How Many Carbs Should You Actually Eat? with Dr. Ben Bikman

Are carbs actually bad for you, or have we been asking the wrong question? In this episode, I'm sitting down with metabolic scientist Dr. Ben Bikman to unpack one of the most confusing nutrition conversations happening right now. We talk about how to know how many carbs your body can handle, why your muscle mass and activity level matter, how carbohydrate quality changes your metabolic response, and why the answer may be different depending on where a woman is in her hormonal life. Ben also explains what happens to insulin sensitivity across the menstrual cycle and after menopause, why fiber matters, how he thinks about food pairing, what a CGM can tell you, and why his perspective on GLP-1 medications has evolved. In this episode: Are carbs actually bad for you? How many carbohydrates should you eat? Good carbs vs. highly refined carbsWhy fiber changes the conversationWhy muscle gives you more metabolic “wiggle room”Carbohydrates, blood sugar, stress, and sleepCan food naturally stimulate GLP-1? More on Dr. Ben Bikman Dr. Ben Bikman is a metabolic scientist and professor whose research focuses on insulin resistance, metabolic health, and the ways nutrition influences human metabolism. He is the author of Why We Get Sick https://benbikman.com/books/ and the upcoming book The Carb Crisis https://link.amazon/B096Jd0u4, which explores carbohydrates through the lens of metabolism and other factors that may influence how our bodies respond to the foods we eat. The Carb Crisis Book: https://link.amazon/B096Jd0u4Website: http://benbikman.com/Instagram: https://www.instagram.com/benbikmanphdFacebook: https://www.facebook.com/BenjaminBikmanPhDYouTube: https://www.youtube.com/@benbikmanTikTok: https://www.tiktok.com/@benbikmanphdX: https://x.com/BenBikmanPhDFor more resources related to today’s episode, visit the podcast episode page: drmindypelz.com/ep371 https://www.drmindypelz.com/ep371 Connect with Dr. Mindy: Join Reset Academy https://resetacademy.drmindypelz.com/reset-academy?utm_source=libsyn&utm_medium=podcast&utm_term=&utm_content=loc-description&utm_campaign=reset-academyWatch the episodes on YouTube https://www.youtube.com/@DrMindyPelz?sub_confirmation=1Follow Dr. Mindy on Instagram https://www.instagram.com/dr.mindypelz/Subscribe to Dr. Mindy’s newsletter https://www.drmindypelz.com/ Disclaimer: This podcast is intended for educational and informational purposes only and is not a substitute for professional medical advice. Always consult a qualified healthcare professional before making changes to your diet, fasting routine, or lifestyle.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Mindy Pelz?

  I want to tell you about something that genuinely moves me. And that's watching what happens when women come together around real health science. There's something powerful that shifts when a woman realizes she's not broken. She's just been given the wrong information. And when she is surrounded by other women who are waking up to that same truth. Wow, it's magic. The healing accelerates. The consistency becomes easier. The loneliness of the health journey just literally dissolves. And that's what I have been watching over and over again, happen inside my Reset Academy, month after month.

• 0:43Mindy Pelz?

  Women who come in frustrated and depleted. They start to find their rhythm. They start to reclaim their energy. And the most beautiful part is they start rebuilding trust with their bodies. Inside my academy, you get monthly trainings, live coaching calls, and an incredible community of women who are all doing this work right alongside you. And I show up every single month with new content, new tools, new ways to explain things. Because your body is always changing and your health education should grow with it. So come join me over there. All you've got to do is find us on resetacademy.drmindypelz.com.

• 1:24Mindy Pelz?

  That's resetacademy.drmindypelz.com. I can't wait to see you there.

• 1:34Mindy Pelz?

  Hey, Dr. Mindy here. And welcome to the Live Like a Girl podcast, where I bring you icons, disruptors, educators, scientists, and doctors that show you what can be possible when you love and celebrate the female body you are blessed to live in. Let's dive in.

• 1:59Mindy Pelz?

  When I wrote Fast Like a Girl, I made a claim that a lot of people did not want to hear. I said that there is a week in every woman's menstrual cycle where her body just handles carbohydrates completely differently. Where that same bowl of pasta that felt fine three weeks earlier now leaves her bloated, foggy, and stuck on the scale. I saw it over and over again in my clinic before I ever put it into a book. Women who could fast easily, glide through keto without a struggle, and then they would hit a wall the week before their period,

• 2:39Mindy Pelz?

  every single month, over and over and over again, like clockwork. So I had to name it. I said, this is real. This is hormonal. This is insulin resistance tied to the luteal phase. And then the internet decided to argue with me. I had wellness influencers, doctors, tell my audience that the whole idea is nonsense, that carbs are carbs, and a woman's cycle has nothing to do with how her body processes them. Yet, every woman will tell you that she craves carbs the week before her period.

• 3:21Mindy Pelz?

  In my strong opinion, that is by design. It's not a sign of weakness. Here's the thing. 70% of all the calories consumed on this planet come from a single macronutrient, carbohydrates. And we still argue about the basic facts of how they behave in a female body. Mix that with some wellness influencers telling women that they need carbs to reduce menopause symptoms, while others strongly state that the path to weight loss during menopause is paved by the ketogenic diet. So today, I want to settle all of this.

• 4:06Mindy Pelz?

  And I want to do it with a person who actually teaches this in a university endocrinology classroom. This is why, once again, I have brought you Dr. Ben Bikman. Ben is a metabolic scientist and a professor at Brigham Young University. And he's one of the clearest voices in the world on insulin resistance. He has authored two books, Why We Get Sick, and now his upcoming book, The Carb Crisis. He's spent his career studying exactly what happens inside the body when insulin stops working the way it should.

• 4:46Mindy Pelz?

  In this conversation, Ben backs up everything I saw in my own clinic with the actual endocrinology behind it. He walks through why progesterone makes the luteal phase a built-in state of insulin resistance. And he makes the case that our carb crisis has less to do with willpower and far more to do with a food system working against us. If you've ever felt like your body inexplicably stops cooperating for one week out of the month, or when you went into menopause, all of a sudden you looked at a carbohydrate and started to gain weight, well, this conversation is your answer.

• 5:30Mindy Pelz?

  It is my true honor to bring you Dr. Ben Bikman. Let's dive in. Well, Ben Bikman, I have to start by just welcoming you back, what I think may be like the 10th time I've brought you on my podcast, because my audience loves what you have to say. So I'm so happy you're here.

• 5:49Speaker 01

  Oh, well, Mindy, there are a few people with whom I feel such a kinship. Really, every time we're visiting, it's almost like I'm visiting with one of my sisters. This is great. I'm glad to be here.

• 5:57Mindy Pelz?

  Yeah, thank you. So in preparation for this podcast, I really dove into my YouTube questions to see where people are getting stuck with carbs. And I feel like carbohydrates are the most misunderstood macronutrient that we have. And you believe that we have a carb crisis, not a sugar crisis. Where do we start to understand if we should be eating carbs or not?

• 6:25Speaker 01

  Yeah, yeah, good question. In fact, it's funny, just as an intro to the answer here. It is interesting to look at how some macros have been so maligned over the decades, like fats, while some have been so embraced. And I'd make the case that we kind of got it perfectly wrong in that regard. Not that carbohydrates are a problem, as I kind of segue into answering the question. But it is, I think, the macronutrient we have to be the most cautious with. Because they're so ubiquitous and they come in so much variety that I don't think it's fair to paint them with the favorable brush that they're often painted with.

• 7:08Speaker 01

  And just to put that in perspective, by some estimates, like the Nutrient Global Database, about 70% of all calories consumed globally are coming from this one single class of macronutrient. And so it is, I think, worth scrutinizing. Despite our obsession with focusing on fat, we eat far fewer of our calories from fat than we do from carbohydrates. So with the question being, you know, how do we eat them? I think that's how you frame it, or how much. I think there are a handful of variables that come into someone knowing how much or how frequently they should be eating carbohydrates, and in what forms. I won't necessarily get into that in this answer.

• 7:51Speaker 01

  But my answer will be a little general in that there are people who can consume much higher amounts of carbohydrates than others and have very little to no consequence. That would be a negative consequence, that is. Whereas there are others who are much more intolerant of them. Part of what goes into that formula would be, the biggest piece of that formula would be how much muscle do you have? And how much are you using it? Where I think it's prudent for people to look at carbohydrates as a fuel. You don't need those carbohydrates for building blocks or for signaling in the body. That's going to be the realm of the fats and the proteins that you eat. Those are going to give you the building blocks.

• 8:35Speaker 01

  Or those are building blocks that you're making, like in the case of, say, cholesterol and all of the sex hormones being built from a single molecule of cholesterol. Well, whether you eat the cholesterol or make it, you know, that's something you need there. But in general, when it comes to carbohydrates, if you're very active, that's a good justification. Where, look at the carbohydrate as fuel. You don't need it as a building block. You don't need it as a signaling molecule, per se, like you do the others, fats and, say, peptides or proteins. But the body can absolutely use it as a fuel. And then beyond athletics, I think more into your realm,

• 9:16Speaker 01

  especially a menstruating woman, a pre-menopausal woman, she can have, within her own cycle, times where she, I would make the case, ought to be a little more judicious and cautious. And because she's a little more insulin resistant, and so there might be a greater consequence to those carbs that are being consumed. And then is it the other period, of course, where she's quite insulin sensitive? And has a lot more metabolic wiggle room. But as much as I've just answered this in the context of metabolic, one of the cases I try to make in the book are the burdens. In trying to identify some of the problem with carbohydrates,

• 9:59Speaker 01

  I have historically really just focused on the metabolic side and that's certainly my strongest background. A person would do well to remember that I'm a metabolic scientist, but I'm capable of reading the literature and to me, there are two other burdens that come with it, which is the anti-nutrient burden, which is a little more relevant to autoimmune conditions. And then there is the chemical burden, which I'm naming that distinct to refer to all the pesticides and herbicides and fungicides that are generally unique to the carbohydrates that we're eating as opposed to, you know, whereas if you look at a comparable amount of calories from same meat, you're going to get those at the level of like a thousandth

• 10:41Speaker 01

  or a millionth of that same, you know, chemical burden or let alone the anti-nutrient burden coming in.

• 10:48Mindy Pelz?

  So let's go to the woman's conversation here in a moment because as you were talking, I was reminding myself that when I put Fast Like a Girl out into the world, I had really studied the glucose and insulin demands of the different sex hormones. And I was practicing different principles of fasting in my clinic and I saw there was a time when women could fast really easy. I was super into the keto diet at that time. I found that that was really easy at times and then other times of her cycle, she couldn't follow fasting or the keto diet at all. And when I saw that trend, I saw that it was the week before her period that she was the most insulin resistant.

• 11:31Mindy Pelz?

  So when I brought that forward in Fast Like a Girl, what has fascinated me is how many people have challenged that concept to the point that I hear some wellness influencers and doctors say, this idea that a woman should have a time to eat carbs and a time not to eat carbs is basically bullshit. Can you, can you explain that to my audience because I still stand by what I brought forward in that book?

• 12:02Speaker 01

  Oh yeah, in fact, I support it as well. And I say this as a professor who teaches endocrinology. Of course, I'm not a clinician and I always have a tremendous amount of respect for clinicians who are on the front lines. They are where the rubber meets the road. I'm the guy, they're the ones who get paid to see patients. I'm the guy who gets paid to answer questions. And that's the beauty of being a scientist. That's my job. But in my endocrinology class, when I teach the female cycle, I make a point, of course, because I'm the metabolic guy of highlighting the role specifically of progesterone. Progesterone is the hormone of gestation. Gestation is a state of insulin resistance. That's one of the physiological states of insulin resistance where the body has become

• 12:47Speaker 01

  insulin resistant on purpose. And so you noting that the, I think you'd said the insulin resistance was highest about a week before her period. That would fall right in that, yes, that would fall right in that luteal phase. And I suspect your audience is much more familiar with this topic than the average individual. But, but just to put the, a very brief version of it, at the beginning of the cycle, she is in her follicular phase. The follicles are growing in her ovaries, waiting for that big, this is the first half of the cycle, waiting for the big estrogen surge, the LH surge, and then one of those follicles will be stimulated to become the dominant and it will actually ovulate and release its egg.

• 13:31Speaker 01

  When that happens, we've now entered into that remaining little structure in the ovary. So that little follicle that was developing, it releases its egg. Now that remnant structure is called the corpus luteum, or technically it's called the yellow body. But, but that is what starts producing this big shift in specifically progesterone. And estrogens are still coming too, but now we've entered that luteal phase, again defined by the corpus luteum, that remaining little remnant within the ovary that ovulated. Not only does that allow all the other follicles to go away and get degraded, to prevent her ovaries from becoming too big, of course, and swelling every month.

• 14:13Speaker 01

  So all the other follicles are told basically, hey, I won, I'm the follicle that won, I ovulated, you can go away now. And then that remnant, the remnant of that follicle starts releasing again, these hormones, the main one being progesterone. Progesterone is a hormone that will not only stimulate some insulin resistance, but I say this with a tremendous amount of sympathy too, because that's, that's when she's the most insulin resistant, but progesterone is also a hunger signal.

• 14:41Mindy Pelz?

  Yeah.

• 14:42Speaker 01

  That as much as we have looked at GLP-1 as this singular kind of elephant in the room and it comes to appetite, and it's a big one, no doubt, but it is far from the only one. There are so many hormones that come in to play when you start talking about balancing hunger versus satiety. Progesterone is a hunger hormone. It's acting kind of like ghrelin is this signal that's coming to the brain, wanting her to eat. And that makes sense.

• 15:08Mindy Pelz?

  Yep.

• 15:09Speaker 01

  That's a phase where her body's wondering, did we just get pregnant? We don't know yet, but just in case, just in case that egg was fertilized and is going to implant, we're just going to start priming the pump. And there is, so back to this physiological insulin resistance, a woman needs to gain a proper amount of fat during her pregnancy. Progesterone's the hormone that wants that to happen. So back to this, your comment, I would support you and defend your view based exclusively on peer-reviewed manuscripts published in human females that have shown this principle. That, to put a very, very fine point on it, I'm unaware of any line of evidence that's

• 15:51Speaker 01

  measured this that doesn't show, I hate to use a double negative there. In other words, every study that has been done measuring glucose tolerance and insulin resistance during this ovulatory cycle in a woman, I've probably seen every one of them. I think every one of them supports the idea that that luteal phase is a state of some degree of insulin resistance and thus some degree of a carbohydrate intolerance. Not that she can't eat them, I would say, but it's just a time to be more careful.

• 16:18Mindy Pelz?

  Yeah. And I would say every woman that I've talked to says, yeah, that I crave carbs the week before my period. And what, and I, and they think it's something wrong with them. Like, like I did something wrong that I can't stick to my diet the week before my period. What I noticed in my clinic was if I allowed those women to eat good carbs, and I want to talk about what good carbs are, then like PMS symptoms went away. They weren't hungry when they started their period, their moods were better. And I came to the conclusion that the PMS is actually worse once a woman's period starts if she tried to diet and exercise too much the week before her period because she's going

• 17:03Mindy Pelz?

  against her own natural biology.

• 17:05Speaker 01

  Yeah. Well, that's, that makes sense. That's brilliant. In fact, I think you've been one of the good, clear voices in this realm.

• 17:11Mindy Pelz?

  Thank you. So what do you think about for post-menopausal women? Because now if progesterone's a hunger hormone and it's starting to go down in perimenopause and menopause, there are a lot of women gaining weight because estrogen has dropped, a lot of women leaning into carbs and gaining even more weight. What do we tell the perimenopausal, post-menopausal woman?

• 17:37Speaker 01

  Yeah, yeah, I would, at the risk of being kind of pithy here, I'd say, welcome to mortality. And by that, I mean, now she may on one hand rejoice that she doesn't have a period anymore, I suppose, but my little joke about welcome to mortality is just kind of based on the idea that a pre-menopausal woman is sort of a metabolic superhero where she can get away with, with more body fat than, and even a little more metabolic wiggle room than her male counterpart can. Now she may say, well, what are you talking about?

• 18:18Speaker 01

  My, my, my husband or, you know, the guys in my life, they can eat, they're so big and hulky, they can eat whatever they want. Yeah, again, muscle mass matters a lot, but estrogens especially, oh my gosh, estrogens have the ability to help a woman kind of become bulletproof, where her body fat has very little negative consequence, pre-menopausal, because the way the estrogens are telling her body how to store fat.

• 18:43Mindy Pelz?

  Right.

• 18:44Speaker 01

  And so with, as much as the news gets a little grim, I think peri and post-menopause, which is, hey, you've lost those estrogens, at least endogenous, and thus your fat is now going to start to have more consequence. By that, to be really precise, she's going to start losing fat cell number slowly over the next decades and that's going to be replaced by fewer but larger fat cells, which is why now she's kind of more mortal. That's what her male counterpart has had to kind of struggle with the entire time where he doesn't have the ability to make new fat cells for the most part, like, like the, like the female does.

• 19:28Speaker 01

  And so I think that that's the bad news of menopause, but at the same time, we could say there is some good news, which is that you are not subject to the, dare I say volatility when it comes to hunger and glucose tolerance that

• 19:45Mindy Pelz?

  Right.

• 19:46Speaker 01

  While you were having your cycle, boy, oh my gosh, I mean buckle up. You've got a lot more planning and a caution or just consideration that would go into how you feel and taking stock of doing what's best, depending on where you are in your cycle. Well, post-menopause, you know, welcome to the kind of more plain ride that guys are on, which is you don't have that kind of variability now. And I think that's an opportunity to really say, okay, this is my new normal and these are the habits. I don't have to be as mindful of different times of the month and be a little more cautious with my fasting or my glucose consumption, whatever.

• 20:26Speaker 01

  She's able to, I think if there's some good news, kind of find some habits that work and then lock them in.

• 20:33Mindy Pelz?

  Yeah. And that's been my experience with fasting is I can teach almost any post-menopausal woman how to fast and they'll find a rhythm very quickly. It's much easier than, perimenopause, very difficult, very turbulent. Pre-menopausal, if I just teach them to fast according to their cycle, it's much easier. So would you say that there's any kind of advantage for carbohydrates for a post-menopausal woman?

• 21:05Speaker 01

  Uh, no, um, I don't, I don't think there's an advantage there. Uh, in fact, I dare say the time has come to be a little more, um, roll up your sleeves.

• 21:17Mindy Pelz?

  Yeah.

• 21:17Speaker 01

  Um, and I say that for a few reasons. One, you will be a little less glucose tolerant and insulin resistant. And those are two different things, but they're complementary, but they're not the same. So I want to be clear. You'll be a little less glucose tolerant and a little more insulin resistant. Now, insulin resistance does play into glucose tolerance, but they are, they are distinct. But at the same time, um, she, uh, she needs to be exceptionally mindful of her brain. And, and the, the reliance of her brain on energy, uh, there are, when you look at the whole pantheon of chronic diseases, men die pretty much more from everything, um, at, at younger ages.

• 21:59Speaker 01

  But the one realm where ladies dominate is brain pathologies. And, and it's an interesting shift as her brain has benefited so much from the flush of estrogens, which are extremely neuroprotective. They're neurogenic, they're metabolically favorable, they help a woman burn more fat than a man does, which is true. She might not think it's true. Estrogens do facilitate fat burning. They also facilitate more fat storing, but she's just cycling through her fat more. She's storing more and burning more and storing more and burning more. There was a paper which was, uh, shockingly interesting. It was mostly based on rodent work and then they found some human correlation. So it's a pretty good compliment in the humans.

• 22:41Speaker 01

  And they found that the, the, the female brain post-menopause starts to become a little more insulin resistant. That's not surprising with the loss of estrogens in particular and just a growing insulin resistance. But that, that the, her, the female brain was so, it was getting so energy deprived because of its forced reliance on glucose, which again, has a gatekeeper where insulin needs to be working well to get that glucose into the brain, at least all sections of the brain. And, and so the, the brain was starting to become energy deficient that it started catabolizing its own white matter, its own, its own physical fatty substance. The brain is a very fat organ, actually has a lot of fat in it, in its substance.

• 23:25Speaker 01

  And it starts burning through its own mass in order to turn that white matter into ketones to try to make up for the energetic gap that is caused by the, the, the growing insulin resistance. So all that to say, she, I think, I think her opportunity to kind of shrug off some bad habits, pre-menopause, now, um, you can't, uh, you've got to be a little more strict.

• 23:52Mindy Pelz?

  Yeah, I saw that study after I put Age Like a Girl out into the world, which was really about how the brain changes for the better as we go through menopause. And what I, when I heard that study, I was like, wait, the brain innately makes ketones so that as it is, uh, adapting to the hormonal change, the brain has telling us what the proper fuel source is by making its own fuel source in the breakdown of neurons as she starts to age. To me, there's no bigger signal that a post-menopausal woman needs ketones than that study.

• 24:32Speaker 01

  Amen. I, I couldn't agree more. Yeah. So all of this is still kind of circling around that initial question you'd asked, which is how much carbs can a person eat? What are they justified in eating? And women, women are just such metabolic curiosities. You're such beautiful creatures, but you're so curious.

• 24:49Mindy Pelz?

  One nice way to say it.

• 24:50Speaker 01

  Yeah, you're so curious. You know, like I've joked before that male metabolism and maybe even male endocrinology, it's like a barber shop quartet. It's so simple, but female endocrinology, it's like a 100-piece symphony. There are so many characters, there's so many individual sections, and within those sections, there are some that are playing louder than others. It is the most elegantly designed system wrapped in the most lovely cocoon of the female individual, but it sure is complicated.

• 25:20Mindy Pelz?

  Very good. You know the way I always say it, as I say, women are like sophisticated violins and men's hormones are like a kazoo. Just one note.

• 25:30Speaker 01

  I like that. Yeah. We're just sitting in the corner with our dunce hat coming along.

• 25:34Mindy Pelz?

  Talk to me about good carbs and bad carbs, because I think that is the new, uh, cultural discussion. Every, all of a sudden, people are like, wait, there's a difference in carb quality?

• 25:45Speaker 01

  Oh, yeah, yeah. In fact, Mindy, let, let me answer that, um, by, by kind of invoking the three burdens that I, that I bring up in the book.

• 25:54Mindy Pelz?

  Right.

• 25:54Speaker 01

  So the, the lowest hanging fruit for both you and I, because of our expertise, is the metabolic burden. And, and so I'll, I'll, I'll start with that view. And, and it's fairly simple, where when you consider the quality of carbohydrates through the lens of the metabolic burden, it can largely be based on how much is this, what's the glycemic load of, of the carbohydrate that I'm about to eat? In other words, how much is this going to result in a significant glucose excursion in my, or, or it can result in a big hyperglycemia? But, and then unfortunately, the higher you go, the lower you're probably going to go as well. And, and that, speaking of the brain again, um, part of what I inserted into the book,

• 26:39Speaker 01

  and I wanted, I wanted to make sure the carb crisis was not redundant to why we get sick. Why we get sick was all about the insulin response to what we eat and then the consequences of that insulin response. And so with this, when I, when I, in, um, in part two, where I talk about the mechanisms and the menace of these dietary carbohydrates, I, I wanted to make sure I was focusing more on, in this case, with regards to the metabolic burden, the glycemic problem, the problems of hyperglycemia and the oxidative stress that comes from that, the problems of just glycemic variability. So we just talked about the brain being so sensitive to energetic changes.

• 27:22Speaker 01

  I couldn't, I was amazed at the quality of evidence and the consistency of the evidence finding that when, when the brain is forced to, uh, live through these hyper, hypo, hyper, hypoglycemic variability moments, um, it start, that alone represents a pathological trigger that starts to compromise cognition, like in real time.

• 27:44Mindy Pelz?

  Wow.

• 27:45Speaker 01

  Um, so, so the metabolic burden, when it comes to understanding what are good carbs and bad carbs, with the metabolic burden in mind, I think you could just say, how much is this going to spike my glucose or not? And the simplest, the simplest way of, of getting to the meat of the matter with that topic is, um, is it a carbohydrate that comes from a bag or a box with a barcode? Or am I drinking the carbohydrate versus biting it and chewing it? Um, not only, uh, and so on that more favorable end, when you are biting and chewing your fruits and vegetables, which are the carbs that I think are the most appropriate or justified in eating, those are good carbs.

• 28:25Mindy Pelz?

  Right.

• 28:25Speaker 01

  You're not only going to eat a lot less because of the simple time of biting it and chewing it, but you're also getting it with fiber.

• 28:33Mindy Pelz?

  I was just going to ask you that. Yep.

• 28:35Speaker 01

  Yeah, yeah. Fiber is, uh, I know people within, within, within our community, Mindy, there are, of course, there's the subset of like the really strict carnivore keto people, which I totally respect.

• 28:47Mindy Pelz?

  Yep.

• 28:47Speaker 01

  Um, but they, there may be some who just universally, um, poo poo fiber. I don't think that's entirely fair. I think it's fair if you don't eat any carbs. Um, but if you are eating carbs, then I think fiber's supposed to come with those carbs. Part of that reason is probably, uh, at least in my mind, part of the reason, part of the justification is that it's going to help reduce the metabolic burden. You're going to significantly slow the digestion of those carbohydrates and the subsequent glycemic and insulinemic bump is going to be significantly blunted. So that's the metabolic view of defining good carbs and bad carbs.

• 29:28Mindy Pelz?

  So would it be fair, I'm just going to stop you right there for a moment, because I want people to grab this. I think then the goal of your carbohydrate quality is how much fiber does it have?

• 29:41Speaker 01

  I think that's a good way to break it down. Yes, that would maybe be the tidiest, simplest way that, of defining it, good versus bad, or distinguishing between the two. You look at it and you say, is there fiber with this carb that I'm about to eat? And if you're looking at that, um, glass of apple juice, there is no fiber there. But if you're looking at the apple, oh my gosh, you know, tear into that thing.

• 30:02Mindy Pelz?

  Right. So one of the ways I've said it is, is it a nature's carb or is it man-made carb?

• 30:09Speaker 01

  Well said.

• 30:10Mindy Pelz?

  Because the man-made carbs, all that processing, they take all that fiber out. But if you, if you look and just go, did nature give this to me? And if the answer is no, then you're probably in a carb without fiber.

• 30:22Speaker 01

  Yeah, well said. I agree with that completely. Yeah, and that's, that's the more articulate way of my view, which was, no, no, no, that's like my, my kind of, um, I, my kind of mnemonic comment of it is, um, if, if it comes in a bag or a box with a barcode, beware. And largely it's because the fiber has been stripped out of it.

• 30:43Mindy Pelz?

  Right. If you supplement with only one ingredient, my vote is that you supplement with magnesium. It's literally the most important mineral on earth for human health. And I think a lot of us think about it just for sleep. But magnesium has so much more power for you than just that. It supports heart health, bone health, muscle tissue, mood, you name it. Magnesium is truly a gift to a stressed out body. But the magnesium you're taking, yeah, this is where it gets a little complicated. You gotta look at the label.

• 31:25Mindy Pelz?

  It's likely it's just one or two forms of magnesium. And some of these forms aren't even really bioavailable. That's why Qualia Magnesium Plus is hands down the most comprehensive magnesium supplement ever made. It has 10 complementary forms of magnesium. Yes, 10. So you don't have to figure out like, which one do I need for sleep? Which one do I need for stress recovery? It's all in this one supplement. Plus, they added 70 trace minerals. And it's now clinically tested. So here's the cool thing about this supplement. Just two capsules a day.

• 32:08Mindy Pelz?

  I take, honestly, I take mine at night. And you're getting the most diverse bioavailable version of magnesium supplement I personally have ever seen. So head on over to qualialife.com/mindy. They're giving our community up to 15% off if you use the code Mindy. Yay, thank you, Qualia. And all of their supplements are backed by their 100 day guarantee. So that's Qualia Magnesium Plus, code Mindy, at qualialife.com/mindy. Enjoy.

• 32:49Mindy Pelz?

  So something interesting that I've been researching is the concept of protein. And I think we're now overusing protein. And I started to dive into this and I was like, oh, here's the simple answer to that. And you said this with carbs. The simple answer is, are you using protein? And I think that's the same question we need to ask with the carb. You said it earlier, like, are you actually using that? Or are we just putting carbs into our mouth because they taste good? Or how are you going to use it now? Are you going to go walk? Are you going to go lift weights? So what could we teach people about the usage of carbs? It's quick energy, right?

• 33:33Speaker 01

  Oh, yeah, for sure. Yeah. So that's the other part of carbs where the more you are moving your muscle to demand the glucose, the more wiggle room you have.

• 33:44Mindy Pelz?

  Right.

• 33:45Speaker 01

  So as much as you and I, we just got done defining good carbs and bad carbs. I define that through the lens of kind of the older, the aged adult, the person who's getting older and just wanting to be their best metabolic overall self. However, I'm blessed to be a university professor. I have multiple college athletes in the class that I'm going to go teach in just a few hours. They're literally NCAA athletes. Okay, come on, you guys can do whatever you want. They're training, they're training five, six hours a day, very high intensity, very high power training. Oh, those guys, you have, you have athletes who can eat 200 to 300 grams of carbs per day, but their output or their demand for energy is so significant that they can be in a robust state of ketosis every single morning.

• 34:30Mindy Pelz?

  Right.

• 34:31Speaker 01

  Because they're using so much of that fuel. So that's the other view where if you're using the glucose, if you're using the fuel, then you don't, I think that line between good and bad starts to blur a bit. Where you have a little more, you have enough metabolic wiggle room that you can handle that what would otherwise be kind of self abuse in someone else. To you, it is just you're fueling the high, high demand of your muscle.

• 34:56Mindy Pelz?

  So it's, so if I'm mostly sedentary, then I'm going to need a lower carb amount.

• 35:03Speaker 01

  Absolutely.

• 35:04Mindy Pelz?

  This was really, really popular in my community. How many carbs should I have? How many? And I really love that we're moving to, well, how many are you using?

• 35:11Speaker 01

  Yeah, well said. Yeah. In fact, that's part of how I, towards the end of the book, I present this view of how can you know where you are? Like, what is your carb tolerance? And a part of it is based on this kind of a loose algorithm of, well, how active are you? What does your CGM show you? You know, there's a handful of inputs that go into this. But suffice to say, it will not be the same with everyone. And I really wanted to make an effort to not come down to a singular one rule. That just doesn't work.

• 35:42Mindy Pelz?

  That's why I love you, Ben. I'm the same way. I'm like, we have to look at this in a holistic view in order to be able to figure out your N of one.

• 35:52Speaker 01

  Yeah.

• 35:53Mindy Pelz?

  And we live in a world where people, 90% of health information is coming from social media. If somebody only has 90 seconds to teach you a concept, they're going to give you an absolute. But these conversations like this can really help people make better decisions for themselves. And I want to make sure my audience knows you have your new book is coming out. We'll leave the link below. So that, because I'm excited about what you're bringing forward. Where does the nervous system fit into this? Because one of the things that I'm seeing with fasters is if somebody's nervous system is frozen, it's really hard to teach them to fast because they're just in a different nervous system state.

• 36:35Speaker 01

  Yeah, well, Mindy, I need you to tell me, what do you mean when you say the nervous system is frozen?

• 36:41Mindy Pelz?

  So this is more leaning towards the polyvagal theory where if you've been in fight or flight for too long, you start to withdraw and numb out.

• 36:49Speaker 01

  Okay, yeah, okay, that makes sense. Yeah. In fact, I like what you're talking about there because the older I'm getting, the more I am mindful of this. And maybe because I teach it, in fact, in next week, in my seminar, in my lecture this semester, we talk about the autonomic nervous system.

• 37:10Mindy Pelz?

  Yep.

• 37:11Speaker 01

  And within the human body, just so the audience is familiar with this, you have different types of, you have different nervous systems, actually. One of the dominant ones that we always think about is what's called the autonomic nervous system. And the autonomic nervous system is split into generally two halves. There's that sympathetic one that you just mentioned, the fight or flight. Or there's the parasympathetic, the rest and digest and reproduce. You know, we could put that there too. I do, that's, I like how you framed it, which is that I do think we live primarily in a sympathetic world.

• 37:42Mindy Pelz?

  Yeah.

• 37:43Speaker 01

  Now, I don't mean that we have compassion for people. That's not what I mean. I mean, through the lens of the sympathetic nervous system where we are, if only we were all more sympathetic, right? We have more patience and tolerance. Yeah. But with the sympathetic nervous system, we have such constant stimulus, whether it is emotional through social media and the algorithm playing into that, because it knows it will grip us a little longer. Or whether it is our poor sleep, poor sleep is a stimulant for the sympathetic nervous system. Or whether it is too much caffeine. Caffeine is of course, obviously a stimulant for that. But most people don't appreciate the metabolic drive to another part of the book, which is

• 38:25Speaker 01

  hyperglycemia activates the sympathetic nervous system. It's almost as if your body is attempting to ramp up its metabolic engine to clear out the glucose that you're forcing it to use or you're forcing it to be flooded with. This is one of the reasons I've started to harp so much on windows for carbohydrates and being exceptionally mindful of that evening window was my own experience. I am a terrible sleeper. I'm just always thinking about stuff. I'm anxious about one thing or another. Or I'm not anxious and I'm just thinking about things. I just am a terrible sleeper. At one time of my life, just a few years ago, I was really looking at numbers and trying to understand my habits.

• 39:09Speaker 01

  I happened to be wearing a sleep tracking device and a CGM. And I noticed this almost perfect overlap where my worst nights and my worst sympathetic kind of tone during the night linked perfectly with when I went to bed hyperglycemic. So most people don't appreciate that hyperglycemia activates the sympathetic nervous system, which means your body's going to be a little warmer because things are moving a little faster. Your heart is beating harder, your blood pressure is higher, it's beating faster. That's a terrible thing to have happening when you're trying to go to bed.

• 39:45Mindy Pelz?

  Yeah.

• 39:46Speaker 01

  The fight or flight doesn't work when you should be in rest and digest mode, or at least certainly just rest mode. So I think the, the fact that we are in this constant state of a sympathetic tone or a sympathetic drive is at least in part driven by our incessant, constant carbohydrate consumption, which keeps us hyperglycemic almost all the time. And this is something fasting is antithetical to. Fasting, actually...

• 40:15Speaker 01

  Now that I said that, there's a study I'm remembering right now that makes me want to correct myself. There is actually a temporary sympathetic bump in a fast. If I remember the timeline correctly, it was around 24 to 36 hours. It's nothing huge, but there's a little bit of a sympathetic bump. But prior to that and after that, no, you are, you are parasympathetic. This is, I think, why some people notice they're so much calmer when they're fasting. They're a little slower to anger. They can handle their spouse's quirks or their kids' drama, things at work, just doesn't faze them quite as much. And I think a part of it is because fasting doesn't want the body to be burning through stuff. It wants it to be kind of toned down.

• 40:58Speaker 01

  So I think that's a good counter to, to that sympathetic drive that we're living in, to try to shift our body over to parasympathetic.

• 41:06Mindy Pelz?

  Yeah, it's interesting. I, when I first started studying women's hormones, I saw that they were dramatically affected by insulin. And this was one reason I got into fasting, because I was like, wait a second. If I can do the ketogenic diet, I can do a lot of fasting and bring their hemoglobin A1C down, get their fasting glucose and insulin down, then their hormones were balanced. But here is where I got stuck, is that above insulin is cortisol. So if cortisol goes up, you become more insulin resistant. So the reason I ask about the nervous system is after watching so many people fast, I've been trying to figure out, why can I give fasting to one person and they rock

• 41:48Mindy Pelz?

  it? And I give fast, that same fasting experience to another one and they get completely shut down. And I've come to the conclusion, it's your nervous system state. So if I'm in fight, right? If I'm in fight or flight, I'm naturally more insulin resistant because my body is moving glucose to the larger muscles so we can get away from the threat that's coming at us. So it gets difficult to lose weight when you're in fight or flight. And if you've been in fight or flight for too long, your nervous system will start to move into this freeze mode. And now we want to numb ourselves. And all of a sudden, the carbohydrate consumption goes way up, but now we're calling it food

• 42:33Mindy Pelz?

  noise. So I love what you just said, because I think that cortisol flexibility and metabolic flexibility go hand in hand.

• 42:44Speaker 01

  That's a good, I like that comparison. I do, in fact, I, cortisol is, cortisol is a powerful agent in the body. It's also essential, and more and more, like, there are people who genuinely lose the ability to make cortisol, where they have an autoimmune destruction of that part of the adrenal glands. And you'll die, you'll die if you don't get that corrected, or supplemented, or addressed. But more and more, I think, one view that might be, this view might be helpful for the audience, you and I both would call these stress hormones, and that's not wrong. They're part of a stress response.

• 43:23Mindy Pelz?

  Right.

• 43:24Speaker 01

  But at the same time, I, I, I wouldn't want people to just uniformly look at them, cortisol or adrenaline, as villains, because

• 43:33Mindy Pelz?

  Yeah.

• 43:34Speaker 01

  They're, I, I more and more, I actually like to call them metabolic adaptation hormones. They're, they're just a signal that your body is shifting in to a different state. For example, I say, I kind of thought through this, because there was so much concern about a cortisol bump with adherence to a ketogenic diet. Mind you, I think that concern is overplayed. It's not as significant, or as relevant, or as consistent as people think. But within a fast, or within the adoption of a ketogenic diet, there is a bump in cortisol. And I found one study that showed it in women only. Men didn't, the male subjects did not have this. And so I, I would hear people say, well, I don't want to adhere to a ketogenic diet, because my cortisol will go up. And, and I would think, one, it's, it's a pretty

• 44:19Speaker 01

  modest bump, and it was shown to be very temporary. But the same thing, over that same period of time, a slightly different time scale, you see epinephrine going up, and you see glucagon going up. You know, glucagon getting a lot more love, and it's going to get even more love when this newest GLP-1 retitriotide comes out, because it's kind of playing on glucagon's ability to signal fat burning. But all that to say, I, I looked at these hormones and thought, well, you could say that, that is, this is a metabolic stress, at least temporarily, as the body shifts. But it's more reflective of just this shift in metabolic, or in fuel use. Back to your comment about metabolic flexibility and cortisol flexibility, I like that. I'd

• 45:02Speaker 01

  never heard it before, and kudos to you. If I ever say it again, I will try to remember to give you credit for it.

• 45:06Mindy Pelz?

  That's all good.

• 45:06Speaker 01

  But, but it, it, it does, I think, help us understand that both are dynamic. With metabolic flexibility, we want the ability to shift between fuels. With cortisol flexibility, we want, we have to have cortisol on occasion. You will die without it. Even epinephrine and glucagon, they're not enough to help make up for what cortisol wants to do, to help maintain blood glucose at a certain level. And, and so it's important not to, as much as over my career, I've painted insulin as a villain, well, sure, but if you don't have it, you die.

• 45:39Mindy Pelz?

  Right.

• 45:40Speaker 01

  Similarly, you need it. Similarly, with cortisol, it's often painted as a villain. And in some contexts, like insulin, it is. But once again, if you don't have it, you're dead.

• 45:50Mindy Pelz?

  Right. It's, you know, the way I like to look at it is, we need a new relationship with these hormones. Just like we need a new relationship to carbohydrates, is like, we were so looking for the absolute. And, you know, you, like, to your point, you need insulin. The one thing I think that's interesting about cortisol is, its primary function is to make you move. So if I, if that was primarily what it was meant to do, you saw a stressor, cortisol came in, you got, you ran from the thing that was going to kill you.

• 46:20Speaker 01

  Yeah, it helps you move. Yeah, it wants to give you the fuel. Yeah, to fuel what you about, what you have to go do.

• 46:26Mindy Pelz?

  Right. So that may, it makes you naturally more insulin resistant, so you have glucose in the big muscles, so you can go. But if you are, you are stuck in a stress state at your desk, now where's that cortisol going to go? And you're not moving. You're going against your biology.

• 46:41Speaker 01

  Yeah, there's no, there's no goal for it.

• 46:43Mindy Pelz?

  That's right.

• 46:44Speaker 01

  Yeah, yeah. I mean, our modern environment has definitely kind of hijacked. Back to the point that you brought up originally, the sympathetic nervous system, gosh, we need it. And it's fight or flight for a reason, because it would have been the physical danger that would have elicited this. But nowadays, we don't have that kind of physical danger. That's so uncommon. It's going to be a mental stressor, that there's no then outlet for it. It's the social anxiety of a young teenage girl feeling left out, or, or an older adult worrying about their child, or their, their retirement. There's no clear villain there. There's nothing to run away from that can act as a depot for all that circulating energy, so it lingers and starts contributing to chronic disease.

• 47:26Mindy Pelz?

  Yeah. What do you think about food pairing, when we're looking at insulin and glucose? Like, so let's say, I want to eat carbs. And I get, I get that I'm going to eat nature's carbs. Does it matter what I pair it with? Should I pair it with a fat? Should I pair it with a protein? Because that's been a new conversation that's emerging.

• 47:46Speaker 01

  Yeah. Mindy, I, my view on that is one of caution, where, where I think that the use of a CGM, which I wholeheartedly embrace, may lead some people into a false understanding of, of the upside or the utility of pairing. So by all of that, I mean, a person could have a piece of bread, and they would eat that plain piece of bread and look at a really big spike in their glucose, and it come back down really quickly, up and down. And then they say, well, look what happens when I pair that piece of bread with a big slab of peanut butter.

• 48:26Mindy Pelz?

  Right.

• 48:26Speaker 01

  Now, what was a really big bump is a kind of more modest, delayed bump. Yeah, but it came with a lot more fat. Now, now, I, you and I are both very friendly when it comes to dietary fat. But combining an insulin spike and carbohydrates with a big bolus of fat, that's a really good way to get fat. Even if the protein and the fat from the peanut butter has shifted the way we digested that bread, we still do digest it. We've just taken one big spike and turned it into more of a mound. Now, I would say, well, there's a value in avoiding the hyperglycemic bump. Absolutely. And especially if for no other reason than it prevents the big drop in the hypoglycemic rebound, which makes you want to go have more pieces of bread.

• 49:12Speaker 01

  So I think there's value there. But looking at it solely through the lens of glycemic control, I think is a little too narrow, because you are still getting an insulin bump from that bread. And now, high insulin plus high calorie with, with fat, boy, that is a wonderfully fattening combination. So, but having said that, by putting the peanut butter on that bread, you probably won't eat as much.

• 49:39Mindy Pelz?

  Yeah.

• 49:39Speaker 01

  Because that is going to be, yes, it's going to be so much more satiating, that if you're just eating the bread with honey on it, or something, oh my gosh, I could easily eat 10 pieces of toast like that. But if I'm putting

• 49:52Mindy Pelz?

  And then take a nap. Then I'd have to take a nap.

• 49:54Speaker 01

  Yeah, that's right. But if I had, if I have a piece of toast or something with peanut butter, I have two and I'm done.

• 50:00Mindy Pelz?

  Yeah.

• 50:01Speaker 01

  And I feel very satisfied. I have a lot of satiation from that. So I don't want any, I don't want my answer initially with CGM alone to present a negative view. I still think pairing is probably the better way to do it. But I think it might be prudent to be mindful of what you're pairing. For example, if I were having a plain piece of bread with cheese, that I don't think is as healthy as an apple with cheese, because the bread essentially has no fiber in it to help control the digestion of that glucose. Whereas the apple still has some digestible, it has some fructose and glucose, which are going to get in. But the fact that it had, or, or maybe let's go back to peanut butter, because I know people will eat an apple with peanut butter. You get an apple slice,

• 50:46Speaker 01

  dip it in peanut butter. I, I think that would be better than a comparable amount of carbs in the form of two pieces of bread, or a piece of bread with peanut butter, where that, that is, there's no fiber coming with that glucose, and you're just ripping right back into the body. So I, I think pairing has value, but I think the pairing is better when it is paired with the carbs that we'd already defined as good.

• 51:09Mindy Pelz?

  With fiber. I was thinking the same thing as you were talking. I'm like, well, what about, I was thinking exactly about apples. I'm like, what about apples and, and nut butter? So then, is there ever a case for bread?

• 51:22Speaker 01

  I hate to say this because I love a freshly baked loaf of bread. It's one of the most intoxicating scents, I think, for me at least. But there's very little case to be made for normal bread as we eat it. I think that the more you have true, this, this comes to the, the kind of burdens in the book, that the metabolic burden and actually the, the other burden, the anti nutrient burden, these chemicals that come with our carbs that want to punish us for eating them by, by compromising our digestion. When you have fermented a carbohydrate, you have not only reduced the amount of digestible glucose

• 52:06Speaker 01

  in that carbohydrate because the bacteria are eating that glucose. They leave the protein, they leave the fat, in fact, they give back good fats in the form of short chain fatty acids. That's why whatever's fermented tastes a bit tart because short chain fats have a tart taste activation. But at the same time, the process of fermentation has often stripped down a considerable amount of the anti nutrients, things like the phytates and the tannins, the tripsin inhibitors, these, these anti nutrients that want to punish us for eating the plant. They're, they get heavily, heavily cut down over the process of fermentation. So to me, back to, so bread, so sourdough, a true fermented sourdough.

• 52:49Mindy Pelz?

  I was wondering about that.

• 52:50Speaker 01

  Yeah, that's what I'm kind of getting around to in a long winded way. But it has to be people who just go to the grocery store and think they're going to buy sourdough bread. Probably what you're buying is just one that's had a little bit of vinegar added into it to give it a tart taste. And so it's a fake sourdough. Now I'm a fan of vinegar, of course, but that's not the same. And so you want to make sure that it's a true sourdough started from a true starter. You know, this, this little colony of a fermented kind of dough. And that's not so common. You can find them, but it's likely not going to be in the typical area of your bread section at the grocery store. It's probably going to be in the kind of bakery section. And you want to turn it over and make sure that it has some mention of a starter.

• 53:31Speaker 01

  Or at least it doesn't show that it has added vinegar into it just to fake the flavor or the taste of a sourdough.

• 53:38Mindy Pelz?

  Yeah. If you are loving the conversations on my podcast and you want to go deeper with me, come join me over on Substack. It's where I share the conversations I'm having behind the scenes. The research that I'm obsessed on and paying close attention to. And really the thoughts I don't always get to unpack here on the podcast or any of my other social media. We're taking women's health, fasting, hormones, food systems, mindset, aging, and what it really means to live like a girl in today's world to a whole new level. You'll also get early podcast access, deeper essays on my thoughts around

• 54:21Mindy Pelz?

  how we can all stay healthy in this modern world. You get community, you get conversations and exclusive content that I only share there. I'm not joking when I said this is my new favorite place. It is currently where I am at. So you can head on over to substack.drmindypelz.com or just search live like a girl with Dr. Mindy Pelz directly in the Substack app. I'm super excited to have you over there. Please introduce yourself and let's dive in to some really good conversations. What do you think of this, how enamored everybody is right now with the GLP-1 drugs?

• 55:06Mindy Pelz?

  Where does this fit in? Because what I'm hearing, and I hope everybody else is hearing this, is that we've abused carbs, there's not much, especially the, the highly refined carbohydrates. There's not much benefit there. And now we have a world that's obese. We have a world that is high in food noise. And so we found a drug to solve for that. And on, you know, it sounds so trite when I say it that way, but then on the flip side, people's food noise going away is life changing.

• 55:35Speaker 01

  Oh, yeah, yeah. Yeah. Mindy, I suspect our thoughts on GLP-1, I, I think they're probably going to be pretty aligned. I initially came out very opposed to the use of GLP-1 medications for obesity. I've been familiar with them since my PhD days.

• 55:50Mindy Pelz?

  Yeah, they're not new.

• 55:52Speaker 01

  Early 2000s, yeah, when they were just used, they were this obscure little diabetes class of drugs. And, and there they, they worked pretty well and the mild nausea was just considered a kind of throwaway side effect. But they found, well, if we kind of turn up the nausea a little bit, that's a crass way of putting it, but I don't think it's totally wrong. Boy, people just started eating less. And, and much of the benefit of GLP-1 appears to be the delayed gastric emptying, but you cannot deny the central nervous signaling. So my own views, I just want everyone to know, have, have evolved a little bit. My initial opposition was based on primarily on the lean mass loss studies.

• 56:34Speaker 01

  However, over time, I have, there are studies now more and more to show that actually muscle mass doesn't change, muscle strength doesn't change. What could be happening is, well, there are slight change in muscle mass, but it's probably the loss of the, the, the lower levels of muscle fat and muscle glycogen, which are accounting for the, the lean mass loss. It's not actual muscle protein because again, muscle strength appears in every study I've seen to be totally unchanged. In some studies, it's even gone up. And part of what is, when people use a DEXA scan to measure body fat and lean mass versus fat mass and fat free mass, even the liver,

• 57:17Speaker 01

  everything in the liver gets considered fat free mass. Even if the liver gets 10 pounds smaller because it has a lot less fat in it, it's marked as a fat free mass loss or a lean mass loss. This was a study done in animals and then confirmed, validated at least at a superficial level in humans, finding that again, a lot of what gets pegged as lean mass loss could just be the reduction in liver mass, that the liver's smaller because it has a lot less fat and glycogen in it, which makes some sense. So my view on GLP-1s is that they should not be used as weight loss drugs. That shouldn't be the marketing or the, the message.

• 58:01Speaker 01

  When the physician gives this to the patient, don't say, this is your weight loss drug. Because to me, that puts the patient in a frame of mind to think, oh, and I'm just going to keep eating what I was eating and as long as I don't, if I'll just stop when I feel sick. Eventually, two things are going to happen. The drug starts to have diminishing returns. That's been well shown at two years. As the dose keeps scaling up, at two years cravings for sweet things comes back to total normal levels, even though they've been scaling up the drug. So you have diminishing returns and then the, at that, along that same time, the almost invariable, just shrugging of the shoulder and saying, all right, well, I'm going to get off the drug. And then they gain all their way back because they never learned habits.

• 58:45Speaker 01

  So to me, to me, the best use of a GLP-1 drug is this is a drug that's going to help you learn to control your cravings for carbohydrates.

• 58:54Mindy Pelz?

  Yeah.

• 58:54Speaker 01

  Because Mindy, everyone, if they're being honest with themselves, that's what people crave. No one's sitting around craving a plate of bacon and eggs, if only, no one. Even you, Mindy, as much as you and I know, we don't crave bacon and eggs. No, we want something sweet and gooey. Yeah, bacon maybe. Because we want something sweet and gooey or salty and crunchy. Bacon can meet that one. But for the most part, it's going to be a carbohydrate that people are craving. And all of the studies of addiction, when it comes to food in humans, it's always carbs. That is the one single consistent thread. Some people would say, well, carbs with fat or carbs alone, but it's always carbs as the one left standing when you look at addiction.

• 59:35Speaker 01

  So I think that's the best where you and I would be kind of preaching this message of control your carbs, be smart about your carbs, good carbs, bad carbs. But then the person comes back a week or a month later and says, I have been trying. I just can't do it. I'm addicted. That to me is the moment where a GLP-1 can be effective because GLP-1s can help with addiction. In fact, this has been shown with cocaine addiction, with alcohol addiction, heroin, gambling.

• 1:00:05Mindy Pelz?

  Gambling's gone down.

• 1:00:06Speaker 01

  Yeah. There are people who, who, there's clearly this kind of off target use to help control addictions. So to me, I would love for the physician to say, here's a drug that's going to help you temporarily learn how to control your carbs and we're going to be working with you to identify habits. And, and then we, I would say, use it at the lowest possible dose.

• 1:00:28Mindy Pelz?

  Right.

• 1:00:29Speaker 01

  Which is just effective enough for, for you to be hearing that temptation. But there's still enough self-will, there's still enough agency involved that you still have to be a little tough and say, no, I hear the temptation and I recognize it, but I'm going to say no. Then we start strengthening that mental muscle to say no, and that gives the person an off ramp. Because they should, I don't think a person should look at these drugs as indefinite. I, I think there should be, the moment a person goes on, working with their clinician, there should be a way for them to see an opportunity to get off.

• 1:01:03Mindy Pelz?

  Yeah.

• 1:01:04Speaker 01

  And I think that opportunity is essentially defined by your ability. Have you developed new habits? Have you overcome some addictions? And now you know what it looks and feels like. So that when you hear those addictions or those temptations, that siren call of that bowl of cereal every, every evening, in my case, can you look at that and say, no, I hear you, I, I see you, but I'm going to, I'm not going to do it. And then you're developing the discipline which enables you to get off it. Just like an athlete who's banged up a knee and they're on a crutch. The crutch just helps them until they're strong enough to get off it. I think the GLP-1 helps them until they're strong enough to get off it.

• 1:01:40Mindy Pelz?

  Do you think there are foods we can eat to make our own GLP-1? Like I'll, I'll show you one that I researched recently that I had to go back and triple check. And it was oatmeal. And what they were saying about oatmeal, what the study said is it slows gastric emptying. And I will tell you, when I was in practice, everybody and their brother eats oatmeal for the, for breakfast. I had, I did not realize that how addicted people were to oatmeal. And I couldn't understand why people couldn't, like, it was almost as powerful as their morning coffee. And I'm wondering if they're, you know, oatmeal's sticky and it's got that gelatinous character to it and it slows gastric emptying.

• 1:02:23Speaker 01

  Yeah, yeah. Well, I, I think that's a, that would be a known, that would be an obvious variable that would be relevant and would be a knock in favor of oatmeal, that it would slow gastric emptying. Anything that generally slows gastric emptying within reason, I think we could look at as a, as a good thing. But there are, for reasons we don't fully know. Some people can have a robust GLP-1 response to a particular food while the other person won't. There was a paper to put a very fine point on this. Indeed, part of what has informed my own view of GLP-1s that I just finished articulating, part of that was influenced by this paper that was published in 1996. And they found that they looked at women and split them into two groups, women who were

• 1:03:08Speaker 01

  lean and women who had obesity. And they gave them a high-fat meal and found that they both had a modest but fairly, there's a little bit of overlap response with GLP-1. Then they gave these two groups a high carbohydrate meal. The lean women had an enormous GLP-1 release. The obese women didn't leave baseline at one time over three hours. At no point did it reach a statistically significant elevation. So, think about this in the compassion that that would elicit in me. One person could eat, let's say, a bowl of oatmeal, which is a lot of carbohydrate, that'd be a high carb meal, and get a big GLP-1 response. Someone may eat those carbs and get no significant GLP-1 response and be deprived of the satiety

• 1:03:53Speaker 01

  and the gastric emptying that would have come with it. So, I think it's prudent for us to acknowledge that GLP-1 matters, boy, does it ever, but not all foods are going to necessarily have an equal response. And so, as much as I wish we could kind of come to a clear algorithm to identify the best foods or the worst foods, I just don't think that's going to be accurate. Back to a message that you and I both, I know you've been a particularly good voice in this regard, everyone is individual, and so it's going to be a matter of some experimentation.

• 1:04:23Mindy Pelz?

  Yeah, and that's where people get stuck. They're like, "Oh, now I gotta think for myself," and it gets really, really difficult. If you could change, just wave a magic wand and change people's relationship to carbohydrates, what would that look like?

• 1:04:39Speaker 01

  Yeah, it would be to try to help change the food culture or our relationship in a way that we were simply getting fewer carbs from bags and boxes with barcodes, that they would be generally whole fruits and vegetables, and then, yeah, I mean, consumed with the fiber that ought to come with those carbs. And then, to go a little beyond just the metabolic, it would be to focus even more on ways to reduce, say, the anti-nutrient burden, like, is it prudent to peel, to remove the peel? Because that's where a lot of fruits and vegetables concentrate their anti-nutrients, especially vegetables. Is it prudent to ferment it?

• 1:05:23Speaker 01

  The more you could look at, when I lived in Russia in the late 90s, and I couldn't believe how much everything was pickled. Of course, cucumbers were pickled, but they would pickle tomatoes, they would pickle watermelon. And I thought, "Pickled watermelon, oh my gosh, it was so delicious." I couldn't believe it, the salty and the little bit of the sweet with it. But suffice to say, anything that is fermented is going to have both reduced the metabolic burden and that anti-nutrient burden. And then, you know, the peeling, especially when it comes to vegetables, if you, by removing the peel or doing like a baking soda wash to try to get rid of some of the chemical residue, because in order to, this is a kind of a big tangent here, but I'll keep it brief,

• 1:06:08Speaker 01

  it is not natural to produce fruits and vegetables as big and juicy and hearty and monocropped as we have. Now, I'm not saying that makes them bad, but when you go into a field and you force that plot of land to only grow tomatoes, which is a perfectly good fruit, it's very healthy and good, very low glycemic load, but it is not natural for this many thousands of acres to only grow tomatoes. Now, again, I'm not saying it's bad, but we have to impose our will on that plot of land to force it to grow that plant.

• 1:06:44Mindy Pelz?

  Yeah.

• 1:06:45Speaker 01

  Yeah, so we have a lot of chemicals that we use to help that happen, and I'm not saying that's uniformly bad, but I don't want those chemicals that are killing the bugs, well, they're not going to do me any good. And so, there are things where a person can, of course, with tomato, you're not peeling off the peel, but where you can, you're removing the external, the portion of it that would have gotten the burden of those chemicals. And when you can't, then something like as modest as like a baking soda, like just scrubbing it with baking soda, baking soda has been shown to heavily remove and neutralize a lot of those pesticide and herbicide, that chemical burden, you know, of the burdens that I've been alluding to. So, to me, if I could wave a wand, I guess I mentioned a lot of little waves here.

• 1:07:28Mindy Pelz?

  You have a big wand, your wand's big, Ben.

• 1:07:30Speaker 01

  Yeah, thank you, thank you, Mindy. Yeah, I think that there's a lot that went into it, but hopefully it kind of can come to the audience's mind, one sort of coherent thought there.

• 1:07:40Mindy Pelz?

  Yeah, and what do you think about for women, if a woman, if you were talking to a woman and she asked you, "What's the number one thing I can do to get my health back on track?" What would it be?

• 1:07:51Speaker 01

  Oh, gosh, that's such a great question. Allow me to have more of a philosophical answer to that and then more of a substantial, actionable one. I would say, one, just be kind to yourself. I think women are a lot, I see this in my dear wife, who is so capable, what an amazing homemaker she is, and I just love her to death, and she is so much harder on herself than I am on myself. I'm critical of myself in ways that I think are productive. She's critical of herself in ways that I don't think are quite as productive. And so, where, when it comes to women, there's just so much more external pressure to look

• 1:08:33Speaker 01

  a particular way, and, oh my gosh, I just, so the philosophical part of my answer is just love your curves.

• 1:08:38Mindy Pelz?

  Yeah, be kind.

• 1:08:39Speaker 01

  Love being a woman, and know that pretty much every single man in your life prefers you that way, you know? Any man who matters, for whatever that's worth. Of course, don't find validation in the men necessarily, but be a little more generous with your view of yourself. And then, the second thing is, I would say, at the risk of oversimplifying it, just control your carbs. That is going to be the primary villain that is making you not feel your best. And at the risk of now saying it for probably the fourth time, if it comes in a bag or a box with a barcode, beware. Focus on whole fruits and vegetables. If they're fermented, wonderful. If they've been washed with a little bit of baking soda, wonderful. But those are going to be deeper layers to it.

• 1:09:24Speaker 01

  If you're just focusing on eating whole fruits and vegetables, you are accomplishing the vast majority of what you'd need to do in order to really live and optimize your metabolic health to optimize longevity and just feeling your best.

• 1:09:37Mindy Pelz?

  Yeah, it's so well said. I agree, it's not complicated, and I think we've overcomplicated weight loss for sure and health.

• 1:09:44Speaker 01

  It's simple, Mindy, it's simple, but that doesn't mean it's easy.

• 1:09:47Mindy Pelz?

  Right, agreed.

• 1:09:48Speaker 01

  That doesn't mean it's easy. So, back to the compassion, back to the individual approach to this, back to the role of GLP-1, you know, and how it's used or how it's abused. And I say that as a college professor, where there are these young, lean, perfectly healthy 20-year-old girls who are on GLP-1s, and I think your parents have failed you, you dear girl, you should not be on this. I literally just had a girl ask me after class the other day, "I heard you talk about this." I'm on a GLP-1, and I'm looking at her thinking, sweetheart.

• 1:10:16Mindy Pelz?

  Why?

• 1:10:17Speaker 01

  Yeah, you need a sandwich. Get off that GLP-1.

• 1:10:20Mindy Pelz?

  Yeah, yeah, agreed, agreed. Oh, well, I love this. I know you gotta go, I could talk to you forever. Talk about your book. Why'd you write it? Where do we find it? I think it's going to make a big impact.

• 1:10:31Speaker 01

  Yeah, I hope. It was a really fun book for me to write, where I wanted to look more at the global diet and wonder, is there something that went beyond just insulin here? And at the time, I'd started collaborating with a colleague here who studies glycation, this irreversible binding of when glucose gets too high, how it will bind to a protein and then permanently change it. And that was the seed for me to start looking into the kind of outline of the book that became The Carb Crisis. Yeah, so it's more just about the substance of those foods themselves, rather than the hormone response to them, but the consequences of those things. But yeah, it's called The Carb Crisis. It's available for preorder now, anywhere books are sold.

• 1:11:16Speaker 01

  I think it's officially released in December. So, depending on when this comes out, you'll still be a little ahead of it. But please, everyone, go preorder. I've never had a bestseller, I'd love to have an actual bestseller.

• 1:11:25Mindy Pelz?

  Oh, Ben, we gotta get that for you. Okay, I'm gonna rally the troops. Yeah, you deserve that. What date is it coming out in December?

• 1:11:33Speaker 01

  I'm sorry, I think it's mid-December. Shame on me, mid-December. But anywhere books are sold now, it's for preorder.

• 1:11:39Mindy Pelz?

  Yeah, yeah, so we'll leave links down in the notes here, and we'll get the word out, because the topic is massively important. So, I always have just appreciate you, I learn so much, and thank you again.

• 1:11:50Speaker 01

  Oh, the feeling's mutual, Mindy. Really, you and I are two peas in a pod, we're fighting the same fight, I love it.

• 1:11:55Mindy Pelz?

  Yeah, great, thank you, Ben.

• 1:11:56Speaker 01

  Thanks.

• 1:11:57Mindy Pelz?

  Thank you so much for joining me in today's episode. I love bringing thoughtful discussions about all things health to you. If you enjoyed it, we'd love to know about it, so please leave us a review, share it with your friends, and let me know what your biggest takeaway is.