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Katie: Hello and welcome to The Wellness Mama Podcast. I’m Katie from wellnessmama.com, and this episode is all about metabolic dysfunction as the basis reason behind practically all ailments and classes from the biggest glucose knowledge set on the earth. And I’m again with return visitor Dr. Casey Means, who’s a Stanford-trained doctor and the CMO and Co-Founder of the metabolic well being firm known as Levels. Her mission is to maximise human potential and reverse the epidemic of preventable persistent illness by empowering people with tech-enabled instruments that may inform sensible, personalised, and sustainable dietary and life-style selections. Her perspective has been featured in all the things from Wall Street Journal to the New York Times and far, way more.
And we get to go deep on this matter in the present day. She actually explains tremendous comprehensively what metabolic dysfunction is and the markers that go into that. The 5 handiest and least costly checks you will get to get a superb image of what’s occurring metabolically in your physique, how glucose is an effective metric right here as effectively, and how one can use it to your benefit, and a lot extra. We speak about very actionable takeaways that everybody can do even with out the information to begin enhancing metabolic well being, in addition to what to do if you’ll be able to get extra personalised knowledge by yourself physicality and what’s occurring and how one can use that to your benefit. She is so well-spoken and such a wealth of information. And like I mentioned, we get to go deep on lots of this in the present day. So, with none additional wait, let’s leap in with Dr. Casey Means. Casey, welcome again. Thanks for returning to the podcast.
Casey: I’m so pleased to be right here. Thanks for having me, Katie.
Katie: Well, I’ll hyperlink to our first dialog for anybody who hasn’t heard it already, however I do know we obtained to go deep on the subject of glucose, particularly in blood glucose, what we will be taught from it. And I’m excited to construct on that dialog with the entire new data out there. I do know you guys have an incredible dataset that I imagine is the largest on the earth on this matter. And there’s a lot we will use this actionable knowledge to essentially affect our lives in a constructive manner. To begin off, I do know that one of many questions I requested in prep for interviews is in the event you had been going to present a TED Talk in every week, what wouldn’t it be on? And I like your reply since you talked about how underpowered cells, or principally metabolic dysfunction, is commonly the basis of practically all illness within the trendy world. And I do know that is why you’re so passionate in regards to the work that you just’re doing with Levels, however I might love to make use of that as a jumping-in level for our dialog in the present day. If you can clarify somewhat background by what you imply by that, and possibly a number of the elements that come into play with metabolic dysfunction and the way that may exhibit in several methods in our lives.
Casey: Yeah, completely. So, the message that I actually… My objective in life actually to get throughout to folks is this concept that so lots of the issues we’re battling in our world in the present day, within the trendy industrial Western world, so lots of the ache factors dealing with our lives and the signs that we’ve got that then result in extra critical situations down the highway are basically all linked by the identical physiology, which is this concept of underpowered cells, primarily metabolic dysfunction.
We’ve been listening to much more about this idea of metabolism and metabolic well being, metabolic dysfunction, blood sugar management over the previous couple of years, and it’s for good cause. And it’s as a result of what we’re actually studying is that the important thing causes of morbidity and mortality within the United States in adults for certain, however even now extra so in kids, is metabolic dysfunction. And so, metabolism is how we convert meals vitality to mobile vitality in our our bodies. We have 37 plus trillion cells in our physique, and all of those trillions of cells each second collectively are doing trillions and trillions of chemical reactions. And principally, our life and our well being is the effervescent up of all of those chemical reactions. And all of them principally must be paid for. All these chemical reactions must be paid for with mobile vitality.
And zooming again to highschool biology, that mobile vitality is ATP. It’s this molecule that principally is how we pay for all these mobile reactions. And that vitality, that mobile vitality, is produced from meals being transformed to mobile vitality. And this idea of metabolic dysfunction principally is that we’re having an issue proper now in our our bodies changing that meals vitality to mobile vitality, which signifies that we principally have underpowered cells. The cause that’s the basis of so many situations that we see in the present day that typically appear totally different, prefer it’s typically, you realize, it’s complicated to be like, effectively, how is Alzheimer’s dementia basically the identical or much like kind 2 diabetes or infertility or erectile dysfunction or stroke or coronary heart illness or retinopathy or persistent kidney illness or persistent liver illness or gout or despair or anxiousness. Well, the truth is all these situations we all know now are both attributable to or accelerated by underpowered cells metabolic dysfunction. So, the explanation for that is that we’ve got over 200 cell varieties in our physique. And what’s attention-grabbing is that every one these cells, after all, got here from one cell, a fertilized embryo, and became 200 totally different cell varieties. And that’s cell varieties in our eyes, cell varieties in our brains, cell varieties in our blood vessels, there’s all these totally different cells, however all of them want vitality to perform correctly. And so, when you will have a elementary drawback occurring all around the physique, a extremely core elementary physiologic challenge like metabolic dysfunction, primarily the issue in changing meals vitality to mobile vitality, it may possibly seem like nearly something relying on what cell kind it’s displaying up in. So, if it’s occurring in a blood vessel, it might seem like a blood vessel associated challenge like coronary heart illness or stroke. If it’s occurring in a mind cell, relying on what kind of mind cell that’s, it might seem like Alzheimer’s dementia, fibromyalgia, despair, anxiousness, migraine, all situations we all know are linked to metabolic dysfunction. If it’s occurring in ovarian theca cell, it might seem like polycystic ovarian syndrome, the main reason behind infertility within the United States, which is a metabolic illness. If it’s occurring in a blood vessel of a penis, it might seem like erectile dysfunction. So principally, it’s a core physiology, a disturbance displaying up in all these totally different cell varieties, trying like all these totally different ailments. But what we basically want to comprehend is that these are branches of the identical trunk. And in medication in America in the present day, we’ve got to begin treating the trunk of the tree versus what we’re doing proper now, which is actually taking part in whack-a-mole with all these totally different branches. And we’re not likely getting very far.
And so, we’re coping with this huge challenge proper now within the United States the place folks, Americans, are getting sicker yearly. Chronic illness charges are going up for nearly each main illness yearly. And that is despite the truth that we’re spending more cash on healthcare yearly as people and as a rustic. We’re spending over $4 trillion on healthcare yearly. That quantity is astronomical. It’s 20% of the biggest GDP in the complete world in human historical past. And as we spend extra, illness charges are going up, and life expectancy goes down. So that’s the definition of it, principally an ineffective method and an unsustainable method. And so, my actual thesis that I really feel that’s actually my goal to share and why it could be my TED Talk is as a result of I feel the explanation we’re seeing these dynamics is as a result of we’re basically approaching the flawed drawback. We’re basically approaching every illness as if it’s a separate siloed factor when actually needing to concentrate on the basis trigger and the factor that connects these ailments, which is metabolic dysfunction.
And it’s one thing that, up till lately, we haven’t actually been ready, we haven’t actually recognized it as a result of the science has come a great distance over the previous 50 to 100 years. We used to have the ability to characterize ailments primarily based on the signs that emerge. And after all, in the event you’re signs as a technique to outline illness, sure, liver illness appears to be like totally different than Alzheimer’s illness, and that appears totally different than gout. So, after all, we deal with it in a different way. But now by genomics and cell signaling evaluation and proteomics and all this stuff that we’ve type of, we now are in a position to actually see contained in the cell extra on a analysis degree. We now know that there’s truly this core physiology that’s resulting in lots of these trendy ailments. And we have to principally modernize the way in which that we deal with primarily based on that understanding. But it’s fairly extensively recognized that it takes nearly 20 years for analysis understanding to make it into scientific observe. And we’re in that messy center proper now the place the science is healthier understood, however we’re not treating that manner. We’re nonetheless treating reactively the signs, and that should change. So, sufferers, I feel, want to essentially empower themselves to know this unifying metabolic idea of illness and work to each perceive and enhance their metabolism in order that they will have their absolute best well being and thrive.
Katie: Yeah, I agree. It’s so vital. And this modification that we’re seeing in healthcare and the way folks, such as you talked about, we’re getting sicker annually regardless of placing more cash sources towards this, regardless of growing consciousness even in some methods about this. And for me, studying the statistic that, for the primary time in two centuries, the present era of kids can have a shorter life expectancy than their mother and father was so staggering. That was a big a part of why I began with Wellness Mama and why I’ve been on this world for 15 years now’s as a result of that stat to me is unacceptable for our children. And I really feel just like the work you guys are doing can be very impactful in serving to change that statistic, particularly now with, as we talked about in our first episode, there may be higher entry to issues like wearable knowledge, to understanding our glucose, to having the ability to run labs, even when we don’t have a health care provider who’s completely aligned in our space. There’s a lot entry, but in addition that may turn out to be overwhelming whenever you get knowledge however you don’t essentially know how one can make it actionable. So, I like that you just guys are placing all these items in place to make knowledge actually actionable for folks. And I’d like to delve into that as a result of I do know you’re additionally now ready to take a look at biomarkers in a really particular manner in methods which are very impactful, particularly when paired with glucose to create measurable adjustments in folks. So, I might love so that you can break down at what you’re discovering on the biomarker degree and what folks can be taught from that knowledge that they’re in a position to now get individually.
Casey: Absolutely. So, you realize, our mission at Levels is to reverse the metabolic illness epidemic. And that’s why we began the corporate. Our actual perception is that to reverse this monumental pattern we’re seeing in metabolic dysfunction, the 1st step is folks want to know their very own degree of metabolic well being, after which they’ve to know how one can enhance it. And sadly, lots of that’s not coming from the medical doctors for the explanations we talked about. We’re simply behind. An unbelievable statistic is that, however that has primarily been proven in two impartial analysis research over the previous 4 years, is that over 90% of American adults now have at the very least one biomarker of metabolic dysfunction. That was 88% about 5 years in the past. And then, as of analysis from a few yr in the past, that’s gone as much as 93.2%. And so, this isn’t a fringe challenge. This is affecting nearly everybody. What is so, I feel, vital for each particular person is to determine if they’ve any biomarkers of metabolic dysfunction that they want to pay attention to. And so, what we’re doing at Levels is aiming to democratize entry to that knowledge as a result of it may be typically really feel like pulling enamel throughout the healthcare system to attempt to get scraps of data. But my perception is admittedly that everybody strolling round ought to be capable to say with certitude, I’m or I’m not metabolically wholesome, and I do know what I have to do by way of my eating regimen and life-style to work on this and to get this in the proper path.
So, we do that in two methods at Levels, each of which I feel are actually vital and which I hope the healthcare system will undertake as a part of mainstream. One is blood-based biomarkers. So, these are single time level measurements that get drawn out of your blood that principally inform you a really clear snapshot of a pillar second in time, that is how I’m doing with metabolic well being. And then the second piece of data that we give entry to is steady glucose monitoring. So that’s a sensor that you just put on on the again of your arm that tells you truly, 24 hours a day, seven days every week, what’s occurring along with your blood sugar ranges. And the blood sugar ranges are an important real-time biomarker as a result of they’re a readout of how your metabolic well being is, as a result of in case your metabolic well being is dysfunctional, in case your cells are having issue principally with that food-to-cellular vitality conversion course of, then what’s going to occur is that the cell is actually going to dam glucose from coming into it as a result of it’s primarily overburdened. It can’t do this course of effectively of changing meals vitality like sugar to ATP. So, the cell blocks the entry of glucose, of sugar into the cell. That’s insulin resistance. And blood sugar ranges will rise.
And so, blood sugar is that this superb biomarker that may inform us like a readout of whether or not there’s issues with metabolism within the physique. And by monitoring glucose in real-time on this extra steady movie-like manner, you can begin to see which meals and which life-style habits are both inflicting large swings and fluctuation in glucose or holding it extra steady. And finally, we wish to maintain it extra steady and in a low and wholesome vary as a result of that’s an indication that metabolic well being is being supported. And so, combining these pillar blood-based biomarkers to present you a way of that is how I’m doing total by way of my studying the tea leaves of metabolic well being with my blood-based biomarkers. And then a real-time software like a glucose monitor that’s providing you with real-time biofeedback on particular person decision-making to maneuver in the proper path. Those two collectively, I feel, are primarily transformational in each realizing the place you stand and realizing how one can enhance.
So, by way of blood-based biomarkers, there’s numerous totally different checks that can provide you want a clue of metabolic well being. The manner I have a look at it’s that there’s in all probability like eight to 12 checks that collectively a extremely seasoned metabolic health-focused physician might have a look at all of them together and once more, like learn the tea leaves and form of, so I’d say like that checklist could be fasting glucose, hemoglobin A1C, fasting insulin, triglycerides, HDL ldl cholesterol, uric acid, ApoB, hs-CRP, an inflammatory marker, and definitely liver perform checks. So, like AST and ALT. And there’s one other check I actually like known as GGT, which is a liver perform check that truly tells you about oxidative stress. So, in the event you can provide me, like, after which having blood stress, not a blood check, however blood stress and waist circumference as effectively, these can provide you one other sense. But these 10 checks or so collectively, in case you have all of them and might have a look at all of them collectively, you’ll be able to just about say whether or not somebody’s obtained an issue with metabolism or not. What we did at Levels is we took 5 of these checks, which is insulin, ApoB, triglycerides, uric acid, and hemoglobin A1C, and we labored with our medical advisory board to say like, okay, with these 5 checks, you will get a extremely clear sign of like, whether or not there’s issues with metabolism. And I’m pleased to speak by the checks like briefly individually if that will be useful.
Katie: Yeah, let’s do this briefly as a result of I might guess most individuals have heard of these checks, or at the very least most of them. But I feel the relevance to metabolic well being is admittedly vital to focus on. And a few of them are usually not frequent on lots of simply panels that somebody maybe has had run earlier than by a health care provider.
Casey: Yeah, yeah. So, I’ll begin with fasting insulin. So fasting insulin, I might say, might be crucial metabolic well being you will get. If somebody mentioned you must get one check, I might say it could be fasting insulin. The cause for that, so insulin is the hormone that’s launched when blood sugar rises. Insulin principally binds to the floor of a cell to the insulin receptor after which permits glucose to enter the cell in order that it may be processed by the mitochondria into vitality. If there may be extra, that glucose will usually be saved as fats. We talked somewhat bit about this, however when the cell is overburdened, and the cell has metabolic dysfunction, which usually means the mitochondria is struggling to maintain up with the inflow of glucose and convert it to vitality, the cell will put a block up known as insulin resistance, which primarily blocks that insulin sign from permitting glucose into the cell as a result of the cell is overburdened. The cell can’t course of extra of that glucose, so it blocks it from coming in, and that glucose will then rise within the bloodstream.
So, the explanation fasting insulin is such a useful check is as a result of it’s primarily displaying you from a extremely early stage that the cells are overburdened. There’s in all probability mitochondrial dysfunction occurring. That metabolic conversion course of will not be working correctly, and the cell is placing a block as much as glucose coming into. The manner the physique responds in a short time is by releasing extra insulin into the physique to attempt to overcome that block. And that appears like rising fasting insulin on a blood check. And the explanation I feel that’s truly much more useful than testing a fasting glucose degree, the blood sugar, is as a result of the physique truly, in releasing that extra insulin to beat insulin resistance, it may possibly truly overcompensate for a very long time. And by pumping out numerous extra insulin, it may possibly truly pressure the cell to push the glucose into the cell, though the cell’s principally saying, we don’t need it, we will’t deal with it. And there’s been attention-grabbing analysis displaying that insulin resistance could be brewing within the physique, and fasting insulin could be rising for over 10 years earlier than fasting glucose rises. And in order that’s a time of compensation the place the physique is principally churning out extra of this hormone, forcing the glucose into the cell earlier than you truly see a change within the glucose ranges. So that’s a window the place we might catch early insulin resistance the place the fasting glucose check will not be going to choose it up. Unfortunately, we don’t check fasting insulin in our standard medical observe. It’s a check you must actually request specifically or get outdoors the system. And there’s lots of cause for this, nevertheless it’s one among, I feel, the largest blind spots in medication proper now. We’ve obtained a state of affairs the place 50% of American adults now have pre-diabetes or kind 2 diabetes, that are each situations of insulin resistance. And we’re not testing for the earliest marker of insulin resistance. It’s so, so, so unusual. So that’s one which I might say ask your physician for it or get it by a particular lab outdoors the system. It’s crucial.
The vary that, then there’s a second challenge, which is that even in the event you get the check, lots of the labs will report these ranges which are actually lenient. And they’ll principally say on a lab slip that something lower than 25 milli use per milliliter is taken into account regular for a fasting insulin. But primarily based on our greatest evaluation of the analysis and coordinating with our superb advisory board of metabolic specialists, it truly seems {that a} fasting insulin of about two to 6 is perfect. And actually whenever you begin getting above like six milli use per milliliter, threat begins going up. So first, you bought to get the check, then you definitely’ve obtained to determine how one can interpret the check in somewhat little bit of a tighter vary. But in the event you can see that your fasting insulin is beneath that six vary, within the two to 6 vary, that’s a extremely good signal that your cells are metabolically pleased, your physique’s not churning out extra insulin attributable to insulin resistance. And it’s only a actually, actually useful sign that your physique is working correctly metabolically. So that’s fasting insulin.
Another superb check that goes hand in hand with that, which is a part of our 5 biomarkers that we’ve chosen as triglycerides. So, triglycerides is a kind of fats within the blood. It’s each a storage type of fats, and it’ll be discovered within the bloodstream that’s created when extra glucose is transformed to fats. So, the physique doesn’t need simply tons and tons of additional glucose floating round. It must put the surplus glucose someplace so it may be transformed to triglycerides and saved in fats cells or present in circulation. And so, triglycerides is one other signal that there’s some drawback with how the physique is changing meals vitality to ATP and it’s making an attempt to place it someplace. So, it places it so in the event you begin seeing an elevated fasting insulin and an elevated triglycerides, you’re beginning to see a sign that the physique’s overwhelmed and it’s not processing this vitality correctly.
Hemoglobin A1C can be a extremely useful check as a result of that is truly a snapshot of extra of like a long-term image of how glucose ranges have been. So, hemoglobin A1C is referring to hemoglobin, which is, after all, a part of the pink blood cell that carries oxygen. How a lot of that molecule within the blood has sugar caught to it principally? So, glycation is the method of sugar sticking to totally different molecules within the physique. And when concentrations of blood sugar are excessive, they’re going to stay to issues extra. And we don’t want sugar to stay to issues within the physique. It principally creates like rusting of the physique. And so, hemoglobin A1C is actually a share of hemoglobin molecules within the physique which have sugar caught to them. And we don’t need sugar caught to something, actually. So glycated hemoglobin. And in order that’s expressed as a share. The customary ranges say that we would like our share to be lower than 5.7% glycated hemoglobin. That’s the traditional vary. Anything above that’s thought of pre-diabetic. What we truly in all probability need optimally is between about 5 and 5.4% of glycated hemoglobin. That’s in all probability the healthiest vary. And so, as a result of pink blood cells stick round within the blood for about 90 to 120 days, this share truly offers us a long-term snapshot of common glucose ranges over the course of 90 to 120 days. That’s fairly helpful. It doesn’t give us a lot of a way of what the fluctuations in glucose are day-to-day. That’s what a steady glucose monitor would inform you. But it offers you similar to a worldwide sense of how a lot sugar has been sitting in my bloodstream. So, we would like that share to be decrease.
ApoB is the fourth check that we do. And it is a actually attention-grabbing check. It’s a part of what we name a sophisticated ldl cholesterol marker. It’s not usually examined in customary observe. But everybody’s in all probability accustomed to the idea of LDL ldl cholesterol, which typically we name unhealthy ldl cholesterol. But there’s truly, what we actually care about is how a lot ldl cholesterol is floating across the bloodstream that we all know can contribute to coronary heart illness or plaques or blockages within the blood vessels. And that’s truly extra than simply LDL. First of all, there’s various kinds of LDL, some which are extra more likely to promote coronary heart illness and blockages than others. And then there’s these different molecules like intermediate density LDL and VLDL, very low-density LDL. And so, there’s these totally different particles within the bloodstream that we simply don’t speak about in our customary ldl cholesterol panel. ApoB is definitely a protein that wraps round these ldl cholesterol particles when they’re floating by the bloodstream. And ApoB is the particular protein that occurs to be on all the center disease-promoting particles. So, it’ll be on IDL particles or LDL particles. And so, what it does is it principally offers you a extra full image of what number of particles within the bloodstream are atherogenic or principally pro-heart illness. And so, some medical doctors are favoring ApoB as a extra exact check of how lots of the true unhealthy ldl cholesterol are within the bloodstream and possibly a greater sign than LDL. So that’s why we included it on our panel versus simply LDL ldl cholesterol as a result of it’s extra all-encompassing for different sorts of unhealthy ldl cholesterol.
And then the final one is uric acid. Uric acid is a extremely attention-grabbing check. We usually hear of it in relation to gout, however it’s truly a lot extra broadly related than simply for individuals who could or could not endure from gout. It’s truly a vital cardiac and total metabolic marker. And uric acid could be raised in a number of totally different mechanisms. One is definitely a by-product of fructose metabolism. So, we’re consuming astronomically extra fructose as one among our types of sugars in our eating regimen now than we ever had been in historical past. High fructose corn syrup was invented within the Nineteen Seventies. And since then, individuals are consuming about 3000% extra fructose than we had been previous to the invention of excessive fructose corn syrup. So, we’ve simply had this astronomical rise in the sort of sugar within the physique, which is inflicting large burdening to our programs. And when fructose is damaged down by our cells, one of many byproducts is uric acid. Uric acid can then go on to trigger issues in our cells by truly damaging our mitochondria and promote cardiovascular issues by a number of totally different mechanisms. So uric acid is a sign of extra fructose within the bloodstream, which we all know is simply deeply metabolically damaging. It additionally could be elevated by what are known as purine-rich meals. And so, these embrace animal merchandise like meat, beer, and sure shellfish. And so, excesses in a few of these issues can even result in improve in uric acid. And then alcohol typically can result in will increase in uric acid. But I’d say, typically talking, of the issues which are contributing to excessive uric acid within the common American, I’d say that the massive consumption of fructose within the type of liquid sugars and sodas, vitality drinks, frappuccinos, processed meals, fructose is now actually in all places. And in order that’s an enormous contributor to uric acid. So that’s an indication on a lab check that the eating regimen actually must be like thoughtfully cleaned up. And it’s one that may change quickly with changes in eating regimen.
So these 5 checks collectively can provide us an actual sign of how issues are going metabolically within the physique. And I might say that, these are good to know like each 4 months or so, each quarter principally in the event you can, as a result of if you’re, initially, in the event you’re staying within the optimum vary for all of those checks, it’s an important signal that your cells are powered correctly and the eating regimen that you just’ve chosen and the life-style plan that you just’re following is like working effectively. It’s an important confirmatory sign that no matter plan you’re on, it’s working. And that’s actually reassuring. I feel so many people are so confused about, am I consuming the proper eating regimen? Should I be plant-based? Should I be carnivore? Should I be omnivorous? Like, ought to I do that plan? And it may be so overwhelming. And what I say is, simply check, like check your metabolic biomarkers. And in the event that they’re in an important and wholesome vary and also you’re feeling good, you’ll be able to really feel assured that what you’re doing is working. And in the event that they aren’t in an optimum vary, then that’s an important start line to make some changes after which retest in a couple of months. And in the event that they’re not transferring in the proper path, then you definitely in all probability want to alter your plan once more. Like it’s actually that easy. I’m on the level the place I refuse to argue about dietary dogma or this, as a result of everybody’s totally different. And actually you simply have to know what’s occurring in your personal physique after which make constant tweaks and comply with them over the course of some and do them for a couple of months after which retest. And it’s actually so simple as, is it getting higher? Is it getting worse? Or is it staying the identical? And primarily based on that data, you may make extra tweaks. So that’s why I feel testing like that is so useful. And you are able to do all these checks for $99 and have lots of actually useful details about the place you stand. So these are the 5 that I feel are actually, actually vital to know in each particular person.
Katie: And I like this as a result of I say usually on right here, on the finish of the day, we’re every our personal main healthcare supplier, and we will work with medical doctors and practitioners, however that accountability nonetheless lies inside us. And I really feel like instruments like this assist us to have higher knowledge and higher entry in making selections which are aligned in changing into our personal main healthcare supplier. And I feel, like I mentioned, this knowledge is invaluable, and naturally, could be very far reaching. Like you defined with the labs, these aren’t simply single markers that inform you one factor. These are very far-ranging and can provide you perception into numerous issues occurring inside your physique. And I do know lots of our listeners are girls and mothers particularly. And I do know that one other space this may present up is within the hormone realm, that there could be an affect with metabolic dysfunction and hormone regulation. And definitely, that will be relevant in occasions like being pregnant and postpartum, but in addition, for many individuals listening, the perimenopause and menopause age is an enormous space of shift. And as you talked about these biomarkers, I do know, for example, that girls’s heart problems threat rises once they undergo menopause and that lots of these shifts can result in different issues within the physique as effectively. So, I might love to talk for a minute to the hormone aspect of that and the way these markers come into play with fertility, with hormones, and the way, after all, that pertains to how we feel and appear as effectively.
Casey: Absolutely. Yeah, I feel that it’s so superb. You simply alluded to this reality about that heart problems goes up for girls after menopause. And I feel that that is one other one of many greatest blind spots in medication. Heart illness is the primary killer for girls within the United States, and it’s a metabolic illness. You know, girls are going to, after menopause, girls principally begin to outpace males on lots of the metabolic ailments. So that’s like weight problems, kind 2 diabetes, coronary heart illness, and Alzheimer’s dementia. And but, this isn’t a phrase or a subject that will get introduced up in these medical doctors’ appointments round menopause, and even within the 30s and 40s whenever you’re making ready for this time, when estrogen goes to drop, and that’s going to place you at a lot greater metabolic threat. And so, I’m simply so grateful for platforms like yours which are speaking about lots of this stuff as a result of we’re simply not getting it from the mainstream.
So, beginning, let’s say, within the 20s and 30s within the fertility dialog, it’s so unbelievable how a lot it’s linked to metabolic well being. The main reason behind infertility within the United States is polycystic ovarian syndrome. And polycystic ovarian syndrome, what we perceive is that it’s very a lot rooted in metabolic dysfunction. It truly, the NIH in 2012 was going to alter the title of PCOS to multi-system, a multi-system metabolic endocrine dysfunction. And they didn’t change it. And I feel it truly would have been constructive to alter the title as a result of not many individuals like polycystic ovarian syndrome, it’s onerous to know what meaning. But, like actually calling it what it’s, which is sort of a metabolic hormonal dysfunction, like actually helps folks determine like the place they should method. So, when insulin ranges are excessive within the physique, and we are going to speak about why it could be due to insulin resistance, that insulin truly indicators a cell within the ovary known as the theca cells of the ovary to provide extra testosterone. So, like androgens and what we usually consider as male hormones. And so, when insulin stimulates the ovary to provide extra testosterone, that actually disturbs the fragile steadiness between testosterone, estrogen, progesterone, all of the intercourse hormones which are so finely tuned. So, this, after all, impacts menstruation, it impacts ovulation, it impacts lots of different issues within the physique too, like selling zits and midline weight problems and hair progress, issues that you just may what’s known as hirsutism, which is actually masculinizing options and issues like that.
So, there’s all this stuff that trickle down from basically hyperinsulinemia, excessive insulin ranges. So, there’s been some superb analysis that reveals that like 12-week interventions with girls which are largely targeted on dietary and life-style interventions that concentrate on actually getting the insulin ranges down, so like actually prime quality, low glycemic eating regimen patterns over the course of 12 weeks, can completely remodel the hormone steadiness. You get the insulin down, you get the stimulation of the testosterone down, and lots of the opposite hormones fall into place, signs decline, durations turn out to be extra common. So, there’s lots of hope right here, and the reason for the excessive insulin ranges in lots of these girls, it’s multifactorial. There appears to be a genetic part, there’s simply dwelling in America, it places us in an uphill battle from the life-style perspective due to the way in which that our meals tradition is, nevertheless it’s multifactorial, genetics, life-style, all this stuff, however no matter how a lot it’s weighted in the direction of genetics or life-style or no matter, it nonetheless seems that these interventions targeted on getting insulin ranges down actually, actually assist. So that’s actually constructive. But by some research, as much as 26% of ladies globally of childbearing age are coping with PCOS. So this isn’t a tiny challenge.
And then, as you get in the direction of these perimenopausal years, there’s actually attention-grabbing analysis displaying that principally menopausal signs additionally correlate with metabolic dysfunction. So, menopausal signs like scorching flashes at night time and sleep disturbances and lots of this stuff that actually affect high quality of life, temper. There’s been fairly a little bit of analysis displaying that these actually correlate in lockstep with diploma of primarily blood sugar dysregulation. So, whether or not that’s a trigger or impact, it’s not totally understood just like the causality, however there appears to be a transparent pattern of the more serious the menopausal signs are, the more serious the metabolic well being is. And if we will maintain the blood sugar ranges down and maintain the metabolic well being in verify, the thought could be that this might doubtlessly probably in actual fact affect menopausal signs, though much more analysis must be executed with that. But, you realize, whether or not a blood sugar spike and crash can set off vasomotor signs like scorching flash, like there’s some analysis to counsel that there could be a hyperlink there.
So definitely, any intervention targeted on holding blood sugar in a decrease and more healthy vary, holding it extra steady, might be a possible adjunctive modality to maintain these signs extra in verify. And Dr. Sara Gottfried wrote a tremendous e-book known as Women, Food, and Hormones that talks quite a bit about this and primarily how one can actually prep for menopause by changing into as metabolically wholesome as attainable to hopefully ease a number of the signs that may be so tough.
Women after menopause, like we talked about earlier, type of go off a metabolic cliff. Estrogen tends to be protecting on the subject of metabolic well being. And so, when that drops quickly, insulin resistance does go up. And so, I’m 36 now, and lots of how I take into consideration the subsequent 10, 15 years for me is considering how one can primarily get myself into the most effective form attainable earlier than going into that transition as a result of it doesn’t matter what, regardless of who you’re, there’s going to be a success that occurs whenever you lose that estrogen. So meaning, ensuring my insulin sensitivity is admittedly good by eating regimen, by life-style. It means resistance coaching now as a result of we lose that muscle mass principally yearly beginning in our mid-30s, muscle mass naturally goes down. And muscle is one among our most protecting issues in opposition to principally metabolic dysfunction as a result of muscle is sort of a large blood sugar sink. It takes up and makes use of glucose, takes it out of the bloodstream. And so, it actually helps with insulin resistance. So, if there’s one factor I might say to girls listening who could be heading into that, it’s like, initially, get a full understanding of your metabolic well being, hopefully by blood biomarkers, by your physician or by a lab outdoors of your physician, know the place you stand, be taught methods to get blood sugar underneath management, stabilize blood sugar, which we will definitely speak about. I do know we talked about quite a bit in our first episode collectively. And then actually, begin constructing muscle so that you go into menopause with a extremely good armor on, that’s principally an enormous blood sugar-stabilizing armor. So, that’s one factor that I simply hear a lot with girls. They’re figuring out 5 days every week, however they’re not truly constructing that muscle. And I feel you’ll be able to actually give it some thought as like a defend to buffer a number of the results of the dropping of estrogen in menopause. One of the ladies who’re, one of many specialists who actually will get into this so deeply is Dr. Gabrielle Lyon, who simply got here out with a e-book known as Forever Strong, all in regards to the energy of muscle. And even one thing we haven’t realized till lately is that muscle is definitely a hormone-secreting organ. So, muscle truly secretes myokines, that are principally pro-metabolic anti-inflammatory hormones. And in order that’s only a actually highly effective software, resistance coaching, in the direction of buffering out lots of this.
Katie: I’m an enormous fan of her work and her e-book as effectively. I feel for girls, particularly, it’s such an vital matter together with all of the issues we’re speaking about really as a result of such as you mentioned, these affect all of us, however particularly girls, we’ve got these different elements to think about, particularly at totally different phases of life and hormones. And I really feel like we’ve made such an unbelievable, you will have, an unbelievable and robust case for the significance of understanding this knowledge and utilizing it in an actionable manner. So, I’d like to take a while to see, I do know you will have an enormous dataset of what are the patterns you’re seeing of impactful adjustments folks could make, particularly as soon as they get this knowledge and have entry to understanding what’s occurring of their our bodies. Are there issues that appear typically and universally useful useful resource eating regimen or life-style adjustments that folks could make that may assist transfer issues in a constructive path?
Casey: Definitely. So, it’s humorous. I simply, I used to be telling you earlier than we began recording, like I simply completed my first e-book, which isn’t popping out for a very long time, however I’m sitting right here after ending the e-book and turning into my writer, and I’m like, it’s 380 pages, and there’s like hundreds of references. And I’m like, what, what’s the greatest takeaway from this e-book about metabolism and blood sugar? And I truthfully suppose one of many greatest takeaways except for the plain, which is, like, get the refined sugars and the ultra-processed grains out of the eating regimen, which principally turns straight to glucose within the bloodstream and eat extra entire meals, like that one, type of a given. But the second is like, strolling might be probably the most highly effective superpower that we’ve got for metabolic well being, and we simply don’t emphasize it sufficient. And that to me, prefer it’s simply studying all these papers, all this analysis, all our ranges knowledge. We should be strolling a lot extra as a tradition. So now, the common American is strolling about 4,000 steps a day, which is about two miles. And whenever you have a look at like trendy hunter-gatherer tribes, they’re strolling like 20,000 steps a day. So, like actually 5 occasions extra. And what’s attention-grabbing is that strolling, though it’s straightforward and it nearly looks like, how might that be so highly effective? Basically, the way in which I give it some thought is in the event you’re even strolling 10 ft, you’re activating nearly each main muscle group in your physique. You’re swinging your arms, you’re utilizing your legs, you’re utilizing the large muscle groups of your legs, and even utilizing them at that actually low depth, it’s inflicting all these pathways inside these muscle cells to turn out to be activated. And so, there’s all these cell signaling pathways that primarily carry glucose channels from the within of the cell to the cell membrane if the muscle is activated in any respect. And so, somebody who sits for three-hour stretches, which is lots of us, I imply, like, and doesn’t actually rise up or ever use that muscle, their glucose channels are simply going to be sitting contained in the cell inactive, and people cells are usually not going to be taking on glucose. But in the event you rise up and stroll for one minute each hour, you’re bringing these glucose channels to the cell membrane to take up glucose and use it. So, somebody who’s transferring even for one minute, each half-hour, each hour, their physique all day is principally bringing these receptors to the membrane to carry glucose out of the bloodstream. Now examine that to somebody who sits for like three-, four-hour chunks, possibly will get as much as go to the make a lunch, will get as much as go to the lavatory each few hours, however in any other case they’re simply sitting at their laptop. That particular person, their cells simply aren’t getting primed to take up glucose. And in order that glucose goes to remain within the bloodstream, it’s going to be extra erratic. And let’s say that particular person even goes and does a exercise within the night after work. So, they’ve sat most all of the day, and so they work out for 35 minutes for an hour or no matter. That’s nice, nevertheless it doesn’t change the truth that throughout that whole remainder of the day, inside their cells, their glucose channels weren’t lively. So, we actually have to flip the script from this idea of like exercising is the reply to truly common low-grade motion is a large a part of the reply. Cause it creates a completely totally different physiology within the physique all through the day.
So, somewhat like psychological picture, I would like folks to essentially ingrain is that by setting an alarm in your iPhone each half-hour to rise up and do 5 air squats or to stroll round your condominium or stroll across the perimeter of your home or stroll as soon as across the block. It’s not only for the sake of getting steps. It’s for the sake of really giving your physique an lively sign to alter the cell signaling pathway, to carry glucose receptors, glucose channels to the cell membrane and maintain your physique on this constitutively lively state of metabolism and glucose uptake. Exercising for an hour on the finish of the day will not be going to mitigate the results of sitting all day. And so, yeah, it’s simply each time you progress these muscle groups, it’s really sending a unique sign to your physique. The analysis is fairly profound. Like in the event you, we discuss quite a bit about 10,000 steps, however truly, lots of the analysis I checked out for the e-book, the true magic quantity seems to be 8,000 steps, and 10,000 is nice, and also you may get some marginal profit, however someplace between the 8,000 to 12,000 steps is principally sufficient to cut back your threat of coronary heart illness, kind 2 diabetes, weight problems, stroke, despair by about 50%. So, if you will get a wearable and simply affirm that you just’re strolling at the very least 8,000 steps a day, it’s principally equal to having the best remedy, like ever invented for any illness by way of prevention. Like it’s truly a lot, way more efficient. We don’t have any medicines that cut back threat that a lot for these ailments. So, it’s near a silver bullet.
Another idea, I really feel like I’ve been grappling with somewhat bit is that, you realize, is the idea actually of train nearly like distracting us from transferring extra all through the day? We suppose that the idea of train is this concept that you’ve got this factor in your to-do checklist, and you must test it out off each day, and that can make you more healthy. And sure, train is nice. But America spends extra on train than every other nation on the earth, and we’re among the many heaviest and getting sicker. The common American family spends $2,000 a yr on well being and fitness-related bills, and that quantity goes up over time. We have extra gyms per capita than any nation in the complete world, and we’re one of many sickest and heaviest international locations on the earth. So, there’s some disconnect between the quantity we’re spending on health, the quantity of gyms we’ve got, the quantity of “exercise” we’re working in the direction of, and our precise outcomes. And I feel that disconnect is the truth that we’ve overemphasized this idea of train, and we’ve under-emphasized the idea of simply transferring your physique extra usually.
And whenever you have a look at like Dan Buettner’s work within the blue zones, this is smart. The populations which have probably the most centenarians, the individuals who stay to 100, are the populations who motion is simply inbuilt to their on a regular basis life. Whether it’s farming or strolling lengthy distances to get issues that they want for simply the every day dwelling. And so, this creates an enormous problem for us as a result of now, in America, lots of us are data employees. We work at computer systems. That’s simply the truth. We’re not going to return and all turn out to be farmers, nor ought to we essentially. But what it does imply is we do must get very inventive about our day-to-day lives as a result of simply because we’re data employees doesn’t imply that we will truly cease transferring if we wish to keep wholesome. This may imply standing desk. This may imply treadmill desk. This may imply setting an alarm each half-hour in your telephone and doing these 5 pushups, 5 air squats, strolling round your home or condominium. This may imply having the default for all your calls be strolling conferences. It may imply rescheduling your subsequent few dinner dates or espresso dates to be strolling or mountain climbing dates. It’s simply having to be actually daring and artistic to in some way construct motion into our day-to-day lives as computer-based data employees as a result of there’s actually no manner of getting round it. We both transfer or we get sick. And in order that’s an extended reply to your query. But we actually have to begin getting extra inventive about marrying the trendy world that we’re dwelling with, dwelling in with the truth of our biology, which is that low-grade motion all through the day is completely obligatory and unavoidable if you wish to be optimally wholesome. So that’s a movement-focused one.
We already talked about resistance coaching, which I feel is one other factor, particularly for girls. It’s like gotta incorporate it. I’ve so many conversations with folks, with Levels members who say, “I’m stuck, and I’m not getting the results I want, and I’m doing everything right. I’m eating healthy, I’m sleeping, I’m meditating, I’m working out five days a week.” And invariably, I say, “Are you resistance training?” And they are saying, “No.” So that’s an enormous one. We obtained to construct the muscle.
And then from the meals standpoint, I’d say, one of many greatest sensible takeaways that I’ve seen from our Levels knowledge, and, at this level, we’ve got over 500 million glucose knowledge factors. We’ve had many tens of hundreds of individuals undergo this system and log their meals. And one of many greatest issues I’ve seen is that breakfast, primarily breakfast, could make or break somebody’s day metabolically. So, if there’s one meal you’re going to concentrate on enhancing for you and your youngsters and your loved ones, it’s breakfast. And the explanation I say it’s because what we see in our dataset is that a number of the absolute best scoring issues on our dataset are breakfast, and a number of the very worst, like worse than dessert scoring issues that we see in our dataset are breakfast. And I might assume that on each ends, folks suppose that they’re making wholesome selections. And so, for example, on the unhealthy finish the place we see the largest glucose spikes, it’s issues like, it’ll be folks consuming issues like granola or prompt oatmeal or a chunk of entire grain toast. We know that pastries, like donuts and bagels and muffins, that these are going to be unhealthy, and people are definitely within the excessive glucose spike class. But a few of these extra seemingly benign meals like toast or oatmeal or some cereals that could be low-fat or might sound wholesome like granola. Some of the largest spikes we see in our dataset are these.
And so, then you definitely’ve obtained on the opposite aspect, you’ve obtained some breakfasts that don’t trigger just about any glucose spikes. So, these are issues we see like eggs and avocado, eggs and greens, even eggs and bacon, or eggs and floor beef, frittata, chia pudding. We get lots of people who log what’s known as the fab for smoothie, which is the smoothie recipe that Kelly LeVeque, superstar nutritionist Kelly LeVeque, popularized. She’s one among our advisors. And it’s superb to see how many individuals log that smoothie, however principally, it’s like a really well-balanced smoothie of protein, fats, fiber, and greens and really low glycemic. That scores very well. So, I feel the takeaway for me is that, primarily like, eliminating these meals which have the refined grains or any processed grains in them, cereals, toast, bagels, clearly pastries, muffins, croissants, issues like that. Just these have a tendency to only actually, actually crush folks. Stick with the protein and fat-forward, fiber-forward breakfast. Because whenever you begin your day with a extra steady glucose, what we see is that folks are inclined to maintain the glucose extra steady all through the remainder of the day. And a part of this is because of the truth that in case you have an enormous glucose spike first within the morning, usually what’s going to occur is that you just spike and then you definitely crash. And whenever you crash, that’s usually when folks mid-morning really feel drained and like they want one other cup of espresso and so they may really feel cravings, they want somewhat snack, may even really feel some anxiousness. That’s what occurs when you will have a glucose crash, and people crashes occur usually after a spike. You don’t have a crash after you will have like a low, in case you have a low glucose elevation after a meal, you normally gained’t crash, it’ll simply be extra steady. But an enormous spike normally get an enormous crash. That crash is known as reactive hypoglycemia. And there was a extremely attention-grabbing paper truly in Nature Metabolism final yr, like premier medical journal, that confirmed that the extent of these post-meal crashes, reactive hypoglycemia was predictive of what number of carbohydrates folks would eat in that whole day and the way hungry they’d be that day. So principally, you spike your self and crash your self, you’re going to be craving extra carbs that day, you’re going to in all probability eat extra energy over the next 24-hour durations. So, in the event you can stabilize your glucose for breakfast, you’re setting your self up for like a 24 hours of success and fewer craving. So yeah, simply actually getting the refined grain breakfasts out of the rotation, I feel, is among the absolute best issues you are able to do to begin your morning robust, maintain your vitality steady, and cut back your cravings all through the remainder of the day.
Katie: Those are such superior ideas. I used to be taking notes as you had been talking, and I do know that by Levels, you guys have a selected supply to assist folks be capable to take all that knowledge under consideration as effectively. So that shall be linked within the present notes for you guys listening on the go, that’s, [email protected].
And I really feel like we by no means have sufficient time once we get to speak since you’re such a wealth of information, and we might chat all day lengthy. So maybe we will do one other spherical typically as effectively. But this has been so useful and so actionable. And I like how deep and particular you bought to go on all these totally different subjects that I feel actually could be impactful for everybody listening. So, Casey, thanks a lot on your time. This has been such a pleasure, and I’m so grateful that you just had been right here.
Casey: Oh, it’s completely my pleasure. And as we had been chatting, I spotted that for a number of the biomarkers, I gave optimum ranges, and for some, I didn’t. So, I’ll be sure to ship you the checklist of all of the optimum ranges for all of the checks that I discussed. And possibly these could be within the present notes, however like uric acid and whatnot and all these. So, wish to be sure folks have these, however I’ll comply with up with all of these for you.
Katie: That sounds excellent. And I’ll be sure in addition to hyperlinks too. I do know you guys have an incredible quantity of instructional materials on all of this for folks to continue to learn and that you just launch lots of content material round it as effectively. So, all of these hyperlinks shall be within the present notes, however I’m deeply grateful on your time. Thank you a lot for being right here in the present day.
Casey: Thanks, Katie.
Katie: And thanks as at all times to you for listening and sharing your most beneficial sources, your time, your vitality, and your consideration with us in the present day. We’re each so grateful that you just did, and I hope that you’ll be a part of me once more on the subsequent episode of the The Wellness Mama Podcast.
If you’re having fun with these interviews, would you please take two minutes to go away a score or evaluate on iTunes for me? Doing this helps extra folks to seek out the podcast, which implies much more mothers and households may benefit from the data. I actually admire your time, and thanks as at all times for listening.