Longevity is built in the quiet metrics: glucose control, muscle, blood pressure, and daily energy. In this conversation from Dietitian Debs, the useful thread is not novelty for its own sake. It is the way small physiological signals become practical guidance for a more resilient life.
Transcript from Dietitian Debs. Timestamps open the original YouTube video at the corresponding moment.
my name is Ben Bimi I'm a cardiologist uh partner admirable cardiovascular consultant founder and CEO of cardiac longevity clinic and I have my one of my good friends and colleagues today Deb Sloan uh dietitian I'll have her introduce herself um and we're going to chat today a little bit about uh metabolic syndrome diabetes diet and cardiovascular disease and everything exciting about nutrition please who are you hey Ben oh why so much to say uh yeah I'm Deb I own my own dietician company called Deb slone Healthy Solutions I've been doing that for oh over 10 years now uh since I moved to Ottawa and I am so excited to be working with Ben now this is a new partnership uh working with the longevity clinic and I see a lot of patients ranging from kids and youth athletes to Celiac patients to people with type 1 diabetes to a lot of menopause people dealing with per menopause and menopause these days and um you you kind of name it lots of different um stuff related to sport nutrition and performance and now obviously with the cardi metabolic health is coming in with lots of patients seeing that so uh this is great Lots to talk about today yeah lots to talk about so I think we're going to
talk about so I think we're going to start with just kind of this idea of metabolic Health right like metabolic health and like what is metabolic health I mean we talked about I had a recent conversation about this I mean a lot of people don't really understand well what that means right like for a lot of people that's not really a tangible thing like what does that mean so I think you are actually a very good person to talk about that because I think essentially metabolic health is about energy input and energy output right so do you want to talk a little bit about that like what does that mean to be metabolically healthy in your you know experience and expertise uh I think overall metabolic Health means that your energy systems your muscles your heart uh are working well for you um efficiently for you so burning the energy that it's supposed to burn using carbs using fat which is influenced by both EXC size and what we put in our body and to some degree genetics as well uh so I think that would be the full picture which I think you know when I'm talking a patients about metabolic Health maybe um as a dietitian I have maybe a strong bias towards the exercise piece I mean I think personally and professionally that's speaks to me but I think that that's a really powerful piece of the puzzle outside of just diet alone uh in terms of being able to manipulate and control your own metabolic health I don't know if that does that answer that question yeah no I think it does right I
question yeah no I think it does right I mean the way I discuss it with patients I usually tell them yeah like it's basically how your body takes in that energy and turns whatever you eat into the units of energy in your body which is essentially ATP so I get a little bit more scientific on yeah you you go for that part but yeah I mean you're right right and then the other thing that you hear a lot about these days I'm sure a lot of our audience have heard is this idea of mitochondria right so a lot of that metabolic health comes to about how your mitochondria is working these power plants inside your cell which produces ATP which is the unit energy block of your body so how does that energy come in How does it go all the way to the level of your mitochondria the engines of the cell and how does that turn into ATP which is the unit energy that all of your organs and tissue can use and the more efficiently you do that the more metabolically healthy you are is that a reasonable dis yeah I mean that's totally reasonable I mean I think we hear about metabolic Health uh when we talk about the cardom metabolic health I think it it often comes out with people who have pre-diabetes or type 2 diabetes it's not exclusively that obviously but I think that's where the term um you know you you know somebody gets diagnosed with pre-diabetes and the doctor says you have metabolic syndrome and they're kind of like what does that mean you know what I mean this full picture of often those you know the blood pressure the cholesterol the triglycerides all of those things um coming together in in sort of all those risk factors you know but but they're all related so I think that's where uh
all related so I think that's where uh the diet and exercise piece is really important because it can you can manipulate all those things and I guess I will will come a little bit early on the topic of my personal experience with type one when we talk about uh like the mitochondria because uh for better for worse I have uh a glucose sensor that I wear all the time that gives me you know constant uh feedback on what's going on to some degree with my mitochondria and how I'm actually able to change that at in an Adaptive way by the type and duration and intensity of the exercise that I do um to it to you know where I've seen my glucose levels actually change in response to training running longer and slower and training that aerobic base where then my glucose levels don't you know drop into hypoglycemia really quickly so it's really cool to to be able to see that actually happen in real time where you can actually train those powerhouses to you know use different energy in different ways um not everybody's wearing a glucose sensor but I mean you know it's happening you know even for somebody who has Type 1 diabetes right yeah so that's very good I'm glad you actually talked about that right because we talk about this metabolic Health a lot of it is this idea of I think it's called metabolic flexibility essentially for sure right like what source of energy is your mitochondria able to use
energy is your mitochondria able to use in order to make ATP right like is it only using glucose or is it able to for example access the fat your adapost tissue right so that's what you're kind of referring to essentially is because you're so metabolically fit despite the fact that you have diabetes your body is able to actually utilize your fat and because of that your glucose levels remain a lot more stable well um I mean the fact that I have type 1 diabetes es um is sort of relevant and not relevant in the sense that it's you know I'm manipulating what I'm doing with insulin which is you know not from an external perspective but what I found really interesting was it was um my ability to change my training which changed the way I was utilizing glucose or fat and then the proportion of which I was doing so so what it means is I mean okay you could call me an athlete and you know put me in in a particular category of people which is maybe not the average person but but regardless it's just an example of what the average person actually is able to do with exercise of any kind right um and to some degree dietary changes you know fasting protocols um changing the ratios of glucose that they're giving themselves and the fat that they're giving themselves and we do this with athletes sometimes right when they're training for distance or ultramarathons and things like that where they train low on low carb and they can train their fat
low carb and they can train their fat cells to to use fat better um or they train on more glucose to get that you know intensity and that performance out and they you know then they become maybe more relying on glucose so it's I think it's interesting to like look at certain individuals maybe that aren't the average person and then extrapolate that information to say that this is actually something that you can that everybody can do to improve their met iic flexibility improve their ability to use fat for energy improve their ability to use glucose for energy and as we age and our muscles start to shrink and all of these things you know we start to see cardiometabolic Health declining or or those metabolic risk factors increasing that some of those external things that we can do with diet and exercise actually do make a really really big difference yeah well that's I think is a very good description so now let's go to the other end of the spectrum right because people ask me about this all the time is like why should I care that I'm metabolically act healthy or not like why does that matter I mean you kind of pointed that out a little bit right like this spectrum is you kind of start from maybe not being super metabolically healthy and then you slowly kind of move into insulin resistance that we're going to talk about a little bit and then pre-diabetes and eventually diabetes so what are what is the price that people are paying for not being metabolically healthy let's talk about let's talk a little bit about that oh well I mean I think it has a trickle down effect to literally
down effect to literally everything on a day-to - day basis from chronic pain you know to inflammation in the body um to getting a good sleep uh to um energy levels you know throughout the day how how their you know if their insulin is fluctuating and their glucose levels are fluctuating throughout the day they're finding that their mood is is not always stable um I mean obviously they should care because they're at higher risk of early death but you know to put it bluntly but um I think on a day-to - day basis when people uh you know tune into their diet a little bit and can get their glucose levels under better you know stability and better control and they start increasing their Fitness level energy mood sleep um mental health all all of these things gut gut regulation to some degree even you know to it's all kind of correlated so I guess you know that's I think what's so great about the clinic too just to plug that a little bit is that we've got you know we've got the sleep and then you've got the you know the psychologist and you've got the nutrition piece and you've got all of those pieces of the puzzle where people actually can dial in on all of those things and see you know because they are correlated right if your sleep as well you're
right if your sleep as well you're going to have a harder time managing your glucose levels if your stress levels are high I mean it's all you know bad if you're don't have energy to exercise it's hard to ask someone to exercise and cook more and you know like so I find that it's it's that SI circular piece uh and has to be kind of comprehensive um can't look at each of the those things in a vacuum I guess yeah no I agree with you right I mean that's why we do it this way in the clinic right like with you kind of managing the diet piece but also we definitely have that sleep optimization piece the exercise piece the mental health piece because they're all very much connected like if you're not sleeping well you won't be able to have proper nutrition you won't be able to lift properly and do proper exercise mental health would feed into all of that right you can't eat well you can't sleep well you can't exercise well and kind of all go circular and yeah I mean I think generally I think it's good to also talk about this metabolic Health versus kind of your weight as well right because a lot of people who are metabolically healthy are somewhat overweight but also they're somewhat shorter breath right like I see that all the time right like people come in with diabetes I get this consult all the time diabetic patient comes in short of breath right and obviously the family doctors worried that because they diabetes the first thing they worry about is okay their shoulder breath they might have blockage in the arteries of the heart right so they send them to me to work them up we don't really find anything cardiovascularly at least there's no obvious cardiovascular
least there's no obvious cardiovascular issues although for sure if you do more look they're going to have aerosis they're going to have plaque in their arteries but a lot of these people are shorter breath because they're not metabolically healthy right right is because they're not actually yeah they're unconditioned so when we talk about unconditioned aerobic capacity Exercise capacity all of these essentially these your metabolic health is about how your body is able to utilize the energy it has how efficiently is able to utilize that energy and that's what I tell them most of the time almost every diabetic patient I have is generally speaking if they're not have a good muscle MTH and exercising there are somewhat shorter breath and it's because they're not metabolically healthy because they are insulin resistant and they're not utilizing energy effectively right I mean you know to plug muscle mass for cuz I'm super passionate about that I even have a a select um group of people who are endurance athletes who are sort of metabolically unhealthy actually those are really interesting people they end up getting diagnosed with pre-diabetes they maybe you know hit menopause or you know a little bit older uh not not women not just women but I do see it a little bit more in women and they're really fit and they're really lean and they're small you know well maybe they're actually a a little bit higher body fat but they look tiny right and they've been doing Endurance Sports for their whole life and um interestingly enough their cholesterol levels are high and their
cholesterol levels are high and their their sugars are a little bit borderline and they're very very frustrated because you know the typical information would be like lose weight or you know start exercising you're talking to this person who's out there trail running for three hours every Sunday you know um but the reality is they have no muscle mass and so to me I think what's becoming clearer and I think it's getting a bit more pressed now too is that lean muscle is a really is basically like the magic pill of all things um super protective over all of these things even if you are fit um cardiovascularly fit which is probably protective to some degree having a having lean muscle mass is actually maybe I don't know if it's more important but equally as important to just being aerobic fit 100% you agree 100% I agree I think and I think you and I have talked about this multiple times before I think muscle mass is probably the most important thing when it comes to metabolic health is specifically right and the way I'm actually curious how you discuss it with clients because what I tell them essentially is you should really think about muscle mass as essentially the engine of your body right absolutely right and it's basically kind of mopping up I mean it's kind of a oversimplification but essentially is that's kind of what it's doing right like it's kind of mopping up all these blood glucose mopping up all this crap out of your blood so it's doing a better you're going to have a better glycemic control as a result your
better glycemic control as a result your blood sugars are going to be better regulated you're going to be more insulin sensitive which is one of the foundations of metabolic health because your muscles respond to insulin actually SW to glucose almost independent of the insulin yeah exactly exactly yeah yeah I mean me I mean I always whether I'm talking to my athletes or just general population trying to you know with pre-diabetes or diabetes or or anybody really um I talk about it as being sort of the you know you're driving a car you're driving a truck or you're driving a little you know a little mini right so th those storage containers are what store your you know your glucose levels so the benefit of having larger containers is that you know you're not it's not going to get poured into fat and you know end up around the belly and and triglycerides you know so and in fact it makes it you know less uh less diet related less less diet dependent I mean my job is trying to help people be less frustrated I think you know they're all coming in frustrated they're frustrated with their predicament they're frustrated with their weight they're having a really hard time losing weight it's hard like it's freaking hard and it's harder for some people than others especially if they already have I think you know that metabolic picture you know maybe genetics or whatever not not on their side and so although I'm a dietitian I think that I spend more I really I do I think I spend more time talking about the the muscle piece because the reality
the the muscle piece because the reality is is that most people especially women right have a really really small calorie budget like it's just the reality of of it and it's not because I said so it's because these energy equations are based on their size and their muscle mass and you know all their age and all these things and so a lot of those things can't be changed well most of those things can't be changed the one thing that can be changed is the size of your storage containers right and how you are manipulating that so I think that as far as the empowering message that I can give to somebody outside of just you know count your calories and stop eating cookies and you know whatever else and which is really really hard to do and you know eat less and eat less especially as you get older because this is happening no matter what right like you get get a few years older and you get a few years older and this trajectory is not not going it's not going well right it's getting worse um so you know I I say to people sort of thinking about the billable hours versus the the investment that you're making where you can sort of sit back in your chair you know as the CEO and the money's coming in you know it's like investing in real estate or something something like that you know so my business model is I see these patients and I fill all hours but then what am I going to do you know on the back end of things to make sure that when I'm 60 70 that I don't have to work you know 10 hours a day so that's where I think the strength training comes in and
strength training comes in and the muscle mass piece so I feel like that message has to be really strong uh because it actually allows people to eat more it actually allows people to be less restrictive with their carbs you know it allows them to have that Bagel it allows them to be more metabolically flexible which is easier in my opinion you know and you know improve their bone health reduce their risk of Falls all the other you know improve their mental health you know probably to some degree improve their hunger hormone regulation improve their sleep most likely improve their functional ability and mobility and probably reduce pain so I mean so many other benefits you know where whereas you know I'm not saying restricting your food is not necessary and changing your diet isn't necessary I'm just saying that from a messaging perspective I like saying increase your storage capacity and make your insulin work better for you rather than take away this take away that because there's no end to that right if you don't change the other piece I think yeah I agree right so I think you said a couple very important words that I just want to double click on so I we talked about the metabolic flexibility that muscle mass brings so is basically this idea that you essentially can eat instead of having a super restrictive diet you're able to eat a little bit more diverse and still
eat a little bit more diverse and still not necessarily gain a whole lot of fat not necessarily gain a whole lot of weight talk about energy budget which is important concept to understand right so basically the reason you're talking about that is because and correct me if I'm wrong is because essentially the more muscle mass you have your basic metabolic rate is higher to begin with so as you're even sitting you're kind of burning calories right so the more muscle you have that kind of basing resting metabolic rate is higher correct so you can kind of lose weight a lot easier because you can you don't necessarily have to restrict your calories nearly as much right in order to lose fat right right you can right and and maintain better right especially especially as you get older right where muscle mass is decreasing anyways and this is where I think too women right struggle like there's everybody's seen that Meme where their husband goes out for a walk and he loses 10 pounds and you know the wife is like doing all this stuff and she you know she gains weight or whatever but I mean some degrees it's true right and that's why I think even with women especially not to say that men are not included in this because it's the same it's just that with women they're usually shorter right they naturally have less muscle mass to begin with with right they don't have the same hormones so women are stuck with a smaller calorie budget and you're going to SP well sorry you're 1, 200 calories that's all you got you know what I mean and you're 5 foot female 5 foot two you know if you're a little taller okay well you got a little few more calories there and um that's
few more calories there and um that's the way the cookie crumbles you can't change anything about it right so the changeable factor is because you're not getting taller you're not becoming a man you're not getting any younger so what's the variable that can change the most and that's why I guess the messaging is that it's not to say that you strength train and it doesn't matter what your diet is absolutely not and of course if you have pre-diabetes or you have glucose issues or you have cholesterol in the blood or whatever there's going to be dietary things I mean that's that's the whole piece of the diet of course there's things we can do to make that better or make that worse um but when it comes to I think strictly speaking about cardiometabolic health body composition if I if you were to say like Deb what's the most important thing right now now it would not be food restriction to me it would be go build some muscle MH very good no I think that's a very good summary um I think it's also good to tell people a little bit about what happens if they don't do that right like um I I always try to kind of draw a picture of what are I mean we talked a little bit about it right like we talked about a little bit about okay so if you don't have enough muscle mass if you are not metabolically healthy you develop issues with your sleep with inflammation with uh your mental health with your functionality basically your functional capacity what you're able to do on a day-to - day basis uh without getting short of breath basically enjoy things you want to do but then in the extreme form of it so let's talk about what
form of it so let's talk about what happens once this turns actually into a disease so what's the next stage after somebody's just metabolically unhealthy what is kind of the extreme of the disease conditions that would develop if they don't take care of their muscle mass and their diet and their weight and all of that uh well I mean I think you see people uh really deteriorate in terms of um well functional ability you know as they get older less able to get around I find arthritic conditions although it sounds counterintuitive but they get worse uh because they're not being used and the muscles around those you know those tissues joints actually they're weaker so there's more stress on the joints I know again people seem to be afraid to exercise as a result of that but it actually is beneficial help them yeah yeah um and then I mean of course the I don't know if this is what you were getting at but in terms of you know the downfalls of having elevated glucose levels and things like that I mean this is where you know little scary right kidney function um Eye Health uh neuropathies I mean these are all things that are real real issues that you know unfortunately it doesn't even take that long I think if glucose levels are not regulated to see some of those things happening right yeah so I mean obviously no good and uh higher risk of heart attack and stroke um probably you can speak to that
stroke um probably you can speak to that a little bit more um and overall I think just a a feeling of unwell you know and and I mean think that it's uh in a counseling position have to be very you know sensitive and empathetic to that to some degree right where people are feeling tired and it's hard to get started right it's it's a bit daunting when they're feeling like crap and they're not sleeping well and um their energy levels are all over the place and you know they are having pain and all you know what I mean so it's difficult to you know maybe their mental health isn't great either uh difficult to get out of that point where you say listen this is going to you are going to feel better you have to just get started and then once you get started you start to drink the Kool-Aid a little bit and then you know so that's where habit change and behavior change happens but it can be difficult when you're feeling bad yeah I think to get you know to get out of that cycle yeah right yeah 100% yeah so I mean you kind of banged all like the the nail and the head right so Pro metabolic Health poor functionality elevated glucose and glucose essentially I mean people don't realize glucose essentially a toxin in a lot of ways I mean it is a unit of energy in your body but excess glucose it damages all your organs right from your kidneys yeah well I'm doing my best you're working on it on but yeah it's like toxin to everything right from your kidneys to your nerves to your
kidneys to your nerves to your cardiovascular system it increases inflamation overall um so that's how it essentially causes all the cardiovascular issues forming plaque in your arteries increasing your risk of heart attack and stroke same thing in your eyes is Toxin to the eyes to the retina people don't realize like people develop all these issues in the vascular of their eyes because excess glucose is a toxin I mean that's kind of a very simple way of thinking about it um and it caus causes all these Downstream effects including all the inflammation and then the Sleep issues and then fluctuation of the glucose makes it even more toxic right because that's when it affects your energy by these kind of wide fluctuation um and that is Diet dependent that's muscle mass dependent absolutely um so and stress by the way we shouldn't under rate that and and poor sleep right um and I guess maybe just to clarify so people don't misinterpret what you're saying it doesn't mean that eating Su sugar glucose or carbohydrates which are effectively the same thing uh is necessarily the problem right it doesn't mean that carbs are bad I mean just because people will interpret what you just said that way right um it means that if you're not metabolically healthy and your body isn't using carbs well and you're overeating them that then there's an issue right and of course in in type 1 diabetes I don't you know I don't make insulin so I'm trying to manage that the best that I can in
to manage that the best that I can in pre-diabetes or type two diabetes there's more ability to change those factors by reducing body weight to some degree getting more active and manipulating the diet which doesn't necessarily mean keto by the way which we're going to get to um to help your body use carbs better or put less stress on the organs that are not working as well even transiently while you're reducing body weight and becoming more insulin sensitive to better use you know better use glucose and not ire the same amount of insulin by not putting as much glucose into the body I guess yeah that's perfect yeah that's perfectly put right like carbs and sugars are not bad too much carbs and sugars are definitely bad and that's variable a little bit depending on your muscle mass and how much activity you do exactly and you and I see some of those patients right that actually our recommendation to them is when you're working out you need to actually have more carbs right you need to have either snack before or afterwards because that's actually going to help you fuel your workout and potentially help you build muscle mass more effectively if you're doing a very uh intense workout session right and by the way unfit people uh or untrained people need more glucose to do the same work right right because they can't utilize their fat yeah and they're you know they're working harder to do the same effort and their body is using more
same effort and their body is using more glucose for the same right so the more trained you get and this is kind of what I was describing before even though I was a fit person but I wasn't really a great Runner and I didn't have a great low Zone aerobic base to burn fat but that's changeable so it's the same thing as you get you know as your muscles grow and as your uh insulin sensitivity increases and as the mitochondria change uh and adapt to what you're doing and you become more efficient at what you're doing right you percentage wise can can use you don't need to fuel as much glucose in other words right you're better at accessing fat for energy very good point because that's almost counterintuitive would think if somebody's overweight and they are just starting to work out that we're going to cut their carbs a lot more aggressively than somebody who is much more advanced but it should be actually opposite they need to eat more carbs if they're just starting to exercise because they need those carbohydrates a lot more for their workout than somebody who is well trained exactly right perfect so uh so now you kind of pointed out a little bit you talked a little bit about weight loss so now you know I think we've convinced people that it's important metabolic health is important and getting muscle mass is important having enough not having too much fat and having enough muscle is important so now you and I see a lot of these patients in longevity Clinic where this a typical patient actually a lot of the patients that we see that come and ask for help are these patients who are metabolically not healthy so they already have insulin resistant we can detect that based on
resistant we can detect that based on their blood work we also see that consistently with their body composition so they have too much of a sort of fat they don't have as much muscle mass and these things are all connected to each other so how do we approach a patient like that like what would be if people want to kind of start on that path what are some of the recommendations that we give that kind of client to try and help them get more metabolic healthy yeah I mean I work with clients in a very sort of personalized way so I mean there are some real General things that I think I would I see a lot of the time and general recommendations around certain dietary strategies and certain let's say dietary um protocols or we won't call them a diet but protocols like Mediterranean diet and things like that that are going to be generally good um you can't go wrong kind of thing right uh but I think that the first step is often awareness building right before people I mean people want to change really you know they come in really motivated and they want to get going and you know they're they want to maybe even go too extreme sometimes my job is to pull back a little bit and say listen like you need to find out where the issue is right that that happens a little bit by talking what's your lifestyle like where is the the top tier problem for you right and that might not be the same for everybody um but most people don't really have a a really uh strong awareness I think of their eating
awareness I think of their eating behaviors and what I often see is that what they recall if they do like a okay what do you eat in in a typical day or you know what's a typical week look like for you in terms of like what are you eating for breakfast lunch and dinner and do you snack and this and that will often be very very different from what I'll see if they're actually you know honestly tracking their food for a period of time without changing anything which is really hard to do because they've already seen me and there's a bias there already um the minute you start tracking there's a bias you know like I don't want to put that in there you know like but it it does highlight you know how all the little things add up and how maybe what you thought you did isn't really what you're doing or you know portions and things like this or where calories even come from so my job isn't I I mean I prefer my job not to be to just hand somebody a diet plan and say do this you know it's it's to say do you understand what the challenges are do you understand what you're actually doing do you understand anything about you know calories at all and when they start putting it down on paper a little bit they start to make their own insights right and that's really valuable because I think when somebody sees it for themselves it often has more uh holds a little bit more power than me just being like guess what right and if they're doing that in a guided way I think rather than just you know downloading a software and getting really frustrated and putting it in there and not really knowing how to make any sense of that information um they get less out of it
information um they get less out of it than they would if they would come and do that with me so sometimes the first stage is just say listen track a little bit and I don't want this to be forever but we need to figure out a way for you to understand a little bit more about what you're taking in and then we can start saying what needs to change because you're seeing the pattern you know you're seeing that you're taking in 800 calories after dinner you know with chips and beer or you see that you know in the morning all you're eating is a bagel and then you're wondering why you're starving and craving sugar all day long these people think that they have like these sugar addictions that are just you know I have no discipline and I'm addicted to Sugar but oftentimes it's a symptom of something else right so I mean ideally it's a process right where they're game to kind of learn a little bit more and then we can start making changes rather than saying change everything or like okay you came H here with you know cardiometabolic factors let's go keto or like let's just start fasting all of a sudden which you know we could talk about that too but it's often a little bit simpler than that to be honest and it's just uh oh I realized that I consumed 500 calories just with the oils and the you know Mayo that I you know butter that I was putting on my toast it's like cool okay that's that's maybe easy to change right maybe some of those things are easy to change or oh I didn't really realize that I was having 10 drinks a week you know maybe they report that they drink you know here and
report that they drink you know here and there but but they don't and that's a lot ofies yeah a couple hundred calories a drink right outside of all the other negative effects that it has right you're usually eating when you're drinking too so there you know other things maybe that's where we start right so it can be changing something or start eating protein takes care of a lot of problems yes right mean we want to talk about protein for sure right of strength training like I could just put that on repeat right yeah yeah exactly so let's talk about that right cuz I think you and I basically almost every single patient that we see that's why we recommend to them because almost none of them are eating enough protein right right uh yeah I mean I think some people you know or they're not Distributing the protein properly or something like that right so why is that important let's talk about that yeah I mean uh what I typically see is people you know they'll come in saying you know I'm hungry all the time or I tried these diets and they don't last or they don't work or I'm not feeling like I have low energy throughout the day um just craving carbs all the time you know sugars you know that 4: 00 crash where they're you know going to the whatever vending machine and you know getting a chocolate bar or something like that so it's it's often a really poor breakfast or none at all right I mean let's let's leave fasting on it we'll shelf that for a while and and talk about the other benefits of that and how it can work for some people but I would say I wouldn't try that first necessarily if somebody's
try that first necessarily if somebody's coming in we're just trying to do basic changes to see um a really high protein breakfast is going to help keep you satiated and often times when people are eating enough protein like they don't have to like overdo it and guzzle protein shakes all day but eating a good portion of protein at breakfast lunch and dinner maybe at a snack around their workout you know what they come and they say to me they say oh I don't know I just like wasn't snagging anymore like I just I I'll be like oh that's interesting they'll just be like yeah that's weird like I just haven't really I don't know do have those sugar Cravings anymore right so there which is when something is no longer hard to do because it's not like they're like can't have the sugar like it's just their brain is saying oh I don't need that so they're not thinking about it so they don't really feel restricted anymore because protein has this really high satiating effect uh of all the macros and so if it's not there people tend to feel more hungry all the time right so they have that propensity to be like I'm I'm hungry hungry and if you're trying to also reduce calories well that just makes it worse so if we're trying to do a combination of you know glucose control feeling stable through the day especially for people who have more uh glucose issues right glucose and Insulin issues where things are going to be less stable and we want people to maintain or be
and we want people to maintain or be able to build muscle mass in a deficit if we're trying to reduce caloric intake protein has to be the star so of all the diets there are out there I mean I would be partial to a higher protein diet yeah you unless you have pre-existing kidney disease or whatever but we don't really see most people the evidence does not show that there's high risk for a higher protein diet and um as far as do you want me to talk about guidelines for that or I don't to talk about guelin yeah so um yeah I mean I think satiety is is key and there's also other like cool things about protein where it actually maybe do talk about the numbers I think you want to talk about what how much protein right like per day yeah well like I mean I think people get confused about that because we we talk about a gram per pound of body weight and if somebody is really o you know if they're obese or they're overweight you know that number is necessarily going to be what we need um we might be looking closer to to supporting their lean mass at least or if they have an ideal body weight we could kind of go down to something like that or you know maybe even a bit less than that right so I'm a little bit of a fan of getting most of it through food and if people feel the therapeutic effects of of a higher protein diet when they're going from like 60 grams to even 100 or 115 if they're satiated there and they're feeling good there I don't feel the need to say well you need to get up to 150 because that's a grand per pound I mean I think we're looking for that higher level of protein where it's you
higher level of protein where it's you know replacing carbs because in most cases they're not active enough to be needing that amount of carbs at that time and they likely have some insulin resistance or you know glucose issues where if they're replacing a little bit of that lean protein is important not not Protein that's you know riddled with that uh that they're going to be full replacing some of the carbohydrates with a little bit more of that lean protein and the lean protein has more benefit to them because it has a higher thermic effect of food which means you burn a little bit more calories eating it less likely to be stored as fat than carbs and fats as a proportion it's not like it doesn't exist but it's just less likely to be converted into fat doesn't affect glucose levels that much helps the muscles and keeps you the most full so all in all right like check right probably the best thing yeah yeah right absolutely yeah so yeah I mean that's bang on right like what you talked about is for every patient almost that we see they're going to get something out of it if they're under muscled protein is going to help them if they are in that kind of pre-diabetic to diabetic range protein is going to help them because it stabilizes their glucose if uh the issue is losing weight is going to help them because of the satiety effect of it exactly uh so protection muscle protection while you're losing weight that's well that's right so almost in every kind of sector
right so almost in every kind of sector that we look at of patients want to optimize their body composition metabolic Health probably looking at their protein intake is a very good place to start yeah so you kind of mentioned this so let's quickly talk about that and then we'll kind of move on to the diets but what is the optimal type of protein so you kind of mentioned this that you want to get high quality protein because I mean we hear this from different people so what should I be eating for my protein supplementation what's the ideal source of protein yeah I mean I think that if we're looking at melding that with recommendations for you know heart health um plant protein is is becoming something that we're talking about more uh so that could be something like tofu Tempe uh you know legumes to some degree not quite as bioavailable and they do have carbs but they're also high in fiber so kind of offsets that a little bit and you know I guess tofu being the the main one there because it's isolated protein when we talk about isolated or lean protein we talk about something that doesn't have uh macronutrients or calories coming from carbs or fats right so it's just the protein right which means in those cases just like with something like lean chicken breast or lean turkey breast or um egg whites and you know lower fat dairy products like cottage cheese or Greek yogurt and to some degree appr prot powder but you know with in moderation uh those are going to be lean sources where you can kind of Eat More For Less right so
kind of Eat More For Less right so because they don't carry fat calories and they don't carry carb calories you can eat a fair bit without getting a lot of calories you're going to easily meet your protein needs very very bioavailable and very satiating MH so I mean that's kind of the short list I guess of the things that are not like lots of foods have protein in them but uh and contribute to your total daily protein requirements absolutely your grains your whole grains your nuts and seeds um you know quinoa to you know but like but I wouldn't call those protein sources yeah right and I think that's where education comes in a little bit uh you you start to sell someone to you know start eating more protein and they start eating a lot of nuts and they start eating a lot of cheese to meet their protein needs you know they end up getting fatter so this is no good yeah um and and so it's just making sure that they understand that those Foods fit and they contribute and they're good to kind of help regulate blood sugar control when you're eating carbs in combinations with you know those fats and stuff like that but lean proteins are the things that you want to bank right you want to identify those uh as those grocery store Staples that are going to be in your fridge and that those should sort of be you know on your plate at meal times canned fish is a great one um can tuna those types of things right and those all fit within the Mediterranean diet is the Mediterranean diet doesn't exclusively mean plant-based it means more plant matter in general and more plant protein as a proportion but also bringing in if you
proportion but also bringing in if you want some of those lean animal proteins Foods right yeah 100% And also Whole Foods right I think a lot of the focus of Mediterranean diet because I see this sometimes like people go and pick up Ultra processed food that says Mediterranean on it and just because it says Mediterranean they think it's a good thing right so I think that's also the other Focus to kind of remind people was a big part of Mediterranean diet and why it's has been effective in the initial research studies is because this is essentially Whole Foods this is unprocessed food that has a huge role in your metabolic health is the fact that you're eating Whole Foods that usually has fiber high quality doesn't have all the preservatives in the craft that can affect your gut health yeah yeah increases energy density right the UPF you eat a lot more of it because it's a ability absolutely yeah so I mean I think you know with so much messaging out there you can get super complex and advanced with nutrition messaging and and stuff and you go you know deep diving but at the end of the day honestly if if everybody filled their plate with more vegetables and everybody filled their plate with lean protein like we'd probably be doing okay you know and if that's like if that's the only thing that you take out of a session with me is to be like oh eat more vegetables and you know identify those lean proteins like chances are you're going to lose some weight you're going to feel better um your cardiometabolic factors are going to improve because by nature of that you're probably eating less sugar you're probably eating less in general because you're just so freaking full I mean that's what people say right
mean that's what people say right they're like I couldn't even eat that much right because they realize that when they fill their plate with those things they're just not that hungry anymore so you know simple simple messaging like Okay add more vegetables to your plate you know prepare those chicken breasts on the weekend so that you have those to add to your salads or whatever I mean then they're not hungry it doesn't feel so hard all right we don't have it's already 4: 40 oh my God time goes by so let's quickly talk about um the diets I want you to like talk about them in like one or two minute intervals let's talk about so we talked about weight loss I think it's pretty good the only thing I'm going to add about weight loss because you talked about it um very briefly is this whole idea of intermittent fasting so let's talk about that quickly and then the difference between essentially these three schools of thought thought for weight loss right like Diet restriction versus calorie restriction versus time restriction how should we combine them how should we think about them in each circumstance let's quickly do an exchange on that okay um I am neutral on fasting I think it works amazing for some people and I think it works really shitty for some people I would say women and this is an observation that is partially you know supported but whatever uh don't want to Deep dive too much I do think that long fasting um doesn't work that well for some people and it ends up biting them in the ass uh muscle is that
biting them in the ass uh muscle is that muscle protein breakdown and then they end up getting hungry at night and then they end up snacking and you know not great and especially if they're fasting through all their workouts and they're trying to increase muscle mass like I think that there are nuances to that where you know maybe even Cy cyclical fasting right on you do like fasted cardio sometimes but not when you're doing your heavy lifting or your your you know hard training or like quite frankly you try it out and you feel like garbage like don't do it you know what I mean like you got to maybe see how that works for you I think that people who do have more glucose regulation issues or um insulin resistance sometimes maybe even at the beginning that a little bit of longer fasting into the morning can be useful to just help their body burn a little bit more fat and get into ketosis for a bit longer but there's probably a point at which it's not benefiting you I mean I don't know if you agree with that but I think muscle mass is a big point I like it's very hard if you're doing hardcore intermittent fasting like if you're doing 186 is going to be hard to build muscle mass like during those six hours I mean we talked about the importance of protein intake like it's going to be very hard hard this is it right and I mean the shorter you're eating window the harder it is to fit in that protein and I would say even observationally I think when people are eating really large meals like I know total calorie intake should be the the top tier thing but like I don't think your body can deal with all of that no not just even just the protein just like that amount of like total caloric volume condensed
of like total caloric volume condensed into one or two meals not healthy I don't think it's great I don't think it's um I mean there is evidence for that for protein absorption actually a little bit um to some degree uh a little bit that's been a bit bit debunked but uh the distribution is going to be more optimal right and I think even when it comes to carbs and fats and calories I mean again if you think of yourself like a car I mean if you stick that you know thing in the car and just stick it in there and stick it in there it's going to overflow if you're so I do think that I I do think in general people are doing better with a high protein breakfast particularly females and particularly active people um but I'm not against it and there is some good evidence for it and there is some decent evidence for fasted cardio as well as far as accessing fat and a little bit more on on fat weight loss um and I do have some people who say that when they don't eat breakfast their hunger is more managed okay you know and if that's true for you where it kind of um blunts your you know like they don't eat breakfast they don't get that like revved up feeling then then okay I mean and if that helps you stay in a calorie deficit easier where you're not having to like micromanage your calories as much then I think it it could work so it could be trial and error so tell me your thoughts about ketogenic that I'm going to ask you fast questions that you're going to answer for me
keto hard not super sustainable hard to do only with healthy fats and what does true keto mean let's find that okay true keto usually means less than 50 grams of of carbs a day okay for most people that can range but uh in general so so and and we're talking all carb so it means at that point you are looking at like even certain fruits and vegetables for sure um you know and I think not the greatest diet for fiber for example not the greatest diet for fiber yeah and and I mean real in reality most people are going to have a hard time doing keto really really well which would mean you know not um exacerbating the cholesterol levels and things like that right by okay great now I can eat all the bacon I want you know cuz that's fat and that's easy and it's allowed where they're only really eating fats coming from that seeds avocado olive oil like I mean it's you know fish whatever salmon or whatever like that's it's challenging and to be honest most people that I see are living as a family unit they're not you know all you know 22y old guys like living on their own you know where they don't have to worry about anybody else but themselves so what you know we have to practically practically speaking understand what that's going to mean for somebody and you know how that's going to affect their lifestyle again I'm not really against it and I think that some people with glucose issues and insulin resistance do do well with it because it it is satiating and it does blunt hunger and when you take carbs out of the equation you can regulate glucose levels and if that helps them get to a certain weight
that helps them get to a certain weight where maybe they can then bring it back you know a in a slow Progressive Way but we talk about metabolic flexibility and I know I'm not giving a short answer here um metabolic flexibility is less if you go keto right so people are often surprised that when they bring back carbs they get fat or well that's because you just told your body to use fat really well and to not use carbs really well so you're not necessarily doing yourself any favors no no so metabolically 100% metabolically not making you active uh making you any better and the challenge with it is that not everybody loses weight on it because of how you practice it right so fat as you said is calie dense very calorie dense so if you're eating super high fat diet you have to eat less yes you have to eat less so the only way you're going to lose weight on a ketogenic diet is if you're instituting some form of calorie restriction the idea is that it creates satiety and that's how you end up eating less but I mean I see people gaining weight all the time on ketogenic all the time yeah and they because they don't recognize Fat's also the lowest on the thermic effective food so you actually probably have to eat less calories than you would otherwise right um if you're full I mean that's great but I mean chances are you're you're really avoiding bagels and muffins and you know grabbing that Tim Horton's donut like is it really because you're in ketosis I think arguably no right you know and um the other thing that I want to talk about kind of talk about that actually let's kind of go into the next
actually let's kind of go into the next one because we don't have that much time is for cardiovascular health right because I mean this is what you and I do together is a lot of these patients have cardiovascular issues what are some of the general recommendations that you would give those people being specific with regards to your recommendations so first off it would be to identify saturated fats and where they come from I mean I think why is that important so saturated fats are the fats that we see as being most correlated with elevated LDL levels and um those are mainly coming from animal fat so I think that is where plant-based diets are we're seeing some traction there as far as you know LDL is a problem well why don't you explain that you're probably a better job than I get on that yeah so trans fats equal LDL right because basically so cholesterol is cholesterol and that's one of the things I hear from my patients all the time is you know there's good cholesterol and bad cholesterol there is no good cholesterol and bad cholesterol what we're talking about here is cholesterol particles right so they L LDL particles and HDL particles that are circulating and moving cholesterol around your body in your blood blood cholesterol is an important physiological part of the processes of your body so you do need cholesterol so cholesterol is not bad right that idea that cholesterol is bad is a basically a a wrong idea altogether the problem is what type of quality of fat are you taking in and how that's affecting your circulating levels of LDL
affecting your circulating levels of LDL particles and the reason LDL particles are bad is because those are the ones that are sticky those are the ones that sticks to the wall of your Ary cause inflammation in the wall of the artery your immune response your immune system responds to those ldr particles and form plaques in your arteries that then cause heart attack and stroke and really what saturated fats do more than anything is it affects the LDL receptors at the level of your liver so it's not like that saturated fat you're taking is directly going into your blood I mean that's a kind of oversimplification of it but that's not how it is is your liver is actually what processes the cholesterol and moves the cholesterol into these different particles and what happens when you're taking a lot of saturated fat is that saturated fat gets stored in your liver so it tells your liver that oh there's too much cholesterol around too much and that what that does is that then it downregulates the LDL receptors on your hepatocytes which is your liver cells and by downregulating those receptors then your liver is not grabbing those LDL particles out of your blood anymore and that what causes the LDL levels to go up so the reason that you know a diet like ketogenic diet and overall red meat saturated fats are bad for you is because it makes your liver think there's too much cholesterol around and therefore it doesn't grab all the ldr particles out of your blood which leads to elevated LDL particles which leads to atherosclerosis which is plaque formation right and the HDL which we
formation right and the HDL which we call the good cholesterol and the blood helps to pull it out right exactly exactly and then what does what elevates h Ste in general when it comes to nutrition and lifestyle yeah so so good fats right which we call you know those polyunsaturated fats olive oil avocados nuts and seeds and and so that's where the Mediterranean diet really shines right because it's focusing on those things and uh not exclusively saying no animal products but just when you're eating those animal products picking the ones that are low in saturated fat which is leaner proteins right which are going to be less calorie done so all round like it it all sort of fits in a nice little puzzle can you quickly talk about how refined sugars play a role in this whole cardiovascular health cholesterol kind of situation um I think we see triglycerides responding specifically to excess sugar it's again where it's deposited in terms of the the type of fat distribution in that around the middle area uh people who who tend to have the cardiometabolic syndrome where the sugar levels and the insulin resistance are up often also have high triglycerides and that can be not only just over fats um over intake of calories and fat but over intake of of sugars and alcohol as well and I think that in general we're seeing you know refined sugars also being a factor in just general inflammation um so cardom metabolic
inflammation um so cardom metabolic health I think is an inflammatory process too okay yeah that makes sense agree yeah totally yeah so I think it's totally about your triglyceride as about your metabolic health so when you're taking too much refined sugar you have you become insulin resistant that kind of leads to all the downstream effects that we talked about a little bit because that would kind of essentially throw your lipid profile out of whack when you're insulin resistance and as a part of that then your HDL particles are and we don't really understand this actually very well of what happens but definitely your HDL cholesterol goes down so we conclude although we are not certain that that affects the HDL particle functionality which is clearing the cholesterol out of the wall of the arteries so it seems like your HDL particles are less functional looks like your LDL particles would go up and we've had an exchange about that so I think it adversely affects your lipid profile once you become insulin resistant and your refined sugars would definitely affect that and as you said as a good marker of that we usually see triglycerides going up usually assign that you're developing metabolic syndrome and insulin resistance which then kind of affects this functionality and balance of hdn and LDL right and I mean at a dietary level if you're eating refined sugars you're usually going to crave more sugars right right I mean you make it makes you hungry it makes your glucose levels fluctuating more even if you don't have insulin resistance per se and then you're usually overeating as a result of that because they're not satiating 100% quickly as a last point I want you to quickly talk about DASH
want you to quickly talk about DASH diet so DASH diet is uh a diet that's more correlated when we think about hypertension and high blood pressure you know if you're looking through the DASH diet though it's really not that different from other protocols like the Mediterranean diet and even the plate method to be honest you know I don't like I'm not a huge proponent of Canada's food guide whatever I don't pull it out in my office on a regular basis but the plate model that they've put out more recently in the last few years actually does do a decent job of just showing people like generally speaking what their plate you know could and should look like uh maybe I I would like increase that like protein component a little bit more for most people than than what it suggest what does it look like in a Canan food gu so half the plate you know half the plate fruits and vegetables and if I'm talking to somebody with diabetes or or insulin resistance I might say like more vegetables over fruits and you know it's it's a quarter plate of those you know whole grains or starchy carbohydrates and uh the other quarter of the plate coming from lean proteins and they've sort of included um you know plant proteins in that category and so I might Edge towards like a little bit more on the protein a little less on the the grains and the carbs depending on the individual so very lowfat diet uh fats kind of you know come into play they're not you know whether within um within some of the proteins that you're choosing with within the you know some of the plant-based things that you're eating uh they don't specifically have like an item for it but it would be sort of on the side where you're you know adding you know there's there's room for adding
you know there's there's room for adding cooking fats and things like that and if from a cardiometabolic standpoint olive oil you know that polyunsaturated fat is is the best I think this whole seed oil thing is like driving me crazy because it's just not Evans based at all but stick with your plant-based oils and you're going to be good right just avoiding butter and things like that as much as possible uh if we're specifically looking at cholesterol levels lowering your your aldl cholesterol so what is exactly then in dash like what are the main principles so the principles would be I mean whole grains um they actually have an inclusive of more dairy products in there because those are higher in calcium and magnesium and potassium um which seem to help kind of regulate blood pressure um it's all sort of those ion Channels with those minerals so they are encouraging uh dairy products and so if you're choosing those you would be also ideally choosing low fat you know your Greek yogurts that are high in protein and low in fat for those things and lots of leafy greens and fiber and things like that otherwise really not not a whole lot of other specific things right that are super intentional but all of those general principles that we would be talking about for uh a balanced diet right also Mediterranean diet right like very similar yeah uh you know you are if you have high blood pressure you might be looking more specifically at sodium which is something that I
something that I would I think we were obsessed with it a few years ago and then we kind of got off that train and if you have high blood pressure you have to be concerned about it if you don't make reasonable choices if you're not eating out if you're eating Whole Foods if you're not buying a lot of processed foods chances are you're you know doing okay yeah uh without micromanaging your sodium there's going to be a few things that like deli meats and things like that but again that's processed stuff right so where you're going to find you know your whole daily sodium intake right there yeah I don't know if you focus on sodium a ton in your practice but so I mean for my heart failure patients I do and definitely hypertension patients I do so those are kind of the two groups that I specifically talk about salt not with anybody else really but I mean heart failure is huge I mean our audience don't probably understand what congestive heart failure means but essentially is these people who retain water that's kind of the easiest way to kind of talk about it we all know what happens when we eat a high sodium diet right we look puffy the next day exactly so those patients are the on that we really have to talk to them about because even one big load of salt if they eat if they go eat out right they have they go to a restaurant it can put them into heart failure end up in the emergency room so for them is extremely important to be aware of their low salt diet right I mean and for Education right I mean just learning how to read a food label right yeah just navigating a food label is really really good first thing to be learning 100% so uh quickly now we're way over time is take home messages so give us some key takeaways
messages so give us some key takeaways if people want to remember two or three things out of this conversation what should they remember strength train two or three times a week Progressive overload and lift heavy uh which we actually do not talk about at all but thanks for you take a look next time um eat protein 30 grams at least at every meal and around your your exercise and fill your plate with a variety I think is cool cuz this whole microbiome thing is like it's amazing and it's going to be the next thing uh a variety of colorful fruits and vegetables the more the merrier you know fiber is also a winning point and I think all of those things together will be allow you to reduce your caloric intake feel satiated have better energy reduce your inflammation uh pull cholesterol out of the blood if that's something you need to be doing and allow you to increase your muscle mass so that you can be a Powerhouse I love it yeah I mean I agree with all of those I I would the only thing I would add is kind of stay away from Ultra processed food right so the more the less processed more whole foods you eat that has a good variety good amount of fiber and protein you're probably doing really really well and if you want to lose weight really kind of watch how much calories you're taking in I mean you have to have variety with good amount of protein but really kind of calorie restriction is
really kind of calorie restriction is essentially how it's just physics right phys but I mean I think that the tome in the Practical side of things is especially if somebody doesn't want to be tracking their food and counting calories right if you have protein on the plate lean protein and you have vegetables on the plate you probably don't have to be micromanaging as much because you're going to be full you're not eating hyper palatable foods that are hard to control the portion um you're going to be snacking in less because you're going to be less hungry and and you your blood sugars are going to be less crazy you're going to have more energy to exercise right and I think older females I find they need a little bit more protein to feel good that's something I've observed so it's sort of again like just keep like I mean these are simple things that we've been saying for a long time people really want to make it complicated but like I had a client the other day who just was like I added protein to my diet this was life-changing and she lost like 15 lounds in a relatively short period of time cuz she just stopped snacking like she was just like I was full I wasn't hungry I wasn't craving things anymore and then I was sleeping better and I had more energy so I was working harder at CrossFit like it was just crazy you know it was just that simple change that changed around everything and then I didn't have to tell her to eat less cuz she just was right that's great when that happens right 100% um oh that's great yeah I think that's a very good summary thank you yeah thanks this was awesome fun we could talk for hours I know we can talk for hours we went over 15 minutes and we still have tons to talk about but next time
Transcript auto-generated by YouTube. Verbatim — duplicates intentionally preserved.
The modern wellness world often turns mechanisms into promises. A calmer approach asks better questions. What is the body being asked to adapt to? What dose can it recover from? What practice still feels intelligent tomorrow?
"Cardiovascular and metabolic health are inseparable from longevity."
Healthspan begins below the surface. Mitochondria, muscle, hormones, glucose control, inflammation (discussed further here), and repair systems shape how much capacity the body has available for work, recovery, and presence.
The strongest longevity practices are rarely dramatic. Training, protein, sleep, light, stress regulation, heat, cold, and metabolic steadiness compound because they are repeated. The advanced work rests on the ordinary work done well.
Use the idea as a ritual, not a performance. Start with the least dose that changes your state. Notice breath, sleep, appetite, training quality, and mood. Those signals tell you whether the protocol is building capacity or simply adding load.
Cardiovascular and metabolic health are inseparable from longevity.
Lean mass, stable blood sugar, and sustainable nutrition matter more than allegiance to one diet label.
The best nutrition strategy is the one that supports energy, body composition, and consistency over time.
Choose one practice you can repeat consistently for the next two weeks.
Track the felt outcome: sleep, focus, calm, recovery, or energy.
Increase intensity only when the current dose leaves you steadier.
