Pod Insights The School of Greatness 6 Ways To Optimize Your Hormone Health & Why It Matters EP 1315 About this episode Dr. Gillett is a dual-board Certified MD in Obesity Medicine and Family Medicine. His practice includes preventative medicine, aesthetics, sports medicine, hormone optimization, obstetrics and infertility, integrative medicine, and precision medicine including genomics. He believes that each human is a unique creation that requires attention to their body, mind, and soul to achieve optimal health. In this episode you will learn:How to adjust your diet to optimize your hormones. The importance of sleep and healthy hormones. The issue with counting calories. How hormone health can affect your relationships. For more, go to lewishowes.com/1315Andrew Huberman on Eliminating Brain Fog, Increasing Your Focus and Controlling Your Motivations: https://link.chtbl.com/1204-podGabrielle Lyon on Why Building Muscle is the Key to Lifelong Weight Loss and Higher Life Expectancy: https://link.chtbl.com/1267-podAndy Galpin on Weight Loss, Stress Management, and Reversing Your Age: https://link.chtbl.com/1247-pod Get more from Lewis! Get my New York Times Bestselling book, Make Money Easy! Get The Greatness Mindset audiobook on SpotifyText Lewis AIYouTubeInstagramWebsiteTiktokFacebookX
Transcript 13,390 words · 2 speakers
Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.
0:00 Speaker 00 When you begin to have hormone dysfunction, one, without realizing it, your partner or your family might notice changes in your mood or changes in your behavior, which might be disconcerting to them. And then on top of that.
0:16 Lewis Howes? Welcome to the School of Greatness. My name is Lewis Howes, a former pro athlete turned lifestyle entrepreneur. And each week, we bring you an inspiring person or message to help you discover how to unlock your inner greatness. Thanks for spending some time with me today. Now let the class begin.
0:41 Lewis Howes? What do you think is the thing that holds most people back in their health? Is it hormone optimization? Or is it something else that they're missing?
0:49 Speaker 00 The most common thing that holds people back is that many people have metabolic syndrome. They don't diet, they don't exercise, they don't control their sleep, or their stress, or their spiritual health even. And they don't control their collective health, their social health as well. So the health of their family, the health of people in their household. And it's almost like you're trying to get into a fraternity or a sorority. If one of those things is off, then you're not going to have optimal health.
1:18 Lewis Howes? So you talk about these main six things, which is exercise, diet, sleep, stress, sunlight, and spirit or spiritual. When did you realize that if one of these six things are out of alignment, that you're probably not going to be feeling as good as you could? When did this come about?
1:36 Speaker 00 During medical school and residency, there's a process of learning about the importance of the body and the mind and the soul.
1:45 Lewis Howes? Really? The mind and the soul?
1:47 Speaker 00 Yep.
1:48 Lewis Howes? In medical school?
1:49 Speaker 00 Yep, and residency as well. During the third year of medical school, you usually start your clinical rotations, and that includes working in the ICU and working with the end of life care team, the hospice team. And often, you see families and individuals that have never been spiritual their whole life. And by spiritual, you could just define that as the self-actualization on Maslow's hierarchy of needs, the pyramid. And individuals that have never considered themselves spiritual or religious are requesting to talk to chaplains, and they also want to talk to their doctor about spiritual health.
2:23 Lewis Howes? At the end of their life, they're thinking about this. That's some of their requests they have with the doctors. Can I find a chaplain or a pastor or someone to talk about? What are they asking to talk about? Is it like with them? Is it about the reason of life or forgiveness? What is the thing they're looking to learn?
2:42 Speaker 00 Often, they're just scared and they have a terminal diagnosis and they've been given days to weeks to live. And they want to figure out, well, everything I've done in my whole life. Perhaps they have regrets. Perhaps they're glad that they've done things. Perhaps they want to talk to their family members earlier rather than just at the at the very, very end. But they want to find meaning, that self-actualization on the pyramid of the hierarchy of needs.
3:09 Lewis Howes? So when you were in residency and you were witnessing this, what was a big eye-opener for you? Were you a spiritual person before this? Or did you say, oh, there's something to this health thing to optimizing, you know, living a longer, healthier life with this spiritual component?
3:26 Speaker 00 Yeah, I'm a Christian and I am spiritual. I would not consider myself religious. But I do think that every human has a soul and also that every human has a purpose. So often I would pray with my patients and I would talk to them and ask them what they think, even among, like, let's just take a group of people, say Christians. Many people in the United States are Christians. There is a huge variation in what people believe about God or even Jesus. And there's also a wide variation of what people feel like they benefit from being a Christian. Some people feel like they benefit. Some people feel like they certainly don't.
4:06 Lewis Howes? Right, right. How much does the soul or the spirit play into optimal health? And how does a soul become unhealthy?
4:18 Speaker 00 This is obviously a particularly difficult question that many theologians discuss back and forth via, I believe it's called apologetics. What I do know is that when the soul is not healthy, often the entire household suffers.
4:32 Lewis Howes? Your family members. Wow.
4:35 Speaker 00 Especially if, and there's obviously exceptions to everything. And the answer to everything is it depends.
4:41 Lewis Howes? Sure, sure, sure.
4:42 Speaker 00 But if, let's say there's a household and they're all Christians. And one individual, perhaps they're at the end of their life, perhaps they're not. They switch their worldview and their spirituality completely. And often you see physical and mental health sequelae, deleterious. So negative sequelae just from that.
5:02 Lewis Howes? From switching your spirituality or your beliefs around spirituality?
5:07 Speaker 00 Correct.
5:08 Lewis Howes? Interesting. But what if one spiritual belief hasn't been supporting you in an emotional or mental or physical way? And you switch it to find something that gives you more meaning and purpose? Would that also hurt it in the family dynamics? Because there's now a break in a belief into a different belief?
5:28 Speaker 00 In the long run, it might be a beneficial change. But in the short run, it's almost always quite difficult.
5:35 Lewis Howes? Yeah, because you're shifting your beliefs around something you thought was, you know, the word of the universe or something, right?
5:42 Speaker 00 Yeah.
5:42 Lewis Howes? You have this identity or this belief that you've had your whole life. And now you think it's a lie, right?
5:48 Speaker 00 It's like changing any other lifestyle intervention or even a medication. If you don't exercise at all, and then all of a sudden you start exercising and you're going hardcore for CrossFit, you're going to have a lot of pain in those first few weeks.
6:00 Lewis Howes? Yeah, absolutely. Fascinating. So the spirit is something that you started. Well, obviously you grew up studying it. But then in residency, you started realizing this is a massive part of what people think about when they're terminally ill at the end of their life. How did you start implementing that or integrating that into your medical practice?
6:22 Speaker 00 It first started just with the request of patients. So patients very often ask their doctor, well, what do you think? Or will you pray with me? Or will you do X? And you do your best to meet those requests. That's actually how I started getting into hormones as well. It's because hormone pathology is very rare. And often patients would request help or even just labs with it. And if you run a lab on someone's hormones, they're very, very thankful. Likewise, if you just simply pray for a patient, I say, you know, I'm not an expert, but I'm happy to do that with you. They're also very thankful.
6:58 Lewis Howes? So when you test for... Hormones, what is the type of tests that people do to get results back about their hormones? And how many of the hormones are there to test?
7:10 Speaker 00 So a general synopsis of hormones is there's several different types, but there's peptide hormones, which are hormones that made up of chains of amino acids. For example, growth hormone. There's also sterile based hormones, so estrogens, progesterone, progesterogens and androgens like testosterone. And then there's also hormones just based on amino acids. For example, thyroid hormone is based on tyrosine. And hormones are just signaling molecules. There's nothing magical about them, but they do a talk between organ systems and even within organ systems. So talking amongst organ systems is called endocrine hormones. Talking within the same organ system is called autocrine or paracrine nearby.
7:51 Lewis Howes? And how does someone know without taking a test that they have pretty good, healthy hormones? Like, how would we know?
7:59 Speaker 00 In general, and how you feel in general, I call that biofeedback.
8:03 Lewis Howes? Okay.
8:03 Speaker 00 So if you're feeling very well and you have good energy and vitality and libido and mood, and you're not sleeping too much and not sleeping too little, then perhaps you have a pretty normal hormone profile. A lot of individuals feel like, you know, I'm just not focusing quite as well as I used to. I'm not as motivated as well as I used to. My libido has changed slightly, my athleticism or even my body composition. And when that happens, it is extremely difficult to guess your hormone profile without getting a blood test.
8:36 Lewis Howes? Really? So you gotta do a blood test, do all the samples and see where the deficiencies are. If one sector of hormones are deficient, is it impacting the other hormones in the body as well? Do they come down? Or can you have really healthy hormones in one area and then unhealthy in another area?
8:58 Speaker 00 It's possible to have healthy hormones in one area and unhealthy in another area. But the process of talking to each other is called feedback inhibition. So you can have negative feedback where they decrease whatever hormone is produced. For example, estrogen can have negative feedback for testosterone production. And it can also have positive feedback where it actually increases it in a cycle.
9:23 Lewis Howes? Interesting, but it sounds like if you're not exercising. If you're eating poor diet, if you're getting very little sleep, if you're overly stressed in a negative way, not with the positive stresses. If you're inside all day, you don't get any sunlight and your spiritual compass has no moral direction, then probably it'll affect all of your hormones at some point. If one of those things is off, it'll probably hurt the hormones, right?
9:49 Speaker 00 Yeah, likely so. And again, the answer to everything is it depends.
9:53 Lewis Howes? Sure.
9:53 Speaker 00 But it's very common to fix whichever one of those modalities is off. And that's why I write prescriptions for lifestyle. So, you know, a nutrition prescription or exercise prescription. I truly believe that food is medicine. And the original medicines were all food and herb based anyway.
10:10 Lewis Howes? Right.
10:11 Speaker 00 And exercise is also medicine.
10:13 Lewis Howes? Is sleep medicine? Is sunlight medicine?
10:16 Speaker 00 Yeah, I would say so. Likely to a lesser degree, diet and exercise have a slightly more powerful effect because your diet is rebuilding every cell in your body continuously. And how you exercise is how the machine works. So if you sit a car in a garage, maybe I could think of a sports analogy as well. I guess racing is a sport too, right?
10:42 Lewis Howes? Yeah, of course.
10:42 Speaker 00 But if you sit a car in a garage, then it's not going to function well.
10:45 Lewis Howes? Right, right. What are the five foods that you would recommend to optimize your hormones? If you eat them consistently, moderately, these would support the growth of the health of your hormones.
10:58 Speaker 00 For individuals in developed countries, which I assume most of our listeners are, I would say fiber would be the number one. Only a small percentage of Americans get enough healthy fiber.
11:11 Lewis Howes? Five percent. Only five percent get that. Wow. How much fiber would we need for it to be a good amount?
11:17 Speaker 00 I'm not sure how many, how much fiber you would need for a healthy amount. But there's three main types of fiber.
11:22 Lewis Howes? Okay.
11:23 Speaker 00 They have what's called an RDA, which is a recommended daily allowance, which is basically, that's what you need to prevent deficiency.
11:30 Lewis Howes? Okay.
11:31 Speaker 00 And there, on most nutrition labels, there is soluble and insoluble fiber. And it's total fiber and dietary fiber. So dietary fiber is the same thing as soluble fiber. And that is one of the types that very few Americans get enough of.
11:47 Lewis Howes? So what does that include? What types of foods?
11:50 Speaker 00 One example of dietary fiber is psyllium husk or psyllium powder. L-methyl cellulose is another type. But there's a lot of, um, most foods have a combination of both soluble and insoluble fiber.
12:02 Lewis Howes? Okay.
12:03 Speaker 00 You also have a special type of fiber known as prebiotic fiber. And think of that as the fish food for your gut microbiome. It's what the good bacteria in general, the good bacteria like to eat. And they, basically, you can't just throw fish into your microbiota tank of your gut and your oral microbiome as well. You need to feed them.
12:23 Lewis Howes? Really? Okay. So these different types of fiber, what would be the top fiber foods that you like to eat or prescribe?
12:32 Speaker 00 I like root vegetables quite a bit. You have to be a little careful because a lot of root vegetables are high in what's called FODMAPs. But FODMAPs are not necessarily evil. An example would be garlic. Another one could be leeks, ginger, chicory root for some individuals. Although chicory root oddly has some interaction with ragweed allergy. So some people can kind of cross react with that, have an allergic response.
12:57 Lewis Howes? So those are some of your favorite fiber foods, right?
13:00 Speaker 00 Mm-hmm.
13:01 Lewis Howes? Um, okay. So what's the second thing you would recommend of the five top foods, fibers?
13:06 Speaker 00 I would say a protein source and then three would be an omega-3 source. One of my favorite protein sources is red meat. There are plenty of good protein sources that are not meat. But you'd certainly want a good protein source, especially if you're trying to optimize your, like your health span or your physical function.
13:29 Lewis Howes? Mm-hmm.
13:29 Speaker 00 It is certainly possible to get all of your necessary vitamins and nutrients without having meat in the diet. And it's also possible to get enough omega-3s without having fish in the diet, but it can be difficult.
13:42 Lewis Howes? Really? So how much, how much meat protein do you eat? And then how much do you recommend a person who's maybe not as, you know, fit and athletic looking as you?
13:55 Speaker 00 Personally, I eat almost, probably not quite one gram, but almost one gram per pound of body weight per day.
14:03 Lewis Howes? Per day?
14:03 Speaker 00 Which is extremely high, but I also like protein quite a bit. And I try to eat sources that are relatively lean because most people, if you just tell the average person to go out and say, "Go eat one gram per pound of body weight", which is a ton, and most people do not need that much. And they will just consume too many calories.
14:21 Lewis Howes? Gotcha, yeah. So how much do you weigh?
14:23 Speaker 00 Two hundred pounds.
14:24 Lewis Howes? Two hundred pounds, so two hundred grams of red meat or protein per day?
14:29 Speaker 00 Protein.
14:29 Lewis Howes? I was gonna say, that's a lot of red meat, right? So two hundred grams of protein, about a pound per body weight, that makes sense. And how much of that protein is red meat daily?
14:40 Speaker 00 About two to three times per week, so not every day.
14:43 Lewis Howes? Not every day, two, three times a week. And it will be, how much of a percentage of the two hundred grams will be?
14:52 Speaker 00 Will be from red meat?
14:53 Lewis Howes? Yes.
14:54 Speaker 00 Oh, on a weekly basis, probably only five to ten percent.
14:57 Lewis Howes? Five to ten percent of the two hundred grams per day of the three days a week. Gotcha. And what are some of the other top proteins you recommend?
15:08 Speaker 00 Salmon is one of my favorite protein sources. Salmon's almost more of an omega-three source in the third category than a protein source.
15:16 Lewis Howes? But it's also high in protein too, right?
15:17 Speaker 00 Correct. I'm a fan of beans as well, so there's a lot of different types of them. Some are relatively low in protein. There's also, you know, like garbanzo beans have a source of protein. Beans like brown beans or black beans also have protein. They are not near as high quality, but they can be complementary to help make up the other half.
15:40 Lewis Howes? Dr. Gabby Lyon also talks about this, you know, why is the high protein so important for also hormone optimization in the diet?
15:50 Speaker 00 A lot of the ancillary hormones, for example peptide hormones or amino acid hormones, are literally synthesized based on the protein that's in the diet. So a lot of proteins, like meat proteins are high in sources of methionine or cysteine or carotene, which is just a peptide with two different amino acids in it. But your thyroid hormone is tyrosine, that's changed over and changed into the thyroid hormone with iodine. And your dopamine is also tyrosine. Tryptophan, another amino acid common in many meats, but also just a lot of protein sources. And of course, some people do take tyrosine and tryptophan as a supplement, enforcing the idea that food is medicine.
16:35 Speaker 00 But tryptophan can form both serotonin and melatonin and many other hormones as well.
16:41 Lewis Howes? What happens if you, let's say, did? Twenty percent of the protein intake per day. So you only did forty grams of protein a day, I guess, as opposed to the two hundred. What would happen to your hormones, your, your muscles, your body and your overall health with twenty percent as opposed to, you know, a gram per pound of body weight?
17:07 Speaker 00 Yeah, and even compared to point four or point five grams per pound of body weight per day, forty grams, you know, that's not, that's, that's, that's pretty low. But if you have a decent amount of muscle mass stored up and let's say you're intermittent fasting or you're on a fasting mimicking diet for fatty liver disease in a short term, then it will have mild effects. But in a long term, it will have significant effects.
17:35 Lewis Howes? Really?
17:36 Speaker 00 Not just because that there's building blocks, but there is a, think of it as the cascade of aging and whether or not aging is normal or pathology doesn't really matter because this cascade still looks. Dr. Pataki with the Mayo Clinic wrote an excellent article about two years ago. And you can see a chart in there and at the top you have, you know, increased calorie consumption, decreased protein consumption, sarcopenia and osteopenia, which is loss of protein in the muscle and loss of bone mass. And then you have a decreased metabolism, then you have metabolic syndrome and insulin resistance, diabetes and hypertension, and then you have all the diseases, the end diseases of aging like cancer.
18:20 Lewis Howes? So what I'm hearing you say, high calorie diet, low protein diet is susceptible to having longer term health risks. Is that what I'm hearing you say? So if you're having just lots of sugars and calories consumption and you're having, you know, a lower percentage of, of protein in the diet, it could cause potentially diabetes down the line, it could. Shorten your lifespan. Is that what I'm hearing correctly?
18:50 Speaker 00 Yeah. Along with that, you have metabolic syndrome and diabetes. And I would consider that the most common cause of hormone dysfunction. That affects your insulin and your IGF-1, which is kind of a marker of growth hormone. It affects your SHBG, which binds all of your sex hormones. Well, actually, it just binds estrogens and androgens, not progestogens. But still, you're going to have a lot of downstream effects. On top of that, high carb, low protein diets are usually highly processed as well.
19:20 Lewis Howes? Right.
19:20 Speaker 00 We call these foods high glycemic in product foods like chips, crackers and cookies.
19:25 Lewis Howes? Stuffed in bags and boxes.
19:27 Speaker 00 Yeah. It's really easy to eat.
19:29 Lewis Howes? It's quick.
19:30 Speaker 00 Yeah, I don't really think it's anybody's fault. But it's just so darn convenient that people overconsume them.
19:36 Lewis Howes? It's quick, it's fast, it's cheap, it's easy, tastes good, right? At least it tastes good in the moment, but it doesn't necessarily feel good long term, right? Because then you start to feel sluggish, stressed, anxious, low energy, right? You're gaining the pounds, you're not burning your metabolism as much. So how does someone increase the growth hormone in the body? In terms of like the healthy growth hormone, not the cancerous side of things. But like the side that's going to make your body composition, your muscles bigger and stronger. You know, look younger, that type of hormone.
20:11 Speaker 00 Yeah. So there's several ways that you can help increase growth hormone. Growth hormone's interesting because it has a very fast half-life, just minutes. And it has what's called pulsatile secretion. So growth hormone-releasing hormone and also ghrelin, which most people are familiar with because it kind of makes you anxious and hungry. They help release growth hormone from the pituitary. And in just a couple of minutes, it will act on various tissues, for example, the liver, to produce IGF-1, which when it's bound to its binding proteins has a half-life of maybe a week. So IGF-1 does a lot of the action of growth hormone. When you overconsume calories, it can help produce growth hormone. There are some amino acids that can somewhat help with growth hormone production
20:54 Speaker 00 since it is a peptide hormone like arginine. But at the end of the day, a lot of it will just come down to how good is your sleep? Since a lot of that pulsatile secretion of growth hormone happens during sleep.
21:08 Lewis Howes? Which is why it's one of the pillars of your, the six pillars of hormone health, sleep. How much sleep are you trying to get a night on average? And how important is it for the, the quality of sleep to be there as well?
21:23 Speaker 00 Around seven to eight hours a night. Both quality and quantity are particularly important. I'm not a sleep scientist, there's lots of good ones out there. But when you're looking at sleep, even if you're one of the individuals that has a genetic predisposition to sleep very, very little, that can also affect your health, including your hormone health, especially over a long time. And it is somewhat possible to stockpile sleep. I know some biometric wearables even have like, this is your stockpiled sleep, which is kinda cool. But you can't really ever truly catch up on sleep.
21:56 Lewis Howes? Right, right, yeah. Shawn Stevenson, who talks about like, sleep debt is a real thing and you can never really pay off the debt.
22:03 Speaker 00 Correct.
22:03 Lewis Howes? You can kinda get back to a standard of where you are now and try to optimize from there. But it's like, if you do 20 years of sleeping very little, it's gonna be, you can't really recover that, right? It's gonna be hard. What do you focus on for yourself the most in terms of like, the hormone you're trying to optimize? Or do you just try to look at it from a holistic approach of like, living in these six categories on a daily basis?
22:27 Speaker 00 I suppose it depends on if you consider some amino acid based molecules hormones. For example, it's dopamine hormone, it's technically like a tyrosine based hormone. So that would be a, one that I would put near the top of the list. But in general, again, hormone health, you want to figure out what's holding you back the most. Is it your androgen, is it your estrogen? Some individuals, and I'm actually in this category as well, struggle with keeping estrogen high enough. Estrogen in both men and women, the average woman has about four times as much testosterone than estrogen. In both men and women, the lower your estrogen, the higher your risk of plaque buildup, the higher your risk of osteoporosis.
23:09 Speaker 00 And in general, the higher your risk that your coronaries are going to be occluded, which is a very common cause of morbidity and mortality in both males and females, especially males.
23:19 Lewis Howes? Okay, interesting. I want to complete the five foods. I'm going off the topic here. So you said fibers, proteins, omega threes. What are the other two that you would recommend?
23:31 Speaker 00 Since we've covered our essential amino acids and our essential fatty acids and our fiber, which is almost always depleted, I would say these two are not as important. But for me, I would put timing of carbohydrates or perhaps lack of carbohydrates. In the morning, I like to not eat too many carbohydrates because I feel that insulin spike and glucose spike and drop down. Some people can be very insulin sensitive and be more prone to this. And also, it causes, it can cause what's called alkaline tide, where your stomach acid produces extra pH. But a lot of foods can cause this as well. So timing of nutrients. And then, if you are more insulin sensitive or your insulin runs very low, insulin is a particularly
24:12 Speaker 00 anabolic hormone. So timing that for a meal before a workout or even after a workout can be helpful. So I would say that would be number four. And then, number five, I would say avoidance of alcohol. So if you drink alcohol, a very small amount is not going to, there's not an alcohol debt like there is sleep debt that I know of. But even in moderate amounts can be harmful for your health in the long run and somewhat in the short run as well. So trying to limit that to, I'd say, for the average person, two to three times per month.
24:49 Lewis Howes? Gotcha. So timing your carbs, can you break that down first for me? When would you prescribe the optimal time to eat and consume carbs for the average person versus maybe someone who trains every day really hard, five, six days a week and an intense workout? What's the difference?
25:07 Speaker 00 The average person, you can parse them out throughout the day as desired. For the elite athlete, and there's been many studies done on this, of course, as there are studies done on everything, but there's been pretty good studies looking at the correlation between the amount of carbs consumed and cyclists with their, I believe their total finishing time. And this was a very long cycling event. Hours throughout the day.
25:34 Lewis Howes? An endurance event, yeah, yeah.
25:36 Speaker 00 And there is a statistically significant correlation where if you are a cyclist that is a faster cyclist, better I suppose, but a faster cyclist, you do consume a higher amount of carbs throughout before, during, and after.
25:53 Lewis Howes? The event, interesting. What if you're just training, you know, for yourself? What is your timed restriction of carbs? When do you eat them? Do you eat them before workout, after workout? Do you fast in the morning and workout? How does that work?
26:08 Speaker 00 Just for convenience, I exercise before I eat in the morning. The kids are asleep and it's really the, just due to convenience, it's the only time that I can consistently do it without putting it off.
26:19 Lewis Howes? You get up, you go and work out, you don't, and then you eat something afterwards.
26:22 Speaker 00 Yeah.
26:23 Lewis Howes? Do you wait a period of time after the body is, you know, moving? Or do you kind of have protein quickly after you work out?
26:30 Speaker 00 Immediately. I'm starving. There's obviously no anabolic window, but if you're hungry and your GI can tolerate it, then I don't see any reason why you couldn't eat right away.
26:41 Lewis Howes? Got you. So you eat right away. What happens if you delay eating protein an hour, two hours after earning, you know, a pretty intense workout, whether it be cardio intensity or a muscle building intensity?
26:52 Speaker 00 It could be marginally, statistically significantly worse for you.
26:57 Lewis Howes? Really?
26:57 Speaker 00 But clinically significantly likely no difference.
27:01 Lewis Howes? Got you. So it is better to consume protein within 30 to 60 minutes, let's say, after a workout?
27:08 Speaker 00 Only if you're fasted.
27:09 Lewis Howes? If you fasted for 12 to 16 hours.
27:13 Speaker 00 Correct.
27:13 Lewis Howes? If you haven't fasted for, let's say you do your workout in the afternoon, you've had a meal or two beforehand, you do it at 5 o'clock.
27:21 Speaker 00 I would say there's no statistically significant benefit or clinically significant benefit.
27:26 Lewis Howes? Of eating quickly or waiting longer to eat afterwards.
27:29 Speaker 00 Correct.
27:29 Lewis Howes? Got you.
27:30 Speaker 00 It's a good example of something that could be statistically significant in a lab where you can see adaptations or changes. Perhaps you're studying mice usually.
27:39 Lewis Howes? Sure.
27:39 Speaker 00 But it's not really applicable clinically because there's so many confounding variables.
27:44 Lewis Howes? So much going on. I mean, I'm glad you talked about alcohol because. I've never, I mean, I talk about this on here, I maybe have like a Baileys on ice like twice a year. I've never been drunk, I've never had a full beer in my life. It just never was a desire of mine. I never felt pulled to it, I never felt called to it. No judgment for people that do it, but I just, for me as an athlete, I knew it would hold me back.
28:08 Speaker 00 Yes.
28:08 Lewis Howes? To accomplish my athletic results. So I was just focused on my mission. And then after, you know, playing football in college and professionally, I was like, nah, why start now? You know, it didn't make sense. I didn't have any money. I wasn't like even trying to spend money on alcohol.
28:22 Speaker 00 Yeah.
28:22 Lewis Howes? And then it just didn't become a desire of mine. But there are countless, you know, research showing the negative effects on the body and on the hormones of alcohol, right? And on the brain, you know, Dr. Daniel Amen talks about his studies too, of seeing brain scans of people, you know, who drink a lot of alcohol and those who don't, and you see, obviously there's other factors that come into environment and stuff as well, but you see the effects on the brain with an amount of consumption of alcohol, you know, a certain amount, right?
28:56 Speaker 00 There's not many neuroscientists that consume a high amount of alcohol, or even a small amount of alcohol.
29:01 Lewis Howes? Not even wine, right? Not even like a couple glasses of wine a week. Is there any benefit at all to the body, to the brain, or to the hormones in a healthy way with alcohol?
29:13 Speaker 00 Physiologically, no, but socially, certainly, yes.
29:17 Lewis Howes? But doesn't that go back into like, okay, if you're just an anxious human being and you need that crutch to have a conversation, that means you've got to address a fear, a concern that's holding you back, an insecurity, and work on that insecurity, whether it be fear of embarrassment or anxiety, like work on that thing.
29:36 Speaker 00 Yeah.
29:36 Lewis Howes? Don't use a crutch, which I'm, easier said than done, but if you could lean into that, it would make you a more competent person, it would increase your health.
29:45 Speaker 00 Certainly.
29:46 Lewis Howes? All that stuff, right?
29:47 Speaker 00 Yeah, another downside of alcohol, including red wine, that some people think about is alcohol is seven calories per gram. So carbs and proteins are four and fat is nine. So alcohol is closer in caloric density to fats than to carbs and proteins.
30:04 Lewis Howes? Yeah.
30:05 Speaker 00 So if you thought about that same amount of alcohol, if it, let's say it's 100 proof or 50%, then fill that up instead with, and this is assuming no sugar, fill it up instead with half oil and pick canola oil or something.
30:20 Lewis Howes? Oh, man.
30:21 Speaker 00 That way, someone's like, oh, olive oil is okay. And then half water, and that's very calorically dense.
30:25 Lewis Howes? That's what it is. Half, half a cup of water, half a cup of oil, essentially, or whatever, that's what you're...
30:31 Speaker 00 Essentially, you know, it is seven and nine, so it's not directly analogous, but it's pretty close.
30:37 Lewis Howes? Yeah, so it's a lot of calories. It's not good for your brain, it's not good for your gut, and it costs money. You know, this is a lot of negative effects to it, then there are positive. A lot of people want to figure out how to optimize for burning fat or removing fat, specifically from the belly and, you know, the back areas. What is the main cause in your mind to, why it's so hard for people to get rid of that extra 20 or 30 pounds of belly back fat?
31:08 Speaker 00 So when you think about fat burning, there's two different phenomenon at play. One is thermodynamics, so there's more calories in than calories out. And then the other is lipolysis. So if you're going to restructure or recomp a building or your body, you have to remove blocks in some places and then put blocks in other places. So a lot of fat burners help with lipolysis. So they break fat molecules down and they increase, for example, mitochondrial beta oxidation, which is basically just you're metabolizing fats and then using them in the electron transport chain in the mitochondria. The details don't really matter, but that's essentially the powerhouse of your cell.
31:51 Speaker 00 And you can do that all you want, but if you're still, you know, in, at caloric maintenance or even excess surplus, then you're just going to take all those blocks and then put them right back into fat cells.
32:02 Lewis Howes? Got you. So you need a caloric deficit, it sounds like, somewhere, at some point, in order to remove... You need to be exercising more than you're consuming. You're burning more calories than you're consuming.
32:16 Speaker 00 Correct.
32:17 Lewis Howes? Or consuming less than you normally would.
32:19 Speaker 00 There's many tools and ways to achieve this, of course.
32:22 Lewis Howes? Sure. What ways?
32:24 Speaker 00 So, the OG way is just counting calories.
32:28 Lewis Howes? Right.
32:29 Speaker 00 And even if you look at doctors and dietitians, we usually underestimate the amount of calories that we consume, I believe by at least 10%.
32:38 Lewis Howes? Wow.
32:39 Speaker 00 And we overestimate the amount of calories that we burn by about 10%.
32:43 Lewis Howes? We think we're burning more.
32:44 Speaker 00 Correct.
32:45 Lewis Howes? Or not.
32:45 Speaker 00 Even doctors and dietitians.
32:47 Lewis Howes? Really?
32:47 Speaker 00 Yeah.
32:47 Lewis Howes? And we think we're eating less, but there's always hidden calories in something, right? Or you maybe didn't weigh it perfectly, or it was a bigger size or something, right? Okay, so that's the original ways to count calories. Do you recommend that strategy?
33:00 Speaker 00 For some individuals, it's particularly helpful. Most of the time that I see a patient in my clinic, and a lot of what I do is obesity medicine, I am board certified in obesity medicine. They have already done that. And many of the time, they say, "It doesn't work, and I eat like a bird." And there is nothing, there's nothing quite as powerful to destroy a physician-patient relationship than to just tell the patient that they're lying, or that they don't know what they're talking about.
33:30 Lewis Howes? Right.
33:30 Speaker 00 So it's not helpful to push that angle of vector. It's just a tool, and there's many tools in the toolbox. For some people, whether it's genetic, or epigenetic, or just their situation that they're in in life, or their mental health, or their hormone health, it makes it very difficult for them to lose weight, almost like it's more difficult for someone in quicksand to get out. So you can teach a person how to dig. That's your lifestyle interventions. But you should also give them a shovel to help out.
34:03 Lewis Howes? Right.
34:03 Speaker 00 It doesn't necessarily mean that you throw a shovel at them.
34:06 Lewis Howes? Sure.
34:06 Speaker 00 But that's where medications and supplements come in, to address, whether it's insulin resistance, or whether it's their mental health, or their hormone health, to help give them the tool to do it themselves.
34:16 Lewis Howes? Hmm, okay. So the counting the calories works for some, doesn't work for everyone. What else would you suggest they do then? Or what have you seen has been really effective consistently for people you've worked with?
34:29 Speaker 00 When I write a prescription for this, I have several different areas or boxes that I can circle. And one of them is number of meals per day. One of them is macronutrients, for example, carbohydrates. One of them is timing of meals. One of them is eating speed. So there's a lot of strategies to develop good eating speed habits. For example, split your meal into three different portions. Consume one, wait 10 minutes. Consume the next one if you would like, wait 10 minutes. And then consume the last one if you would like.
35:03 Lewis Howes? So don't just put it all in your mouth in 10 seconds. That's what I'm hearing you say, which is kind of my whole childhood. Just like eat as fast as you can, not know that you're full and just keep eating more, right?
35:14 Speaker 00 These are extremely powerful for pediatric patients for childhood obesity. I believe in the New England Journal of Medicine did a study. And it was called the Turtle Bite Study. Where every five or 10 bites at some interval, they took one. The kids took one bite that was extremely slow. And it was helpful for recomposition of those kids.
35:36 Lewis Howes? Really? You mean recomposition of their bodies?
35:40 Speaker 00 When you're in the field of pediatric obesity medicine, you're not really going. Your end target's not weight loss.
35:47 Lewis Howes? Sure.
35:48 Speaker 00 It's usually weight gain, but a body recomposition.
35:52 Lewis Howes? Huh, so less fat.
35:54 Speaker 00 Correct.
35:54 Lewis Howes? Weight gain, but more like you're growing as a child either way. But it's diversifying the weight gain, I guess, right?
36:01 Speaker 00 Correct.
36:02 Lewis Howes? Directing it in another place. Interesting. Okay, so we have meals per day, timing of meals, eating speed. I think you said one or two others.
36:11 Speaker 00 Timing of meals, that would kind of incorporate intermittent fasting, which is not. It's more of a health tool rather than a weight loss tool.
36:18 Lewis Howes? Meals per day, eating speed, timing.
36:20 Speaker 00 I'm sure there are other tools. Those are the ones that I remember off the top of my head.
36:23 Lewis Howes? If you were just saying, hey, listen, I don't want to count calories, you know? I'm probably not going to do the intermittent fasting thing. I'm not gonna eat slower or like split it up in three things. That seems like too much work for me. But I will eat one less meal a day, right? Or only a certain amount of meals and then I'll essentially be intermittent fasting in that process. But if I looked at it as okay, what would my meals per day look like? If I wanted to consume a little less calories, obviously I'm gonna feel hungry, but when can I do it where I'm not gonna wanna munch on extra calories? What would that be? Skip dinner? Is that, you know, what does that look like?
37:00 Speaker 00 I would say skip eating after dinner and don't even worry about taking away a meal. No eating after 7pm. That being said, if you do remove one meal, whether it's breakfast or lunch or dinner, it is not helpful at all for weight loss or body composition.
37:16 Lewis Howes? To remove one meal is not helpful?
37:17 Speaker 00 Correct. So in isolation, removing one meal is not helpful at all for weight loss.
37:22 Lewis Howes? Really?
37:23 Speaker 00 It's truly an intervention for health reasons if you would benefit from that. Less mTOR signaling, less like growth signaling in cells in general, or more of a reprieve where your body's immune system has a chance to go throughout the rest of your cells and see if there is abnormal ones.
37:42 Lewis Howes? Okay.
37:43 Speaker 00 For most individuals, unless they like doing that for mental clarity, whatever benefit, some people really like skipping breakfast. But many people, especially those that struggle with metabolic syndrome, have other pathologies. There are several new ones. There is sleep eating syndrome where you eat, you're sleeping, you wake up and then you eat and you don't even realize it.
38:02 Lewis Howes? Really?
38:02 Speaker 00 You see that there's, you know, a bag of chips and you literally don't even remember it, almost like sleepwalking.
38:07 Lewis Howes? Wow.
38:08 Speaker 00 And there's also night eating where you consume almost all of your calories between dinner and bedtime. Often these individuals also stay up late at night.
38:16 Lewis Howes? Those are chips, snacks and other like kind of emptier calories, right?
38:20 Speaker 00 Correct. But they don't eat breakfast.
38:22 Lewis Howes? Really? Ice cream cookies or whatever it might be, yeah.
38:25 Speaker 00 Yeah.
38:25 Lewis Howes? So that's, that's the time where you could really, if you just stop eating after dinner, you'll, you'll eat less calories. And that sounds like you're still at kind of like the even maintenance. You're not a caloric deficit, correct? Unless you eat less in each meal.
38:42 Speaker 00 Correct. And obviously it's possible to be in a deficit and do that as well. But that's your biggest bang for the buck is not eating anything after dinner. Because society values family dinners and also social dinners with colleagues and whatnot, it would be very difficult to tell everybody to stop eating dinner. But if you wanted to design the perfect, like in a lab, Truman Show style, whatever you want to call it, not eating after about 3pm would be even more beneficial.
39:14 Lewis Howes? For weight loss.
39:16 Speaker 00 For health reasons.
39:16 Lewis Howes? For health, not weight loss.
39:18 Speaker 00 I don't think it would have any effect with weight loss. Maybe it would, but that I know of it has not been studied.
39:24 Lewis Howes? Gotcha. So it's truly because you could still consume all your calories in the morning and in the afternoon before 3 o'clock for the day. You could still consume a lot of calories, is what you're saying. So you'd still have to cut the amount of calories in that timing window.
39:41 Lewis Howes? And then you'd just be intermittent fasting longer, right? Which would help for health benefits and maybe would, I guess, help cleanse some of the dead cells and kind of like regenerate new cells, that type of thing, but not necessarily for weight loss. That's what I'm hearing you say. But at the end of the day, it sounds like it's a caloric deficit.
39:59 Speaker 00 Yeah, and it's just a matter of helping provide individuals with the tools that will work best for them. So for some, they might need a shovel and for some, they might want and or need a backhoe.
40:11 Lewis Howes? Sure, sure. What, it doesn't seem like you've ever been out of shape. Have you ever been overweight?
40:16 Speaker 00 When I had my first child, I was about 40 pounds overweight.
40:21 Lewis Howes? Really?
40:22 Speaker 00 Yeah, and I could hardly tell because I'm so.
40:24 Lewis Howes? You're tall. Yeah, it's hard to see. So it's kind of like the fat's just a little bit everywhere, right?
40:28 Speaker 00 Yeah.
40:28 Lewis Howes? So how did you burn that 40 pounds? What did you do?
40:33 Speaker 00 I eliminated all liquid calories.
40:35 Lewis Howes? Yeah.
40:35 Speaker 00 I ate foods of low caloric density, but high nutrient density.
40:40 Lewis Howes? Like what? These five types of food groups are?
40:43 Speaker 00 Mm-hmm.
40:43 Lewis Howes? Yeah.
40:43 Speaker 00 A lot of salmon. I love spinach. I had a lot of spinach. That would kind of go under the fiber category. I love carrots, although carrots don't have a lot of dietary fiber. They're just kind of empty, insoluble fiber, if you will. Not totally, of course.
40:57 Lewis Howes? But it's not, not many calories.
40:59 Speaker 00 Yeah. And a few months later, I was kind of back at my baseline.
41:04 Lewis Howes? Really?
41:05 Speaker 00 Yeah.
41:05 Lewis Howes? Forty pounds, just like that, a few months? Just by changing the way you ate?
41:09 Speaker 00 My biggest intervention was I eliminated all liquid calories. And I did not have any more than two caloric beverages. Whether it was, you know, like a coffee with a bunch of cream in it. I did learn to like black coffee during that time. And I still do. But no more than two beverages with calories in them per month.
41:30 Lewis Howes? Interesting, because like something like a bulletproof coffee, which is, you know, a lot of people talk about intermittent fasting with a bulletproof. That still has a lot of calories, doesn't it?
41:38 Speaker 00 I don't know the macronutrient profile on bulletproof offhand, but I believe it's mostly protein.
41:44 Lewis Howes? Okay.
41:44 Speaker 00 So if it's, the one exception to that for some individuals could be a protein shake. And you would probably want to consume this in the morning rather than the evening. That way you can have the benefit of some degree of appetite suppression. Some protein shakes like casein, which is an interesting one to talk about because it can also affect prolactin. And some people negatively, if their prolactin's too high, casein can increase it. But casein's also digested very slowly. And it has a lot of amino acids in it that will activate mTOR. So during your eating window through the day, if you consume your casein at the beginning of the eating window, then it could be helpful to provide satiety and also help with anabolism.
42:29 Speaker 00 But if you consume it at the end of your day, then it's gonna essentially cut short your fasting period.
42:35 Lewis Howes? So if you have a protein shake after eight o'clock, right? Say someone's working out consistently and they're doing a workout in the morning or the afternoon. They eat their dinner, but then they're still hungry and they say, well, let me just do a protein shake, right? It's a hundred fifty, two hundred calories, but it's twenty to forty grams of protein. Are you saying having that because it got the calories, it's extending the eating window?
42:58 Lewis Howes? So it's not allowing you to burn off those calories more? What are you saying there?
43:03 Speaker 00 That would be more for health reasons. For example, let's take an intermittent faster that right before bed every night, they have a shake of 50 grams of casein. So that's essentially making their intermittent fasting for health reasons worthless.
43:17 Lewis Howes? Why?
43:17 Speaker 00 Because their mTOR is still very active for many hours at night. However, if you are looking at the satiety benefit of specifically protein, if your shake has just protein in it, then that's going to help provide some degree of satiety.
43:34 Lewis Howes? Well, you're not hungry, is what you mean, yeah.
43:36 Speaker 00 Yep, and there's obviously a lot of factors to this. One that has received a lot of press recently is called GLP-1. There's all these different drugs like semaglutide that are GLP-1 agonists. And if you look at carbs, carbs spike up GLP-1 very quickly. GLP-1 is produced in a lot of areas, but a lot of it is the gut and also the pancreas. And then fat will increase very, very slowly, but it will increase GLP-1 for a long time. The protein is somewhere in between.
44:09 Lewis Howes? Of these six areas, which one will affect hormones the most if you neglect? If you have the other five that you're doing a great job at, but you neglect your nutrition and it's all processed food and high-calorie sugary drinks? Or you don't exercise at all, but you eat perfect and you do everything else perfect? Or you don't get that much sleep? Or, you know, your stress is through the roof, whatever it might be? Or you have no spiritual compass? Which one do you feel like will hurt you the most? If the other five are great and one is out of sync?
44:47 Speaker 00 I would say diet and exercise hurt you equally the most. However, exercise is slightly more acute. You'll see a billion different studies, and a lot of them are talking about the release of things like testosterone or growth hormone during or right after exercise. So they can give a bit of an effect, but a lot of that's autocrine or paracrine. For example, there's different types of IGF-1, which is the growth hormone sequelae. So when you're looking at those studies, they can affect you to some degree acutely, and a lot of that is just how you feel. In the long run, so if you just all of a sudden stopped exercise versus stopped eating a healthy diet, they will affect you relatively equally.
45:31 Speaker 00 But how you, like, the hormone effects of exercise are more easy to see in the acute time phase. And maybe this stuff is mostly just scientifically significant, but not clinically significant.
45:44 Lewis Howes? Sure, sure.
45:45 Speaker 00 But there is very clear statistically significant data on it.
45:49 Lewis Howes? What do you think is the biggest risk for men and the biggest risk for women over the next five to 10 years of the what's happening in the world, the environment, the way people are eating, you know, the way people are not moving their bodies? What is the biggest risk?
46:06 Speaker 00 I'd say it's probably relatively similar. The biggest risk for some time has been metabolic syndrome. And part of that is not getting outside. One of the S's is sunlight, and that does encompass heat exposure and cold exposure and walking and just being outdoors. Humans are meant to be outdoors, and we have been for a long time. Now we have these wonderful artificial environments. But it's not necessarily good for health. And in the last few years, we have been indoors and not socializing and not outside more than ever. So that is going to be fuel on the fire of metabolic syndrome.
46:45 Lewis Howes? What does metabolic syndrome mean?
46:47 Speaker 00 Metabolic syndrome is a kind of a constellation of disease that includes insulin resistance, high body fat, specifically abdominal body fat, a high BMI, a large abdominal circumference around the umbilicus, which is the belly button, and high cholesterol, high glucose, high A1C, which is the average glucose over the last few months. And that together is metabolic syndrome, also known as prediabetes, which about 40 to 50% of Americans have. And many of them don't know it.
47:27 Lewis Howes? Almost 50% of Americans have prediabetes.
47:30 Speaker 00 Correct.
47:31 Lewis Howes? And what is prediabetes? When do you reach the point of prediabetes? What is the, is it BMI? Is it something else?
47:36 Speaker 00 There's a couple of ways to check it. One is two different fasting blood glucoses, truly fasting, over 100. That's actually not a great way to check it. Better ways to check it is an A1C, which is the hemoglobin molecule that is glycosylated, so has a glucose attached. You can also check it with a glucose tolerance test, which is quite good. Or things like fructose amine or glycosylated albumin. Those are just proteins that, again, have a glucose attached. So you're looking at how your body partitions glucose in the vascular system versus inside the cells.
48:12 Lewis Howes? Wow. Okay, so how do we, how do we prevent metabolic syndrome? Does that mean we gotta be outside more frequently? Does it mean we be outside longer? Is it taking, you know, 10, 20 minute breaks outside? What does that look like?
48:26 Speaker 00 It encompasses all six of the lifestyle pillars. Again, mostly diet, lifestyle, and being outside. But some of it just has to do with, and these are less strong effects, but some of it is the endocrine disruptors in the environment, like bisphenol A. And some of it is the processed foods, the trans fat. Those things will have a significant but small effect, but it could be additive and cumulative as well. So all those other small things that add up will have an effect. And they're just, again, they're, they're maybe not a log, but they're a stick on the fire of metabolic syndrome in our society.
49:10 Speaker 00 Screening is one of the best ways, if you screen for it. And there's actually a goal, one of the national health organizations has a goal called Healthy People 2030. And one of the goals is to decrease the prediabetes prevalence, I believe, from forty to thirty-four percent.
49:33 Lewis Howes? Wow.
49:33 Speaker 00 It's a pretty small decrease, but it's good to have a goal in the right direction.
49:37 Lewis Howes? How are you planning to do that in the next eight years?
49:39 Speaker 00 To screen people, because if you screen them, then you can treat them. And there's, every year, there's many new medications and supplements, which again are just tools to help for metabolic syndrome. If you treat people that have metabolic syndrome or prediabetes, then it is considered completely reversible. However, if they develop diabetes, then it is very difficult.
50:02 Lewis Howes? It's very challenging, yeah. I mean, you're in the Midwest, you're in Kansas. I lived in, you know, I grew up in Ohio. I lived in Minnesota. I lived in Missouri in St. Louis. I lived in Alabama for a little bit of time. And now I live in Los Angeles. And it seems to be, when you go to the Midwest, you see a lot of obesity, right? You see a lot of people who are probably fit in this category of prediabetes, or they have diabetes, right? They're, they're struggling, let's say, with their weight and with their weight loss. Is that an accurate statement? When you're out and about with the family at a different events or at the store and you see this, correct? Why do you feel like it might be more in the middle of America
50:46 Lewis Howes? than what it seems to be on the edges of America?
50:50 Speaker 00 It's almost all lifestyle. People are taking very similar medications and supplements. People are not moving as much. They drive more. Some cities are almost exclusively driving back and forth. You never see bikes on the road or joggers or hikers.
51:05 Lewis Howes? Really?
51:05 Speaker 00 Yeah. And this tends to correlate very closely. You can look at an epidemiological map, and you can see that the Midwest and the South are usually the worst.
51:16 Lewis Howes? The Midwest and the South.
51:17 Speaker 00 Yep, higher incidences of obesity, prediabetes, many different health criteria.
51:23 Lewis Howes? I think a lot of that is lifestyle, that they're just not moving their body, they're not walking, biking, hiking.
51:29 Speaker 00 And they have different, yeah, they have different diets too.
51:31 Lewis Howes? And very processed diets, right?
51:33 Speaker 00 Yeah.
51:33 Lewis Howes? High calorie, sugary drinks, alcohol, all that stuff, right? Is that an educational thing? Is that a cultural thing? Is it a society like norm? What, what is that? You think it's a combination?
51:47 Speaker 00 It's a combination. One of the terms that's been thrown out there is called food intelligence. So on one side of this, it's not necessarily a dichotomy, but on one side of a spectrum or continuum, you have individuals that might not have very good of food intelligence.
52:03 Lewis Howes? Or access, you mean, or education around it?
52:05 Speaker 00 Yeah, food deserts is part of it, access is part of it too. And of course, there's people who are like uninsured or under, underinsured. But even if you account for confounding variables of like socioeconomic status and being a certain percentage above or below the federal poverty level, you see that people make different choices with food.
52:24 Lewis Howes? Interesting.
52:25 Speaker 00 And there's no such thing as good or evil foods. And I'm sure you and I have different preferences too. For example, maybe I love spinach and you hate it.
52:35 Speaker 00 But when you're learning how to eat healthier and healthier foods, some people will swing all the way to the other side of the continuum where they develop conditions like, and this is an official term, but orthorexia, or I call it intellectualized eating, where they're terrified of eating something that might be an unhealthy, bad food.
52:56 Lewis Howes? Like anything processed, they're terrified of it, right? Which might, which causes more stress and anxiety as opposed to just, okay, I'm gonna have some of this, you know, 10, 20% of the time and allow myself to have some as opposed to being so strict.
53:09 Speaker 00 Yes.
53:10 Lewis Howes? Right? Which could cause hormonal side effects too, correct? If you're stressed about it all day long and worried about it. It's not gonna allow you to just kind of relax when you eat. But it sounds like prediabetes, because I remember hearing years ago it was like a third of Americans was obese or prediabetic or something. And now it's forty to fifty percent range?
53:30 Speaker 00 There's an interesting study done and they looked at what's called metabolically healthy. So they looked at A1C and they looked at glucose. They looked at BMI and I believe abdominal circumference around the belly button and also lipids. So cholesterol. So the cholesterol was, you know, that'll add a percentage of people. That added about thirty percent of individuals that didn't meet the other criteria. But only, it was six point, I think it was six point eight percent. So only about seven percent of Americans were considered metabolically healthy.
54:06 Lewis Howes? Seven?
54:06 Speaker 00 By those parameters.
54:08 Lewis Howes? Seven percent of America?
54:10 Speaker 00 Correct. If you removed cholesterol, that would increase to about thirty-five or forty percent.
54:15 Lewis Howes? Gotcha.
54:16 Speaker 00 But that's still not a very high number.
54:17 Lewis Howes? Holy cow. How do these, how does hormone health affect relationship health? And the quality of your relationships with your partners or in business or in your career intimately and family?
54:33 Speaker 00 There's a lot of interplay with the amino acid hormones or neurotransmitter hormones. So testosterone and dopamine are sort of close cousins. And estrogen is somewhat of a cousin with serotonin as well. And when you begin to have hormone dysfunction, one, without realizing it, your partner or your family might notice changes in your mood or changes in your behavior, which might be disconcerting to them. And then on top of that, some people will take on what we call the sick role. And this is extremely interesting when it comes to men's health.
55:13 Speaker 00 Because when you look at mental health, things like anxiety, stress as a general overarching term, or even depression.
55:23 Speaker 00 Men do not like going to the doctor. I would say more often than not, I ask the male what brings them in and they say, "The wife made me come in."
55:32 Lewis Howes? Sure.
55:33 Speaker 00 But part of that is that the male doesn't want to take on the sick role. It's almost this, this is too strong of a term, but kind of like a passive, they're passively self-harming by not wanting to go to the doctor. They know something is wrong, but they don't want to go because they don't want to be seen as weak, taking on that sick role.
55:53 Lewis Howes? Interesting. So it could hurt the relationship for sure. If you're not willing to, you know, take care of the hormones, if you're not willing to check on it, if you feel like something's off and take care of it, right? I'm seeing that with men, speaking of men, sperm count is down in the country, I guess probably in the world too. Testosterone is down, is that right, sperm count? You know, and there are other things happening with men. Is that all related to these six elements too, into their hormones? And how can men start to reclaim their sperm count and testosterone in healthy ways?
56:31 Speaker 00 I think a lot of it is, is related. It's not necessarily a direct correlation. A lot of it is the changes of the culture as well.
56:44 Lewis Howes? Really?
56:45 Speaker 00 Yeah.
56:45 Lewis Howes? With testosterone and sperm count?
56:48 Speaker 00 Not necessarily directly, but indirectly, yes. So you have a, a culture or, you know, in general, you're doing less physical labor. You're doing less manual labor jobs. And for thousands of years, in general, males, you know, work outside.
57:05 Lewis Howes? Work outside, working, lifting, heavy stuff, yeah.
57:07 Speaker 00 Correct. A physical job and something that, you know, provides, it's lower on that chart of Maslow's hierarchy of needs. It's your physical needs. There's, for many thousands of years, humans have had a difficulty achieving those physical needs. And now that we don't have that, it almost makes it harder to, because without thinking, if you're going for your physical needs and you're moving and you're probably not consuming a ton of calories, you're just trying to make ends meet and trying to make enough food for the family. Then you're not worried about self-actualization.
57:45 Lewis Howes? Right.
57:46 Speaker 00 So it's almost like a blessing in disguise. It's a blessing but a harm that we just worry about that now.
57:52 Lewis Howes? So men need to be outside more, moving more, lifting heavier things. Is that what you recommend?
57:59 Speaker 00 And and women as well.
58:00 Lewis Howes? And women as well. What happens if women aren't outside lifting everything? Should women be lifting everything for their body weight and size?
58:08 Speaker 00 Yes, in fact, I would say in general, the average male who is trying to optimize health probably needs to live more like the average female who's trying to optimize her health and vice versa. So the female probably needs to do more resistance training and eat more protein, and the male probably needs to do more cardiovascular training.
58:27 Lewis Howes? Really?
58:27 Speaker 00 And think about things like, you know, fiber and hydration and things like that.
58:32 Lewis Howes? And relationships and connection and all those things.
58:36 Speaker 00 Yep.
58:36 Lewis Howes? Why do you think women need to eat more protein and lift more weights or do more resistance training?
58:43 Speaker 00 There's always exceptions to this, but many women will come to the doctor or even just start a new fitness phase, and they will find some sort of cardio to do, and they will go on a, I'd call it a crash diet. You know, it's not a perfect term.
59:01 Lewis Howes? Right, right.
59:01 Speaker 00 But a very low calorie diet, even without the supervision of a doctor. And by the way, if it's beneath around 1,200 calories per day, it should always be under the supervision of a physician.
59:11 Lewis Howes? From men and women?
59:12 Speaker 00 Correct. But in general, you see many more female patients that do that. And along with that very low calorie diet, they're also consuming a very low amount of protein, and they are not doing resistance training. The average individuals who is losing weight of every pound that you lose, about 35% of that is lean body mass.
59:35 Lewis Howes? You don't want to lose your lean muscle.
59:36 Speaker 00 Correct.
59:37 Lewis Howes? Right.
59:37 Speaker 00 And statistically, or on average, the, a female is not going to have as much lean body mass that they can lose. If they lose 20 pounds and seven pounds of that is lean body mass, they lose all of that metabolic potential.
59:54 Lewis Howes? To burn, right, to burn, yeah.
59:56 Speaker 00 Yeah.
59:57 Lewis Howes? Interesting. So you want more muscle you have. The thing that women will say is, well, I don't want to look bulky, right? It's what a lot of women say. I don't want to look like a man or I don't want to be bulky and have these huge muscles. But you want to have a certain amount of lean muscle mass, which will help your metabolism, will help you burn the fat more or process the fat, right, into the muscle. And so without that lean muscle, you're losing all the extra health benefits.
1:00:27 Speaker 00 Yes. Unless a female is injecting anabolic steroids, lifting weights or resistance training is not going to make them look more bulky.
1:00:35 Lewis Howes? It's not.
1:00:35 Speaker 00 They might look more bulky than the average female at baseline, but...
1:00:40 Lewis Howes? Who doesn't work out.
1:00:41 Speaker 00 Correct, correct. But that being said, them compared to their other self in an alternate universe, if they do resistance training and lift weights, they will look less bulky.
1:00:51 Lewis Howes? Right, right. What does your workouts look like then? Is it one a day? And if you're in the, I'm trying to lose 20 to 40 pounds, having a child phase that you're in, is it two a days, a few times a week to help burn extra calories? What does it look like for you?
1:01:08 Speaker 00 I very seldom do two a days. And as an athlete, perhaps you do more exercise than me. But I try to exercise at least two times a week. And I feel best when I exercise five to six times a week, or even seven times a week. Sometimes it is particularly difficult if there's sick kids or there's a lot of duties to be done.
1:01:31 Lewis Howes? Yes.
1:01:31 Speaker 00 Sometimes you can kind of exercise by doing farm chores or taking care of the chickens or the garden. But it's just not the same.
1:01:39 Lewis Howes? I'm going to carry the bags around the blocks a couple of times for 10 minutes and until I have to throw in the garbage or something, yeah.
1:01:45 Speaker 00 Yeah, just not the same.
1:01:46 Lewis Howes? Do some curls while you're like walking to the backyard or the front, you know, the front street to drop off bags.
1:01:51 Speaker 00 Yeah. Even heavy manual labor jobs like cutting firewood, it does not replace the need to exercise.
1:01:59 Lewis Howes? Really? How long do you work out for if it's ideal? You have all the time in the world, how much would that, how much time would that be?
1:02:06 Speaker 00 If I had all the time in the world, I probably would do two a days.
1:02:09 Lewis Howes? Really?
1:02:09 Speaker 00 Yeah, seven days a week. But a lot of it would just be easy, perhaps some easy zone two cardio.
1:02:14 Lewis Howes? Got you, some light jogging or walking up hills or something like that.
1:02:18 Speaker 00 Yeah.
1:02:20 Lewis Howes? And is there a benefit then to twice a day? You know, thirty to sixty minutes twice a day over just one intense sixty minute session?
1:02:28 Speaker 00 I don't think there would be any benefit. I'm also not an exercise physiologist.
1:02:32 Lewis Howes? Sure.
1:02:32 Speaker 00 But I doubt that there would be a significant benefit. And if you did two a days that were vigorous.
1:02:39 Lewis Howes? It'd be hurt you maybe.
1:02:41 Speaker 00 Correct, including hormonally, it could be very detrimental.
1:02:45 Lewis Howes? Really? But if you did an intense, not intense, but you just did a solid resistance training, you lift.
1:02:51 Speaker 00 Yeah.
1:02:52 Lewis Howes? And then the second workout was a thirty minute jog or run. Would that affect the hormones in a negative way? If you did a lift and then a run at night that was twenty to forty minutes?
1:03:07 Speaker 00 It shouldn't, assuming adequate caloric intake. So, you know, if you exercise twice a day, you're gonna need to consume more calories to be close to your maintenance.
1:03:15 Lewis Howes? Or if you wanted to burn, lose weight or burn more fat?
1:03:20 Speaker 00 Exercise, and this is what's really interesting. You're, even if you exercise twice a day and you burn a huge amount of calories, your body will increase the hunger to make up for that. So you'll probably feel like you're starving, especially if you're trying to be in a deficit if you're doing two a days. It will not help you lose weight faster, but it will help you maintain more lean body mass and it will help keep it off.
1:03:45 Lewis Howes? Interesting.
1:03:46 Speaker 00 You can study two groups and tell one of them to exercise and one of them not. And they will lose very equitable amounts of weight.
1:03:54 Lewis Howes? Based on nutrition and calories?
1:03:56 Speaker 00 Correct.
1:03:56 Lewis Howes? Interesting.
1:03:57 Speaker 00 But if you just look at the average individual and some people are, will follow, there is a show called The Biggest Loser and some people follow graduates of that. And they're no different than the normal population when it comes to their chance of rebound. So about ninety percent of people, if not more, will gain back the weight that they lost. So it's very common to see someone who has lost weight and then gained it back, but relatively rare to see someone who's kept it off. And the studies look at the common denominator of what that five or 10% of people have in common. And as they've picked up an exercise habit, a movement pastime to last a lifetime.
1:04:36 Lewis Howes? It's a lifestyle habit, right? It's not a, we're gonna do this for six months and then be done. It's, this is who I am, a new identity for the rest of my life. And that could be, you know, I'm gonna work out in the mornings and then I'm gonna do a walk for 20, 30 minutes after my dinner. And that's just my routine now, where your body is just kind of like burning that extra calories or whatever.
1:04:58 Speaker 00 Is that, is that your routine?
1:05:00 Lewis Howes? It's not my routine necessarily, but I feel like I want that to be my routine. You know, I feel like that would be a, a, a great, healthy. And I also think it would help you probably with digestive things. And I still think it would help you, you know, connect with the person you're walking with. If that's your partner, I also think it would probably help you sleep better. As opposed to just, I'm gonna eat and sit on the couch for the next couple hours. That's my interpretation, I might be wrong, but that's what I would assume would happen.
1:05:30 Speaker 00 Yeah, I think, I think that would be a great intervention. It's interesting to look across cultures of what people do. For example, in Spain, they have the siesta and after lunch, people often walk somewhere and then walk back, even among their colleagues. And I think that would be a great trend to start.
1:05:46 Lewis Howes? Absolutely.
1:05:47 Speaker 00 Is walks after lunch.
1:05:48 Lewis Howes? I love this, man. This is, uh, been inspiring stuff. Is there anything else you feel like we need to talk about to address optimizing hormone health? You know, losing body fat, you know, and, and just being a healthier human?
1:06:01 Speaker 00 Many individuals ask me about optimizing hormone health for sports performance. And that kind of goes into the discussion of performance enhancing drugs. But it, at the end of the day, it is possible to optimize your hormones specifically to help with athletic performance. If your starting profile is decent, then it's not going to be a very powerful intervention. But if you're borderline hypogonadal, or even if you're female and you have a borderline low testosterone or low androgens to start, then it can be quite powerful.
1:06:34 Lewis Howes? Right. And what would be the the main supplements to optimize hormones people should be taking on a consistent basis?
1:06:41 Speaker 00 My favorite supplements for the general population, of course, because again, it always depends, would be creatine, which is very hard for your body to synthesize.
1:06:49 Lewis Howes? I've heard this before.
1:06:49 Speaker 00 As much creatine. I get asked very often about creatine's effect on an enzyme called five alpha reductase. It will slightly increase your testosterone and your DHT. Five alpha reductase converts testosterone to DHT.
1:07:03 Lewis Howes? Really? Five, what is it called? Five what?
1:07:05 Speaker 00 Five alpha reductase. It's the enzyme that finasteride works on. Many supplements also work on this enzyme. Creatine will slightly increase this, but not to a degree in most people where it will hasten hair loss. Many people are concerned with high DHT because of hair loss and also prostate enlargement. So creatine is not a huge concern for those two reasons.
1:07:27 Lewis Howes? So those two, the creatine, the five alpha?
1:07:30 Speaker 00 Creatine works on five alpha reductase. That's just an enzyme.
1:07:33 Lewis Howes? Got it.
1:07:34 Speaker 00 So depending on your level, then some people might want to increase the activity of this enzyme and some people might want to decrease it, but not without talking to their doctor.
1:07:43 Lewis Howes? Sure, sure.
1:07:44 Speaker 00 The next supplement I would say is L-carnitine. L-carnitine is the smallest peptide. So it's a peptide therapy, I guess. You can also take it, but it's not very orally bioavailable. It's just two amino acids that are together. And you can also inject L-carnitine. L-carnitine is found in red meat. That's why it's called carnitine, the same base word of carne. But it will increase the density of your androgen receptor in the cytoplasm. So you can, even with the same testosterone level, you can kind of do more with it. And then it will also increase the amount of energy that is pushed inside your powerhouse of the cell, which is called the mitochondria.
1:08:29 Lewis Howes? Okay. Anything else?
1:08:31 Speaker 00 I'd say another one honorable mention is ensuring that your cystine and glutathione are optimized. Some people just take glutathione by itself. It's your body's main antioxidant, and your body usually converts it to its active form when it's inside the cell. But you can take precursors that can potentially help.
1:08:50 Lewis Howes? This is inspiring, Kyle. I'm so grateful that you're here and you're sharing your wisdom. I want people to follow you before I ask the final couple of questions. They can go to GilletteHealth.com, or also follow you on Instagram, @KyleGilletteMD. You've got a lot of wisdom teachings and, you know, micro content there that can help people as well. You answer a lot of questions. It's really powerful stuff. You have a clinic as well in Kansas City, near Kansas City, where you're helping with a lot of these things as well. So you guys bring in patients, and it sounds like you will prescribe a lot of things before medicine, is what I'm hearing you say in this clinic. You'll do an assessment. You'll prescribe
1:09:35 Lewis Howes? one of these six things and things that they can do to optimize through food and exercise first. Then if medicine is needed, you'll prescribe that. Is that kind of what I'm hearing?
1:09:45 Speaker 00 I would describe it as holistic care. So you're caring for the individual, and we do our best to provide whatever they may need when they join our clinic, whether it's via telemedicine or in person in Kansas City, or hopefully both. They essentially become really good friends, almost like family to us, and we care very deeply about all of them. And we want them to have the highest quality and quantity of life.
1:10:08 Lewis Howes? So you do telemedicine as well? So if someone's not in Kansas City, they can be a patient through calling in? How does that work?
1:10:15 Speaker 00 Often so. We do like to see people in our Kansas City clinic. But, and I actually just published an article about telemedicine in the MSL journal. The patient population that is not able to see their doctor in person every time is very underserved and often they're also uninsured or underinsured.
1:10:37 Lewis Howes? Right.
1:10:37 Speaker 00 Often they live in rural areas, but perhaps they live in a big city as well and they just, it's whether it's traffic or time, you drive 30 minutes, you wait an hour and then you finally see the doctor and you've wasted an entire day. Whereas if it's telemedicine, maybe it's just a follow-up or a lab follow-up and you very quickly touch base and it saves you a lot of time. That's, it's never going to be as good as an in-person visit where you can do a physical exam if you need to, but the two together, you're getting a visit where that person would likely not have healthcare at all.
1:11:11 Lewis Howes? Yeah, so it's better than nothing.
1:11:13 Speaker 00 Yeah.
1:11:13 Lewis Howes? And how do people get access to that? Just go to your website and they can sign up and call in and...
1:11:20 Speaker 00 If they go to GilletteHealth.com, they can schedule a free intake if they're seriously interested in the clinic and we will chat with them.
1:11:27 Lewis Howes? Very cool. And what are the type of people that you work with specifically? What types of cases?
1:11:32 Speaker 00 We do quite a bit. We do a lot of hormone pathology. We do a lot of obesity medicine. We do a lot of fertility as well. So I'd say we really do quite a bit of everything.
1:11:45 Lewis Howes? Sure.
1:11:45 Speaker 00 But...
1:11:47 Lewis Howes? Those are more your specialties.
1:11:48 Speaker 00 Yeah. I'd say we have probably 55 to 60% female and the rest are male.
1:11:55 Lewis Howes? Okay.
1:11:56 Speaker 00 And in general, we concentrate on adult patients.
1:11:59 Lewis Howes? Gotcha. Okay, cool. So I want people to follow you, check it out. What else can we do to support you today? Where can we send people to besides your website and social media and the clinic? Anything else we can do?
1:12:10 Speaker 00 We have a brand new YouTube channel.
1:12:12 Lewis Howes? Okay.
1:12:12 Speaker 00 Gillette Health. So we dive very deep in the rabbit hole of a lot of health niches.
1:12:18 Lewis Howes? Sure.
1:12:19 Speaker 00 Usually every other video, we have one that is kind of like off the deep end, technical and then one more aimed at the layman.
1:12:26 Lewis Howes? Okay, cool. Check you out on Instagram, on YouTube and the website. We'll have it all linked up. This has been really inspiring. I want to acknowledge you Kyle for... Your commitment to this, I mean, you're a young guy, but you've been obsessing about this since your teens, it sounds like, of really figuring out how to optimize total human health and hormones and all these different things. So to be diving into the research the way you do, I know you study it so much, to be practicing with people on a consistent basis to see what results are working and how to improve that, and now to be sharing this publicly online with people is really inspiring. So I acknowledge you for that gift and for trying to help heal
1:13:07 Lewis Howes? a lot of people's physical health. This is a question I ask everyone at the end. It's called three truths. So imagine it's your last day on earth, many years away. You live the perfect life you want to live. And for whatever reason, though, you've got to take all of your work with you. So all of your writing, your teaching, your content, YouTube videos, all this stuff, it's got to go to the next place at the end of your life. Go somewhere else. But you get to leave behind three lessons with the world. And this is all we would have to remember you by, three truths that you would share. What would be those three truths for you?
1:13:41 Speaker 00 These three will probably be more practical rather than metaphysical.
1:13:44 Lewis Howes? Right.
1:13:45 Speaker 00 But I would say each human body is a machine. And just like you test a car coming off the assembly line and you hook it up to the computer and evaluate all the different markers. When you're ideally young, but if you haven't right now, get a baseline lab panel with everything. Not just hormones, but all of your lipid and cardiovascular and inflammatory markers as well.
1:14:09 Lewis Howes? Okay, that's one.
1:14:11 Speaker 00 And then the second one is know your tribe or know who your main group is. So whether it's your family or your close friends, perhaps your doctor's even involved, perhaps they're not, doesn't really matter. But find what your in-group is and come up with a
1:14:31 Speaker 00 A purpose or a reason to live on that Maslow's hierarchy of needs that we lived, that we talked about earlier.
1:14:37 Lewis Howes? Okay.
1:14:38 Speaker 00 And then three is just, don't be afraid to talk about things. So, you know, one of the things that's been popularized recently is sexual health. And now men are not near as ashamed to talk about even optimizing their sexual health or sexual health pathology. Mental health has been popularized as well. So now it's perfectly fine to talk about mental health issues. And that's wonderful. And hopefully hormone health is soon to follow.
1:15:04 Lewis Howes? Sure.
1:15:05 Speaker 00 So, don't be afraid to talk about that. And also, don't be afraid to talk about your spirituality or other taboo topics. A conversation will just bring synergy and benefit for both parties.
1:15:17 Lewis Howes? Yeah, I love that. Those are great, Kyle. Final question for you, what's your definition of greatness?
1:15:22 Speaker 00 Definition of greatness is achieving something that you're very proud of. So perhaps it's different, but achieving something that you would look back and not regret.
1:15:35 Lewis Howes? What's something that you'd be proud of achieving?
1:15:37 Speaker 00 I think I'm proud of being able to share my thoughts. This is me, I'm not playing a character. I'm proud that I can sit in podcasts like this one and say, well, you know, one, I'm a physician and I'm willing to test your hormones and people should do it more. Two, that I'm a Christian. Three, that, you know, I have a family, I'm kind of a stereotypical Keynesian. And I fly to places like, like here and do these podcasts. And it's just me. And it's just because I'm willing to say what I've learned. I really enjoy this. And the only reason why I'm doing it is to help people. So, I'm proud of that.
1:16:19 Lewis Howes? Love that, man. Thanks, Kyle. Appreciate you being here, man.
1:16:21 Speaker 00 Thank you.
1:16:22 Lewis Howes? Thanks, brother. Thank you so much for listening. I hope you enjoyed today's episode and it inspired you on your journey towards greatness. Make sure to check out the show notes in the description for a full rundown of today's show with all the important links. And also make sure to share this with a friend and subscribe over on Apple Podcasts as well. I really love hearing feedback from you guys, so share a review over on Apple and let me know what part of this episode resonated with you the most. And if no one's told you lately, I want to remind you that you are loved, you are worthy, and you matter. And now it's time to go out there and do something great.
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