Shocking Dark Side of Keto, Intermittent Fasting & Caloric Restriction (& What to Do About It)

Nick Urban [00:00:07]:
Are you

Nick Urban [00:00:08]:
a high performer, obsessed with growth, and looking for an edge? Welcome to MINDBODY Peak Performance. Together, we’ll discover underground secrets to unlocking the full potential of your mind, body, and spirit. We’ll learn from some of the world’s leading minds, from ancient wisdom to cutting edge tools and everything in between. This is your host, Nick Urban. Enjoy the episode. Should you reconsider intermittent fasting, extended fasting, skipping breakfast, going keto, carnivore, or some other form of low carb? Is there a better and faster way to fat loss? What about caloric restriction? Is that the golden bullet to extend longevity and improve insulin resistance and overall health, or are there potential deal breaking drawbacks to all of these? In this episode of the podcast, I’m excited to bring a rather controversial alternative perspective to much of what we learned today about diet and nutrition. Why? Because so much of what we hear these days is really an echo chamber about how all of the things I just listed are essential habits for health and performance and well-being. But while they each have their time and place and use case, there’s more to the story than blanket recommendations.

Nick Urban [00:01:40]:
And in this episode, we’re unpacking a lot of those. Here, we’re exploring the concept of pro metabolism or optimizing your cellular energy production while minimizing the amount of metabolic byproducts and waste you create, why that is one of the keys to long lasting health, the truth around the energetic efficiencies of certain hormones and neurotransmitters, why running and relying exclusively on ketones, at least in the organs that can, might not be everything it’s made out to be. So we go in-depth into brain energetics and how glucose versus ketones work in the brain and which is the actual cleaner burning fuel, how and why restricting calories can actually cause your metabolism to down regulate so that you’re burning fewer calories every day, and they work in spite of the stress, and they work despite the stress. Our guest touches on the potential downsides of omega threes and specifically fish oil. We explore the concept of how there are no so called essential carbohydrates and the difference between a nutrient being essential and something that’s optimal for health and performance. Because if the body can make its own carbohydrates, that shows that it’s an important thing to have. For example, the body has a bunch of redundancies in place to make sure that you’re always able to create carbohydrates. And, sure, you can do that through the process of gluconeogenesis, converting other nutrients into glucose.

Nick Urban [00:03:17]:
But those have some pretty big trade offs, and they’re very inefficient. We talk about one of the surprising but leading causes of death, and that is metabolic endotoxemia. And if you’ve heard of lipopolysaccharides, LPS, how that fits into diet and nutrition, all that and a whole lot more in this episode, which is actually just the first episode in a 2 part series I recorded with our guest. The second part will be out next week. You can find the show notes to this one at mindbodypeak.com/172. So who is our guest? Our guest this week is Jay Feldman. He’s a health coach, independent researcher, and the host of the Energy Balance podcast. Jay has degrees in neuroscience and exercise physiology and decided to forego medical school after realizing that the conventional medical approach was not the solution to the health problems that so many of us face.

Nick Urban [00:04:14]:
After working through various conventional and alternative health paradigms and trialing countless diets, Jay came across the idea that cellular energy is the foundation of our health. Embracing this discovery, he now uses the energy balance approach to help men and women around the world maximizing their cellular energy, optimizing their health, and achieving freedom from low energy symptoms and chronic health issues. If you want to check out his work, and I suggest that you do, you can find the Energy Balance podcast on all major platforms, and his website is jfeldmanwellness.com. For another resource that I found helpful when I started learning about these concepts years ago, you might wanna check out the Ray Peete newsletter archive. He is one of the first people to talk about seed oils and pro metabolism and thyroid and hormone optimization and to highlight a lot of the things that are on the current cutting edge of health and wellness. Now whether you choose to actually implement any of these things for yourself, I’m not suggesting you just blindly believe what we’re saying. Go ahead and dig into the resources in the show notes, and check out Jay’s work because he helped me better understand a lot of these concepts for myself. And although some of the studies he cited were convincing, it wasn’t until I started actually implementing this into my own I added some more carbohydrates, cut down a bit on the fat.

Nick Urban [00:05:41]:
I added some carbohydrates, and I cut down on the dietary fat that I noticed that I look, feel, and perform at a higher level. Stay tuned for part 2 next week. But for now, sit back, relax, and enjoy this conversation with Jay Feldman. Jay, welcome to the podcast.

Jay Feldman [00:05:59]:
Hey, Nick. Thanks for having me.

Nick Urban [00:06:02]:
This will be a controversial episode because you have a platform that dives into a field of study called bioenergetics, bioenergetics nutrition, bioenergetics health. And from what I understand of it, cuts against the grain for a number of different health and wellness related domains. So today, we’re gonna be talking about like, this is my understanding of it, and these are some of the topics. And you can correct me where I’m misunderstanding, like, the key components. I’m interested in getting your take because this is your field of work. But bioenergetics is a pro metabolic, like, metabolism first style of living that emphasizes energy production, efficient energy production with special emphasis on the thyroid, keeping stress levels low, cortisol low, some interest in certain lesser known discussed hormones like progesterone and pregnenolone. You talk about antinutrients and certain foods that may or may not be better choices than others, fasting, intermittent fasting, and even the controversial nature of serotonin and a lot of other things, what would you say are the core principles of all this?

Jay Feldman [00:07:19]:
Yeah. And that’s a great introduction to some of the spicier aspects to things that are a lot more controversial for sure. But there’s a lot of similarities too, with, you know, other health orientations and perspectives. But one of the central places where there’s a difference is in what we view as health and non health and. In other perspectives, we might have, you know, a view that centers around nutrition in terms of a central dogma or a kind of starting place that let’s say animal foods are bad and we’re in a vegan, vegetarian camp or on the other side, plant foods are bad and and we’re more on the carnivore camp or anything, you know, we’re instead the idea that whatever our ancestors did is ideal. Right? And we might be in more of a kind of primal paleo ancestral sort of sort of camp or perspective there. And as I was saying, there’s similarities and differences between my perspective and and these other ones, but coming from a different place. So my the the idea behind the bioenergetic view of health is that the energy that is produced inside of the mitochondria of every cell, we’re talking about ATP, that is the driving force that allows for function and allows for health.

Jay Feldman [00:08:31]:
And when we are in degenerative states, when we’re dealing with symptoms, chronic health issues, whatever we might be facing, those are the result of a lack of energy. And so, you know, basically inefficient ATP production and therefore then a lack of ATP. And so the focus here is adjusting our diet lifestyle and, you know, everything else that goes on in our, in our environment to maximize the amount of ATP we produce. And along with that, minimize stress as well and maximize thyroid function. Those things are kind of secondary or, or effects of maximizing our efficiency and production of ATP. So that’s kind of the central point. And then when we, as I was saying, when we look at nutrition, we would determine how the presence of a certain macronutrient or the absence of another or the presence of a certain vitamin or mineral or polyphenol, whatever it is, would affect our capacity for energy production and saying whether we’re talking about a different, you know, a supplement or sleep or exercise or anything else.

Nick Urban [00:09:33]:
The way I’ve conceptualized this is that, say, you have a city and there’s a storm, energy production suffers a little bit. The city must decide how to divert the resources, the limited energy available, and certain areas will have less energy available. They’ll be throttled. Things won’t work quite as well. You also wanna keep certain vital infrastructure online so they’ll get higher percentages of the energy. They’ll stay online working at full capacity. But then over time, if that was to continue, then the body would start to work less efficiently because the areas that are important to your long term survival don’t get prioritized. They’re the ones that get throttled.

Nick Urban [00:10:14]:
And as a result, depending on your body, your genetics, your epigenetics, your constitution, your biochemistry, whatever you wanna call it, that will eventually present with different symptoms and over the long term as different diseases.

Jay Feldman [00:10:28]:
Yeah. That’s a great way to think of it. Another one that I think a lot of people might know more personally would be something like, a bank account and and looking at income and and, you know, your the amount of money you have and so you if if your bank account value is going down, if there’s less energy available, you have to start cutting on costs and you have to just put that money toward the essentials. And over time, if it keeps going down and you’re still struggling to make more money or have more money in the bank, then even those those initial costs become an issue and you try to reduce those and find lower quality food that you can pay less for or, you know, like lower rent or something like that, And maybe you start to rack up some debt as well and start to take out loans or credit card debt or whatever. And and the same sort of thing happens physiologically where first, if we’re running low on energy, we stop the kind of extra spending, the extra things on the areas that we don’t need to be functioning optimally, like our brain or reproductive function, things that are not immediate necessities in this moment to, you know, make it to the next day. And then over time, even our basic, you know, liver function and digestion and skin health and things like that, those can deteriorate as well as there’s still lack of energy and we have to continue to conserve. So, yeah, very similar analogy.

Nick Urban [00:11:47]:
Let’s rewind a bit and to get to paint a picture of what this looks like. Tell me what you’ve done so far today for your health, your performance, and your bioharmony as it pertains to bioenergetics.

Jay Feldman [00:11:58]:
Sure. I mean, nothing too fancy today. Normally, this would be the time right now that I would be outside and getting some sunlight, so that got skipped today. But, you know, woke up and had breakfast, which I guess could be pretty unique compared to a lot of people, and we can talk about why I would say having breakfast is important, you know? And, yeah. So non fasting, had breakfast, and then, mostly today was spending time, you know, doing some research and and work on the computer and then had lunch, and and here we are. It wasn’t wasn’t anything too exciting. Although I’m sure as we talk about the specifics, you know, having consistent meals, eating carbohydrates, things like that. I’m sure, those will be a bit different.

Nick Urban [00:12:38]:
So We’re gonna get into those. But to illustrate this example, I think describing what you had for your meal or what a typical meal specific breakfast looks like for you, might bring up some ideas of how this could vary from most other approaches to nutrition.

Jay Feldman [00:12:54]:
Yeah. And, you know, every day is a little different. Seasons are a little different and everything. So the caveat is that this is what I ate today is not perfect for me or you or anyone else. This is just what I ate today. In any case, breakfast day was a crustless quiche, so it was, you know, eggs and and a couple of cooked vegetables and chicken that was in there, with some cheese on top and a smoothie alongside that, and then coffee with milk and some sugar in there. So that was breakfast. And then lunch was, a it was actually again chicken chicken breast in, in a soup with some cooked vegetables and chicken broth and, and then some apple and some dried fruit as well on the side and some chips cooked in, in low poofa oils.

Jay Feldman [00:13:42]:
And, Yeah. That was that was launched. There might have been a few other things I’m missing.

Nick Urban [00:13:45]:
Gotcha. Yeah. So we’ll discuss the specifics of actually creating a diet. These follow these principles. Before we get into that offline, we were talking about the concept of hormesis or when you’re doing something stressful, be it exercise, going in the sauna, a cold plunge, eating certain foods, plant foods primarily that are high in antinutrients. The widespread belief is that those exhibit benefits because of the stress they’re creating in the body, and the body compensates or hypercompensates and upregulates biochemical defense pathways and everything. And that as a result, you’re stronger or more resilient as a result of it. And that’s, like, a lot of the popular health topics these days are believed to work because of that principle.

Nick Urban [00:14:35]:
But what you’re mentioning is that it’s not necessarily because of the principle of hormesis. It may be in spite of it.

Jay Feldman [00:14:43]:
Yeah. And that’s a that’s a great explanation there. Right? So the idea with hormesis is we’re causing some amount of stress or damage. And initially, this was investigated using very toxic things like mercury, arsenic, cadmium, pollutants, ionizing radiation. And what they would find is they would provide these things to a cell or to an animal. Normally, you know, eventually, it’d be looking at full organisms and see that it provided it caused some damage, but it also provided some benefit. So maybe there was some, you know, negative effect, but at the same time, maybe there was a reduction in cancer incidence. And so they said, hey, look, this is, you know, they coined this this, name for the the process called hormesis.

Jay Feldman [00:15:24]:
This was back in the 19 fifties, maybe 19 forties, and said these things are actually beneficial. It’s actually good to have a little bit of poison in the right amount in order to make your body stronger and it gets you know, it has stronger defenses and and actually prevents disease. What they found with that initial research was when the whole organism was looked at in all of the disease processes, there wasn’t actually a net benefit. So there might’ve been a reduction in cancer into this cancer incidence in one area, maybe I’d say the liver, but then there would be increases elsewhere. And on the whole, it wasn’t actually providing in that benefit. But anyway, this, that was kind of the start of this concept. And since that point, it’s been a prevailing scientific theory that is used to, to explain the benefits of all sorts of different things that we do. So one of the most well known ones is caloric restriction, which is basically eating less calories.

Jay Feldman [00:16:18]:
And of course that’s stressful, especially when we’re talking about that energy availability and, and not having enough and our bodies then responding and wanting to conserve energy. And so caloric restriction is something that’s pretty well known to extend lifespan in certain organisms and provide various other benefits. And the other things get lumped in this category as well. Like exercise that you mentioned, fasting, eventually low carb diets, cold thermogenesis, various plant compounds. They all end up getting lumped in here because they’re, they share this, these kind of stress inducing pathways and damage inducing pathways with the assumption that we know that some of these things are beneficial, right? We know caloric restriction is beneficial. We know exercise is beneficial. We know there are these beneficial outcomes. So it must be due to this response to the stress that’s being caused.

Jay Feldman [00:17:07]:
It must be due to these adaptive mechanisms. That is the part that I would say is not only inaccurate, but also dangerous because what it ends up doing is equating the. Something like exercise, the benefits that you’re getting from exercise to the benefits you would get from low doses of mercury or arsenic or cigarette smoke or various other interventions. And a lot of people aren’t suggesting that, but the concept they’re promoting is inherently supporting that. Like there is, there is no way of getting around that, that part of the concept. Now, there was some really great research by Hans Celia, who was kind of the father of, of the idea of stress. And he, his research really elucidated what’s actually going on here. And so he identified that everything that we experience has what’s called a stressor effect, meaning it can cause stress, whether we’re running or we’re exposed to mercury or we’re avoiding carbohydrates or eating fewer calories or we’re in the sun, you know, just from sunlight and heat, whatever it is, there is some utilization of energy that can lead to stress.

Jay Feldman [00:18:18]:
Basically, if we use too much energy relative to what we have, our body reacts with stress and it has to accumulate some resources or kind of, mobilize some resources to handle what’s going on. But what Hans Sallier also identified was that there are unique aspects or effects of each of anything we could, could, could experience. And these are called specific effects. So yes, both sunlight and mercury have a stressor effect, but they also have specific effects that are entirely different in terms of our physiology. And, you know, for sunlight that would include things like vitamin D production and increasing dopamine and raising body temperature. Whereas with mercury, it would be things like interfering with mitochondrial respiration and, you know, causing organ damage and things like that. In identifying this, what he basically came to was that the stressor effects are always going to come at some cost, right? There’s always a cost there because we are responding to a suboptimal aspect of our environment, but the specific effects are what can make something beneficial. And essentially if the specific effects can outweigh the stressor effects, then we can end up with a net benefit.

Jay Feldman [00:19:26]:
And if not, then we end up with a net negative. And so when it comes to sunlight, let’s say we’re getting 15 or 20 minutes of sunlight and we’re not burning. So they’re, you know, stress wise, there’s, there’s not so much, we’re not creating much in the way of damage or stress, but we have various beneficial effects of the sunlight. And that’s a situation where this one intervention would be beneficial. Whereas if instead you had an hour of sunlight, or you were to come, you know, then of course the stressor effects would be much greater. And if we were to compare it to something like mercury, the stressor effects are bad and the specific effects are bad. And so we end up with a, a loss loss, you know, lose lose. So what we’re getting at here and what’s and we can kind of, you know, maybe touch on it very briefly in terms of some of the other research with caloric restriction, but the the kind of end summary ends up being that whether we’re talking calorie restriction or fasting or exercise, the benefit doesn’t actually come from the stress that’s being caused, but rather from the specific effects that are are being induced.

Nick Urban [00:20:24]:
Got it. So hormesis isn’t entirely incorrect in your paradigm because it gets right the fact that the dose of whatever it is determines your biological response to it, but it’s not necessarily that the stress that’s caused by whatever intervention, say, sunlight and, say, spending 10 minutes versus 10 hours is what’s causing the benefit? It’s just because you’re not you’re not taxing your systems as much.

Jay Feldman [00:20:49]:
So yes and no. The so the idea of of it being dose based is central to hormesis, but is also, I would say, missing the point, right? Because when we’re talking mercury, there is no dose where it’s actually beneficial. And, and that’s very different from what they’re saying. They’re saying everything has a dose response curve. If you have too much, it’s bad. If you have too little, it’s bad. The right amount is good. And that’s the case with mercury in the same way it is with water.

Jay Feldman [00:21:13]:
And so both of them are working through these hormetic pathways. And so. Even though there is a dose aspect that that alone is not responsible for the effects of whatever substance we’re or intervention we’re talking about. So does dose matter? Of course. And that’s going to affect both the stressor and specific effects, but it is not the only thing. And that’s that is an an important distinction between what my my view and and the hormetic view.

Nick Urban [00:21:40]:
How do you reconcile a lot of the research that exists and is constantly coming out showing that some of the foods to avoid and things that the bioenergetic paradigm recommends avoiding yield tremendous health benefits in certain circumstances. And, of course, if we think it’s the fish oil that’s causing the reduction in inflammation and it’s yielding all these great changes, it might not actually be the fish oil, but something else inside of it or something else entirely that how do you reconcile all that?

Jay Feldman [00:22:10]:
Yeah. So when it comes to looking at any study or research, there’s a number of things we need to consider. So one is what is the actual outcome we’re looking at? For example, if our outcome is LDL levels and we’re using that as a proxy for heart disease, well, there’s a lot of steps in between those things. And just because we increase LDL doesn’t necessarily mean that we’re increasing the risk of heart disease. And so just because you consume polyunsaturated fats, whether we’re talking omega sixes or omega threes and it lowers LDL and and lipids in the blood, does that actually mean it’s going to translate to reduced cardiovascular risk? And so that’s one aspect that we need to consider. Another one is how are we actually getting that effect? Because the mechanism through which we do it can often give us insights as to how relevant the findings are. So if we wanna stick with this example of of lipids and and polyunsaturated fats, when we consume omega threes, they do lower lipids in the blood. The way that they actually do it is by creating oxidative stress inside the liver that prevents the export of fat into the lipid carriers, into the blood.

Jay Feldman [00:23:12]:
So you don’t have VLDL secretion or the VLDL secretion is decreased when you introduce the omega threes because of the oxidative stress inside of the liver. If we just look at this outcome, this marker of VLDL or LDL, we are missing how we’re creating it and the way the mechanism is important because that would raise some questions. Right? That might raise some at least yellow flags that just because we’re changing this marker, a, doesn’t mean we’re changing the actual outcome we’re looking for, and b, the way that we’re doing it is pretty suggestive that this might not be such a good thing. So that is one aspect of it is the outcome. But then another, you know, is is the methods that are done in the research and the the the mechanisms that we’re talking about. So if we come back to caloric restriction, which is something that pretty much is one of the most universally agreed upon interventions for improving health and lifespan. And if you look at the vast majority, pretty much all, nearly all, not not every, but most of the studies looking at caloric restriction, they’ll say, it’s extremely beneficial. It improves metabolic health and and disease risk and it improves, you know, increases lifespan.

Jay Feldman [00:24:23]:
And to break that apart takes a lot of, of nuance because we have to trace back to where that’s starting and then how it’s building. Because we have to keep in mind as well, when we’re building something on, let’s say hormesis and we’re taking the assumption that a bit of damage is good, and then we, you, we provide some intervention that causes a bit of damage and we’re assuming it’s good because of that, we’re building on, on multiple prior assumptions. And so in the case of calorie restriction, a lot of it is coming from animal models that are not particularly relevant to us. So a lot of it is, at least the original research was done on C. Elegans, which was a nematode, a tiny microscopic worm. And what they would do is they would find that any form of stress, whether it’s caloric restriction or overcrowding, you know, if there’s too many in in a small area causes stress that extends the lifespan. And you could see that and say, oh, that’s that’s great. We should be doing those things, right? We should be creating some stress from pretty intense stress for us, you know, consume 20% fewer calories than you need to so that you can live, you know, 20% longer.

Jay Feldman [00:25:24]:
And when you look at how it’s done, it really provide, you know, brings up some question marks in this case. One of the main ways through which C elegans lifespan gets extended is that as it’s developing, it enters into what’s called a dower phase, which is essentially a suspended hibernation state where the nematode doesn’t grow. It just kind of, really lowers its metabolic rate significantly and doesn’t it kinda like gets hard and and hibernates. I mean, just just like you would imagine hibernation. And then eventually it’ll it’ll enter out of that phase and and go through its life. And so if you look at the total amount of life that it was alive, it’s longer, but a huge portion of that is coming from this hibernation state that’s induced by stress, by a poor environment. So would we assume that that’s going to translate to humans? I mean, that’s that’s a pretty big leap. And also there’s an inherent cost there, which is when they’re in this hibernation state, they’re not functional at normal capacity, they don’t move, they don’t, can’t reproduce or anything like that, and you do end up seeing parallels in humans, which is if we restrict calorically, we do turn down a lot of different functions and that’s that there’s a cost there.

Jay Feldman [00:26:34]:
So might there be lifespan expense extension based on that study? Maybe, but there might be a huge cost and also we don’t hibernate in the same way as these nematodes, so that would need to be considered. You know, when we look at other studies, and there’s there’s a ton of different studies on rats looking at this, I’ll just kind of highlight a couple, maybe one in rats and one in in primates or one kind of set. So in rats, one thing that they’ll often do is they’ll have one group that’s fed ad libitum, which means they’re given free access to food as much as they want, and another group that’s calorically restricted. And they say, hey, look, this calorically restricted group, they weren’t obese, they lived longer, you know, they’re, they’re doing way better. And what they actually find is that there was not actually any benefit to the caloric restriction. There was just a negative to the ad libitum feeding, meaning that these rats are being given access to basically purified diets of starch and sugar and, and, you know, just not real, you know, seed oils, basically all kind of mixed up in a chow and they’re free to eat as much as they want. And due to the nature of the food, you know, dysregulated hunger signals, lots of weight gain and. Impaired health.

Jay Feldman [00:27:38]:
And then as a result, shorten lifespan, and they say, hey, look, if you if you restrict the calories, they’re better. And the reality is that this is just known to be a feature of ad libitum feeding, and if you feed them a quote normal amount that won’t cause the weight gain, then and you compare that to calorie restriction, there’s not actually a benefit. There’s a number of other kind of confounding variables there, but one that I wanna mention that’s really parallel that has been done in primates is they’ve looked at they’ve had these studies where they’ll have primates and they’ll give them a calorically restricted diet and see they that they live longer. And then following that, there were some studies that looked at this in 2 different groups. They basically had one study where the the primates were given a similar diet to the rats. Right? They’re given a fuel a fully purified, you know, fully processed diet. And they looked at them on a normal diet versus clerical restricted and the clerically restricted group did better. They then had a different group, which was fed a normal whole food diet that was appropriate to the animal.

Jay Feldman [00:28:37]:
And they had a clerical restricted group and a not clerical restricted group. And there was no difference. There was no extension in lifespan. So these these examples just point to point to a few of the confounding variables that we have to consider when we’re interpreting research. And it’s difficult because those things take time and nuance and and exploration. It’s also maybe part of the fun of it, at least for me. But we it’s also reason to to be very cautious about just taking the conclusion from a study or the conclusion that someone is making based on a study without those details. And that’s not even starting to talk about other issues in research, like issues with replication of, of data.

Jay Feldman [00:29:17]:
Like a lot of, a lot of studies are not replicable, replicable, meaning that they’re not actually creating a reliable result that we can then do again and and find the same result. There’s obviously a lot of, influence when it comes to research from industry because it has to be funded somewhere, somehow, somewhere. So when there’s money involved, there’s interest involved and that’s something to consider, not in every study, but in a lot, you know, especially pharmaceutical pharmaceutical based studies. Right? If they’re looking at medications, there’s money and incentive involved to show that whatever medication makes a lot of money is looks better. So, and there’s ways that they manipulate the way the study is done to try to get a certain outcome, like changing the dose of the compared medication so that it’s not as effective and using it at a lower dose than would normally be used and comparing it to the, quote, new and better drug just at a at a real dose, things like that. So there’s a lot a lot of possibilities that can interfere with interpretations or or just taking the conclusions of a study at face value.

Nick Urban [00:30:19]:
Yeah. And also reporting, relative risk versus absolute risk. There’s so many different things. And how what about the people who report tremendous life improvements from things such as intermittent fasting? Like, every longevity expert these days recommends some form of fasting with some form of frequency, and you hear all kinds of things from people reversing type 2 diabetes to gut health improvements, to skin clearing up, to better mental clarity. And I know from my own research to contribute those to other things, such as perhaps the mental clarity is coming from an increase in stress hormones, and that’s not necessarily good or beneficial, but it could give you the extra burst of energy. But what do you say when you hear people talking about how intermittent fasting or any forms of these, I guess, more extreme caloric restriction are, like, panaceas for longevity?

Jay Feldman [00:31:15]:
Yeah. It’s it’s a great it’s another really good example. So we talk fasting. There are a lot of benefits that people might experience, and we don’t wanna discount those. Right? That just like we don’t wanna discount the possible, you know, results of a study, but we wanna figure out how and why, and is this the best way to accomplish that with the least negatives and most benefits? And, and I think that’s the, you know, kind of objective way we wanna look at it. And so when it comes to fasting, there’s no doubt that people have a lot of benefits. I would say there are really 3 main areas that we can kind of peg for the, you know, to be responsible for those benefits. The most notable one is, has to do with gut health.

Jay Feldman [00:31:57]:
So when someone is eating an average diet or even a decent diet, the likelihood of bacterial overgrowth or imbalances is really high. And. When that happens and we have excess bacteria consuming the food that we’re taking in and we want to be, you know, digesting and absorbing, those bacteria will produce various toxic byproducts. One of the most well known is called endotoxin or LPS for short, which is short for lipopolysaccharide. This is something that’s pretty well known to be extremely harmful inflammatory to the point that it can be lethal and is responsible for death and severe infection like sepsis. And so what’s been shown is that moderate levels of endotoxin, which is called metabolic endotoxemia, is found in pretty much every chronic health condition you can come up with from diabetes and insulin resistance and obesity to cardiovascular disease and, you know, neurodegenerative conditions. And so most people on a daily basis are essentially being poisoned by endotoxin just from eating the typical food they’re eating that then feeds bacteria and causes turnover and production of of endotoxin, which then gets absorbed. A lot of times the foods they’re eating might also be increasing the absorption of endotoxin by increasing intestinal permeability.

Jay Feldman [00:33:18]:
So that alone can cause most of the issues someone might be dealing with. That alone can be, you know, causing autoimmunity, it can be causing weight gain, it can be causing brain fog, it can be causing joint pain. And so if we’re able to take that variable out, we can have massive benefit. And that’s one of the main ways that people feel better on an intermittent fasting regimen. And that’s, you know, that they’re basically not feeding the bacteria for 1, so there’s gonna be much less endotoxin production. And during that time of much less inflammation, it allows for the bacteria to start to rebalance a little bit. That would be the first one. And that can, again, make a massive difference for someone in terms of how they feel day to day and in terms of weight loss and things like that.

Jay Feldman [00:34:03]:
So So that’d be the first one. You mentioned another one too, which is stress hormones. So when we don’t eat and that, you know, kind of day to day bank bank account is is getting drained, our body reacts with stress. There’s alarm bells going off and it releases the stress hormones, which are typically glucagon, adrenaline, and cortisol. And this happens whether we don’t eat, it happened, you know, it can also happen if we exercise, right? If we’re creating an energy deficit by exercising, we’ll increase those stress hormones so we can provide resources to keep exercising. It’ll happen on a low carb diet. Oh, another example is having coffee on an empty stomach. That’s a good way to increase stress hormones too.

Jay Feldman [00:34:41]:
And when that happens, we can feel really energetic because our bodies are recognizing there’s an emergency and up regulating all of our energy production in that moment so that we can handle whatever’s going on. And that can feel good. It can feel like our brain’s turning on, it can feel like we have a lot of energy, and then a lot of times as well we can feel like then we eat and we feel much lower. Our energy goes down a lot and that’s normally a sign that we were having really high stress hormones and then they’ve decreased. So that can be another reason why someone feels a lot better. And the last one I’ll mention is that a lot of people are dealing with insulin resistance, meaning that they’re not efficiently using the carbohydrates that they’re consuming. And so they might be consuming a decent amount of carbs, but they’re not actually metabolizing them and converting them into energy. When we go to fasting or we go to a low carb diet or caloric restriction, we end up relying more on fat since fat is that backup kind of energy storage or fuel storage that we use when we don’t have as much food coming in.

Jay Feldman [00:35:38]:
And using fat as a fuel can be really helpful when we’re not using glucose well. We’re basically going from very poorly burning glucose to adequately burning fat, and that can provide a lot of relief. We can actually get more ATP. And these three things, these are all specific effects, right? These are all aspects of fasting that are not directly stressor effects. Although I guess one of them is the stress hormones, but the other 2 gut relief and, and the reliance on fatty acid oxidation, Those are specific effects that can be really beneficial, but there is a major cost here. There’s a cost to running on those stress hormones. There’s a cost to clerk restriction. There’s a cost to not eating consistently.

Jay Feldman [00:36:18]:
And that’s coming from that stressor effect where basically our bodies are recognizing an emergency. They’re recognizing famine or starvation to some extent. And they’re responding to that by trying to conserve energy. So short certainly might be feeling a lot better, but as that continues long term, the costs tend to accumulate and our bodies try to spend less and less energy on everything from digestion to brain function to reproductive function to, you know, maintaining musculature and on from there. And so, you know, skin, hair skin, hair, and nails is another really common one as well. So sleep will tend to to, degrade as a as a result. We might notice anxiety. A lot of issues tend to crop up over time, and and that’s because of the accumulation of those stress effects.

Nick Urban [00:37:04]:
I heard Georgi Denkoff mentioning that high stress levels from cortisol, epinephrine, norepinephrine, all those, they are incredibly, like, tissue destructive and to specific tissues such as the brain too, and that was enough to get me to decide to decide to start eating breakfast more often and reducing my fasting window to overnight, basically. And that’s what I’ve been doing for a while, and I noticed that I feel better on it now than I did. Now that I’m more metabolically flexible, I can burn both fats and glucose.

Jay Feldman [00:37:36]:
Yeah. That’s it’s funny that you mentioned metabolic flexibility because most people, like most of us, when we’re being told by someone that we wanna increase our metabolic flexibility, normally the suggestion is have less carbs, do fasting. You need to shift into burning fat. And the irony of that is that most people are already burning fat. What even the most degenerated, whether we’re dealing with type 2 diabetes, whether we’re dealing with cardiovascular disease, those are all cases where fatty acid oxidation is significantly upregulated. And glucose oxidation is the one that’s really failing, where we’re not effectively converting glucose all the way through to ATP with mitochondrial respiration. Typically we’re stuck in just anaerobic glycolysis where we’re converting that glucose to lactate and using it extremely inefficiently while we’re using fat as our major fuel sources, our major energy source. And so, yeah, the the irony of the metabolic flexibility suggestions is that really we wanna fix our glucose metabolism, not the fat metabolism, which is really kind of the default state when we don’t burn glucose well.

Nick Urban [00:38:36]:
Interesting. So if someone is new to all this, they’re following the standard American diet currently, and they want to work on their metabolic flexibility, they should instead focus on making sure they’re able to utilize process and utilize glucose more effectively.

Jay Feldman [00:38:52]:
Right. Exactly. And, you know, the reality is when we’re doing things to support our health, that will be a byproduct. So whether the intervention is walking more consistently or getting sunlight or sleeping more or eating whole foods, you know, if we’re just talking the basics when we’re coming from the standard American diet, all of things, all of those things will help to improve our glucose metabolism. So, you know, the, it might not change the kind of initial intervention so much, but later on, it’ll definitely change whether we’re including carbohydrates and fasting, and things like that because that’s not going to support metabolic flexibility. It’s just gonna shift you deeper into fat burning.

Nick Urban [00:39:27]:
I wanna talk more about the practicals of how to actually implement this, but before we do, we’ve talked about burning different substrates, whether it’s fat or glucose. And for physical performance, athletes have long known that carbohydrates, while not absolutely essential in the strict dictionary definition of the term, they are really helpful key for performance. And it’s from what I’ve learned from your Energy Balance podcast, which is a great listen. I recommend you guys check it out to go deeper and learn about this entire paradigm. It really simplifies and explains a lot as well as covering the science. But how do you explain the difference in metabolism and the output of energy from glucose versus ketones and fat in the body and the brain because that’s one of the most common things that I used to believe and I read, and it seems to be parroted parroted around the Internet that ketones burn cleanly and glucose is a dirty fuel. Therefore, you want your brain to run exclusively on ketones, and you wanna minimize glucose as much as possible even though it’s not really possible. But yeah.

Jay Feldman [00:40:41]:
Yeah. So many misconceptions wrapped up, wrapped up in, in there, where to start. So when we’re comparing the biological context of when we’re mostly relying on fat versus when we’re mostly relying on carbs and fat and ketones tend to go together because essentially we’re only going to have ketones if we’re really depleted in carbs or calories. That’s the only time where we’re going to produce ketones. So as a starting place, it’s really a question of carbs versus fat, especially also because even when we’re fully on a ketogenic diet, most of our energy needs are coming from fat. In our brain, about 60% will come from ketones and the rest will still be from glucose. And then the rest of our bodies, again, most of it is gonna be fat. Really, ketones aren’t used so much in the rest of the body, mostly just in in the brain.

Jay Feldman [00:41:26]:
So when we think about this biologically, the times when we’re mostly relying on fat and some ketones are during periods of intense and extended stress, like famine or starvation, or if we are in a heavily stressful environment environment, maybe we’re doing excessive exercise, like we’re running away from something or we’re battling something or whatever it is, these sorts of times of intensely high energy demands and a lack of energy supply. And when that happens, we rely on our backup fuel, the fuel that we store as our reserves in body fat, which is fat. And then the opposite is when we’re well fed, when we have lots of abundant food available, we’re relying more on carbohydrates, especially in more abundant places and times where you have more carbohydrate based foods available like fruits as an example. Now in that the former state of stress, famine, starvation, while we’re relying on fat as a fuel, that is a time of conservation. Right? We were talking about this earlier in terms of the kind of bank account analogy, but when there’s not a lot of fuel coming in, that’s when we shift toward fat. And it’s also time when we wanna shift toward conserving the amount of fuel we have and the amount of energy we’re using because we’re recognizing that this environment is not supportive of a high amount of output. Right? We don’t have a lot of high quality fuel coming in and we’re relying on our reserves. And that is built into the physiology of how we use fat and carbohydrates.

Jay Feldman [00:42:52]:
So when we’re oxidizing fat, when we’re burning fat in the mitochondria, it ends up providing various signals that encourage the conservation of fuel. It helps us slow down the rate at which the engines are producing energy so that we can conserve the fuel and run on it for longer in comparison with glucose, which is going to be a much higher output and produce a lot more energy, which is great for when we have a lot of fuel available, we’re not in a kind of high stress environment. So that’s the kind of bigger picture context. And then along with that, there are hormonal implications or hormonal effects of using fat versus carbs that further shift us toward more of the kind of starvation state versus the abundance state. And this has to do with certain stress hormones, so when we’re relying mostly on fat, we’re going to be upregulating stress hormones like glucagon and adrenaline and cortisol. And short term, these help us deal with whatever issue we’re facing and they up regulate metabolism. But long term, they do the opposite and they suppress our metabolic rate. They turn down our non important or less important functions, and eventually also encourage us to store as much body fat as we can so that we can deal with the future famine.

Jay Feldman [00:43:59]:
You know, any food that we have, we want to try to store it so that we can survive. And these are basically survival type hormones and they turn down our high output hormones like thyroid hormones. So they turn down the thyroid hormone production and conversion and they turned down the reproductive hormone production, you know, turned down testosterone, turned down progesterone, and, will cause that shift toward more of a hibernation state in the long term. So that’s the big picture context. And then we can dig into the specifics of we’ve got these different fuels, glucose, fat, and ketones, and we’re using them in various amount, you know, varying amounts at different times and in different places like the muscle versus the brain and what are all the differences there. So

Nick Urban [00:44:42]:
That’s great. And I also remember either from one of your podcasts you mentioned it or from Georgie reading that the cortisol levels and someone following a low carbohydrate diet really closely mirror someone with a cortisol dysregulation syndrome called Cushington syndrome?

Jay Feldman [00:45:01]:
Yeah. Cushing’s Cushing’s syndrome. Yeah. Yeah. So the that definitely is the case, especially early on. One thing that’s always mentioned and is, is worth highlighting is that cortisol won’t stay extremely highly elevated for the entire time of someone’s on keto. So there’s normally an adaptation period of about 6 weeks where it’ll be clearly elevated After that, you’ll see less cortisol and more glucagon and, you know, you see some epinephrine as well, but then you really start relying mostly on glucagon, which really has most of the same effects. It still impairs thyroid hormone conversion, still ends up slowing respiration long term, still shifts us to fat burning over carb burning.

Jay Feldman [00:45:40]:
And then eventually, as the stress accumulates, you will start to see cortisol come back up later on.

Nick Urban [00:45:46]:
And then to get into the the other part of the equation, the like, what’s going on in the brain specifically with the different fuels?

Jay Feldman [00:45:55]:
Yeah. So when we compare glucose versus fat and ketones, as I was saying, there’s intricate mechanisms that are inbuilt that act as certain signals. And we’ll start with just comparing glucose and fats since that’s what’s happening in most of the body, and then we’ll we’ll throw ketones into the mix. Because again, if you’re producing ketones, you’re mostly burning fat. You know, the ketones are really just providing some energy for about 60% of the brain or providing 60% of the energy for the brain, whereas most of the body is running on fat. So when we’re comparing glucose and fat, it’s essentially as opposed to this idea of glucose burning cleaner or sorry, burning dirtier and fat burning cleaner. I mean, there’s there’s really no basis for that at all and it’s really largely the opposite. So one of the main things that dictates the efficiency of mitochondrial respiration is the production of different electron carriers, specifically NADH and FADH2, and looking at the ratio between those.

Jay Feldman [00:46:52]:
So when we look at the FADH2 to NADH ratio produced by carbohydrates versus that produced by, by fat, especially at long chain fats, there’s a difference of as much as 250%, where glucose is producing 250% lower FADH2 to NADH ratio relative to long chain fats. And as a result of that, there basically ends up being issues at the electron transport chain with the fat oxidation where you have increased electron drop off at complex 2 and you have some kind of competition between complex 1 and complex 2 for the electronic acceptor ubiquinone. And as a result of the higher FADH2 dot NADH ratio, you end up with basically impaired electron transport on what’s called reverse electron transport and an increased reactive oxygen species production. Along with that, you end up with a much lower NAD to NADH ratio. And the NAD to NADH ratio is basically the primary determinant of how efficiently the cell or the mitochondria is producing ATP and also the speed with which it does it. If you have a low NAD10 ADH ratio, you’re going to have a much slower rate of respiration. And it slows down considerably versus if it’s much higher, you’re going to be running through fuel much, much quicker. And so with the fat oxidation, you end up with a much lower NAD, 10 ADH ratio and as a result, a much slower rate of respiration and also basically you end up with kind of blockages throughout the Krebs cycle that end glycolysis that are responsible for that slowing of respiration.

Jay Feldman [00:48:27]:
So it’s like the the kind of short of it where essentially that ends up with producing a lot more reactive oxygen species relative to ATP production and also at a much slower rate. There’s also differences in carbon dioxide production where, glucose will produce 50% more carbon dioxide than than fatty acids, assuming they’re happening at the same rate. But also when we consider that the glucose oxidation happens at a faster rate, there will be an even higher rate of carbon dioxide production relative to fat. So all all of this is just a mechanism to to signal, to basically say we’re using a lower quality fuel and we wanna burn it slower and and conserve fuel and and have lower our metabolic rate versus the opposite with glucose. So that’s kind of the short of it. And when we look at the brain, it kind of lends further support and then we can also look at the effects of ketones. So the brain can’t use fatty acids as a fuel, can’t use those, you know, kind of long chain fats we’re talking about and really doesn’t use any fats at all. It relies almost entirely on glucose or ketones.

Jay Feldman [00:49:29]:
And the reason for that is exactly what we were just saying, which is that the fatty acids lead to much higher rate of oxygen species production relative to ATP and also at a much slower rate. And those two things can’t happen in the brain. The brain is much more sensitive to oxidative stress. It has very, very high metabolic needs. And so as a result, fatty acids aren’t an option. And that’s why we’re left with glucose or ketones, both of which are used much more efficiently or burned much more efficiently compared to fat. So when we compare those 2, the glucose and ketones, they’re much more similar in the way that they’re used to produce energy, but glucose still edges the ketones out in pretty much every way, which is they still lead to more carbon dioxide production that the ketones don’t, and they also still have a higher NADH to FADH2 ratio or a lower FADH2. NADH ratio.

Jay Feldman [00:50:21]:
And so the difference is much smaller, the difference between glucose and ketones, to the point that ketones are still used pretty efficiently to the point that they can even be used in the brain. So ketones in general are are going to be fine for that, for that need, but when compared to glucose, they’re still not even as, as efficient. Now ketones do have some other effects in the brain that are looked at to be beneficial, although some of which are hormetic. So. And this dovetails in with what we were discussing earlier. So a couple of things to consider is, again, there are hormetic pathways that get induced from ketones and it’s because they do up regulate some level of oxidative stress. There is some rectified species production, there’s lipid peroxides, you know, there’s elevations in markers of oxidative stress at first when using ketones in the brain, then there’s the activity of the defensive pathways, nrf2, AMP Kinase, uncoupling and uncoupling proteins, n AMPT, things that help to increase antioxidants, increase defenses, and restore that n a d ten a d h ratio. And those things are generally looked at as beneficial.

Jay Feldman [00:51:30]:
I would say we won’t have a lot of caution around that, But in the case that we’re dealing with a pretty rough state, you know, we’re we’re dealing with issues in the brain, those things could provide some benefits even though it’s happening through some negative means. Of course, we would prefer to have those benefits without inducing the oxidative stress and damage, especially in a state that’s already dealing with oxidative stress and damage. I don’t think it’s really beneficial at all to be inducing those things. And so the the kind of short of it there is I don’t think those hormetic pathways are actually responsible for the benefits of the ketones. But there are a couple other things to consider. So one is that we were talking about insulin resistance systemically and having issues utilizing glucose and that if we can’t use glucose well and and we can at least use fat well, that’s better than nothing. The same thing is is true with ketones. So So when it comes to to the brain, a lot of people have been discussing how in Alzheimer’s and other neurodegenerative states, there’s some level of insulin resistance and some people are calling that type 3 diabetes.

Jay Feldman [00:52:28]:
It’s essentially the same as what’s going on elsewhere, which is that the brain is not using the glucose very efficiently. When you have a state like that and you provide ketones, there’s going to be a ton of benefit because you’ve gone from very poorly burning of fuel to very efficiently burning a slightly less optimal fuel. And in in a lot of cases, that’s going to to be really helpful. And so that’s, I think, really the main area where ketones are providing benefits. They do have some other specific effects where they help to increase GABA and lower glutamate, which can help a lot in the brain and help kind of with relaxation. And they do have some independent antioxidant effects, like they they can help, to kind of scavenge and and scavenge reactive oxygen species and they can activate some pathways that are beneficial through non hormetic means. So there are some benefits to ketones in a degenerated state. But when we’re talking about optimally using carbs versus fats versus ketones without any issues in the mitochondria, glucose went out very clearly, whether we’re talking the brain, whether we’re talking the liver, whether we’re talking anywhere else.

Jay Feldman [00:53:30]:
And so I think that would be the kind of central point, but there’s, of course, nuance that there’s reason why people might feel better when they’re shifting to fatter or ketones.

Nick Urban [00:53:40]:
Yeah. I don’t wanna get too far off track, but you mentioned several times about increasing CO 2 being a good thing. And I think there’s a misunderstanding of the 2 molecules, oxygen and carbon dioxide, one being good being not being oxygen and CO 2 being this evil waste product. Can you expand upon your thoughts on CO 2 and why you think it’s beneficial?

Jay Feldman [00:54:04]:
Yeah. So as you said, most of the focus when it comes to respiring, like breathing, is on oxygen as being the the kind of one that we need, and carbon dioxide is just being that harmful waste product that we have to clear out. And the irony there is that we need carbon dioxide production in order to use the oxygen that’s coming in. So we need oxygen for sure. It’s necessary to produce energy. But if our cells are not producing carbon dioxide, they actually can’t take up the oxygen from hemoglobin. Basically, there needs to be an exchange there where the cells are producing lots of carbon dioxide and then that leaves a cell and the hemoglobin picks up the carbon dioxide and drops off the oxygen in its place. And so if we want to effectively use oxygen inside of ourselves, which is the whole point of oxygen, the whole point of breathing, we need to make sure we’re producing a lot of carbon dioxide.

Jay Feldman [00:54:53]:
And if we produce less, our our cells, our tissues take up less oxygen. It’s a very sensitive system that that will will vary based on how much carbon dioxide we’re producing. So this is seen, you know, in in various cases. One of, you know, really good example is altitude sickness where when we go up to altitude and we’re not oxygenating as well, we find a lot of benefit from increasing carbon dioxide production. And the primary drug that’s used for altitude sickness is called acetazolamide, and it reduces the breakdown of CO 2, so it helps to increase our carbon dioxide levels so that we can more efficiently use the glucose, which of course there’s less of it at altitude. And you basically see that play out in a in a number of different areas, but that’s kind of the short of it is we need to be producing a lot of CO2 to use the oxygen that’s coming in. There are some other benefits to the CO2 as well. It actually has direct antioxidant effects that helps to inhibit or protect against reactive oxygen species and reactive nitrogen species, and it helps to convert them to less harmful forms and, helps to, yeah, protect us in states of hypoxia and states where we’re not using enough oxygen and actually is really beneficial to have enough carbon dioxide or increased carbon dioxide.

Nick Urban [00:56:09]:
Are you a fan of any of the therapies or protocols or devices that help increase CO2 directly or help you help your body increase CO2 levels?

Jay Feldman [00:56:18]:
Yeah. I mean, if we’re talking about directly increasing CO2, I think some of the things that are normally talked about are, are certain breathing techniques, like Buteyko breathing, bad breathing, and both of those I think are effective ways to increase CO 2, especially if those become if those help to influence our normal breathing practices, I think that that’s great. In general, the things that make it toughest to have enough CO 2 are chronic stress. Right? Things that are shifting us to fat burning over glucose burning, things that are creating increases in the stress hormones that cause hyperventilation and cause left cause us to breathe out CO2. So those, you know, I mean, those are the foundations we want to focus on, but I think Buteyko breathing can be great. Bag breathing can be great. You can get, you know, a CO2 tank and and do, like, a CO2 bath. So that’s not as much breathing it in, but you basically would, you know, there are some of these that you can find where you get, like, a basically, it’s like a big bag that you put your body in and then you fill it with CO 2, but it seals.

Jay Feldman [00:57:19]:
And so you have to be careful with those kinds of things because you can’t breathe pure CO 2. You know, that’s that can be dangerous, but, you can absorb it through your skin, so that’s an option. So there’s times where oxygen is administered, like, kind of like severe emergency states, and they do find that if they add a percentage of carbon dioxide, it’s the the outcomes are way better, way more protective when it comes to heart attacks and TBI and stroke, and altitude sickness. There’s a lot of benefit to inspiring some amount of CO 2, but we’re talking normally a few percent. It’s, I think, like, up to, like, 5%. You can’t I don’t think you can go too much above that.

Nick Urban [00:57:58]:
Yeah. I always wondered because of the Bohr effect why they administer pure oxygen to the athletes on the field. And when people come to the hospital, maybe they don’t. Maybe I’m just mistaken, but it didn’t make sense to me based on, like, the rudimentary understanding I had of it.

Jay Feldman [00:58:11]:
Yeah. I don’t think it’s a good idea. And and they do have comparison studies in those, you know, like in heart attacks and and TBI and things like that showing significant benefit to including carbon dioxide relative to just having pure oxygen. When it comes to, you know, administering that for athletes, I think part of it can be placebo effect. I think part of it also is that pure oxygen stimulates the stress systems. And so that might be helpful in a case where you’re not actually dying or close to dying, but you’re just trying to kind of have more, quote, energy for the moment, then it could help, you know, increasing stress could help in that situation, but definitely not something you wanna do after a stroke or after a heart attack.

Nick Urban [00:58:50]:
But even that case, it seems like it might increase energy, but if it’s a a long endurance sport or something, you wouldn’t necessarily wanna do that because you only have so much burn before your recovery becomes taxed, and you can no longer train after that match or event or whatever it is because you need more time to recover.

Jay Feldman [00:59:07]:
Right. Yeah. But it’s so hard to parse that out. Right? If you’re in that situation, it’s, like, I feel good in the moment. It’s helping acutely. Could that be coming a long term detriment? Definitely. But, you know, is that just from what you did during the game or if you know?

Nick Urban [00:59:19]:
Alright. I appreciate you taking the time to explore these controversial topics with us today. You just listened to part 1 of this miniseries, and part 2 will come out next week. I don’t want you to miss it. So if you’re not already, please subscribe, and that way you’ll be notified when the next part comes out. If you have any questions or comments on the things we discussed, I’d love to hear from you. So go ahead and drop a comment in the YouTube version of this video. And if you found it interesting, I’m sure that you have a friend or family member that could use this information as well.

Nick Urban [00:59:53]:
Thanks for helping me get this information out there. Thank you for tuning in to this episode. Head over to Apple Music, Spotify, or wherever you get your podcasts and leave a rating. Every review helps me bring you thought provoking guests. As always, you can find the show notes for this one at mindbodypeak.com/andthenthenumberoftheepisode. There, you can also chat with other peak performers or connect with me directly. The information depicted in this podcast is for information purposes only. Please consult your primary health care professional before making any lifestyle changes.