Episode 249

The REAL Story Of Ozempic, Weight Loss, And The Metabolic Crisis 94% Of Us Are Facing

Leading metabolic health doctor & researcher Casey Means, MD, discusses how GLP-1 receptor agonists like Ozempic & Wegovy work, the differences between obesity and metabolic health, how to avoid metabolic dysfunction, and much more.

Leading metabolic health doctor & researcher Casey Means, MD, discusses how GLP-1 receptor agonists like Ozempic & Wegovy work, the differences between obesity and metabolic health, how to avoid metabolic dysfunction, and much more.

In this episode of the Liz Moody podcast, host Liz Moody delves into the hot topic of Ozempic, weight loss, and the underlying metabolic crisis in America. Dr. Casey Means, a leading metabolic health expert, co-founder of Levels, and author of New York Times best-selling book Good Energy, provides a science-based, nuanced perspective on these issues. They discuss the distinction between obesity and metabolic health, the influence of modern lifestyles on metabolic dysfunction, and the holistic approaches needed to improve metabolic health without relying solely on medications like Ozempic. The conversation also explores practical strategies to enhance mitochondrial function, such as dietary adjustments, movement, and reducing exposure to toxins. 

  • 02:24 The Obesity and Metabolic Health Debate
  • 04:57 Understanding Different Types of Fat: Subcutaneous, Visceral, and Intracellular
  • 06:36 Ozempic’s Impact on Metabolic Health
  • 07:56 Mitochondria and Metabolic Health
  • 08:32 The Eight Pillars Affecting Mitochondria
  • 12:00 Ozempic: Mechanisms and Physical Effects
  • 26:24 Natural Ways to Boost GLP-1 and Inhibit DPP-4
  • 30:22 The Food Industry and Cravings
  • 37:42 The Consequences of Obesity and the Healthcare System
  • 38:50 Personal Responsibility vs. Systemic Forces
  • 39:43 The Impact of Policy on Health
  • 40:53 Understanding Metabolic Health
  • 45:09 Tracking Biomarkers for Better Health
  • 47:34 Addressing Hidden Health Issues
  • 58:11 The Importance of Movement vs Exercise
  • 59:57 The Dangers of Ultra-Processed Foods
  • 01:04:21 The Root Cause of Health Issues

For more from Casey, you can find her on Instagram @drcaseyskitchen or www.caseymeans.com. You can find her new book, Good Energy: The Surprising Connection Between Metabolism and Limitless Health, where books are sold.

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The Liz Moody Podcast cover art by Zack. The Liz Moody Podcast music by Alex Ruimy.

Formerly the Healthier Together Podcast. 

This podcast and website represents the opinions of Liz Moody and her guests to the show. The content here should not be taken as medical advice. The content here is for information purposes only, and because each person is so unique, please consult your healthcare professional for any medical questions.

The Liz Moody Podcast Episode 250.

The REAL Story Of Ozempic, Weight Loss, And The Metabolic Crisis 94% Of Us Are Facing

The REAL Story Of Ozempic, Weight Loss, And The Metabolic Crisis 94% Of Us Are Facing


[00:00:00] LM: Hello, friends, and welcome to the Liz Moody podcast, where every week we’re sharing real science, real stories, and realistic tools that actually level up every part of your life. I’m your host, Liz Moody, and I’m a best selling author and longtime journalist. Let’s dive in. Ozempic is the buzzword of the year.

[00:00:19] Everyone is speculating about who’s There are podcasts about whether it’s healthy, whether it’s not. There are talking heads going back and forth on its moral and financial implications. But for all of the conversations that I have heard, everyone is missing a key component. The metabolic crisis is in this country that’s leading to people wanting to take ozempic in the first place?

[00:00:41] Is ozempic treating our metabolic health? Is it negatively impacting it? If we lose weight with ozempic, are we missing the root metabolic issues that are still causing downstream diseases? Why do we have such intense cravings for unhealthy food that we need GLP 1 antagonists to quell them? [00:01:00] The truth is, these types of food cravings have only existed incredibly recently in history.

[00:01:04] you And, we can get rid of them in under four weeks, no ozempic necessary. This episode is an incredibly balanced, nuanced, science grounded dive into the real story of ozempic, weight loss, and the metabolic crisis that is facing this country. My guest today is one of the world’s leading metabolic health experts.

[00:01:27] Dr. Casey Means is a Stanford Medical School trained doctor, former researcher at the NIH Stanford and NYU, co founder of the metabolic health tech company Levels, and the New York Times best selling author of Good Energy, the surprising connection between metabolism and limitless health. One super quick note, I know that 50 percent of you listening to this episode do not follow the podcast.

[00:01:52] Take a second now to hit that follow or subscribe button. It is the best way to support the podcast and it makes sure that episodes show up right in [00:02:00] your feed. Go ahead, do it right now. I’ll wait. Trust me, you do not want to miss out on any of our upcoming shows. They are jam packed with science and stories that will change your life.

[00:02:10] Alright, let’s get right into the episode. Casey! Liz, so good to see you. I’m so excited to have you here. It’s so nice to podcast with friends. Like, it just is a whole different energy. It’s a dream. It really is. It’s a good energy.

[00:02:22] CM: It is a good energy.

[00:02:23] LM: One might say. Okay, we have so much to get into today, but let’s just start with, do you think that obesity in itself is a disease that needs to be combated?

[00:02:33] Like, if somebody’s markers are great across the board, Um,

[00:02:41] CM: I think when we look at the way that obesity is being talked about, I think you’re getting at a key point, which is it is important to look at biomarkers because there’s a difference between obesity and metabolic disease. There’s a category of people who have excess weight who are obese.

[00:02:56] termed metabolically healthy obese, MHO. And these are people who have [00:03:00] excess weight, but actually their metabolic biomarkers are quite good. And so I think the key question we really need to ask for everyone talking about this issue is, do we know what our level of metabolic health is? Because if our metabolic health is good, that’s going to slash our risk for pregnancy.

[00:03:15] pretty much every chronic disease that’s plaguing Americans today. BMI is just a number. Metabolic health biomarkers can tell us so, so much more about our health. With that said, I do think it’s important to recognize that having excess physical weight and pounds on the body can have implications for our health and our experience of life outside of metabolic health.

[00:03:35] that are important to know about, for instance, joint pain. So having excess weight puts excess pressure on our joints. And that is something important to recognize. Every pound of increased weight puts six pounds of increased pressure on our knee joints, for instance. People who have obesity have about a 20 times higher likelihood of getting a knee replacement than someone who is not obese.

[00:03:54] Those are things to think about. You also want to think about things like surgical risk and complications. So, [00:04:00] in my time as a head and neck surgical trainee. There was a very different approach that had to be taken for someone who had significantly excess adipose tissue because it makes the surgery sometimes more difficult.

[00:04:11] It makes it take longer. And when I think about actually my reasons for wanting to try and really work towards, I would say, a lower weight. I think about if I had to have emergency surgery, making it as easy for the surgeon as possible. So there are reasons outside of just the metabolic health biomarkers.

[00:04:29] Another one to think about is just the excess adipose tissue can put pressure on your chest, which can make respiratory issues more likely, like obstructive sleep acne and just from the literal pressure of excess weight. And then There are certain conditions like skin folds can lead to infections and fungal infections developing under skin folds.

[00:04:45] So there’s things to keep in mind just related to having excess adipose tissue above and beyond metabolic health that I think can be part of the conversation. And. I think a quick additional thing to add here is that there’s lots of [00:05:00] different types of fat that are really important to understand.

[00:05:02] There’s subcutaneous fat, visceral fat, and intracellular fat. Each of those have a very different risk profile. Subcutaneous fat, which actually the fat that we can see, that’s the fat that’s, you know, under our arms or on our legs. This is actually the fat that’s least scary for our health. It actually doesn’t have a strong impact on our lifespan.

[00:05:20] It’s the visceral fat that’s actually hidden that covers our organs, of which we have a much smaller amount, and the intracellular fat, which is actually hidden inside our cells, those are the two types of fat more associated with metabolic disease that are known to be associated with an increased risk for chronic disease and shortening our life.

[00:05:35] So, understanding subcutaneous versus visceral fat. fat is actually really important. And that can be done through things like body composition scans, like DEXA scan or in body scan, or even rudimentary with like a waist to hip ratio, like just taking a tape measure and getting a ratio of your waist to your hip size, because that can tell you how much weight is around your organs.

[00:05:57] treating both of those types of fat equally? [00:06:00] That’s a good question. I actually don’t know how much it has an impact on visceral versus subcutaneous fat. I know it works on both because we know that people do actually lose visceral fat when they’re on ozempic because it’s inducing caloric restriction, which is going to take fat out of any part of the body that it can to use for energy.

[00:06:18] We do know that ozempic, somaglutide, that it is causing us to lower our blood sugar levels and is improving insulin. Um, and it’s also known to have a negative impact on insulin sensitivity. And so that will have an impact on visceral fat, which is known to be associated with insulin resistance. So certainly, it’s going to have an impact on that fat that we know is metabolically damaging.

[00:06:36] LM: This is one of my questions, and it’s one of the things that I think is missing from the Ozembic conversation, is people say, Look, people need ozempic. Their health is really at risk. This is an intervention that people might die without that. Is it treating the actual things causing people’s poor health or is it causing them to lose weight and that’s having downstream effects on their health?

[00:06:57] How is it actually impacting the things [00:07:00] that are causing dysfunction versus just the weight.

[00:07:04] CM: When I think about what is causing the obesity epidemic that we’re having in America right now, where in some populations up to 50 percent of people are obese, you know, this is a very, very modern phenomenon.

[00:07:17] 150 years ago, obesity was very, very rare. Now it’s Close to half the country. And when we put overweight and obesity together, we’re talking about 75 percent of the country. So there’s this thing happening in the world that our bodies are living in where we’re basically 3D printing more fat. And so I think the big question, the question that I’ve really devoted my life for is what is the body responding to in the environment?

[00:07:41] That’s causing us to just lay down all this fat because that’s what’s happening. And then that question unravels really into a much broader conversation, which I ended up having to write a 400 page book about because it is complex, but really it all. narrows down, in my mind, to what’s happening with our [00:08:00] mitochondria, which is, you know, you remember from high school biology, it’s the powerhouse of the cell.

[00:08:03] It’s this part of the cell that takes food energy and converts it to cellular energy. When the mitochondria is hurt by things, it will not effectively turn food energy to cellular energy to power our lives. Instead, food energy will be shunted to stored energy. which is stored as fat. And so then the question is, well, why is our mitochondria not doing as good a job as it has throughout human history in converting food energy to cellular energy?

[00:08:24] And that gets into tens of thousands of papers that talk about what in our environment is doing that. There’s eight main pillars that I talk about in Good Energy about what the things we know are hurting the mitochondria. Ultra processed nutrient poor food. So not supporting the mitochondria enough with nutrients and overburdening the mitochondria with too many essentially food substrates to process.

[00:08:49] So it’s an overwhelmed, tired machine that doesn’t have enough resources. You’ve got our sedentary behavior, so we’re not actually pushing the cell to process enough energy because we’re not moving enough. Sleep deprivation, [00:09:00] which spikes our cortisol, which directly inhibits our mitochondria. Our very poor emotional health in the modern world because, you know, we’ve got, you know, Fear inducing media string into our eyeballs 24 hours a day, which actually caused our mitochondria to essentially almost be stunted when the mitochondria get all the signals of psychological fear instead of channeling energy essentially towards rebuilding and homeostasis and helping us thrive.

[00:09:25] They actually channel a lot of energy towards like defense and alarm and inflammation. And so you’ve got the emotional world that’s basically crushing our mitochondria. Then we’ve got over 80, 000 synthetic toxins in our food, water, air, and personal care products and home care products, many of which are direct mitochondrial disruptors.

[00:09:41] We’ve got a changed relationship with light, so so much more blue light at night and not enough sunlight during the day. Sunlight is one of the key regulators of mitochondrial function and circadian rhythms. We have a different relationship with temperature. So whereas we used to have big swings in temperature throughout almost all of human history, like if you live in Colorado, it might go from 30 to 100 degrees in the course of [00:10:00] one day.

[00:10:00] And that’s actually a stimulus for our mitochondria. Cold stimulates our mitochondria to do more work and heat stimulates antioxidant genes that protect our mitochondria. And now we’re always at 72 degrees. And the last one is huge use of over the counter and prescription medications, many of which are mitochondrial disruptors.

[00:10:15] So those are eight pillars of our modern world, which So much data shows it’s really hurting our mitochondrial function, and instead of food energy to cellular energy, we’ve got food energy to fat. And, so then when I think about the conversation around Ozempic, while it is, in many people, actually improving their metabolic health, which is great, by essentially, Working on one of those pillars, which is essentially getting us to eat less of that processed food that’s overwhelming our mitochondria.

[00:10:43] It’s doing nothing for all those other aspects of our environment that are hurting our cells, hurting our mitochondria. So I think that While in individual patients it certainly can have a real amazing jumpstart in helping us clear through some of these substrates that are [00:11:00] totally overwhelming our cells and our mitochondria, it unfortunately doesn’t actually change the holistic environment that’s really, we know is just crushing our cellular health.

[00:11:10] LM: Is it impacting your mitochondria directly in any way or would it just be impacting your mitochondrial health via the food that you’re intaking?

[00:11:18] CM: Data’s coming out basically like by the day showing the differential impacts that these medications are having. Like for instance, maybe it’s having an anti inflammatory effect in the brain.

[00:11:27] Maybe it’s having an impact on microbiome. So there’s like a lot coming out. I think the big answer is we don’t really know. There’s so much that we don’t know about these medications. They’re long term effects, microbiome effects, reward circuitry effects, mental health effects, all these different things.

[00:11:42] So I don’t think we know for certain what the direct effect on mitochondrial function is. In fact, we don’t even have very many good ways to measure mitochondrial function. But in the sense that they are helping us work through stored substrates and process some of that overwhelm, I think that can be a very positive effect for people who are [00:12:00] using it.

[00:12:00] LM: Okay, so let’s get into the mechanism of action. Confusion because I find that fascinating that we know some of the ways it works, but we’re discovering other ways it works. And it’s very mysterious. A recent study found that it significantly reduces the risk of kidney failure and death for people with type two diabetes and chronic kidney disease.

[00:12:18] It’s also been found to reduce the risk of strokes and heart attacks by 20 percent over three years. It also lowered blood pressure in that same study. It lowered inflammation levels as measured by blood proteins made by the liver and cholesterol. all. Why do you think all of these things are happening?

[00:12:33] CM: The way that the medication is working, so it’s a GLP 1 receptor agonist. GLP 1 is a hormone that’s naturally made in the body by the L cells of the gut. It’s what’s called an incretin hormone, and there’s actually GLP 1 receptors all over the body. They’re in the brain. There’s some in the lung. They’re in the pancreas.

[00:12:51] The main mechanisms of action of why it’s leading to the weight loss and anti diabetogenic effects, is because it appears to be stimulating. [00:13:00] insulin secretion and has an insulin sensitizing effect, which then lowers our blood sugar and helps us clear blood sugar from the bloodstream. That may be part of why it has an anti inflammatory effect, because high blood sugar levels stimulate inflammation.

[00:13:12] Then it’s also acting centrally in the brain to have an impact on our satiety and our desire for food, essentially. So a third mechanism in the stomach is that it’s delaying gastric emptying, so it’s making you actually digest food more slowly. So you’ve got glucose lowering and insulin secretion, you’ve got delayed gastric emptying, you’ve got a decrease in hunger or cravings in the brain.

[00:13:38] Those are some of the main known mechanisms of how this is working.

[00:13:43] LM: And then you mentioned microbiome and I find the microbiome fascinating because I feel like we discovered it so recently and it is so important. Do we know at all what impact it’s having on the microbiome?

[00:13:54] CM: Yeah, if you go to PebMed and start looking in GLP you’re going to find [00:14:00] essentially the full spectrum of the possible results.

[00:14:02] Improves dysbiosis, improves this particular species of bacteria in the gut. I think it’s really hard to make a conclusive take right now on what it’s doing in the microbiome because one, we don’t fully understand the microbiome even at baseline and how it changes day to day and then the studies done on it with GLP 1 are limited and heterogeneous.

[00:14:23] LM: Does it? directly impact our metabolic health, or would you say that it impacts our metabolic health simply because of we’re going to be eating less, or is it via the insulin response? What impact is ozempic having on our metabolic health?

[00:14:35] CM: Metabolic health is defined many different ways. One way to define metabolic health is by looking at the biomarkers that are classically used to define metabolic health.

[00:14:43] These are things like fasting glucose, triglyceride levels, HDL levels, Hemoglobin A1C, HOMA IR, which is a measure of insulin sensitivity, waist circumference, and blood pressure. It has an impact on positively impacting many of those biomarkers. If we’re looking at objective biomarker [00:15:00] criteria, waist circumference, fasting, glucose, it appears to be having a very positive effect on metabolic health.

[00:15:07] The part that I think is still Time will have to tell is when you’re looking at the world that we’re living in, which is still extremely toxic to ourselves in many ways across all those pillars that I mentioned, if we don’t fix a lot of those things, what are the real long term societal impacts of not addressing them and using a shot, you know, https: otter.

[00:15:31] ai

[00:15:38] Really focusing our energy on all the things that we know impact cellular health. So, by just focusing on specific metabolic biomarkers, I think one thing. We might lose sight of is what do our lives actually look like on a holistic level? Because, you know, I always think about like a fish in a fish tank.

[00:15:57] If you have like a very sick fish and most Americans [00:16:00] were very sick fish right now, six and 10 have chronic illness. Children are getting very sick and that fish is very sick and it’s in a. Fish tank filled with super dirty water. What would you do for that fish? Would you take that fish and put it in clean water and then hopefully that fish will get healthier, which we anticipate that it would?

[00:16:18] Or would you take that fish in a dirty tank and give an injection every week for the rest of its life and some of its biomarkers get better and we say like, okay, this is the answer. That to me just doesn’t. totally feel like it’s fully capturing the whole thing. So I think by specific biomarkers, we do see an improvement if people stay on this drug long term.

[00:16:40] When they get off the drug, oftentimes a lot of those things immediately reverse course. And so the answer is yes, it looks like it’s improving certain biomarkers of metabolic health.

[00:16:51] LM: I’m curious then, because we’ve talked about on this podcast in your previous episode, you talk about it at length in your book, but our metabolic health impacts depression, [00:17:00] anxiety, acne, infertility, insomnia, heart disease, erectile dysfunction, type 2 diabetes, Alzheimer’s, cancer, and more.

[00:17:07] So do you foresee ozempic having a positive impact on all of these downstream metabolic diseases?

[00:17:16] CM: Well, research is showing that it is having a positive impact on some of these diseases. It’s been shown to be very helpful for women with polycystic ovarian syndrome, which is so tied to metabolic health.

[00:17:27] There’s some data showing that it’s improving people’s depression symptoms, although there’s other really concerning research, mostly in the EU, saying that it may predispose to increased suicidal ideation. And then some of the studies showing that stroke risk and heart attack risk had favorable improvements on the medication.

[00:17:46] So I think that if you are improving these metabolic biomarkers, that is a sign that your body is processing energy more effectively. That’s going to have a positive upstream [00:18:00] impact on several metabolic conditions. The thing that I think is really important to recognize, though, is that you can achieve many of those same outcomes without the medication, right?

[00:18:11] There are dietary and lifestyle strategies that focus specifically on mitochondrial capacity that also have incredibly rapid improvements in things like PCOS. There’s several studies showing reversal of PCOS with simply a whole foods, high polyphenol rich, low carbohydrate diet. This is a medication that is Upwards of 11, 000 per year per patient that is intended to be taken for life because when you get off the medication, people often have a very rapid reversal of the improvement.

[00:18:42] So while the answer is yes, I think while people are on this medication, they may see an improvement in some of the downstream effects. The other branches of the metabolic tree, aside from obesity or overweight, however, there is a cost to it financially, a cost of side effects and other [00:19:00] alternatives, I think, that have virtually zero side effects and that may also have similar improvements.

[00:19:04] LM: And we’re definitely going to get into a lot of alternatives. And we’re also going to get into. the fish tank and some of the problems that we run into with trying to change the water in the fish tank. Can you explain why a lot of these improvements are going away when people get off the drug? Because

[00:19:19] CM: it’s a medication that is acting as a peptide in the body.

[00:19:25] So we make GLP 1 naturally and we make it, you know, on a cyclical pattern throughout the day and after we eat. And this medication is essentially giving you a lot more of it in a longer acting version. So if you take that away from people and nothing else has changed in terms of the way that their relationship with food is or what types of food they’re eating or other aspects of their environment, you can imagine that not only will People potentially go back to their prior eating habits when the stimulus has been just taken away, but there [00:20:00] may also be rebound effects from basically the drug having been sensitizing the body over time that it actually causes the hunger to come back with a vengeance, which is what you hear from people saying that when they got off it, they felt like Insatiably hungry because that stimulus has been taken away.

[00:20:16] So you’ve been getting tons of GLP 1 for months or years and your natural amount that you’re making may be a fraction of that. And then that huge amount is taken away. You can imagine people might feel extremely, extremely, it’s almost like a chaotic withdrawal from having that medication.

[00:20:32] LM: That’s interesting.

[00:20:33] I haven’t heard that. I’ve heard like, if you can change your habits, that’s great. You can go on it. You can go off it. But I hadn’t heard that people. Sometimes report being hungrier when they go off of it because essentially their relationship with their hunger cues is really messed up at that point.

[00:20:47] CM: Well, I don’t know for certain. If you have an exogenous compound going in your body for months or years that’s quelling your cravings and that’s immediately [00:21:00] removed, that’s going to probably be a challenging situation. You hear a lot of reports about people feeling extremely hungry after getting off the drug.

[00:21:07] And so I think there’s a lot of. Doctors who I think are doing a great job of talking about, okay, if people are going to use this medication, because for many people this is going to be such an incredible, like, way for them to jumpstart their weight loss journey if just nothing else they’ve tried has worked, then use the jumpstart as a way to create a holistic plan in your life and use that increased energy and motivation from the treatment.

[00:21:35] rapid success you might be having with the drug of losing weight to get a lot of these other pillars sorted out so that you’re really protecting yourselves for when and if you get off of it. So that might be like learning how to cook with whole foods and learning how to stock your kitchen with nutrient dense, high protein foods that are going to trigger your own satiety and stimulate your own [00:22:00] GLP 1 and Get the resistance training going so that you keep the muscle mass up get the sleep habits in better Standing get rid of the toxins that are also going to clutter up the mitochondrial function So how can this be not like the single silver bullet that people depend on for life at great expense?

[00:22:19] potentially a jumpstart That can then allow you to get a lot of the other pieces in place for a long term sustainable strategy. So there are definitely physicians practices and individual doctors and people on Instagram all talking about like how to create the optimized surround sound around a drug like this if you’re choosing to use it.

[00:22:40] LM: Let’s jump into GLP 1. Can you explain in the simplest terms the impact that GLP 1 is having on our bodies? GLP

[00:22:45] CM: 1 is an incretin hormone. It’s made by the L cells of the small intestine, and it travels throughout the bloodstream anax locally and binds to a receptor on cell membranes and then has an impact in different parts of the body.

[00:22:58] In the brain, it [00:23:00] can reduce our that sense of cravings and hunger and make us actually feel very full in the pancreas it can be protected for the pancreatic beta cells that make insulin and cause us to stimulate more insulin secretion and actually inhibit glucagon which is another hormone that actually causes blood sugar levels to rise.

[00:23:17] So it stimulates the hormone that causes glucose to go down and inhibits the hormone that causes glucose to go up. And then in the stomach, it’s acting on the receptors to decrease gastric emptines so that the food that we do eat is actually dripped into the small intestine slower. So we basically feel fuller for longer.

[00:23:34] So those are the main ways that it’s acting in the body. It’s secreted by the L cells. The L cells are actually dynamic in their concentration in the small intestine. So we can actually make more or less L cells in the gut based on different factors in our lifestyle. In the body naturally, it’s rapidly degraded by an enzyme called DPP 4.

[00:23:53] When you make it naturally, it’s very short lived. The drugs last for longer because they’re synthetic compounds. [00:24:00] But the DPP 4 is a protein that will chew through the GLP 1 that you make. Interesting that there’s foods and different things that we can actually eat that inhibit DPP4 to keep the GLP 1 that you make in the body around longer.

[00:24:14] So that’s kind of its natural life cycle in the human body. Do we all make the same amount of GLP 1? No, people make different amounts of GLP 1 and, like, people with type 2 diabetes tend to make less GLP 1 naturally than people who do not. People with fatty liver disease may make less GLP 1. And so it’s hard to know, like, the chicken and the egg there, but it does seem to be variable across the population in different disease states.

[00:24:42] LM: Is that one reason why certain people might be more prone to gaining weight?

[00:24:48] CM: It’s possible. Again, I think it’s hard to know the chicken and the egg in that situation. When we look back historically at humans, like, Overweight and obesity has been very, [00:25:00] very rare throughout history until about a hundred years ago it existed, of course, but in the single digits now it’s 75%.

[00:25:07] So I don’t think that is like a natural inclination towards that is necessarily the full picture. Also, if we look at the mammalian world outside of human species, 1 and have similar mechanisms, there aren’t really any other, you know, animal species that have an obesity or overweight epidemic. And so I think we’re looking probably more at environmental factors and maybe how environmental factors are epigenetically changing the amount of GLP 1 we produce or the expression of it.

[00:25:35] But a sheer natural predisposition doesn’t, from a historical epidemiologic perspective, I don’t think is probably the driving force of the issues we’re seeing today.

[00:25:44] LM: Are there any negative impacts of trying to make more GLP 1?

[00:25:49] CM: Not that I can think, trying to make it naturally. Most of the things that improve GLP 1 levels in your own body are like incredibly healthful strategies, [00:26:00] like eating more green vegetables that have a compound called thylakoids in them, which we know stimulates GLP 1, or eating more protein that has valine or glutamine.

[00:26:11] Fiber is another one. These are very, very safe, and so I don’t see any big downside with shaping a dietary strategy or a lifestyle strategy around working to try and improve GLP 1 levels naturally.

[00:26:24] LM: Can you share some of the natural ways that we can increase our GLP 1 levels and decrease our DPP 4

[00:26:31] CM: levels?

[00:26:32] For sure. So when I think about it, I’m thinking in like three first principles ways. How do we make more L cells in the gut so that we can make more GLP 1? How do we get each L cell in the gut to make more GLP 1? And then how do we inhibit DPP 4 so we actually keep the GLP 1 around longer? And the research shows that there’s actually different strategies for each of those.

[00:26:54] So for making more L cells of the gut. Actually eating [00:27:00] very high fiber diet seems to be one of the biggest ones. So both high fiber diets and then high blood levels of short chain fatty acids, which are the chemicals that the microbiome make after we digest fiber, both of those are known to increase. L cell differentiation.

[00:27:17] High antioxidant diets also seem to have an impact on L cell proliferation and antioxidants are found in colorful fruits and vegetables. A lot of the compounds that give fruits and vegetables color are often antioxidant compounds as well as a lot of spices and teas, coffee, cocoa, many nuts and seeds as well.

[00:27:35] And then lastly, for increasing L cells, there’s Actually, some data that shows that ginseng has an impact on L cell proliferation. These are mostly animal studies, but I think that’ll be an interesting, promising point of research. So then next you want to think about how to get each of your L cells to make more GLP 1.

[00:27:53] This is one where, I love this word, but thylakoids are something that we want to maximize. So when you think about what makes [00:28:00] plants green, it’s the chloroplasts that basically turn sun energy into starches and help the plant make oxygen. The thylakoids have Compounds in them that are digested by the gut and stimulate the L cells to make more GLP 1.

[00:28:15] So eating as little as like 5 ounces of spinach has enough to have a stimulatory effect on GLP 1, which is incredible. The other things that increase GLP 1 are amino acids, so protein. We hear that protein triggers satiety. But one of the reasons is because specific amino acids actually bind to nutrient receptors on the L cells of the gut and cause them to make more GLP 1.

[00:28:37] And valine and glutamine seem to have a significant effect on that. So a few others here. So probiotic rich foods have been shown to increase GLP 1 secretions. This is all your favorite things like kimchi and sauerkraut and natto and Greek yogurt and kvass and low sugar kombucha. Curcumin has a stimulatory effect on GLP 1.

[00:28:55] So this comes from turmeric. I take about 2, 000 milligrams of curcumin every day because it’s both anti [00:29:00] inflammatory and stimulates GLP 1. The elagitanins in green tea stimulate GLP 1. And lastly, certain nuts seem to promote GLP 1 secretion, and in particular, pistachios. So this is just looking at some of the research that says, like, what can we put in our mouths that can essentially be processed by the L cells of the gut to increase our GLP 1 secretion.

[00:29:22] And no surprise, it’s a lot of healthy whole foods that we already sort of know intuitively are healthy, but may have a specific satiety promoting effect. And the last one is, how do we inhibit DPP 4? So how do we actually keep the GLP 1 secret? that we make around longer. And these get a little esoteric.

[00:29:38] Dark berries like blueberries and cranberries seem to have an effect on DBB4, but also things like Mexican oregano, rosemary, thyme, black beans. So these are all simple things we can put in a, Um, diverse healthful diet that may have an impact on our own natural levels of GLP 1. And I think the key [00:30:00] common denominator in all of them is they’re all real whole foods.

[00:30:03] And that’s really the key point. We know that when we’re eating nutrient dense whole foods, it’s going to have the most stimulatory effect on our satiety mechanisms. A lot of the ultra processed foods that we’re eating that make up 70 percent of our diets today are engineered to make us essentially insatiable and to make us want more food and to subvert a lot of these natural satiety mechanisms.

[00:30:22] So,

[00:30:22] LM: do hyper process foods work on GLP 1 in the opposite way? Or do we know why they are so craveable and how they’re acting in our body to be so craveable?

[00:30:33] CM: Well, first of all, one thing to recognize is that back in the 1980s, three of the four biggest mergers that happened in the U. S. were cigarette companies acquiring processed food companies.

[00:30:43] So addiction as a business model is like built into, um, uh, uh, uh, How these processed food companies make money. So Philip Morris bought Kraft and this is happening over and over again. The scientists that are on staff in a lot of these companies are exquisitely [00:31:00] familiar with hijacking reward circuitry in the brain.

[00:31:02] And that’s what the ultra processed food in our country is doing. Over 70 percent of the calories on the shelves in our grocery stores and that we’re eating are these foods that Never existed in human history that are made in a factory and that are designed by scientists to take us to our bliss point psychologically.

[00:31:17] So we want more and more and more. Then in the 1970s, we invented high fructose corn syrup, also a brand new phenomenon that tracks perfectly with the increased rise in childhood obesity and put that in almost everything because it was super cheap to put in food because the government subsidized the production by subsidizing corn through our fine farm bill.

[00:31:38] So we have this super cheap sugar, which in many ways is so much worse than other forms of sugar that are not high fructose corn syrup because fructose as a molecule drives hunger. It uniquely drives hunger. If you think about fructose in the wild, we find it in the super ripe fruits at the [00:32:00] end of summer that animals are going to eat before they go into hibernation.

[00:32:04] So the bears are looking for berries at the end of season. And what happens is when the berries are ripe and filled with fructose, bears start eating them and fructose flips a switch in the brain that totally subverts our satiety mechanisms and causes the bear to eat as many berries as it Possibly can before winter, which then, of course, causes it to store fat, which it then lives off for several months.

[00:32:29] So the food industry knows this. That’s called the survival switch, and it’s been well documented, fructose drives hunger. Fructose also drives aggressive food seeking behavior and violence because bears need to out compete other bears for all those berries. In a child’s body who’s drinking soda, we are driving the brain to try and get as much food as humanly possible, because that’s what fructose does to our brain, and essentially to pack on fat.

[00:32:52] In preparation for a hibernation that’s never coming and so all Americans basically by eating ultra processed food with high fructose corn syrup, which is the [00:33:00] majority of what’s in our grocery stores are essentially totally bypassing our natural satiety mechanisms, turning us into essentially like.

[00:33:08] Animals that think that there is a scarcity situation and we have to actually get as much food as possible and pack on fat. And that’s what’s happening in our culture.

[00:33:18] LM: Will our satiety set point change if we only eat whole foods? If we stop eating hyper processed foods, will we stop overeating?

[00:33:27] CM: This has been well documented in research that in as little as four weeks of people eating whole foods diets and eliminating ultra processed carbohydrates, that people’s satiety mechanisms and desire for food drops astronomically.

[00:33:42] One thing I say to people, not only from what the research tells us, but also from my own experience, being very overweight and losing weight, is There is a silver bullet for hunger and insatiable cravings, which I have definitely had in my life. And it is doing whatever you can to [00:34:00] eat as much real, nutrient rich food as possible.

[00:34:04] So even if it’s not eliminating the foods that you love, it’s like front loading. Every meal, every day, with things that we know promote satiety, so protein and as many nutrients as humanly possible, which means the freshest food as possible, because those are going to have the most nutrients, because that’s going to tell your body, squirt out all those satiety hormones into your bloodstream, which then make it so much more effortless to not be hungry.

[00:34:29] So I think if we can stimulate our satiety hormones, which we do by stimulating, Satiety hormone secreting cells of our body with what they need to secrete satiety hormones. It does become a lot more effortless because the effort that we feel, the cravings that we feel, that’s our body essentially responding to not getting what it actually needs to give us the signal to make it easy.

[00:34:53] So front loading, doing whatever you can possibly do to get the real food into your body. For some people, [00:35:00] I have a friend who didn’t like to cook, didn’t want to do a lot of meal prep, so she literally just ate chicken and broccoli for like a month, because she’s like, I like it, that’s what I can eat, it was real food.

[00:35:09] The common denominator is it’s protein and real food and antioxidants that are going to stimulate the body to create satiety hormones. And so, to me, that is The biggest magic bullet. And I know it feels very hard to do that because we love these foods so much. And I’ve totally been there. But I think knowing that there’s like a real biochemical purpose to it, it will actually make your life so much easier.

[00:35:31] I think that can sometimes be motivating

[00:35:32] LM: and as quickly as a month, four weeks. Yeah, that’s really interesting. It’s something, though, that I find tricky about this whole thing. When Ozempic first came out, I was like, No, hard. No, I hate it. And then you know, As I thought about it more, I thought about all of these companies that are spending so much time and money and energy hijacking our cravings, hijacking what our body wants, and I was like, well, if science is working against us, it almost [00:36:00] feels like Like, it makes sense that we need science to overcome that hurdle as well.

[00:36:06] We need this outside thing that’s going to have a bigger impact and help us get over this hump because we’re working against forces that are engineered to be so craveable to hijack our body’s cues so, so greatly.

[00:36:23] CM: I definitely hear that rationale. What I would hope is that we generate a little sense of, like, resistance and anger against what is being done to us from both sides, both the side that’s selling us the solution and the side that’s getting us addicted, and say, like, I’m actually not gonna line either of your pockets with money, I’m gonna choose this.

[00:36:42] What is the most evidence based strategy, which is eating real food and focusing on sleep and walking and doing these simple things that are actually more effective than even the Ozempic. And I think what everyone needs to realize is that like, there is such a huge devil’s bargain playing out that we are all victims of in this [00:37:00] country, where there’s a 4.

[00:37:02] 3 trillion healthcare system that makes more money when we’re sick. That’s healthcare, pharmaceutical industry Even the insurance industry, so there’s a 4. 3 trillion health industry, quote unquote health that makes money when we are sick and makes less money when we’re healthy, and then there’s a 2 to 4 trillion ultra processed food industry that needs us to be addicted to their food.

[00:37:24] And eating and consuming as much of it as humanly possible to make their shareholder returns. So there’s a revolving door between these companies of get people sick and addicted to ultra processed food and put out all this propaganda that says ultra processed foods are fine and a calorie is a calorie and these marketing things that make no sense.

[00:37:42] And then tell people also that there’s no consequences of. Having excess weight or excess fat when in fact being obese shortens your lifespan significantly and then you have this health care system that in no way is there to reverse disease, prevent disease or [00:38:00] heal disease, but it’s just there to manage you for life with long term pills.

[00:38:04] And when the pills fail, do surgery on you. That’s super profitable. So that’s the world We’re living in and there is an escape hatch. The escape hatch is doing the most disruptive thing you can possibly do in modern American society, which is eating fresh real food and taking walks and sitting down and eating a dinner table with your family and getting enough sleep and opting out of like the insane hustle culture that makes us think we have no worth if we’re not working all the time.

[00:38:34] Manage our mental health, set boundaries, the technology and detoxify a lot of our environment, which sounds like a lot, but it’s a lot less than injecting yourself every week for the rest of your life or being dependent on the health care system for the next 40, 50 years.

[00:38:50] LM: I think a lot of what we’re talking about is our personal responsibility and a lot of the public conversation is about what is our responsibility?

[00:38:58] For our health [00:39:00] and what is a product of the systems in which we live. I get frustrated sometimes because we do live in a world that makes it really hard for us to be healthy. You’re sharing all these incredible strategies. We’ve had a lot of incredible strategies for a really long time, and we still are sitting too much because that’s what our jobs demand of us.

[00:39:17] We are being subject to advertisement on a moment to moment basis that are telling us what to eat. How? Do you view personal responsibility when we are up against these systemic forces that are working against us? I agree we should get angry, but it doesn’t change the fact that we live in this world that makes personal responsibility difficult.

[00:39:38] Mm hmm.

[00:39:39] CM: It certainly does. Every card is literally stacked against Americans right now. Our farm bills are Taking taxpayer money and driving it towards the foods that are making us sick so that the foods that are making us sick are cheaper, where you can go into a convenience store and soda is actually cheaper than water because we subsidize the high fructose corn syrup in it.

[00:39:58] We’ve got the USDA [00:40:00] school lunch program, which serves 3 billion meals per year, has a operating budget bigger than Chick fil a, McDonald’s and Starbucks combined and doesn’t even follow its own USDA guidelines for what should be in the food. It’s serving absolutely horrific food to kids with 200, 300 percent of the added sugars that the USDA even allows or recommends for children.

[00:40:22] You’ve got 60 percent of mainstream media ad funding coming from pharmaceutical industries, that’s illegal in almost every other country in the world except New Zealand. We can advertise ultra processed foods to kids on our TVs, whereas that is not allowed in most other parts of the world. So and of course, like you said, our jobs make us sit.

[00:40:39] The technology is just, you know, So pervasive. And so yes, it’s very, very difficult. The way I think about it, the way I focus on it in my work is to try and hit it at every level. I think that step one of the message I have to share with people is that [00:41:00] I think that part of why we get paralyzed and feel like things are so hard is because the system has made it that way, like confusion is part of the business model of all these industries.

[00:41:10] And so if I can help people understand that there’s actually a very simple road out of most of the symptoms and diseases that we’re facing today, based on following the science, and that is just increasing mitochondrial capacity. And there’s A handful of evidence based ways that we can do that across food and sleep and exercise and stress.

[00:41:28] And we need to focus our arrow on the evidence based strategies to improve mitochondrial capacity if we want to melt our mitochondrial dysfunction and all the branches of the tree of metabolic dysfunction, which is essentially every chronic symptom and disease we’re facing in the U. S. The message is that it’s actually so much simpler than we’ve led to believe.

[00:41:43] And so for me, step one is. Helping spread basic education about how the body works and how the environment is crushing our health so we know exactly where to point the arrow of our time, money, and effort to dig our way out of that hole. Because I think it is the mass confusion that’s actually [00:42:00] making it harder for people.

[00:42:01] Do I be keto? Do I be paleo? Do I be carnivore? Do I be vegan? Do I do zone 2? Do I do HIIT training? Do I do resistance? Do I do yoga? Do I need to do sleep consistency or is it sleep quality, like how much deep sleep do I need? It’s so crazy and actually when we just think about Our health, from the standpoint of compassion for ourselves and our mitochondria, like what are the biochemical things they need to function properly, it cuts through a lot of that noise and then know how to track it for ourselves over time.

[00:42:29] So track a few basic biomarkers every six months. Know if the things you’re doing are working. We all have personal responsibility, but how to make that personal responsibility like so much more fun. focused and pointing the arrow of that personal responsibility on what’s going to actually like make the highest leverage difference for our health.

[00:42:48] That’s really like what my life’s purpose is because I think the highest leverage way is focusing on understanding a little bit about your metabolic health, what’s really affecting it and then track it over time. Then I also focus [00:43:00] on policy. So I was just in D. C. like talking to Congress and I think there’s really high leverage areas of policy that we can educate policymakers on so that they realize it’s actually in their best interest and their constituents best interest to shift the farm bill and shift the school lunch program and shift the way we’re allocating SNAP funds, which right now 10 percent of the SNAP budget, which is for the Low income food assistance is going towards soda.

[00:43:25] And so that’s basically direct taxpayer money to this diabetes water. Our laws around pharmaceutical advertising on TV. So at the systems level, it’s a lot harder because the entrenched interests are so big. But I do see a lot of hope with what we’re doing in Congress. There are people thinking about these things.

[00:43:42] And the crazy thing is that if we can fix some of the incentives that screw up our metabolic health, it’s actually one of the fastest ways to also help our climate, which is really Wild because so much of what’s creating our climate instability has to do with our industrial agriculture system, which is also what’s directly driving metabolic issues.

[00:43:57] So that’s the big message is [00:44:00] there’s some simple high leverage things we can do around the personal responsibility that we have. And if we focus on the right arrow. We can make a lot of impact. I think about my mother who I talk about in the book. She’s sort of an example of the archetypal American patient who was super dependent on the healthcare system and ultimately got let down by it.

[00:44:17] She died prematurely after 40 years of basically missed warning signs of metabolic disease that ultimately led to her premature death. And I look at someone like my mother who was spending so much time and so much energy, like, trying to be healthy, but didn’t have like a metabolic framework. So she was throwing spaghetti at the wall.

[00:44:39] She tried all these food delivery programs, like Nutrisystem, and this was like the 90s and early 2000s. And she felt good about it. But looking back, I’m like, none of that food. Supported mitochondrial health. It was low calorie, but it had artificial sugars and it had seed oils and it was refined all the process grains.

[00:44:57] If she had been able to direct all that time, [00:45:00] money and energy towards what actually matters. I think she had a very different outcome. How do we make the personal responsibility that we do have focused on the right thing is how I think about it.

[00:45:09] LM: What biomarkers would you suggest tracking?

[00:45:11] CM: I think about it like small, medium, large, everyone should be doing small at least twice a year, and then of course like the sky’s the limit on labs, but when we think about small, which is the basics, we want to understand the basic biomarkers of metabolic dysfunction, this is what is written all the research in the literature, how we define metabolic syndrome, so this is fasting glucose, triglycerides, HDL cholesterol, and so on.

[00:45:32] blood pressure, waist circumference. Some studies also add in hemoglobin A1c. Based on the studies that show that 93. 2 percent of Americans right now are metabolically unhealthy, they’re looking at these ranges for those biomarkers. If we have a fasting glucose under 100 milligrams per deciliter, HDL above 40 for men or above 50 for women, A triglyceride level less than 150 milligrams per deciliter, waist circumference less than 35 inches in women or 40 [00:46:00] inches in men, blood pressure less than 120 over 80, and hemoglobin A1c, which is a 90 day average marker of blood sugar, less than 5.

[00:46:08] 7%. If all of those are true and you’re not on medication for any of those biomarkers, like a blood sugar medication or a blood pressure medication, you are in the 6. 8 percent of Americans quote unquote metabolically healthy 6. 8%. So those are the basics that your doctor can order for you twice a year, three times a year, covered by insurance.

[00:46:31] If they’re all in that normal range, you can safely say that your cells are metabolically doing pretty good work. I would say we actually want a tighter range for a lot of those biomarkers like optimal, for instance, for triglyceride is definitely less than 100. If you look at the research, less than 100 is a safer range to be in the less than 150.

[00:46:52] Fasting glucose, we want it more 70, 85, not just less than 100. The beauty of every single one of those biomarkers is that they can change radically in one [00:47:00] month. If you change diet and lifestyle, many of those biomarkers can significantly change in as little as four weeks. And I’ve seen that across patients I’ve had, across levels members.

[00:47:12] It’s incredible. They’re all very actionable with simple lifestyle habits. So we should be tracking those throughout the course of our whole lifetime. If they’re in a normal range, we slash our risk of every chronic disease.

[00:47:22] LM: If somebody is eating really whole foods, they’re adhering to the eight pillars as well as they can, and those numbers still aren’t in the right place, is there anything that you find often is slipping through the cracks?

[00:47:34] So that’s

[00:47:34] CM: the type of patient that I would absolutely have a two hour visit with them and talk really about what’s going on in their life. Is there one of those pillars or multiple of those pillars where there’s actually stuff going on that we’re not addressing? For instance, someone might say like, Oh yeah, I definitely work out several times per week, but like, are you doing any resistance training?

[00:47:54] Are you building muscle? Or is it more really light? activity. [00:48:00] Or someone might be exercising four or five times a week for 45 minutes, but they’re not walking at all during the day. So really just drilling in on like everything, what products you’re using in your home. I would drill in exceedingly on the stress piece.

[00:48:15] Like, they might say they’re not stressed, but like what’s actually happening in your life? What happened in your childhood? What are your thoughts inside your head each day? Because that can have a huge impact on metabolic health. I’d screen them for sleep apnea for sure, because sleep apnea is going to just tank metabolic health.

[00:48:29] And a A lot of people who have it don’t know they have it. So at that point, I’m going to go from small to the medium and large categories. So I might do my next tier of labs, which includes like fasting insulin levels, a CRP level looking for any inflammation. And if inflammation were really high, I’d want to dig into like, are there any like chronic low grade infections going on?

[00:48:50] Is there like a parasite or something going on that is making that CRP level high? Okay. Bye. I’d want to look at liver function testing, so AST and ALT, and get a sense of how [00:49:00] their liver’s doing. Is there anything that might be affecting the liver? I love uric acid, which is a metabolic biomarker that can tell us about how much fructose is coming into the diet.

[00:49:09] Vitamin D levels for sure, because that is super actionable, and Right now vitamin D levels are so low in our country because we’re spending 93. 7 percent of our time indoors away from the sunlight and so vitamin D levels are really low and that’s going to have a huge hit on insulin sensitivity. So those are kind of the next tier of blood work I would do.

[00:49:28] And then. Above that, I would be doing micronutrient testing, vitamin testing, like low B vitamin status can have a very significant impact on metabolic health, magnesium, zinc levels, I’d be looking at hormones like thyroid hormone, sex hormone levels, DHEA, estrogen, progesterone, testosterone, stress hormones like cortisol.

[00:49:50] Probably doing body composition scanning, like a DEXA scan, maybe genetic testing, like three by four genetics, things like that. But if the body’s metabolic health biomarkers are [00:50:00] not in the optimal range, there is something that is hurting our body’s most fundamental process of making energy. And as a physician, and as a person, The question we’re going to ask is like, why?

[00:50:12] Like, what is happening? Because our baseline is that it should be working properly for the vast majority of us. So it’s kind of becoming Sherlock Holmes and thinking through uncovering every little rock and stone and nook and cranny of what could be hurting this sort of precious system’s ability to do what is ultimately its birthright, which is to convert energy in the body.

[00:50:35] LM: Is it possible for All of us to achieve this in today’s world. And let me clarify that question with the micronutrient depletion in soil with the air that we are breathing with the things in our water. Is this state of health still achievable to everybody?

[00:50:51] CM: I like to believe that it is. The way I think about it is when our collection of cells that are our body [00:51:00] are 40 trillion cells are Surrounded by an environment in which the cells are getting their needs met, and they’re not overburdened with things that they can’t process, we will have health.

[00:51:11] The beautiful thing about the human body is that we are not a static thing. We are a process. Every day, hundreds of billions of cells die and are reborn. So we’re constantly rebuilding ourselves, and everything we’re putting into our body is the printer ink to 3D print that version of our body five minutes from now, a week from now, a year from now.

[00:51:32] So that’s Very cool. And also very hopeful because it can change. We have incredible detoxification systems in our body. We’re constantly filtering things out. We’ve got the lymphatic system drain from our legs. We’ve got the lymphatic system draining from our brains. We have recycling process in ourselves.

[00:51:48] So it’s all happening. So if we can put a body in a situation in which the cells needs are met and it’s not being overburdened with toxins, like I think almost anyone can move towards much, much better health. The [00:52:00] question I think you’re asking is more of a systems level issue like. Is it resource wise possible?

[00:52:06] LM: Well, and are those toxins so pervasive? Like the idea of trying to not overburden ourselves with toxins in a world that is filled with toxins from the moment that we wake up to the moment that we go to sleep feels like a heavy lift these days.

[00:52:21] CM: I think it is a heavy lift. And I do think that like a lot of my energy and time goes towards what I would consider protecting my body from the world.

[00:52:29] What I buy and what I filter and how I treat my water and the food I purchase. And so I totally agree with you with the personal responsibility or the agency that we have, how do we actually put those resources towards what matters? Because this is the thing. Americans are already making the effort to try and be healthy.

[00:52:47] I truly believe that most people do want to be healthy, but I think that again, there’s like 8 trillion of industry that want us to be confused and kind of put our resources towards the wrong things. And so I think if we just. Truly redirected a lot [00:53:00] of that energy towards what matters. People would make huge gains.

[00:53:03] So we know that 50 percent of Americans go on a diet every year. They literally try to change their eating habits. And unfortunately, I think probably what a lot of them are doing is some type of really unsustainable strategy that’s not actually giving the cells what they need and taking away the things that the cells don’t need.

[00:53:21] And so that’s what I focus on is like, how do you focus the arrow on what matters? Cause there’s so many simple, like low hanging fruit wins. Like next time you have to buy cleaning supplies for your house. Just buy one that doesn’t have artificial scents in it, because we know these artificial scents are volatile organic compounds that directly hurt our mitochondria.

[00:53:40] If we are going to buy a new water bottle, buy a glass one, not a plastic one. If we’re going to buy new Tupperware, get glass ones and not plastic ones. Like, it doesn’t have to be change everything all at once, but like, we are going to be purchasing things throughout our life, so if you can get, the organic bamboo sheets, which on Amazon are not more expensive than a lot of the synthetic [00:54:00] polyester sheets.

[00:54:00] Do that. Get rid of the Glade plug in from your bathroom and throw it away because it actually does have an impact. In many cases, a lot of things actually end up being cheaper because you don’t have to buy so much of this extra stuff that we’re doing, the scented products and the scented lotions and all this stuff.

[00:54:15] So know what the landscape is, and then as you’re designing your days and designing what you buy, pick the things that are going to put less burden on yourselves. And I think, in mass, those small micro decisions, like, have a huge, huge impact. Like, for cleaning supplies in my house, basically for all soap, I use a gallon jug of organic Dr.

[00:54:36] Bronner’s Castile unscented soap, which is like, 30 and lasts for like 10 years vinegar, water and essential oils for all my sprays and some baking soda. So it’s less expensive. And right there. I am changing what I am breathing and putting on my skin every day for the next 10 years. That makes a big difference.

[00:54:57] If you switch to Coconut [00:55:00] oil for lotion instead of a scented lotion with 70 unrecognizable ingredients that’s cheaper and has a big impact. So I really try and focus on just like these small wins and then our air quality. Well, one thing, air quality is way better outdoors than indoors. So one simple thing we can do is try to spend lots more time outdoors, which has A massive impact on health.

[00:55:22] It improves our vitamin D levels. It improves our mental health massively and our stress levels just by being outdoors and being if you’re around trees even better, but you don’t even have to be around trees and the air is less polluted. So that’s a simple one. We spend 93. 7 percent of our time in our homes in the four walls of our homes or in our car.

[00:55:39] Try to move more of your activities that are being done inside to outside. If you have to chop vegetables, do it on a little table on your deck or whatnot. If you’re gonna catch up with your kids playing with toys in the living room floor, just move the toys outside or to a park. Simple wins like that. I don’t even think people know that they matter right now, and so we’re not even doing them.[00:56:00]

[00:56:00] So that was really the purpose of, of writing Good Energy was to like, Give an action plan of how to get creative in your life with the simple things we’re doing every day to make them so much more supportive for our cellular health.

[00:56:14] LM: We’ve already talked about so many things, and we’re going to talk about even more.

[00:56:18] And I just want people to come away with an action plan as much as possible. Can you give us three tasks to improve our mitochondrial health, things that we can do immediately? I would say step one is know your baseline.

[00:56:31] CM: Email your doctor today through the electronic health record and ask for those biomarkers that I talked about.

[00:56:37] Say you want a fasting glucose, a triglyceride, an HDL, hemoglobin A1c, and you want to get your blood pressure taken sometime soon. And you can do your waist circumference at home and note whether you’re in that normal and optimal range. You got to know we should all be able to rattle off what our triglycerides are all the time.

[00:56:52] So know your baseline and how it’s changing over time. Step two is do anything you possibly [00:57:00] can to clear out all the ultra processed foods in your house because nothing will make it easier to manage cravings than to move away from ultra processed foods. They are designed to do that. Built and sold to you to make you want to eat more so if you can get rid of them and try and swap them with things that are easier, I think that’s a huge step.

[00:57:21] What that looks like because people might say, Well, what’s ultra processed food? Not all packaged food is ultra processed. Flackers are not ultra processed, but they’re packaged. Zen basil seeds are chia seeds. They’re packaged. They’re not ultra processed. Ultra processed Foods are the foods that on the label are going to say any amount of ultra processed refined added sugar, ultra processed refined industrial seed oils, corn oil, sunflower oil, safflower seed oil, vegetable oil, others, and then ultra processed refined white flour.

[00:57:56] So if it says like bleached white flour or something like that, [00:58:00] whole wheat flour, that’s a different story. But if it has ultra processed refined grains, ultra processed refined seed oils, ultra processed refined sugars. It is driving your cravings. It is not good for your metabolic health. So that’s number two.

[00:58:11] And then I think the third one I would say that’s very simple is reframe the conversation from exercise to movement. The, one of the best things we can do to support our mitochondrial health is move more throughout the day, even if it’s very low grade, like walking. We in the U. S. Have confused exercise for movement to our great detriment.

[00:58:34] This fuels the 800 billion fitness industry, which as the fitness industry grows, we’re actually getting sicker. And I think part of this is because it confuses us to think that exercise replaces low grade movement. The human body and ourselves are meant to be in motion throughout the day. So I’m not saying to give up exercise if you’re exercising, but finding ways to move every hour or so throughout the day, even for two to three minutes, walking around the house, doing some [00:59:00] air squats, getting the muscles contracting.

[00:59:02] It will push your glucose channels to the cell membrane so that you can dispose of and use more glucose throughout the day. If you’re sitting all day and then exercise for an hour, those glucose channels have been locked up inside your cells all day. We need to get them to the membrane, which means making sure to move regularly.

[00:59:16] So just find ways to walk more throughout the day. The research shows that anything above 7, 000 steps per day has massive impacts on mortality rates, obesity rates, Alzheimer’s rates, depression rates, even gastric reflux, and so many other conditions. Drops by like, 40 to 60 percent just with 7000 steps a day.

[00:59:39] And that is because steps are our proxy metrics for how much we’re moving throughout the day. So know your baseline, get rid of the ultra processed food from your kitchen and really try and front load with real nutrient wrench food and try to move much more throughout the day. I think those three things alone can be life changing.

[00:59:57] LM: And ultra processed foods, as we’ve talked about, [01:00:00] have a negative impact on our health because they Mess with our ability to sense when we are sated and when we need to stop eating and because they don’t have nutrients. So when we’re eating all this food, we’re not actually getting the nutrients that ourselves need to thrive.

[01:00:14] Is there any other reason that ultra processed foods are something that you would recommend we avoid entirely?

[01:00:20] CM: There’s several reasons. So ultra processed foods are foods that are not found in nature. And so from that standpoint alone, they’re foreign to the body. Most of the conditions we’re dealing with today in the United States have some element of inflammation.

[01:00:34] And if you think about what is inflammation, it’s fundamentally the immune system being fearful of something. And I think when we think about ultra processed foods being this foreign substance that our microbiome and our bodies don’t really know what to do with, we can understand how it’s such a driver of inflammation.

[01:00:50] So the definition of an ultra processed food is something where the constituent components of the whole food have been separated, like the individual molecules, [01:01:00] and then repackaged with other separated components of other foods back into essentially some sort of like hybrid. frankenfood. So, like, the reason that whole wheat bread is actually not an ultra processed food is because you take a piece of grain, you grind it, and you use everything in that bowl to make the bread.

[01:01:18] So the bran, the germ, the kernel, everything’s in there. When you switch to ultra process, which is where things get bad, you pull out the bran or you pull out the germ and then you mix that with some other pulled out part of another food to create something that’s never been before found in nature. And that’s very confusing to the body and then often takes out the part that is most delicious, but least nutritionally sound for the body.

[01:01:45] So it drives us. To have blood sugar spikes and be very hungry. That’s what’s happening. We convert whole wheat flour to white flour. And so, like you said, these foods are going to take the most hyper palatable part and put that in the food and then remove all the key [01:02:00] nutrients that are required for ourselves to function properly.

[01:02:02] And if we think about hunger, one framework for hunger is that hunger is what happens when your body is going to. psychologically drive you to seek out more food because it’s not getting its actual needs met. And so ultra processed food is the ultimate example of this. It not only independently causes you to want more food, but it doesn’t meet yourself needs, which therefore is going to drive you to seek out more food.

[01:02:24] And if you keep eating ultra processed food, you will never meet those needs. So that’s why we’re eating ourselves to death in this country because we’re overfed, but undernourished. The third issue is that these foods to keep them shelf stable over long periods of times have so many additives that we know are very bad for health.

[01:02:41] Some are mitochondrial disruptors, some are straight up carcinogenic, and some directly lead to neurotoxicity like red 40, which we know is very, very bad for our mental health. We’re talking about preservatives, colorings. Artificial flavorings, emulsifiers, gums, stabilizers, things like this [01:03:00] that are made in a factory and that are totally confusing ourselves.

[01:03:02] And most processed foods will have those in them. Ultra processed foods are a less than 100 year old experiment that have absolutely failed and they need to be relegated to the annals of history because they may take down our entire species. The last thing I’ll mention is that. They are artificially cheap because of so many of the components that make them up are subsidized by our farm bill.

[01:03:25] So they’re cheap up front, but they obviously cause costs down the road with the health impacts. They’re not only destroying our soil through industrial agriculture, but they’re also covered in glyphosate, of which we use about 400 Billion pounds per year in the United States, which is hurting our microbiome and our cellular health on top of it.

[01:03:42] This is a big ask. If you’re listening to this podcast and your health is not what you want it to be, if you eliminate ultra processed foods the rest of your life, your life will get so much better.

[01:03:49] LM: Other than confusion, why do you think we haven’t made these changes? A lot of this information has been around, eat vegetables.

[01:03:58] Most of us have an intuitive sense [01:04:00] we should do that. Most of us have an intuitive sense that Cheetos aren’t particularly good for us. But we continue to eat the Cheetos. We continue to not eat the vegetables. We continue to not move our bodies. We continue to not sleep very well. We continue to not change over our products.

[01:04:15] Why do you think we have been historically so resistant to make those changes?

[01:04:21] CM: Historically is an interesting term, because this is so new. We’ve been around for tens of thousands, if not hundreds of thousands of years, behaviorally modern humans, and like, this is like decades long. So, I think we’re still figuring it out.

[01:04:33] But to me, if we’re talking about the root cause of all of this, I think it actually gets to a much bigger picture level, which is that In our Western culture, we have just become so devoid of awe for the human body, and we are so busy. We’re so bought into this capitalistic hustle culture of our entire value is how much financial productivity we have that has then really undermined [01:05:00] community.

[01:05:01] We become so urbanized and technological, both of which have actually made us in many ways more isolated from close community ties. And in our Western paradigm, we’re so de spiritualized. And I think we very much see the body as this thing that like is an object that lives and dies. And, you know, we just eat food for calories and it’s all just so devoid of the truth, which is that we are each completely a miracle.

[01:05:33] We self assembled out of matter in an infinite expanding universe and each have a consciousness and are sitting in a room talking on a microphone on a planet spinning through space in a solar system. Like it’s crazy. It’s totally crazy. And it’s like, we have forgotten how wild this is. And so in that forgetting of the miraculousness and the awe, and I think a lot of this has to do with the fact that we are inside [01:06:00] literally All the time, 93.

[01:06:02] 7 percent of our time, we’ve forgotten the miracle of our lives. And so it makes it a lot easier to trash our bodies and to just basically say, like, I’m just this thing living in this box and I’m going to die and it can’t really get better. And the TV says the only way it can get better with a shot or with a pill.

[01:06:21] In this lack of awe and lack of sense of miraculousness for what we actually are, I think that’s very existentially scary. And then we try and look for any dopamine hit that’s going to make us feel better. And then we’re on the hamster wheel of dopamine, which is really hard to get off. And that’s the sugar, that’s the gambling, that’s the porn, that’s the social media, that’s the glucose spikes, that’s the sex, that’s the random hookups.

[01:06:46] It’s just the whole world we’re living in that essentially is a dopamine hit to mitigate the existential anxiety. ameliorated by focusing on just cheer, awe and gratitude for just the [01:07:00] miracle of being alive. And so I think that’s actually the root root root cause of everything. And I think there’s an all out war to make us forget that, like to make us think that This is sort of all we’ve got and we should just be hedonistic and live it till the end.

[01:07:14] And so I think actually getting back to like spirituality, or if you’re not spiritual, just bigger picture gratitude, focusing on awe, it can actually unlock a lot of sustainable health habits because I know that if I think about my body as a miracle, then I wanna feed it well. And so I think starting at that level, whether it’s your why or whatever it is, like.

[01:07:36] It’s totally critical for long term sustainable behavior change.

[01:07:39] LM: Can you tell us a little bit in

[01:07:41] CM: your own words about your wonderful book? Sure. So my book is called Good Energy, The Surprising Connection Between Metabolism and Limitless Health. This is the ultimate metabolic handbook. So it’s really in three parts.

[01:07:54] The first part is basically the science class you never had. that like I wish everyone could have to understand their [01:08:00] body on a deep level and to really appreciate how awe inspiring it is. So it’s the science, what metabolic dysfunction is, what it really means. Then we get into some of the systems issues, which is like, why have we got into a place where almost every American is metabolically dysfunctional, literally 93%.

[01:08:15] Like why has that happened? We unpack it because I think it’s important to understand the context we’re living in. And then the second half of the book is just like. exactly how to understand and fix it. So the biomarkers that you need to ask your doctors for to understand your metabolic health, they’re cheap, they’re easy, which wearables actually have value, which don’t.

[01:08:34] optimal ranges, not just normal ranges. You will understand deeply what triglycerides mean, what uric acid means, and it’s not that complicated. And then all the pillars that we can basically impact in our life that affect our mitochondrial health and metabolic health and the simple evidence based strategies to improve those pillars.

[01:08:54] Often it’s totally free. And so how to basically focus your arrow on what matters and And then [01:09:00] there’s 30 Recipes, and there’s a four week plan for improving metabolic health. I hope that people just really, that it absolutely changes their life and makes them feel more empowered and more like the miracle that they are.

[01:09:12] LM: You packed a lot into that book, and I can say I’ve personally seen you pour your heart and soul into it for a really long time, and you’re so mission driven, and I just admire the change that you’re trying to make in the world so much. Thank you. Thanks, Liz. Thanks for coming on. Thank you. I had so much to ask Casey about ozembic, metabolic health, and weight loss, and I didn’t want to cut any of the answers that you need to hear.

[01:09:37] So I never do this, but I split this episode into two parts. Make sure that you’re following the podcast wherever you like to listen on. For part two next week, we’re going to get into the exercise, nutritional, and lifestyle support strategies that you can implement for greater mitochondrial efficiency, the role that hormones play in weight management, and how we can impact our hormones to impact our weight, the debate [01:10:00] on weight loss drugs for children, Ozempic’s role in the addiction crisis, how Ozempic and metabolic health are hugely impacting our fertility.

[01:10:09] Trust me, you do not want to miss that part of the conversation and so much more. So I will see you next week for all of that. That’s all for this episode of the Liz Moody Podcast. If you love this episode, one of the best ways that you can support the pod is by sending a link to your friends, your family, your partner, your coworkers, you name it.

[01:10:30] You’re helping grow the podcast and you’re helping the people you love change their lives. If you’re new to the podcast, welcome. I’m so glad that you’re here. Make sure that you’re following the podcast on whatever platform you like to listen on. You’re going to go to the main podcast page. That’s the one that lists all of the Liz Moody podcast episodes, and you will see the word follow under the logo on screen.

[01:10:51] Spotify, and then there’s a little follow with a plus sign button on the top right of that same page on Apple Podcasts. This way you will not miss out on any new [01:11:00] episodes. They’ll appear right in your feed every single Wednesday and every single Monday. Okay. I love you and I’ll see you on the next episode of the Liz Moody podcast.

[01:11:14] Oh, just one more thing. It’s the legal language. This podcast is presented solely for educational and entertainment purposes. It is not intended as a. Substitute for the advice of a physician, a psychotherapist, or any other qualified professional.

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