27:42.319 --> 00:27:53.039
I I just read a study about uh twins in cognitive aging, where they took twins and they actually looked at cognitive function and brain atrophy, so how much the brain shrunk.
00:27:53.200 --> 00:27:53.440
Wow.
00:27:53.599 --> 00:27:56.720
And uh including in uh identical and fraternal twins.
00:27:56.960 --> 00:28:01.440
And you know what one of the best predictors for healthy brain aging in the twins was?
00:28:02.640 --> 00:28:03.519
Leg power.
00:28:04.079 --> 00:28:05.200
Basically like a leg extension.
00:28:05.920 --> 00:28:06.079
Yes.
00:28:06.559 --> 00:28:07.680
And I'm like, that's cool.
00:28:07.839 --> 00:28:08.079
Yeah.
00:28:08.319 --> 00:28:08.960
That's a cool study.
00:28:09.200 --> 00:28:09.279
Yeah.
00:28:09.519 --> 00:28:11.839
And there are a lot of ways that don't neglect your squats, people.
00:28:15.359 --> 00:28:16.160
My bumper sticker.
00:28:16.400 --> 00:28:16.640
I love it.
00:28:16.880 --> 00:28:23.119
But if you think, I mean, there's there's now like, you know, the that that degree of human evidence, but like mechanistically it makes so much sense.
00:28:23.200 --> 00:28:23.440
Doesn't it?
00:28:23.599 --> 00:28:28.480
Because your muscles aren't just your muscles are, and I say this with the full weight of what this means, endocrine organs.
00:28:28.720 --> 00:28:28.799
Right.
00:28:28.960 --> 00:28:30.640
So your adrenaline glucose uptake.
00:28:31.680 --> 00:28:36.000
But like they secrete hormones like you know, a recin that go to the brain, increase BDNF levels.
00:28:36.160 --> 00:28:39.519
They are so the whole class of molecules and hormones secreted from the muscles has a term.
00:28:39.599 --> 00:28:42.160
It's called myokines, myo for muscle kines for hormones.
00:28:42.319 --> 00:28:48.160
And your muscles are derived neurotrophic factors to brain-derive neurotrophic factors like muracle growth for neurons.
00:28:48.480 --> 00:28:48.880
Acronyms.
00:28:49.599 --> 00:28:54.880
Your bottom line is your muscle communicates directly to your brain to help it grow and stay healthy.
00:28:55.039 --> 00:28:59.200
So, yes, things like a run or doing some squats actually do help your brain.
00:28:59.519 --> 00:29:00.240
Yeah, amazing.
00:29:00.480 --> 00:29:00.720
Yeah.
00:29:00.880 --> 00:29:04.240
I mean, that definitely uh tracks with kind of what we see in our data.
00:29:04.480 --> 00:29:08.880
I mean, we definitely see people who just only lift have worse cardiovascular profiles.
00:29:09.119 --> 00:29:10.240
You know, not surprising, right?
00:29:10.400 --> 00:29:11.440
Like you I think you need both.
00:29:11.599 --> 00:29:16.400
I think your heart rate, your resting physiology matters, you know, in terms of long-term health.
00:29:16.559 --> 00:29:24.400
And so um, yeah, getting the heart rate up, whether it's via circuits or you know, some dedicated sprinting or something like that is important.
00:29:24.799 --> 00:29:25.599
Yeah, you need to put the work in.
00:29:25.839 --> 00:29:27.279
It doesn't need to be long and arduous, though.
00:29:27.519 --> 00:29:28.079
No, I agreed.
00:29:28.640 --> 00:29:32.480
I've gotten into have you used those vertical ski ergs, the ones where you like pulled.
00:29:33.200 --> 00:29:34.240
I have this.
00:29:34.400 --> 00:29:43.039
If I have no time, I'll do um a high-intensity workout where I do full out sprints for two minutes on that, two minute rests, and then repeat for like five to seven.
00:29:43.279 --> 00:29:46.400
If you really go hard, it's like you're you're you are smoked.
00:29:46.640 --> 00:29:47.200
I mean two minutes.
00:29:47.279 --> 00:29:47.920
That's a that's important.
00:29:48.319 --> 00:29:48.799
You are smoked.
00:29:49.039 --> 00:29:49.519
That's a long time.
00:29:49.680 --> 00:29:52.640
But you can see nice ropes too that you things like that.
00:29:52.799 --> 00:29:55.200
Like it's a full it doesn't need to be boring, you can change it up.
00:29:55.279 --> 00:29:56.160
It can actually be a lot of fun.
00:29:56.319 --> 00:29:58.319
You need to find something that's get yourself out of breath.
00:29:58.960 --> 00:29:59.119
Yeah.
00:29:59.599 --> 00:29:59.759
No.
00:29:59.920 --> 00:30:02.720
Um and find a way to have that be satisfactory.
00:30:03.039 --> 00:30:03.359
I love it.
00:30:03.599 --> 00:30:03.839
Okay.
00:30:04.079 --> 00:30:04.559
Myths.
00:30:04.720 --> 00:30:05.359
Oh, myth two.
00:30:05.759 --> 00:30:06.319
Myth number two.
00:30:06.559 --> 00:30:09.200
Poor sleep directly causes cardiovascular inflammation.
00:30:09.359 --> 00:30:10.079
Trevor Burrus, Jr.: Is this a myth?
00:30:10.319 --> 00:30:11.359
Or am I supposed to say this is true?
00:30:11.680 --> 00:30:13.839
Uh this is uh I'm gonna call it true.
00:30:14.079 --> 00:30:14.480
So okay.
00:30:14.640 --> 00:30:14.720
Yeah.
00:30:15.039 --> 00:30:15.680
Let's start with you.
00:30:15.759 --> 00:30:18.720
You're the sleep expert, so if I say anything wrong, you can fact check me, but I will, I will.
00:30:19.039 --> 00:30:19.599
But okay.
00:30:19.680 --> 00:30:25.599
I think let's start with what we agree on in terms of the correlational evidence, which is I will say we do have some whoop data here, which is interesting.
00:30:25.839 --> 00:30:29.039
So 1.45 million members.
00:30:29.359 --> 00:30:29.519
Okay.
00:30:29.839 --> 00:30:30.000
Okay.
00:30:30.160 --> 00:30:37.279
HRV, so HARE variability was approximately five milliseconds lower on poor sleep nights, okay, which is clinically significant.
00:30:37.680 --> 00:30:43.440
Resting heart rate was approximately 3.5 beats per minute higher on poor sleep nights.
00:30:43.680 --> 00:30:48.640
88.6 percent of members showed lower HRV after their worst sleep nights.
00:30:49.119 --> 00:30:49.279
Yeah.
00:30:49.759 --> 00:30:52.480
So there's HRV in in resting heart rate.
00:30:52.720 --> 00:30:53.759
The question is about inflammation.
00:30:53.839 --> 00:30:56.400
So I'll tackle that first and then we can switch back to the heart rate metrics.
00:30:56.880 --> 00:31:04.000
Which is, okay, we agree, I'm sure, that like sleep deprivation and shift work is associated with worse cardiovascular outcomes.
00:31:04.079 --> 00:31:08.720
I think it's something like 20% increased risk of a cardiovascular event if you're a shift worker.
00:31:08.960 --> 00:31:09.119
Yes.
00:31:09.200 --> 00:31:10.400
That's a correlation.
00:31:10.480 --> 00:31:12.799
You could have like, you know, donuts at the nurses' station, maybe.
00:31:13.599 --> 00:31:14.720
Are there mechanisms?
00:31:14.880 --> 00:31:17.039
Uh I can think of a few, and I can send you this paper.
00:31:17.200 --> 00:31:22.079
The one that jumps to mind has to do with the um hypocretin hematopoesis axis.
00:31:22.160 --> 00:31:23.279
So I'll unpack that jargon.
00:31:23.440 --> 00:31:25.680
Hypocretin is a hormone released from your brain.
00:31:26.160 --> 00:31:27.680
It's kind of like a Swiss Army knife.
00:31:27.759 --> 00:31:31.599
It's involved in sleep, also called a rexin, but it also is a signaling molecule.
00:31:31.680 --> 00:31:37.759
So it communicates with different parts of your body, including the hub of where blood cells are produced, the bone marrow.
00:31:37.920 --> 00:31:40.240
Hematopoesis is the generation of new blood cells.
00:31:40.400 --> 00:32:02.559
So there are at least preclinical evidence, so animal models, because you can't do these experiments easily in humans, but showing that sleep deprivation causes changes in signaling of this hormone from the brain to the bone marrow, causing inflammatory cells to be produced and then go into arteries and actually promote inflammation, which is a core feature of heart disease.
00:32:02.720 --> 00:32:06.880
So does sleep deprivation associate with poor cardiovascular outcomes in humans?
00:32:06.960 --> 00:32:07.119
Yes.
00:32:07.279 --> 00:32:12.480
Are there mechanisms to describe directly how sleep deprivation can cause inflammation in blood vessels?
00:32:12.559 --> 00:32:13.039
Also, yes.
00:32:13.359 --> 00:32:14.880
I'm gonna call that not a myth.
00:32:15.200 --> 00:32:15.359
Yeah.
00:32:15.680 --> 00:32:16.319
I don't know if you agree.
00:32:16.559 --> 00:32:16.799
You're right.
00:32:17.680 --> 00:32:17.839
All right.
00:32:18.000 --> 00:32:19.200
Sleep does cause inflammation.
00:32:19.519 --> 00:32:26.480
It it does, you know, and we obviously can't measure inflammation directly, but um but yeah, I mean uh You can HSGRP.
00:32:27.039 --> 00:32:27.359
Right, exactly.
00:32:27.440 --> 00:32:31.039
Uh, with resting physiology, we can't directly measure inflammation.
00:32:31.359 --> 00:32:35.279
But through this mechanism through this very plausible uh scenario you just outlined.
00:32:35.519 --> 00:32:36.960
I have a funny story for you, actually.
00:32:37.279 --> 00:32:39.119
I I I you know I do a lot of experiments.
00:32:39.279 --> 00:32:43.759
One of them I did recently was with this new drug Gratitrutide, the GLP3.
00:32:44.079 --> 00:32:45.519
It was an intense month.
00:32:45.680 --> 00:32:53.599
We can get into that experiment later, but one of the things that happened when I I was just for one month and it was at a low dose, but my biological age went up.
00:32:53.839 --> 00:32:55.440
Now that's weird.
00:32:55.680 --> 00:32:57.759
And I looked at that signal and like, that's weird.
00:32:57.920 --> 00:33:01.440
Why would one month of taking this GLP increase my biological age?
00:33:01.680 --> 00:33:02.720
This is probably what happened.
00:33:02.960 --> 00:33:05.440
So biological age, there's different ways to calculate it.
00:33:05.680 --> 00:33:09.200
One of the ways involves incorporating inflammation as one of the metrics.
00:33:09.599 --> 00:33:12.480
One way you measure inflammation is something called HSCRP.
00:33:13.119 --> 00:33:16.640
And sleep deprivation can bump it short term.
00:33:17.119 --> 00:33:21.119
So one of the things that was happening when I took this medication is my heart rate went up a lot.
00:33:21.599 --> 00:33:22.720
We see this jittery.
00:33:24.160 --> 00:33:24.559
Yeah, yeah.
00:33:24.640 --> 00:33:26.480
We see this in our data with GLP users.
00:33:26.559 --> 00:33:26.640
Yeah.
00:33:26.880 --> 00:33:30.400
Their cardiovascular profiles take a huge hit on GLP ones.
00:33:30.720 --> 00:33:33.680
My resting heart rate went from low 40s to mid-70s.
00:33:34.000 --> 00:33:34.960
It was a huge jump.
00:33:35.200 --> 00:33:37.200
But as a function of that, I was like jittery.
00:33:37.440 --> 00:33:39.119
Like my energy expenditure went through the root.
00:33:40.880 --> 00:33:44.160
So I the night before the the t the follow-up test, I had five hours of sleep.
00:33:44.480 --> 00:33:47.200
And so what I think happened is my HCRP bumped acutely.
00:33:47.440 --> 00:33:49.519
So my inflammation marker went up like acutely.
00:33:49.599 --> 00:33:52.640
And so then when it calculated my biological age, it's like, well, you're older.
00:33:52.960 --> 00:33:54.240
Anyway, that's an anecdote.
00:33:54.400 --> 00:33:55.359
I'm like, Wow.
00:33:55.599 --> 00:34:04.400
So I mean, we definitely see you know exercise attenuates that negative impact on cardiovascular profile, but not that much, um, only slightly.
00:34:04.640 --> 00:34:07.359
But it is that is a really interesting interaction.
00:34:07.440 --> 00:34:13.280
Um and and the downstream effects, you know, are could be problematic for some folks.
00:34:13.360 --> 00:34:20.320
Trevor Burrus, Jr.: The emphasis on for some people, I mean, to be clear, probably somebody's asking if they're like looking at me is like, why is this person with a BMI of like 21, 21, 100?
00:34:20.400 --> 00:34:20.800
I'm like, right.
00:34:20.960 --> 00:34:21.920
I did not do this for my health.
00:34:22.000 --> 00:34:22.960
I did this at the risk of my health.
00:34:23.039 --> 00:34:29.840
I like to guinea pig myself if people know me, because you know, I I like to understand how things work in part through personal experience.
00:34:30.000 --> 00:34:33.519
I think some of the effects of these medications are incredible, well beyond weight loss.
00:34:33.760 --> 00:34:42.000
Well, I think it's at the tip of the iceberg that said sometimes you try something and something weird happens in an individual like it did to me, and then you want to troubleshoot.
00:34:42.079 --> 00:34:45.599
So I'm not putting any value judgments on this or any other GLPs.
00:34:45.679 --> 00:34:46.880
It was just like, well, that was interesting.
00:34:47.119 --> 00:34:47.280
Yeah.
00:34:47.679 --> 00:34:54.960
Well, I think what's important about the way you experiment is that you're you're looking at all sorts of different markers, right?
00:34:55.199 --> 00:35:03.760
You're not just blindly going on how you feel, you're looking at very objective things that you wouldn't be able to assess without a a blood test.
00:35:04.000 --> 00:35:04.159
Yeah.
00:35:04.320 --> 00:35:06.159
Um I think that's an important caveat, right?
00:35:06.400 --> 00:35:08.400
I got 127 biomarkers for that experiment.
00:35:08.480 --> 00:35:13.119
And again, the purpose was like, I want to guide people through their health journey at the same time.
00:35:13.360 --> 00:35:15.920
Everybody has a different risk tolerance and things that matter in life.
00:35:16.079 --> 00:35:16.239
Right.
00:35:16.400 --> 00:35:20.239
So some people might be like, I know it's not great for my health, but I'm gonna go out and party and drink.
00:35:20.480 --> 00:35:21.199
I won't judge that.
00:35:21.280 --> 00:35:22.880
You know it's not good for your health, you're gonna do it anyway.
00:35:23.039 --> 00:35:25.119
I'm the person that's like, I'm gonna experiment on myself.
00:35:25.199 --> 00:35:25.280
Right.
00:35:25.440 --> 00:35:28.480
I'm not saying this is good for my health, but I really want to figure out what's going on.
00:35:28.639 --> 00:35:32.719
So I've done some crazy experiments, and so this is just part and parcel for me.
00:35:32.800 --> 00:35:35.519
I'm not advocating for any particular way of doing things.
00:35:35.599 --> 00:35:37.920
It's just a way I explore the world and I enjoy it.
00:35:38.000 --> 00:35:42.880
Aaron Powell Before we get to the next myth, what is the craziest experiment you've ever done?
00:35:42.960 --> 00:35:47.599
Aaron Powell The first one that was kind of my launch into social media was the Oreo versus Staten study.
00:35:48.159 --> 00:35:48.960
Oh, this is so good.
00:35:49.039 --> 00:35:49.519
I yes.
00:35:49.920 --> 00:35:50.320
So okay.
00:35:50.400 --> 00:35:57.199
So for a little bit of background and I- People might want to pause the podcast now and go to PubMed and type in Oreo statin.
00:35:57.760 --> 00:36:00.960
Because you're not going to believe me until so it is a is a paper.
00:36:01.119 --> 00:36:03.360
Um for for background.
00:36:04.000 --> 00:36:05.360
Yeah, talk about why you did this.
00:36:05.679 --> 00:36:09.280
Because I think that this is like So this is This is just you in a nutshell.
00:36:09.360 --> 00:36:09.519
Trevor Burrus, Jr.
00:36:09.599 --> 00:36:10.559
It is me in a nutshell.
00:36:10.800 --> 00:36:22.320
Um so we were studying a group of people who with very interesting cholesterol metabolisms where you know people think, oh, you have high cholesterol, you have low cholesterol, it's kind of static, maybe diet affects it a little bit.
00:36:22.559 --> 00:36:23.519
This is something different.
00:36:23.760 --> 00:36:31.840
We were seeing people, and let's just say I'm one of those people, who can change my cholesterol levels 500% basically overnight.
00:36:32.400 --> 00:36:33.360
This does not happen.
00:36:33.840 --> 00:36:36.320
This does not exist in medicine in the medical textbooks.
00:36:36.559 --> 00:36:54.800
And the levels can get so high, including in me, that the only other circumstance in which they're known is a very deadly one in a million genetic disease called familial hypercholesterolemia, a study of which ended up snowballing into a Nobel Prize and kind of kicked off the modern era of you know heart health, cholesterol understanding.
00:36:55.199 --> 00:37:05.039
So now we're seeing this group of people like it's so weird that it's like if you saw someone who could snap their fingers and change from being five foot to eight foot back to five foot, like it's metabolically like that.
00:37:05.440 --> 00:37:06.320
But people can do it.
00:37:06.639 --> 00:37:10.400
And when we started studying it, we were publishing some papers, but like nobody cared.
00:37:10.480 --> 00:37:13.119
And I'm like, how does nobody care about this?
00:37:13.440 --> 00:37:16.719
This is uh medically incredible.
00:37:16.960 --> 00:37:22.559
And I don't have a lot of, you know, I didn't have resources, second-year medical students.
00:37:22.719 --> 00:37:27.679
I don't have ad money, I don't have money for like the you know,$10 million I want to do the defender study.
00:37:27.840 --> 00:37:30.559
So I'm like, okay, how can I make people pay attention?
00:37:30.960 --> 00:37:32.400
And I just kind of got a naughty thought.
00:37:32.480 --> 00:37:45.679
I'm like, well, what if I devised the most diabolical, click-worthy, but legitimate experiment where in this case I can lower my cholesterol by understanding my own physiology with Oreos.
00:37:46.559 --> 00:37:48.239
Let me unpack how I think this works.
00:37:48.800 --> 00:37:51.599
So I mentioned earlier in the podcast I went on a ketogenic diet.
00:37:51.840 --> 00:37:54.239
That helped with my ulcerative colitis, but something weird happened.
00:37:54.480 --> 00:37:56.880
My cholesterol went sky high.
00:37:57.199 --> 00:38:00.159
It first tripled and then over quintupled.
00:38:00.400 --> 00:38:10.159
It went from sitting in the 80s and 90s to peaking LDL, just the LDL, near 600, which anybody medically listening might have just had a little heart attack of their own.
00:38:10.239 --> 00:38:10.400
Yeah.
00:38:10.800 --> 00:38:12.639
Doctors don't believe me until they see the test.
00:38:12.800 --> 00:38:14.800
So it is uh uh astronomical.
00:38:14.880 --> 00:38:23.360
But the weird thing was when I started a ketogenic diet, it wasn't like I was guzzling butter and bacon and had no fiber, I was like, avocados, salmon, olive oil, nuts.
00:38:24.719 --> 00:38:47.840
Long story short, what probably happens in me and people like me is if you're metabolically flexible and lean, when you switch from carb burning mode, because I was, you know, you run on carbs for fuel if you're getting carbs, to fat burning mode, and you're ketogenic, your body starts trafficking fat fuel throughout the body, and it needs a carrier, you know, delivery trucks, let's just say, to do this, and those delivery trucks have incorporated within them cholesterol.
00:38:48.320 --> 00:38:54.239
So you can have a system that fluxes fat throughout the body as fuel that gets revved up.
00:38:54.639 --> 00:39:01.760
And this as a phenomenon creates a certain signature in the blood, including an increase in LDL cholesterol along with very high HDL and low triglycerides.
00:39:02.000 --> 00:39:06.239
So if we talk about like the lipid markers for metabolic health, very, very high HDL.
00:39:06.320 --> 00:39:09.760
My HDL is like 125, triglycerides very low, like 30.
00:39:10.079 --> 00:39:11.360
It's an extreme profile.
00:39:11.519 --> 00:39:29.920
But the punchline here is if our hypotheses were correct, and I say R because I had a team of people working with me, it's not a solo effort, are right, then if the problem, quote unquote problem, is I don't have carb fuel, if you just add carb fuel back, shouldn't the quote unquote problem high cholesterol go away?
00:39:30.079 --> 00:39:33.519
If the hypothesis is correct, it doesn't need to be a healthy carb, it doesn't need to be a carb swap.
00:39:33.599 --> 00:39:40.639
It can be a pure addition of any carb, which means I can take my normal diet and binge Oreo cookies on top of that, which is what I did.
00:39:41.199 --> 00:39:47.760
But I like to dot my I's and cross my T's, so I decided I would go to Harvard's institutional review board and say, I'm gonna do this.
00:39:48.079 --> 00:39:48.800
Can you give me permission?
00:39:48.960 --> 00:39:50.400
They're like, sure, go ahead.
00:39:50.559 --> 00:39:51.679
You can experiment on yourself.
00:39:51.840 --> 00:39:58.719
And then I also did it as a crossover experiment, which means I have two faces, and the comparator was high dose statins.
00:39:59.280 --> 00:40:07.199
So front-of-the-line medications grossed hundreds of billions of dollars for pharma, and I'm like, I'm gonna take Oreos and compare them to statins in this experiment on myself.
00:40:07.280 --> 00:40:08.159
So I did this experiment.
00:40:08.239 --> 00:40:13.199
You can look up the exact methodology, but bottom line is Oreos outperformed statins.
00:40:13.440 --> 00:40:14.079
Yeah, that's the punchline.
00:40:14.239 --> 00:40:20.079
Was Oreos were twice as powerful as statins at lowering cholesterol and worked three times as fast.
00:40:20.320 --> 00:40:21.679
And it's it's legitimate.
00:40:21.760 --> 00:40:24.880
It doesn't mean, again, what what am I trying to say with this?
00:40:25.039 --> 00:40:27.679
Am I trying to put a value on LDL or Oreos or statins?
00:40:27.840 --> 00:40:28.239
None of that.
00:40:28.639 --> 00:40:34.400
It's being like, whoa, you can do this with a human body and you can do it in a predictive manner.
00:40:34.559 --> 00:40:36.960
It wasn't a fluke, it was like, I think this is gonna happen.
00:40:37.119 --> 00:40:40.239
I broadcast before I did it, this is my hypothesis, like a good scientist.
00:40:40.320 --> 00:40:40.880
Then I did it.
00:40:41.119 --> 00:40:42.400
You pre-registered, you did the whole thing.
00:40:42.960 --> 00:40:53.039
I mean, it was an N equals one that I got exemption, so I didn't need like an actual pre-reg, but I I literally went on a very popular vegans podcast, who's also like a friend, and I'm like, hey, I'm gonna do this thing.
00:40:53.280 --> 00:40:58.000
Like the world, I might be a fool, I might be wrong, but I'm gonna do the thing, and the thing worked.
00:40:58.079 --> 00:41:00.400
So that was the craziest experiment I ever did.
00:41:00.559 --> 00:41:04.159
And honestly, this is the funniest part, it's been replicated a lot.
00:41:04.480 --> 00:41:16.719
Because people like me, there's a lot of them, and increasing number because more and more people play with diet, so more lean people are trying ketogenic diets and developing metabolisms like mine, where cholesterol goes up, including doctors at Harvard.
00:41:16.880 --> 00:41:21.360
So there's people that were like, my senior residents during med school, and they're like, I can't believe this worked.
00:41:21.440 --> 00:41:22.400
By the way, I have this profile.
00:41:22.480 --> 00:41:23.119
Will it work on me?
00:41:23.199 --> 00:41:25.440
I'm like, I can't tell you to do this.
00:41:25.760 --> 00:41:31.039
You are a licensed clinician, I can't tell you not to do it, and they would come back later and they're like, it worked.
00:41:31.360 --> 00:41:35.039
The one time I told somebody not to do it was a resident who was pregnant.
00:41:35.119 --> 00:41:38.639
And I'm like, oh please finish your pregnancy before trying this.
00:41:39.039 --> 00:41:40.480
She came back later and said it worked.
00:41:41.119 --> 00:41:43.039
So there's a story for you.
00:41:43.280 --> 00:41:44.800
But yeah, I've done a lot of experiments like that.
00:41:44.880 --> 00:41:47.440
And the point is never to proselytize for one approach.
00:41:47.599 --> 00:41:52.159
The point is to be like, let's get excited about what you can do with your body.
00:41:52.400 --> 00:41:58.639
Because the outcome of changing cholesterol, like whatever, nonsense, doesn't really impact my health as far as I'm aware.
00:41:59.119 --> 00:42:08.239
But if I can do that, think about what you can do with an outcome you actually care about if you understand your individual physiology.
00:42:08.400 --> 00:42:12.079
And I trust me, people can have unbelievable transformation stories.
00:42:12.159 --> 00:42:14.880
So this was just kind of just I mean, you can call it clickbait, that's what it was.
00:42:14.960 --> 00:42:24.480
It was still legitimate science, but it was clickbait to like start a conversation around this niche area of cholesterol metabolism, which is one of my nerdy passions.
00:42:24.719 --> 00:42:38.320
So more than anything for me, it was a social experiment to see can I use the tools at my disposal to get people excited and interested in some nerdy esoteric scientific topic.
00:42:38.559 --> 00:42:47.840
And I've been devoting the last couple of years of my life to figure out how to do that, how to get people excited about science and metabolism.
00:42:48.079 --> 00:42:53.519
Because at the top of you know, the surface, as you opened with, it's not, it doesn't sound sexy.
00:42:53.760 --> 00:42:53.840
Right.
00:42:54.079 --> 00:43:00.159
You know, you know, eat your rainbow, five a day, balance fiber, gut health, like all the platitudes.
00:43:00.239 --> 00:43:13.280
And there's so many platitudes that need to be deconstructed because there's so much nuance and just like scientific awe that is at our fingertips, under our noses, things that you can do, and the data are there.
00:43:13.360 --> 00:43:21.119
There's like human trials showing how you can change your macronutrient distributions to get a 600 calorie per day increase in energy expenditure without changing activity at all.
00:43:21.199 --> 00:43:24.320
Like those human trials exist, nobody talks about them.
00:43:24.559 --> 00:43:30.239
And to surface those things and talk about them is just it's an absolute pleasure, um, which is why I love doing this.
00:43:30.559 --> 00:43:35.440
I want to apologize to everybody in advance for talking fast because we're getting close to time, but we have a lot of topics we want to cover.
00:43:35.679 --> 00:43:35.840
I know.
00:43:36.000 --> 00:43:38.159
So just like put it on 0.75 speed for what follows.
00:43:38.400 --> 00:43:38.559
Perfect.
00:43:38.800 --> 00:43:44.159
Uh yeah, so that that that thing I just kind of teased, which I'm glad you you're you're biting the the hook there.
00:43:44.320 --> 00:43:45.119
I I bit I bet, yeah.
00:43:45.360 --> 00:43:48.239
It was so this okay, is gonna start in the weirdest of places.
00:43:48.480 --> 00:43:50.719
Did you hear about the sugar diet trend last year?
00:43:50.960 --> 00:43:51.119
No.
00:43:51.360 --> 00:43:51.920
This was a thing.
00:43:52.079 --> 00:43:52.719
Google it.
00:43:52.880 --> 00:43:55.360
There were like influencers, like I'm doing the sugar diet.
00:43:55.440 --> 00:43:59.119
And when I say the sugar diet, I mean like candy, fruit juice, Skittles.
00:44:00.159 --> 00:44:00.800
Raisins.
00:44:00.960 --> 00:44:02.719
And they were like, and I'm losing body fat.
00:44:02.800 --> 00:44:04.400
And I'm like, this is nonsense.
00:44:04.639 --> 00:44:05.920
This can't possibly work.
00:44:06.320 --> 00:44:10.079
But I knew some people who were trying it, and I'm like, all right, it's it's interesting enough that I'm gonna dig into it.
00:44:10.239 --> 00:44:12.960
Coincidentally, around that time, a paper dropped in Nature Metabolism.
00:44:13.199 --> 00:44:21.679
Nature Metabolism is a highly regarded journal and it had three human control trials in it, where they did something that's gonna sound very counterintuitive, but I will unpack it.
00:44:21.920 --> 00:44:26.480
They gave lean, healthy men, that was population, a low protein diet.
00:44:27.039 --> 00:44:28.719
Low protein, not high protein.
00:44:28.960 --> 00:44:36.400
They cut their protein down to nine percent of calories from protein, and their energy expenditure went up by about 20%.
00:44:36.960 --> 00:44:46.480
They did three separate studies, and every time, energy expenditure went up by 20%, and there was no loss, significant, uh no significant loss of lean mass over that study period.
00:44:46.800 --> 00:44:47.760
How long was the study period?
00:44:48.000 --> 00:44:48.960
Five week intervention.
00:44:49.039 --> 00:44:50.639
So it was admittedly a short time frame.
00:44:51.119 --> 00:44:55.440
And I wouldn't say I'm not recommending this, but again, metabolic fascination.
00:44:55.599 --> 00:44:57.760
What was going on with their metabolism?
00:44:57.840 --> 00:45:00.559
Probably what was happening is a couple things.
00:45:00.800 --> 00:45:08.559
One was a change in a hormone called FGF-21, which the liver can make and it can affect fat cells and cause an increase in energy expenditure.
00:45:08.800 --> 00:45:11.119
And there are probably some other things going on with the microbiome.
00:45:11.360 --> 00:45:13.119
So this is where the story takes a new turn.
00:45:13.360 --> 00:45:17.280
Where it came out in a paper, it was in Nature or Cell, one of the big two.
00:45:18.159 --> 00:45:19.679
I guess big three, if you include science.
00:45:20.239 --> 00:45:22.480
Where they started to look at brown fat.
00:45:22.719 --> 00:45:26.000
So just to catch people up, there's different types of fat in the human body.
00:45:26.079 --> 00:45:29.360
There's white fat, which is like your storage fat, and different types of white fat.
00:45:29.519 --> 00:45:30.880
We could talk about you know visceral fat.
00:45:30.960 --> 00:45:32.960
And then there's very metabolically active fat.
00:45:33.039 --> 00:45:37.280
So brown fat and another type called beige fat, which is like its cousin, that produces a lot of energy.
00:45:37.360 --> 00:45:39.599
It burns off calories like gangbusters.
00:45:39.920 --> 00:45:43.679
But the funny thing is And that declines significantly after Age.
00:45:44.079 --> 00:45:44.400
Birth, right?
00:45:44.480 --> 00:45:44.800
Like I don't know.
00:45:45.280 --> 00:45:48.559
Typically the brown fat does, the beige fat you can produce.
00:45:48.880 --> 00:45:49.119
Okay.
00:45:49.440 --> 00:45:49.679
Anyway.
00:45:49.840 --> 00:45:49.920
Yeah.
00:45:50.400 --> 00:46:00.719
Their lineages are a little bit different, but that aside, if you put humans in a scanner and basically look at brown fat activity across adults, massive variation.
00:46:00.960 --> 00:46:06.559
Some people have a lot of really active beige fat that's burning off energy, and other people have like none.
00:46:06.800 --> 00:46:08.079
It's a metabolic injustice.
00:46:08.559 --> 00:46:16.800
But then what they did was they tried to figure out what is the signature of these really metabolically active fat people, humans.
00:46:17.599 --> 00:46:19.679
And they look in their microbiomes.
00:46:20.000 --> 00:46:25.679
Long story short, the microbiome is secreting molecules that can collectively activate brown fat.
00:46:26.320 --> 00:46:28.159
And different people have different microbiome profiles.
00:46:28.239 --> 00:46:29.679
So here's where things get cool.
00:46:30.320 --> 00:46:42.159
They tried to identify the minimal consortium, a team of microbes that collectively produce a cocktail that can activate thermogenesis, fat metabolism, burning off energy.
00:46:42.400 --> 00:46:46.239
They ended up with four, which they combined into a probiotic they called HU4.
00:46:46.400 --> 00:46:49.920
I don't know if it stood for human four for four bugs, but that's what I think.
00:46:50.480 --> 00:46:53.280
And then this hasn't been trialed in humans yet, but they give it to mice.
00:46:53.679 --> 00:46:57.360
The reason you do it with mice first is you need to wipe out the microbiome, so that's heavy antibiotic treatment.
00:46:57.679 --> 00:47:02.239
But they were effectively able to show they could massively boost the mice's uh energy expenditure.
00:47:02.480 --> 00:47:02.639
Wow.
00:47:02.960 --> 00:47:15.039
So I'm kind of cobbling the story together here, and I can send you those two papers, but what probably is happening to some extent is the protein restrictions changing the microbiome to change metabolism in a way that downstream activates energy expenditure.
00:47:15.280 --> 00:47:16.480
It's still being sussed out.
00:47:16.559 --> 00:47:21.920
I know the original team is doing more work in women, older people, and people with obesity to see if the effect replicates.
00:47:22.079 --> 00:47:26.800
But like I'm not saying go do a low protein diet now, although I've tried this and it does work.
00:47:26.880 --> 00:47:28.719
I tried it with a 4 to 1 ketogenic diet.
00:47:28.800 --> 00:47:29.679
It was crazy.
00:47:29.840 --> 00:47:32.559
I could not stop from losing weight and I just kept on eating weight.
00:47:32.880 --> 00:47:35.519
Is that just be I mean, how what's the caloric profile?
00:47:35.599 --> 00:47:36.239
Is it is it happens?
00:47:36.480 --> 00:47:37.199
For ketogenic diet?
00:47:37.360 --> 00:47:42.159
No, no, no, for this low protein and so 9% kilocalories from protein was what they did in the study.
00:47:42.400 --> 00:47:42.559
Okay.
00:47:42.800 --> 00:47:45.599
So you can kind of break that down to pace depending on your overall intake.
00:47:45.760 --> 00:47:49.199
But um and I will be clear, people say like don't mix fat and carbs.
00:47:49.360 --> 00:47:53.760
One of the studies was high fat, high carb, low protein.
00:47:53.840 --> 00:47:58.079
I think it was 41% carb, 50% fat, low protein, and it still worked.
00:47:58.400 --> 00:47:58.960
What?
00:47:59.280 --> 00:48:03.039
So they had to increase the people's uh energy intake to prevent them from losing weight.
00:48:03.199 --> 00:48:07.039
They just kept on increasing the calories, like five, six hundred calories, they still lost weight.
00:48:07.280 --> 00:48:09.920
And again, it wasn't necessarily lean mass.
00:48:10.079 --> 00:48:12.559
There wasn't a significant negative nitrogen balance that normalized.
00:48:12.880 --> 00:48:13.920
Did they look at visceral fat?
00:48:14.400 --> 00:48:15.039
They didn't.
00:48:15.199 --> 00:48:17.280
I would love to have them look at visceral fat.
00:48:17.440 --> 00:48:20.239
But again, not advocating for this, but like think about how cool that is.
00:48:20.320 --> 00:48:24.400
And also then think what if you could hack this and make that probiotic work in humans?
00:48:24.559 --> 00:48:24.719
Yeah.
00:48:24.880 --> 00:48:27.519
Could you make a probiotic that burns 600 calories per day?
00:48:28.079 --> 00:48:28.239
Sure.
00:48:28.880 --> 00:48:29.119
You could.
00:48:29.519 --> 00:48:31.760
In theory, you could if you can get it to stick.
00:48:32.400 --> 00:48:36.719
Because then you could modulate people's beige and brown fat activity, which is like wild.
00:48:36.960 --> 00:48:39.199
So we are on the cusp of doing these things.
00:48:39.599 --> 00:48:40.400
That's just insane.
00:48:40.719 --> 00:48:41.679
Which is cool.
00:48:42.320 --> 00:48:44.639
I can send you the PubMed references, like the DOIs.
00:48:48.159 --> 00:48:53.760
Effectively, the way I think about it is you're giving a meta like think about the people with certain like advantages genetically.
00:48:54.159 --> 00:48:56.239
Maybe they're tall, maybe they have like great musculature.
00:48:56.480 --> 00:48:57.679
Yeah, or they have active brown fat.
00:48:59.760 --> 00:49:04.400
That benefit and give it to someone who's quote unquote less fortunate metabolically.
00:49:04.800 --> 00:49:05.920
People call things cheap.
00:49:06.079 --> 00:49:07.920
I'm just like, take your advantages, take your winds where you can.
00:49:08.320 --> 00:49:09.760
Also, if it's improving your overall health.
00:49:10.000 --> 00:49:10.159
Yeah.
00:49:10.480 --> 00:49:12.639
Which in this case, I see no reason to think that it would be harming you.
00:49:12.800 --> 00:49:20.320
In fact, there are animal model literature showing FGF-21 certain pathways can increase longevity in animals, but I'm saying the net benefit's probably good to health.
00:49:20.880 --> 00:49:29.119
Would you imagine if if if this continued beyond the five weeks, and let's say we get into 10, 15 weeks, do you think there would be a shift in lean mass given that there's a decrease in protein?
00:49:29.280 --> 00:49:31.760
Or as long as you're still stimulating the muscle, you should be fine.
00:49:32.159 --> 00:49:33.280
Honestly, it hurts.
00:49:33.679 --> 00:49:34.800
It's hard for me to speculate.
00:49:34.960 --> 00:49:37.920
I would say I would be careful, especially if you're an older adult.
00:49:38.159 --> 00:49:38.320
Yeah.
00:49:38.719 --> 00:49:41.519
A lean, healthy person probably has a little bit of buffer room to wiggle with.
00:49:41.760 --> 00:49:42.079
Right, right.
00:49:42.320 --> 00:49:43.519
I I still would be careful.
00:49:43.679 --> 00:49:43.760
Yeah.
00:49:44.000 --> 00:49:48.639
I will say that I think right now we're a little bit in the protein maxing era and it's overhyped.
00:49:49.039 --> 00:49:53.920
More is not necessarily better, and probably people need less than they think they need.
00:49:54.000 --> 00:49:55.519
And metabolism adjusts differently.
00:49:56.480 --> 00:50:00.960
How much protein do you think as someone who just spends their life studying this?
00:50:01.119 --> 00:50:01.199
Yeah.
00:50:02.000 --> 00:50:05.519
How much protein does the average adult, healthy adult, need?
00:50:05.840 --> 00:50:15.360
This is such a hard question to answer because when some when when people are giving the advice of the RDA is too low, which is like, you know, 0.8 grams per kilogram.
00:50:15.599 --> 00:50:15.679
Right.
00:50:16.079 --> 00:50:17.760
Which is 0.36 grams per pound.
00:50:18.000 --> 00:50:22.159
I'm like, uh at a population average, I think it is harmful to give that advice.
00:50:22.320 --> 00:50:23.280
I much rather use go.
00:50:23.840 --> 00:50:25.199
We're quadr quadrupling that.
00:50:25.519 --> 00:50:28.559
I much rather see a person look for one gram per pound.
00:50:28.800 --> 00:50:28.880
Right.
00:50:29.119 --> 00:50:31.519
I do not think that to be clear, I do not think that is harmful.
00:50:32.079 --> 00:50:38.000
And in terms of like even just satiety signaling, if you're gonna be eating a decent amount of protein, I think that is a good place to start for your average person.
00:50:38.159 --> 00:50:38.320
Right.
00:50:38.559 --> 00:50:40.000
Not discounting that.
00:50:40.320 --> 00:50:43.039
Do you need that metabolically to preserve or build muscle?
00:50:43.199 --> 00:50:43.440
No.
00:50:43.679 --> 00:50:43.920
Right.
00:50:44.159 --> 00:50:51.599
There was actually a really fascinating study in 2024 where they took lean people and fasted them for seven days.
00:50:51.760 --> 00:50:54.719
Water only, completely water-only fast, and then did a refeed.
00:50:54.960 --> 00:50:58.320
And basically after the fast and the refeed, very little lean mass was lost.
00:50:58.639 --> 00:50:59.119
Interesting.
00:50:59.440 --> 00:51:06.480
So your body is pretty smart about you know preserving critical infrastructure, so muscle.
00:51:06.639 --> 00:51:06.800
Right.
00:51:07.039 --> 00:51:11.280
So I do think we're right now overhyping protein because it's a macronutrient that's very easy to love.
00:51:11.519 --> 00:51:11.920
I love it.
00:51:12.079 --> 00:51:14.639
Like I'm not gonna not eat a 16-ounce ribeye if I get served it.
00:51:14.800 --> 00:51:15.599
It's easy to sell, too.
00:51:15.840 --> 00:51:16.559
It's easy to sell.
00:51:16.719 --> 00:51:19.119
So, you know, um I'm not I'm definitely not anti-protein.
00:51:19.199 --> 00:51:21.679
I'm not saying do a 9% kilocalories from protein diet.
00:51:21.760 --> 00:51:24.400
I'm just saying there's there's another level here worth exploring.
00:51:24.559 --> 00:51:25.360
And we'll leave it at that.
00:51:25.679 --> 00:51:27.039
All right, let's talk about visceral fat.
00:51:27.280 --> 00:51:28.239
We we mentioned it.
00:51:28.400 --> 00:51:34.880
So it it definitely plays obviously a super large role in just overall metabolic health and functioning.
00:51:35.199 --> 00:51:37.119
I had my visceral fat done in November.
00:51:37.280 --> 00:51:38.480
I'm due to get it done again.
00:51:38.639 --> 00:51:40.400
I think it's 0.14 pounds.
00:51:40.719 --> 00:51:41.440
It's pretty good, right?
00:51:41.760 --> 00:51:42.000
Pretty good?
00:51:42.239 --> 00:51:42.480
Yeah.
00:51:42.880 --> 00:51:46.559
Um so why don't we just talk about what is visceral fat?
00:51:46.719 --> 00:51:48.880
How does it how is it different from other fat?
00:51:49.039 --> 00:51:49.119
Yeah.
00:51:49.360 --> 00:51:51.199
Why do we need to kind of keep track of it?
00:51:51.360 --> 00:51:56.079
What are ranges that are helpful or good for for us to think about in terms of age?
00:51:56.159 --> 00:51:57.039
And yeah.
00:51:57.519 --> 00:52:03.119
So um when you think about like general fat, let's set aside brown and beige fat.
00:52:03.280 --> 00:52:05.840
Um you have fat that is subcutaneous, so under your skin.
00:52:06.000 --> 00:52:08.159
Think love handles, think muffin top.
00:52:08.400 --> 00:52:09.440
Maybe you don't like it.
00:52:09.679 --> 00:52:23.679
But honestly, if you it jiggles and you can pinch it, it's probably less harmful than visceral fat, which is the type that sits in your abdominal cavity, wraps around your internal organs, and it is inflammatory, harmful.
00:52:23.840 --> 00:52:32.639
The analogy I come back to because I think it's kind of funny and cute, and I love funny and cute analogies is like if you an endocrine organ, which secretes hormones, had a baby with a cancerous tumor, that's visceral fat.
00:52:33.119 --> 00:52:33.599
Oh, dang.
00:52:33.760 --> 00:52:34.320
Okay, that's good.
00:52:34.400 --> 00:52:35.360
That's that's a sticky one, right?
00:52:35.440 --> 00:52:39.360
That's that's it's spinning off inflammatory molecules, it's harming your heart, it's harming your brain.
00:52:39.519 --> 00:52:56.639
In fact, a recent study came out, 2026, out of I think collaborators at Harvard and in Israel and Germany looking at this was drawn from I believe four different randomized control trials, but visceral fat and visceral fat change and changes in brain function and brain volume over time.
00:52:56.719 --> 00:53:01.280
And specifically visceral fat, not subcutaneous fat was associated with quicker brain shrinkage.
00:53:01.440 --> 00:53:05.679
If you kept your visceral fat lower for longer, your brain was healthier, your cognition was healthier.
00:53:05.840 --> 00:53:07.280
And there are mechanisms to explain that.
00:53:07.360 --> 00:53:10.000
Also, visceral fat potently like harms the heart.
00:53:10.079 --> 00:53:12.480
So, long story short, you want to reduce it.
00:53:12.719 --> 00:53:14.000
The question then becomes how?
00:53:14.559 --> 00:53:19.199
I'll give you my bullet point list, which is first and foremost the most powerful things or the least sexy things.
00:53:19.519 --> 00:53:22.079
Sleep, exercise, general proper nutrition.
00:53:22.239 --> 00:53:25.039
If you're losing overall body fat, you're probably losing visceral fat.
00:53:25.199 --> 00:53:28.639
There are a few things that might potently reduce visceral fat specifically.
00:53:28.880 --> 00:53:30.079
Two come to mind.
00:53:30.559 --> 00:53:32.000
Resistant starch.
00:53:32.639 --> 00:53:39.920
So there are double-blinded, calorie-controlled human RCT data showing uh resistant starch.
00:53:40.079 --> 00:53:41.920
In this type, I think it was type 2 resistant starch.
00:53:42.000 --> 00:53:44.960
We won't go into the four types, but was able to reduce visceral fat in humans.
00:53:45.199 --> 00:53:46.960
So uh it was 40 grams.
00:53:47.039 --> 00:53:56.320
I'm just gonna give people the practicals and the protocol, 40 grams for eight weeks of type 2 resistant starch found from high amylose maize, is what they did.
00:53:56.400 --> 00:54:03.039
So if people look up resistant starch, visceral fat, nature, one of the nature journals published it, they can find the paper.
00:54:03.119 --> 00:54:07.039
But that was able to reduce visceral fat, probably again, changing the microbiome.
00:54:07.360 --> 00:54:11.760
Resistant starch, change microbiome, microbiome makes hormones that affects visceral fat.
00:54:12.320 --> 00:54:17.920
The other thing that's very potent, and you can't get it without a prescription, uh, is tesimerella in the peptide.
00:54:18.079 --> 00:54:18.239
Okay.
00:54:18.480 --> 00:54:24.239
So there's a peptide out that is FDA approved for visceral fat reduction, specifically in patients with HIV.
00:54:24.639 --> 00:54:28.800
Historically, that population was given drugs that caused visceral fat increase, so that's what it's studied in.
00:54:28.960 --> 00:54:32.320
But that through acting on the growth hormone pathway can reduce visceral fat.
00:54:32.480 --> 00:54:36.960
So, point being, it's important for brain health, heart health.
00:54:37.119 --> 00:54:45.599
You can reduce it through healthy lifestyle practices, some things that are readily available, resistant starch, and then there are new things coming out like these peptide.
00:54:46.000 --> 00:54:52.400
So gut biome health is the thing to address first if you want to improve your visceral fat.
00:54:52.480 --> 00:54:54.320
Aaron Ross Powell I would say a lot of your health.
00:54:54.480 --> 00:54:57.840
Um the resistance starch aspect is a very particular intervention.
00:54:57.920 --> 00:55:01.280
Aaron Powell So what you're saying is you can't do it all with food or nutrition.
00:55:01.440 --> 00:55:02.000
Trevor Burrus, Jr.: You could.
00:55:02.079 --> 00:55:02.880
I mean, you sure you could.
00:55:03.280 --> 00:55:05.440
Or or you accelerate it with exercise, food.
00:55:05.599 --> 00:55:07.599
If you're doing all the things you can accelerate.
00:55:07.760 --> 00:55:14.880
Trevor Burrus, Jr.: This is one of those things where I'm like, really what I'm trying to tell you is not here's a magic bullet, even though resistance starch is very cool.
00:55:14.960 --> 00:55:22.320
It's more here's another really important outcome of all the boilerplate things you're probably already told about.
00:55:22.400 --> 00:55:25.119
So when you're at the gym, let's do an autopsy in this conversation.
00:55:25.360 --> 00:55:25.599
Yeah, yeah.
00:55:25.840 --> 00:55:26.639
You're doing squats.
00:55:27.039 --> 00:55:28.320
What are you doing those squats for?
00:55:28.480 --> 00:55:30.000
Because you're not doing it just to build muscle.
00:55:30.239 --> 00:55:40.559
You're doing it to change your transcriptone, so those 55 to 59% of genes stay healthy, to build your brain, because you're sending BDNF there, and now we know about that twin study, to reduce your visceral fat.
00:55:40.639 --> 00:55:46.159
Like those are the reasons you're doing the boilerplate fluffy health and you know nutrition things.
00:55:46.639 --> 00:55:49.039
That is what's happening inside your body, even if you don't know it.
00:55:49.199 --> 00:55:59.119
So if you're taking nothing else, maybe some like extra motivation for hitting the gym or eating well, because what it's doing to you is so profound and so beyond what people appreciate.
00:55:59.199 --> 00:56:06.400
It's not just shrinking, you know, gut and aesthetics, it's not just building muscle, it is so much more, it's changing your body's operating system.
00:56:06.719 --> 00:56:06.960
Amazing.
00:56:07.199 --> 00:56:08.079
Which I find very cool.
00:56:08.159 --> 00:56:14.000
Aaron Powell So you have this really beautiful philosophy or framework about staying curious.
00:56:14.239 --> 00:56:20.719
How what's your message for our listeners and how do they think about curiosity as a as an entry point?
00:56:21.039 --> 00:56:21.280
Yeah.
00:56:21.440 --> 00:56:28.880
Uh at the risk of seeming redundant, I'll I'll kind of end where I started, which was with my health journey.
00:56:29.679 --> 00:56:33.119
Because I really wanted a solution to be handed to me.
00:56:33.280 --> 00:56:36.000
And I got to a place where I was very desperate and hopeless.
00:56:36.239 --> 00:56:44.320
And just the little bit of curiosity that kept me afloat got me to try something that eventually saved my life, and I say that without exaggeration.
00:56:44.480 --> 00:57:04.320
Um and since then I have found so much pleasure, not only in exploring the natural world, but being on a quest to figure out how to get that light to go on in someone's eye, where they realize taking care of yourself, experimenting on your body in safe and responsible ways, learning about your own like underlying biology isn't a chore but an immense privilege.
00:57:04.480 --> 00:57:18.880
There was so much joy in that, that like the journey and indulging in what I think is very a very basic human quality that we all have within us, curiosity, is like is such an immensely powerful tool.
00:57:19.199 --> 00:57:34.320
Because once you unlock that pleasure, you start on this lifelong journey of always experimenting and iterating on your health and applying the scientific process to you as like an organic being.
00:57:34.480 --> 00:57:41.599
And when you do that, like that is that is the only guarantee or as close as a guarantee you can have that your health will ascend rather than decline.
00:57:41.679 --> 00:57:43.199
And most of ours are declining.
00:57:43.440 --> 00:57:46.000
It doesn't mean every experiment will gonna work, it's not how science works.
00:57:46.159 --> 00:57:53.840
It means that every one you're gonna learn something from and you're gonna iterate, you can do the next thing and the next thing and the next thing forever, and it's not a chore, it's fun.
00:57:54.079 --> 00:57:58.239
So when you can excite that spirit in someone, that's what stay curious means to me.
00:57:58.400 --> 00:58:04.719
It unlocks pleasure, it unlocks community, and it is as close to the secret of lasting health as you can get.
00:58:05.119 --> 00:58:05.840
I love that.
00:58:06.000 --> 00:58:06.800
It's perfect.
00:58:07.119 --> 00:58:09.280
Well, Nick, I could just talk to you all day long.
00:58:09.440 --> 00:58:13.360
Um, I love the way you think about science, I love the way you communicate it.
00:58:13.440 --> 00:58:20.480
Um, you're doing uh just exceptional work and um deeply grateful for all of your contributions at just still a young age.
00:58:20.559 --> 00:58:22.800
You've got your whole lifetime uh ahead of you.
00:58:23.199 --> 00:58:23.679
I appreciate it.
00:58:23.840 --> 00:58:24.960
So yeah, so thank you so much.
00:58:25.199 --> 00:58:25.760
Thank you so much.